EXAM 2

A baby is born with a myelomeningocele and needs urgent surgery to repair the defect. The parents want to take the baby home instead. What does the healthcare professional tell the parents about the purpose of this surgery? a. "Surgery is much easier on a tiny infant than on a larger, older baby." b. "If your baby has surgery this young, he/she cannot feel pain." c. "Additional nervous system damage will occur the longer we wait. cerebrospinal fluid (CSF) may accumulate, resulting in further dilation and enlargement of the sac " d. "Prompt surgery is needed to prevent total paralysis later on."

"Additional nervous system damage will occur the longer we wait. cerebrospinal fluid (CSF) may accumulate, resulting in further dilation and enlargement of the sac "

A person has been diagnosed with acute lymphocytic leukemia (ALL) that is positive for the Philadelphia chromosome. What statement by the healthcare professional is most appropriate? a. "This is good news and means the ALL is not very aggressive." b. "This is a very rare finding in adults who have ALL." c. "We are planning to get your disease in remission, but it will be hard." d. "You will need colony-stimulating support during your treatment."

"We are planning to get your disease in remission, but it will be hard."

A couple who both carry the sickle cell trait wish to have children. What does the healthcare professional tell them is the chance that each pregnancy will result in a child who has sickle cell disease (SCD)? a. 20% b. 25% c. 33% d. 50%

25%

Hypotension is likely to occur when an infant or child is greater than _____ % dehydrated. a. 2 b. 5 c. 7 d. 10

10

What is the life span of platelets (in days)? a. 10 b. 30 c. 90 d. 120

10

Bilirubin is a byproduct of the destruction of which aged cells? a. Platelets b. Protein c. Leukocytes d. Erythrocytes

Erythrocytes

What is the life span of an erythrocyte (in days)? a. 20 to 30 b. 60 to 90 c. 100 to 120 d. 200 to 240

100 to 120

Hypovolemic shock begins to develop when intravascular volume has decreased by what percentage? a. 5 b. 10 c. 15 d. 20

15

Daily evaporative water loss after a burn injury is approximately how many times the normal? a. 5 b. 10 c. 15 d. 20

20

By the time osteoporosis is visible on an x-ray examination, up to what percent of bone has been lost? a. 30% b. 40% c. 50% d. 60%

30%

A health care professional is teaching a group of college women about increasing calcium in the diet to prevent osteoporosis. A participant asks at what age is peak bone mass is reached in women. What response is best? a. 15 years b. 20 years c. 30 years d. 35 years

30yrs

The neural groove closes dorsally during which week of gestational life? a. Second b. Fourth c. Eighth d. Twelfth

Fourth

How many days does it take for the entire epithelial population of the small intestines to be replaced? a. 30 to 45 b. 15 to 25 c. 7 to 15 d. 4 to 7

4-7

A newborn displays pallor, tachycardia, and has a systolic murmur. What hemoglobin value does the healthcare professional correlate with these manifestations? a. 11 g/dL b. 9 g/dL c. 7 g/dL d. 5 g/dL

5 g/dL

In a full-term infant, the normal erythrocyte life span is _____ days. a. 30 to 50 b. 60 to 80 c. 90 to 110 d. 120 to 130

60 to 80

A 4-year-old child with a burn injury has entered the catabolic flow phase. What assessment would the healthcare provider correlate with this situation? a. Oxygen saturation normal on room air b. 7 pound weight loss in 1 week c. Capillary refill <2 sec d. Blood pressure 89/56 mmHg

7 pound weight loss in 1week

The adult intestine processes approximately how many liters of luminal content per day? a. 3 b. 6 c. 9 d. 12

9

Which pathway carries sensory information toward the central nervous system (CNS)? a. Ascending b. Descending c. Somatic d. Efferent

A Peripheral nerve pathways can be afferent (ascending) pathways that carry sensory impulses toward the CNS. Efferent, or descending, pathways innervate effector organs. "Somatic" is a branch of the peripheral nervous system and consists of both motor and sensory pathways.

Both oligodendroglia and Schwann cells share the ability to do what? a. Form a myelin sheath b. Remove cellular debris c. Transport nutrients d. Line the ventricles

A The function of oligodendroglia (oligodendrocytes) is to deposit myelin within the central nervous system (CNS). Oligodendroglia are the CNS counterpart of Schwann cells. Microglia remove cellular debris. Astrocytes transport nutrients. Ependymal cells line the ventricles.

What part of the brain mediates the physical expression of emotions? a. Hypothalamus b. Basal ganglia c. Medulla oblongata d. Subthalamus

A The hypothalamus is generally responsible for the physical manifestations of emotions. The nuclei of the basal ganglia are important for coordination of voluntary movement and cognitive and emotional functions. Reflex activities, such as heart rate, respiration, blood pressure, coughing, sneezing, swallowing, and vomiting, are controlled in the medulla oblongata. The subthalamus flanks the hypothalamus laterally and serves as an important basal ganglia center for motor activities.

What is the membrane that separates the brain's cerebellum from its cerebrum? a. Tentorium cerebelli b. Falx cerebri c. Arachnoid membrane d. Falx cerebelli

A The tentorium cerebelli is a membrane that separates the cerebellum below from the cerebral structures above. The falx cerebri dips between the two cerebral hemispheres along the longitudinal fissure. The arachnoid membrane (or arachnoid mater) is a spongy, weblike structure just underneath the dura mater that loosely follows the contours of the cerebral structures. The tentorium cerebelli (not falx cerebelli), a common landmark, is a membrane that separates the cerebellum from the cerebral structures above.

The health care professional is caring for a person who has a pathologic fracture. The patient asks the professional to explain the condition. What response by the professional is best? a. The outer surface of the bone is disrupted, but the inside is intact. b. A stable fracture where the cortex of the bone bends but doesn't break. c. A fracture that happens at the site of an abnormality already in that bone. d. It was caused by the cumulative effects of stress on the bone over time.

A fracture that happens at the site of an abnormality already in that bone

A student reads in a chart that a baby was born with an encephalocele. The student asks the healthcare professional to explain this condition. What explanation by the healthcare professional is best? a. A herniation or protrusion of brain and meninges through a defect in the skull b. A protruding saclike cyst of meninges filled with spinal fluid and is a mild form of spina bifida c. Protrusion of a saclike cyst containing meninges, spinal fluid, and a portion of the spinal cord through a defect in the posterior arch of a vertebra d. Premature closure of one or more of the cranial sutures during the first 18 to 20 months of an infant's life

A herniation or protrusion of brain and meninges through a defect in the skull

A patient suffered a seizure for the first time. The spouse asks the healthcare professional to explain what a seizure is. What response by the professional is best? a. Actions that occur without conscious thought because of a stimulus b. A sudden, explosive, disorderly discharge of brain cells c. A disease where a person has frequent seizures like this one d. A series of excessive, purposeless movements.

A sudden, explosive, disorderly discharge of brain cells

A newborn has meconium ileus. What diagnostic test does the healthcare professional advise the parents about? a. Colonoscopy b. Pulmonary function studies c. A sweat test d. Nerve conduction studies

A sweat test

Which condition may result from pressure exerted by a pituitary tumor? a. Hypothyroidism b. Hypercortisolism c. Diabetes insipidus d. Insulin hyposecretion

ANS: A If the tumor exerts sufficient pressure, then thyroid and adrenal hypofunction may occur because of lack of thyroid-stimulating hormone (TSH) and adrenocorticotropic hormone (ACTH). These result in the symptoms of hypothyroidism and hypocortisolism. The remaining options are not associated with the pressure exerted by a pituitary tumor.

A patient has been diagnosed with acute lymphocytic leukemia (ALL) and asks the healthcare professional to describe it. What description by the professional is most accurate? a. ALL is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood. b. In ALL, immature blasts cells replace normal myelocytic cells, megakaryocytes, and erythrocytes. c. B cells fail to mature into plasma cells that synthesize immunoglobulins. d. The translocation of genetic material from genes 9 and 22 create an abnormal, fused gene identified as BCR-ABL.

ALL is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.

The concentration of the final urine is determined by antidiuretic hormone (ADH), which is secreted by which gland? a. Posterior pituitary b. Thyroid c. Parathyroid d. Anterior pituitary

ANS: A ADH, which is secreted from the posterior pituitary gland, controls the concentration of the final urine. ADH is not secreted by any of the other options.

When does an individual have their full complement of renal nephrons? a. At birth b. At 6 months of age c. At puberty d. Between the ages 18 and 21 years

ANS: A All the nephrons are present at birth, and their number does not increase as the kidney grows and matures

Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct? a. Antidiuretic hormone b. Aldosterone c. Cortisol d. Adrenocorticotropin hormone

ANS: A Antidiuretic hormone is required for water to be reabsorbed in the distal tubule and collecting duct. The later, straight segment of the distal tubule and the collecting duct are permeable to water as controlled by antidiuretic hormone. The other options are not involved in this process.

Which serum glucose level would indicate hypoglycemia in a newborn? a. 28 mg/dL b. 40 mg/dL c. 60 mg/dL d. 80 mg/dL

ANS: A Serum glucose <30 mg/dL in newborn (first 2 to 3 days) and <55 to 60 mg/dL in adults is associated with hypoglycemia.

What imbalance lessens the rate of secretion of parathyroid hormone (PTH)? a. Increased serum calcium levels b. Decreased serum magnesium levels c. Decreased levels of thyroid-stimulating hormone d. Increased levels of thyroid-stimulating hormone

ANS: A PTH is the single most important regulator of serum calcium. When serum calcium levels are low, PTH secretion is stimulated; when calcium levels are high, PTH secretion is inhibited. PTH secretion is not inhibited by magnesium or thyroid-stimulating hormone levels.

A person who has experienced physiologic stresses will have increased levels of which hormone? a. Cortisol b. Thyroid hormone c. Somatostatin d. Alpha endorphin

ANS: A Stress has been shown to increase adrenocorticotropic hormone secretion. Thyroid hormone, somatostatin, and alpha endorphin are not increased with stress.

Which glycoprotein protects against urolithiasis and is a ligand for lymphokines? a. Uromodulin b. Nephrin c. Urodilatin d. Cystatin

ANS: A Tamm-Horsfall glycoprotein, also known as uromodulin, is the most abundant urinary protein, protects against bacterial adhesion and urolithiasis, and is a ligand for lymphokines. This statement is not true of the other options.

The glomerular filtration rate is directly related to which factor? a. Perfusion pressure in the glomerular capillaries b. Diffusion rate in the renal cortex c. Diffusion rate in the renal medulla d. Glomerular active transport

ANS: A The filtration of the plasma per unit of time is known as the glomerular filtration rate (GFR), which is directly related to only the perfusion pressure in the glomerular capillaries.

What provides the best estimate of the functioning of renal tissue? a. Glomerular filtration rate b. Hourly urine output c. Serum blood urea nitrogen and creatinine d. The specific gravity of the solute concentration of the urine

ANS: A The glomerular filtration rate provides the best estimate of the level of functioning of renal tissue. The other options are not used to assess renal tissue function.

The only surface inside the nephron where cells are covered with microvilli to increase the reabsorptive surface area is called the: a. Proximal convoluted tubules b. Distal tubules c. Ascending loop of Henle d. Descending loop of Henle

ANS: A The only surface inside the nephron where the cells are covered with microvilli (a brush border) is called the proximal convoluted tubules. This proximal convoluted tubular lumen consists of one layer of cuboidal cells with a surface layer of microvilli that increases the reabsorptive surface area.

What is the functional unit of the kidney called? a. Glomerulus b. Nephron c. Collecting duct d. Pyramid

ANS: B The nephron is the functional unit of the kidney. Although the other options are also located in the kidney, they are not its functional units.

Which patient would the healthcare professional assess for elevated levels of antidiuretic hormone (ADH) secretion? a. Being treated for small cell carcinoma of the stomach b. Taking high dose acetaminophen (Tylenol) for arthritis c. Had a hip replacement operation 14 days ago d. Has long-standing kidney disease from diabetes

ANS: A A common cause of elevated levels of ADH secretion is ectopically produced ADH by tumors, such as small cell carcinoma of the duodenum, stomach, and pancreas; cancers of the bladder, prostate, and endometrium; lymphomas; and sarcomas. High doses of antiinflammatory medications are a risk factor, but acetaminophen is not an antiinflammatory medication. Surgery within the last 5 to 7 leads to increased ADH secretion. Kidney disease does not lead to excess levels of ADH.

Which is an expected hormonal change in an older patient? a. Thyroid-stimulating hormone secretion below normal b. Triiodothyronine level below normal c. Cortisol level below normal d. Adrenocorticotropic hormone level above normal

ANS: A Aging causes overall thyroid-stimulating hormone secretion to diminish but does not bring about the other changes.

Which of these is a lipid-soluble hormone? a. Cortisol b. Oxytocin c. Epinephrine d. Growth hormone

ANS: A Cortisol and adrenal androgens are lipid-soluble hormones and are primarily bound to a carrier or transport protein in circulation. The other options are water-soluble hormones.

What is diabetes insipidus a result of? a. Antidiuretic hormone hyposecretion b. Antidiuretic hormone hypersecretion c. Insulin hyposecretion d. Insulin hypersecretion

ANS: A Diabetes insipidus is a result of insufficient antidiuretic hormone (hyposecretion). It is not related to insulin secretion.

Which pathologic changes are associated with Graves' disease? a. High levels of circulating thyroid-stimulating immunoglobulins b. Diminished levels of thyrotropin-releasing hormone c. High levels of thyroid-stimulating hormone d. Diminished levels of thyroid-binding globulin

ANS: A High levels of circulating thyroid-stimulating immunoglobulins are found in more than 95% of individuals diagnosed with this disease.

Hypoglycemia, followed by rebound hyperglycemia, is observed in those with what? a. The Somogyi effect b. The dawn phenomenon c. Diabetic ketoacidosis d. Hyperosmolar hyperglycemic nonketotic syndrome

ANS: A Hypoglycemia, followed by rebound hyperglycemia, is observed only in the Somogyi effect.

A patient is having a water deprivation test. The patient's initial weight was 220 pounds (100 kg). The next weight is 209 pounds (95 kg). What action by the healthcare professional is most appropriate? a. Stop the water deprivation test. b. Administer salt tablets. c. Continue with the test as planned. d. Take the patient's blood glucose.

ANS: A In patients with severe diabetes insipidus the water deprivation test can be diagnostic. However, it can also be risky; if the patient loses more than 3% of body weight, cardiovascular collapse and shock can occur. This patient has lost 5% of initial body weight, so the professional should stop the test. Administering salt tablets does not take priority over stopping the test. Glucose measurement is not relevant.

A diabetic patient has not taken insulin in several days and has an extremely high blood sugar. What electrolyte would the health care professional assess as the priority? a. Potassium b. Calcium c. Sodium d. Chloride

ANS: A Insulin facilitates the intracellular transport of potassium, phosphate, and magnesium. Without insulin, potassium does not get transported to the intracellular environment and the serum potassium will rise. The health care professional would assess the patient's potassium level as the priority.

A patient has nephrogenic diabetes insipidus (DI). What treatment does the healthcare professional anticipate for this patient? a. Exogenous ADH replacement b. Intranasal desmopressin c. Water and sodium restriction d. Loop diuretic administration

ANS: A Nephrogenic DI is usually treated with administration of fluids, or intranasal (or oral) desmopressin. Neurogenic DI is treated with ADH replacement therapy. Water restriction would not be helpful. Thiazide (not loop) diuretics can improve moderate nephrogenic DI.

Where is antidiuretic hormone (ADH) synthesized, and where does it act? a. Hypothalamus; renal tubular cells b. Renal tubules; renal collecting ducts c. Anterior pituitary; posterior pituitary d. Posterior pituitary; loop of Henle

ANS: A Once synthesized in the hypothalamus, ADH is stored and secreted by the posterior pituitary and acts on the vasopressin 2 (V2) receptors of the renal duct cells to increase their permeability.

A student asks the professor to differentiate Type 2 diabetes mellitus from Type 1. The professors' response would be that Type 2 is best described as what? a. Resistance to insulin by insulin-sensitive tissues b. Need for lifelong insulin injections c. Increase of glucagon secretion from beta cells of the pancreas d. Presence of insulin autoantibodies that destroy beta cells in the pancreas

ANS: A One of the basic pathophysiologic characteristics of type 2 diabetes is the development of insulin-resistant tissue cells. Type 1 diabetes always must be treated with insulin. Type 2 diabetes can be treated with insulin but there are other options. Pancreatic beta cells are destroyed in Type 1 diabetes. Increased glucagon is not secreted from pancreatic beta cells in Type 2 diabetes.

Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake? a. Biguanide (metformin) b. Sulfonylureas (glyburide) c. Meglitinides (glinides) d. α-Glycosidase inhibitor (miglitol)

ANS: A Only biguanides decrease hepatic glucose production and increase insulin sensitivity and peripheral glucose uptake. The sulfonylureas and meglitinides stimulate insulin release from pancreatic beta cells. The α-glycosidase inhibitors delay carbohydrate absorption in the gut.

What is the portion of the pituitary that secretes oxytocin? a. Posterior b. Inferior c. Anterior d. Superior

ANS: A Only the posterior pituitary secretes oxytocin and antidiuretic hormone (ADH). The anterior pituitary secretes adrenocorticotropic hormone (ACTH), follicle-stimulating hormone, growth hormone, luteinizing hormone, prolactin, and thyroid-stimulating hormone (TSH). There is no inferior or superior portion of the pituitary gland.

The student asks the professor for a definition of "orexigenic neurons." What description by the professor is most accurate? a. Promote appetite and stimulate eating b. Suppress appetite and inhibit eating c. Increase overall metabolism d. Promote satiety after eating

ANS: A Orexigenic neurons promote appetite, stimulate eating, and decrease metabolism. The anorexigenic neurons suppress appetite, inhibit eating, increase metabolism, and promote satiety after eating.

Where is oxytocin synthesized? a. Hypothalamus b. Paraventricular nuclei c. Anterior pituitary d. Posterior pituitary

ANS: A Oxytocin is synthesized in hypothalamic neurons and is stored and secreted by the posterior pituitary. The paraventricular nuclei and anterior pituitary are not involved in oxytocin synthesis.

A healthcare professional reads a chart that notes the patient has panhypopituitarism. What does the professional understand that term to mean? a. The patient has a lack of all hormones associated with the anterior pituitary gland. b. The patient has a lack of all hormones associated with the lateral pituitary gland. c. The patient has total adrenocorticoptropic hormone deficiency. d. The patient has a dysfunction of the posterior pituitary gland due to a tumor.

ANS: A Panhypopituitarism is the term denoting the lack of all anterior pituitary hormones.

Where are target cells for parathyroid hormone located? a. Tubules of nephrons b. Thyroid gland c. Glomeruli of nephrons d. Smooth and skeletal muscles

ANS: A Parathyroid hormone acts on its plasma membrane receptor only in the distal and proximal tubules of the kidney's nephron.

A health care professional is caring for a patient admitted to the hospital with severe anorexia. What action by the health care professional would be most important? a. Ensuring the patient is on a cardiac monitor b. Facilitating laboratory testing of electrolytes c. Arranging a psychiatry consultation d. Assessing the patient's favorite foods

ANS: A Patients with severe anorexia can have cardiac dysrhythmias, so this patient should be placed on a cardiac monitor as the priority. The other actions are appropriate; they just do not take priority.

Which laboratory value is consistent with diabetes insipidus (DI)? a. Low urine-specific gravity b. Low serum sodium c. Low urine protein d. High serum total protein

ANS: A The basic criteria for diagnosing DI include a low urine-specific gravity while sodium levels are high. Protein levels are not considered.

Which hormone is involved in the regulation of serum calcium levels? a. Parathyroid hormone (PTH) b. Thyroxine (T4) c. Adrenocorticotropic hormone (ACTH) d. Triiodothyronine (T3)

ANS: A The parathyroid glands produce PTH, a regulator of serum calcium. Thyroxine (T4) and triiodothyronine (T3) are thyroid hormones. ACTH is the main regulator of cortisol secretion and adrenocortical growth.

A patient who is diagnosed with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits, but the antidiuretic hormone (ADH) level is low. Although the patient has had no intake for 4 hours, no change in the polyuria level has occurred. What treatment or diagnostic testing does the healthcare professional prepare the patient for? a. Administration of desmopressin b. Serum copeptin testing c. Insulin administration d. Renal angiogram

ANS: A The stated symptoms are reflective of neurogenic diabetes insipidus (DI) which can be treated with desmopressin. Desmopressin will cause an increased ability to concentrate urine. Copeptin is a precursor of ADH and obtaining a serum level is useful in diagnosing dipsogenic DI. The patient does not need insulin or a renal angiogram.

Which hormone inhibits the secretion of growth hormone (GH)? a. Somatostatin b. Thyroxine c. Thyroid-stimulating hormone d. Calcitonin

ANS: A Two hormones from the hypothalamus control GH secretion: (1) GH-releasing hormone (GHRH), which increases GH secretion; and (2) somatostatin, which inhibits it. Thyroxine and thyroid-stimulating hormone are related to thyroid function. Calcitonin helps regulate serum calcium levels.

The student asks the professor to explain the role of pyrophosphate, potassium citrate, and magnesium in the formation of kidney stones. What response by the professor is best? a. They inhibit crystal growth. b. They stimulate the supersaturation of salt. c. They facilitate the precipitation of salts. d. They enhance crystallization of salt crystals.

ANS: A They inhibit crystal growth

Goodpasture syndrome is an example of which of these? a. Antiglomerular basement membrane disease b. Acute glomerulonephritis c. Chronic glomerulonephritis d. Immunoglobulin A (IgA) nephropathy

ANS: A- Antiglomerular basement membrane disease

Pyelonephritis is usually caused by which type of organism? a. Bacteria b. Fungi c. Viruses d. Parasites

ANS: A- Bacteria

Food enters the stomach via which orifice or sphincter? a. Cardiac b. Upper esophageal c. Gastric d. Fundal

ANS: A- Cardiac

An 85-year-old person has a urinary tract infection. What clinical manifestation does the healthcare professional expect to see in this person? a. Confusion and poorly localized abdominal discomfort b. Dysuria, frequency, and suprapubic pain c. Hematuria and flank pain d. Pyuria, urgency, and frequency

ANS: A- Confusion and poorly localized abdominal discomfort

Which abnormal laboratory value is found in glomerular disorders? a. Elevated creatinine concentration b. Low blood urea nitrogen (BUN) c. Elevated immunoglobulin A (IgA) d. Low serum complement

ANS: A- Elevated creatinine concentration

What term is used to identify the condition that exists when the urethral meatus is located on the undersurface of the penis? a. Hypospadias b. Epispadias c. Hyperspadias d. Chordee

ANS: A- Hypospadias

Saliva contains which immunoglobulin (Ig)? a. IgA b. IgE c. IgG d. IgM

ANS: A- IgA

What is the mechanism for developing Wilms tumor? a. It involves tumor-suppressor genes located on chromosome 11. b. Development involves an autosomal dominant inheritance pattern. c. Wilms tumor is an autoimmune disorder. d. The development of a Wilms tumor is a congenital anomaly.

ANS: A- It involves tumor suppressor genes located on chromosome 11

Hypothyroidism, edema, hyperlipidemia, and lipiduria characterize which kidney disorder? a. Nephrotic syndrome b. Acute glomerulonephritis c. Chronic glomerulonephritis d. Pyelonephritis

ANS: A- Nephrotic syndrome

What medical term is used to identify a functional urinary tract obstruction caused by an interruption of the nerve supply to the bladder? a. Neurogenic bladder b. Obstructed bladder c. Necrotic bladder d. Retrograde bladder

ANS: A- Neurogenic bladder

What is the first indication of nephrotic syndrome in children? a. Periorbital edema b. Scrotal or labial edema c. Frothy urine d. Ascites

ANS: A- Periorbital edema

A child with acute poststreptococcal glomerulonephritis is voiding smoky, brown-colored urine and asks the healthcare professional to explain what causes it. What explanation by the professional is best? a. Presence of red blood cells b. Presence of urobilinogen c. Slough from the collecting tubules d. Protein in the urine

ANS: A- Presence of red blood cells

Which urine characteristics are indicative of acute tubular necrosis (ATN) caused by intrinsic (intrarenal) failure? a. Urine sodium >30 mEq/L b. Urine osmolality >500 mOsm c. Fractional excretion of sodium (FENa) <1% d. Urine sediment has no cells, some hyaline casts

ANS: A- Urine sodium >30

The functional kidney is associated with which embryonic organ? a. Metanephros b. Mesonephros c. Pronephros d. Endonephros

ANS: A- metanephros

What is the direct action of atrial natriuretic hormone? a. Sodium retention b. Sodium excretion c. Water retention d. Water excretion

ANS: B Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) inhibit the secretion of renin, inhibit angiotensin-induced secretion of aldosterone, vasodilate the afferent and constrict the efferent glomerular arterioles, and inhibit sodium and water absorption by kidney tubules. The other actions are not a result of the atrial natriuretic hormone.

Innervation of the bladder and internal urethral sphincter is supplied by which nerves? a. Peripheral nerves b. Parasympathetic fibers c. Sympathetic nervous system d. Tenth thoracic nerve roots

ANS: B The innervation of the bladder and internal urethral sphincter is supplied by parasympathetic fibers of the autonomic nervous system. The process is not dependent on any of the other options.

What effects do exercise and body position have on renal blood flow? a. Exercise and body position activate renal parasympathetic neurons and cause mild vasoconstriction. b. They activate renal sympathetic neurons and cause mild vasoconstriction. c. Both activate renal parasympathetic neurons and cause mild vasodilation. d. They activate renal sympathetic neurons and cause mild vasodilation.

ANS: B Exercise and change of body position activate renal sympathetic neurons and cause mild vasoconstriction. The other options do not have these effects on renal blood flow.

Kidney stones in the upper part of the ureter would produce pain referred to which anatomical area? a. Vulva or penis b. Umbilicus c. Thighs d. Lower abdomen

ANS: B Kidney stones in the upper part of the ureter would produce pain in the umbilicus. Sensory innervation for the upper part of the ureter arises from the tenth thoracic nerve roots with referred pain to the umbilicus. The other options would not experience such referred pain.

Blood vessels of the kidneys are innervated by the: a. Vagus nerve b. Sympathetic nervous system c. Somatic nervous system d. Parasympathetic nervous system

ANS: B The blood vessels of the kidney are innervated by the sympathetic noradrenergic fibers that cause arteriolar vasoconstriction and reduce renal blood flow. The other options are not involved in this process.

The area of the kidneys that contains the glomeruli and portions of the tubules is called the: a. Medulla b. Cortex c. Pyramids d. Columns

ANS: B The cortex contains all the glomeruli and portions of the tubules of the kidneys. Although the other options are also located in the kidney, they do not contain the glomeruli.

A health care professional wishes to provide community screening for obesity. Which population should the professional focus on as the priority? a. Caucasians b. Non-Hispanic blacks c. Hispanics d. Asians

ANS: B Non-Hispanic blacks have the highest age-adjusted rate of obesity at 48.1% followed by Hispanics (42.5%), non-Hispanic whites (34.5%), and non-Hispanic Asians (11.7%). The professional's priority should be on the group with the highest prevalence rate, which is non-Hispanic blacks.

A person has hypothyroidism. What chemical does the healthcare professional advise the person to include in the diet? a. Iron b. Iodine c. Zinc d. Magnesium

ANS: B A lack of iodine can lead to hypothyroidism.

A researcher is moving to an area with a year-round cold climate. The researcher asks the health care professional how people in these areas are able to adjust to the temperature. What response by the professional is most accurate? a. They have less adipose tissue. b. They have more beige (bAT) adipose tissue. c. Their bone marrow produces more adipose tissue. d. They gain weight which insulates them.

ANS: B Chronic exposure to cold climates causes the conversion of white adipose tissue (WAT) to beige adipose tissue, which is thermogenic. Changing the amount of adipose tissue overall does not help with acclimation to cold climates.

Renal failure is the most common cause of which type of hyperparathyroidism? a. Primary b. Secondary c. Exogenous d. Inflammatory

ANS: B Chronic renal failure is the most common cause of secondary hyperparathyroidism because of the resulting hyperphosphatemia that stimulates parathyroid hormone secretion. Although the other options may occur, they are not the most common types of the disorder.

A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500 mg/dL; positive urine glucose and ketones; serum potassium (K+) 2 mEq/L; serum sodium (Na+) 130 mEq/L. The patient reports that he has been sick with the "flu" for 1 week. What relationship do these values have to his insulin deficiency? a. Increased glucose use causes the shift of fluid from the intravascular to the intracellular space. b. Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis. c. Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis. d. Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss.

ANS: B Decreased glucose causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis, which have resulted in the symptoms listed in the question. Glucose is not being used which accounts for the high serum glucose. The pH indicates acidosis, not alkalosis. DKA is a metabolic, not respiratory, process.

Which compound or hormone is secreted by the adrenal medulla? a. Cortisol b. Epinephrine c. Androgens d. Aldosterone

ANS: B Epinephrine is secreted by the adrenal medulla. Cortisol, androgens, and aldosterone are secreted by adrenal cortex

Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone (TH) and is inhibited when plasma levels of TH are adequate. What is this an example of? a. Positive feedback b. Negative feedback c. Neural regulation d. Physiologic regulation

ANS: B Feedback systems provide precise monitoring and control of the cellular environment. Negative feedback occurs because the changing chemical, neural, or endocrine response to a stimulus negates the initiating change that triggered the release of the hormone. Thyrotropin-releasing hormone (TRH) from the hypothalamus stimulates TSH secretion from the anterior pituitary. Secretion of TSH stimulates the synthesis and secretion of THs. Increasing levels of T4 and triiodothyronine (T3) then generate negative feedback on the pituitary and hypothalamus to inhibit TRH and TSH synthesis. A positive feedback loop would have the opposite effect. Neural regulation is a type of hormonal control that involves the nervous system. Physiologic is not a specific type of hormone regulation.

Why does giantism occur only in children and adolescents? a. Their growth hormones are still diminished. b. Their epiphyseal plates have not yet closed. c. Their skeletal muscles are not yet fully developed. d. Their metabolic rates are higher than in adulthood.

ANS: B Giantism is related to the effects of excess growth hormones on the growth of long bones at their epiphyseal plates in acromegaly. It is not related to skeletal muscle development of metabolic rate.

What effect does hyperphosphatemia have on other electrolytes? a. Increases serum calcium b. Decreases serum calcium c. Decreases serum magnesium d. Increases serum magnesium

ANS: B Hyperphosphatemia leads to hypocalcemia.

A patient weighs 82 pounds and is hospitalized for anorexia. In order to prevent refeeding syndrome, how many calories should the person eat in the first two days? a. 400 b. 745 c. 936 d. 1200

ANS: B In order to prevent refeeding syndrome, feedings should start slowly at about 20 kcal/kg/day. This 82-pound person weighs 37.2727 kg, so that would be 745 calories a day.

Which form of diabetic insipidus (DI) will result if the target cells for antidiuretic hormone (ADH) in the renal collecting tubules demonstrate insensitivity? a. Neurogenic b. Nephrogenic c. Psychogenic d. Ischemic

ANS: B Only nephrogenic DI is associated with an insensitivity of the renal collecting tubules to ADH.

Which hormone triggers uterine contractions? a. Thyroxine b. Oxytocin c. Growth hormone d. Insulin

ANS: B Oxytocin is responsible for the contraction of the uterus and milk ejection in lactating women and may affect sperm motility in men. Thyroxine is the major hormone secreted by the thyroid gland helps regulate metabolic activity in the body. Growth hormone is essential to normal growth and maturation. Insulin helps cells utilize glucose.

Most protein hormones are transported in the bloodstream and are what? a. Bound to a lipid-soluble carrier b. Free in an unbound, water-soluble form c. Bound to a water soluble-binding protein d. Free because of their lipid-soluble chemistry

ANS: B Peptide or protein hormones, such as insulin, pituitary, hypothalamic, and parathyroid, are water soluble and circulate in free (unbound) forms. They are not bound to carriers or lipid soluble.

What is the target tissue for prolactin-releasing factor? a. Hypothalamus b. Anterior pituitary c. Mammary glands d. Posterior pituitary

ANS: B Prolactin-releasing factor targets the anterior pituitary gland to stimulate the secretion of prolactin.

A severely malnourished patient is in the hospital to improve nutrition. On the second day, the patient reports palpitations and difficulty breathing. After placing the patient on a cardiac monitor, what action does the health care professional take next? a. Take the patient's temperature. b. Have lab drawn for electrolyte levels. c. Cancel the patient's next meal. d. Facilitate a chest x-ray

ANS: B Refeeding syndrome occurs when patients are fed too quickly, causing rapid shifts of fluids and electrolytes, often leading to dysrhythmias. After placing the patient on a cardiac monitor, the professional should next ensure that serum electrolytes are measured. The patient's temperature is not relevant to this situation. The patient should continue to eat although calories should be decreased. There may or may not be a need for a chest x-ray.

A patient has acromegaly. What assessment by the healthcare professional would be most important? a. Skin condition b. Sleep patterns c. Bowel function d. Range of motion

ANS: B Sleep patterns are important to assess for in patients with acromegaly because sleep-disordered breathing such as obstructive sleep apnea is common. The skin in patients with acromegaly will be coarse. Bowel function may or may not be altered. Range of motion is decreased as an expected consequence of the disease.

How does progressive nephron injury affect angiotensin II activity? a. Angiotensin II activity is decreased. b. Angiotensin II activity is elevated. c. Angiotensin II activity is totally suppressed. d. Angiotensin II activity is not affected.

ANS: B Angiotensin II is elevated

Hypercalciuria is primarily attributable to which alteration? a. Defective renal calcium reabsorption b. Intestinal hyperabsorption of dietary calcium c. Bone demineralization caused by prolonged immobilization d. Hyperparathyroidism

ANS: B Intestinal hyperabsorption of dietary calcium

A patient has an enlarged tongue, body odor, rough skin, and coarse hair. Which laboratory result does the healthcare professional associate with this presentation? a. Decreased blood glucose b. Increased growth hormone c. Decreased ACTH d. Increased TSH

ANS: B This patient has clinical findings suggestive of acromegaly which is caused by high levels of growth hormone (GH), often from a pituitary adenoma. It would result in high blood glucose and no effect on ACTH or TSH.

A patient has overactive bladder syndrome. Which classification of drug does the healthcare professional plan to teach the patient about? a. b-Adrenergic blocking medications b. a-Adrenergic blocking medications c. Parasympathomimetic medications d. Anticholinesterase medications

ANS: B a-Adrenergic blocking medications

Which anomaly is often associated with Wilms tumor? a. Renal anaplasia b. Aniridia c. Anemia d. Hypothyroidism

ANS: B- Aniridia

When does urine formation and excretion begin? a. At birth b. By 3 months' gestation c. By 6 months' gestation d. By 8 months' gestation

ANS: B- By 3 months' gestation

In the mouth and stomach, salivary a-amylase initiates the digestion of which nutrients? a. Proteins b. Carbohydrates c. Fats d. Fiber

ANS: B- Carbohydrates

In immunoglobulin G (IgG) nephropathies such as glomerulonephritis, IgG is deposited in which location? a. Juxtamedullary nephrons b. Glomerulus basement membranes c. Mesangium of the glomerular capillaries d. Parietal epithelium

ANS: B- Glomerulus basement membranes

When the right kidney is obstructed, how will the glomeruli and tubules in the left kidney compensate? a. Increase in number b. Increase in size c. Develop collateral circulation d. Increase speed of production

ANS: B- Increase in size

Which glomerular lesion is characterized by thickening of the glomerular capillary wall with immune deposition of immunoglobulin G (IgG) and C3? a. Proliferative b. Membranous c. Mesangial d. Crescentic

ANS: B- Membranous

What effect is a result of inhibiting the parasympathetic nervous system with a drug such as atropine? a. Salivation becomes thinner. b. Salivation decreases. c. The pH of saliva changes. d. Digestive enzymes are inhibited.

ANS: B- Salivation decreases

Acute glomerulonephritis (AGN) may be accompanied by a positive throat or skin culture for which bacteria? a. Staphylococcus aureus b. Streptococcus c. Pseudomonas aeruginosa d. Haemophilus

ANS: B- Streptococcus

A professor has taught a student about skeletal alterations seen in chronic kidney disease. Which statement by the student indicates the professor needs to give more information? a. Parathyroid hormone is no longer effective in maintaining serum phosphate levels. b. The parathyroid gland is no longer able to secrete sufficient parathyroid hormone. c. The synthesis of 1,25-vitamin D3, which reduces intestinal absorption of calcium, is impaired. d. The effectiveness of calcium and phosphate resorption from bone is impaired.

ANS: B- The parathyroid gland is no longer able to secrete sufficient parathyroid hormone

What causes vesicoureteral reflux to occur in children? a. Children do not ask for help in urinating in a timely manner, and urine is forced up into the ureters. b. The submucosal segment of a child's ureter is short, making the antireflux mechanism inefficient. c. The trigone lying between the opening to the ureters and the urethra is underdeveloped in children. d. As the bladder fills in infants and children, it pulls the smooth lining of the transitional epithelium away from the ureters, making the reflux valves ineffective.

ANS: B- The submucosal segment of a child's ureter is short, making the antireflux mechanism inefficient

What is the pathophysiologic process responsible for the autoimmune disorder of hemolytic-uremic syndrome (HUS)? a. Immunoglobulin A (IgA) coats erythrocytes that are destroyed by the spleen, and remnants are excreted through the kidneys. b. Verotoxin from Escherichia coli is absorbed from the intestines and damages erythrocytes and endothelial cells. c. Endotoxins from E. coli block the erythropoietin produced by the kidneys, which reduces the number of erythrocytes produced by the bone marrow. d. Failure of the nephron to filter urea increases the blood urea nitrogen, which binds to erythrocytes that are subsequently destroyed by the spleen.

ANS: B- Verotoxin from Escherichia coli is absorbed from the intestines and damages erthryocytes and endothelial cells

How are glucose and insulin used to treat hyperkalemia associated with acute renal failure? a. Glucose has an osmotic effect, which attracts water and sodium, resulting in more dilute blood and a lower potassium concentration. b. When insulin transports glucose into the cell, it also carries potassium with it. c. Potassium attaches to receptors on the cell membrane of glucose and is carried into the cell. d. Increasing insulin causes ketoacidosis, which causes potassium to move into the cell in exchange for hydrogen.

ANS: B- When insulin transports glucose into the cell, it also carries potassium with it.

What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion? a. Macula densa b. Visceral epithelium c. Juxtaglomerular apparatus (JGA) d. Filtration slits

ANS: C Control of renal blood flow, glomerular filtration, and renin secretion occur at the JGA. Together, the juxtaglomerular cells and macula densa cells form the JGA. The control of renal blood flow, glomerular filtration, and renin secretion is not directed by any of the other options.

Which hormone is synthesized and secreted by the kidneys? a. Antidiuretic hormone b. Aldosterone c. Erythropoietin d. Angiotensinogen

ANS: C Erythropoietin is produced by the fetal liver and in the adult kidney and is essential for normal erythropoiesis. This statement is not true of the other options.

Which cells have phagocytic properties similar to monocytes and contract like smooth muscles cells, thereby influencing the glomerular filtration rate? a. Principle cells b. Podocin cells c. Mesangial cells d. Intercalated cells

ANS: C Mesangial cells and the mesangial matrix, secreted by mesangial cells, lie between and support the glomerular capillaries. Different mesangial cells contract like smooth muscle cells to regulate glomerular capillary blood flow. They also have phagocytic properties similar to monocytes. The other options are not capable of these functions.

Which process makes it possible for ureters to be transplanted successfully? a. Compensatory hypertrophy b. Erythropoietin secretion c. Peristalsis d. Collateral circulation

ANS: C Peristalsis is the process which makes it possible for ureters to be transplanted successfully. This process is maintained even when the ureter is denervated. The remaining options are not relevant to transplant success.

On average, what percent of cardiac output do the kidneys receive? a. 10% to 20% b. 15% to 20% c. 20% to 25% d. 30% to 35%

ANS: C The kidneys are highly vascular organs and usually receive 1000 to 1200 ml of blood per minute, or approximately 20% to 25% of the cardiac output.

A person diagnosed with type 1 diabetes experienced an episode of hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The healthcare professional teaches the person that what is the most probable cause of these symptoms? a. Hyperglycemia caused by incorrect insulin administration b. Dawn phenomenon from eating a snack before bedtime c. Hypoglycemia caused by increased exercise d. Somogyi effect from insulin sensitivity

ANS: C The most likely cause of these symptoms is hypoglycemia, which is often caused by a lack of systemic glucose as a result of muscular activity or decreased food intake. Hyperglycemia is not characterized by these symptoms. The Dawn phenomenon is manifested by an early morning elevation in blood glucose. The Somogyi effect is distinguished by early morning (i.e., 4 AM) hypoglycemia followed by hyperglycemia upon arising.

Compared with a younger individual, how is the specific gravity of urine in older adults affected? a. Specific gravity of urine in older adults is increased. b. Specific gravity of urine in older adults is considered high normal. c. Specific gravity of urine in older adults is considered low normal. d. Specific gravity of urine in older adults is decreased.

ANS: C The specific gravity of the urine in older individuals tends to be on the low side of normal.

What is the trigone? a. A smooth muscle that comprises the orifice of the ureter b. The inner mucosal lining of the kidneys c. A smooth triangular area between the openings of the two ureters and the urethra d. One of the three divisions of the loop of Henle

ANS: C The trigone is a smooth triangular area lying between the openings of the two ureters and the urethra. The other options do not accurately identify the trigone.

What term is used to identify the movement of fluids and solutes from the tubular lumen to the peritubular capillary plasma? a. Tubular secretion b. Ultrafiltration c. Tubular reabsorption d. Tubular excretion

ANS: C Tubular reabsorption is the movement of fluids and solutes from the tubular lumen to the peritubular capillary plasma. This selection is the only option that correctly identifies the process.

How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness? a. 75 to 100 ml b. 100 to 150 ml c. 250 to 300 ml d. 350 to 400 ml

ANS: C When the bladder accumulates 250 to 300 ml of urine, it contracts and the internal urethral sphincter relaxes through activation of the spinal reflex arc (known as the micturition reflex).

Which statement is true regarding urodilatin? a. Urodilatin inhibits sodium chloride and water reabsorption in the medullary part of the collecting duct. b. It inhibits antidiuretic hormone (ADH) to prevent water reabsorption in the medullary part of the collecting duct. c. Urodilatin is stimulated by a rise in blood pressure and an increase in extracellular volume. d. It is stimulated by a fall in blood pressure and a decrease in extracellular volume.

ANS: C When the circulating volume and increased blood pressure are increased, the distal tubule and collecting duct produces urodilatin (a natriuretic peptide). Urodilatin inhibits sodium and water reabsorption from the medullary part of collecting duct, thereby producing diuresis

How high does the plasma glucose have to be before the threshold for glucose is achieved? a. 126 mg/dl b. 150 mg/dl c. 180 mg/dl d. 200 mg/dl

ANS: C When the plasma glucose reaches 180 mg/dl, as occurs in the individual with uncontrolled diabetes mellitus, the threshold for glucose is achieved.

Which renal change is found in older adults? a. Sharp decline in glomerular filtration rate b. Sharp decline in renal blood flow c. Decrease in the number of nephrons d. Decrease in urine output

ANS: C With aging, the number of nephrons decreases. The other options are not necessarily related to aging.

Which laboratory value would the nurse expect to find if a person is experiencing syndrome of inappropriate antidiuretic hormone (SIADH)? a. Hypernatremia and urine hypoosmolality b. Serum potassium (K+) level of 5 mEq/L and urine hyperosmolality compared to serum c. Serum sodium (Na+) level of 120 mEq/L and serum osmolality 260 mOsm/kg d. Serum potassium (K+) of 2.8 mEq/L and serum hyperosmolality

ANS: C A diagnosis of SIADH requires a serum sodium level of less than 135 mEq/L, serum hypoosmolality less than 280 mOsm/kg, and urine hyperosmolarity. Potassium levels are not considered a factor.

A person wants to know if eating only plant-based foods is advisable as a way to cut cholesterol to near-zero levels. What response by the health care professional is best? a. "No, you will become extremely malnourished." b. "Yes, that is an effective way to eliminate cholesterol." c. "No, many hormones are made from cholesterol." d. "Yes, that will increase the action of insulin."

ANS: C All the lipid-soluble hormones except thyroid hormone are synthesized from cholesterol, so it is a needed substance in the body. Vegetarian and vegan diets can be healthy so malnutrition is not the issue. Insulin is water soluble.

A student asks the health care professional why obese people are at higher risk for hypertension than non-obese individuals. What response by the professional is best? a. They produce more ghrelin in the stomach. b. Their thyroid gland secretes less hormone. c. They produce more angiotensinogen. d. They secrete fewer endocannabinoids.

ANS: C Angiotensinogen is a precursor of angiotensin I, which, converted to angiotensin II, is a potent vasoconstrictor. Angiotensinogen is produced both by the liver and by adipocytes; therefore obese individuals have more, leading to increased vasoconstriction and increased systemic vascular resistance which leads to high blood pressure. Ghrelin, produced in the stomach, increases food intake. The thyroid gland function is not directly linked to obesity. Endocannabinoids are associated with increase in appetite and nutrient absorption

A person has abnormally severe tooth decay and erosion of the tooth enamel. What problem should the health care professional assess the person for? a. Anorexia nervosa b. Binge eating c. Bulimia d. Refeeding syndrome

ANS: C Chronic vomiting and exposure to gastric acids leads to loss of tooth enamel and decay. These are not signs of anorexia, binge eating, or refeeding syndrome.

Why does polyuria occur with diabetes mellitus? a. Formation of ketones b. Chronic insulin resistance c. Elevation in serum glucose d. Increase in antidiuretic hormone

ANS: C Glucose accumulates in the blood and appears in the urine as the renal threshold for glucose is exceeded, producing an osmotic diuresis and the symptoms of polyuria and thirst. Ketone formation would lead to acidosis. Insulin resistance will promote hyperglycemia. And increase in antidiuretic hormone leads to water retention.

Regulation of the release of insulin is an example of which type of regulation? a. Negative feedback b. Positive feedback c. Neural d. Physiologic

ANS: C Hormone release is governed by three factors: chemical factors, endocrine factors, and neural control. An example of neural control is when insulin is secreted in response to increased glucose in the blood. Negative feedback is seen when changes occur in chemical, endocrine, or neural control that lead to decreased synthesis or secretion of a hormone. Positive feedback occurs when changes in one of the factors lead to increased synthesis or secretion of a hormone. "Physiologic" is not a specific type of regulation.

Why is the control of calcium in cells important? a. It is controlled by the calcium negative-feedback loop. b. It is continuously synthesized. c. It acts as a second messenger. d. It carries lipid-soluble hormones in the bloodstream.

ANS: C In addition to being an important ion that participates in a multitude of cellular actions, Ca++ is considered an important second messenger. Serum calcium levels are mainly controlled by parathyroid hormone. Timing of synthesis is not related to the control of calcium levels. Calcium does not carry lipid-soluble hormones in the bloodstream.

What does aldosterone directly increase the reabsorption of? a. Magnesium b. Calcium c. Sodium d. Water

ANS: C In the kidney, aldosterone primarily acts on the epithelial cells of the nephron-collecting duct to increase sodium ion reabsorption. Aldosterone does not directly increase the reabsorption of magnesium, calcium, or water.

To ensure optimal thyroid health and function, which mineral does the health care professional advise a nutrition class to include in the daily diet? a. Iron b. Zinc c. Iodide d. Copper

ANS: C Iodine is needed for thyroid stimulating hormone (TSH) to stimulate the secretion of thyroid hormone (TH). The other minerals are important for good health, but not related to the health and function of the thyroid gland.

A patient has diabetes mellitus. A recent urinalysis showed increased amounts of protein. What therapy does the healthcare provider educate the patient that is specific to this disorder? a. More frequent blood glucose monitoring b. Moderate dietary sodium restriction c. Treatment with an ACE inhibitor d. Home blood pressure monitoring

ANS: C Microalbuminuria is the first manifestation of diabetic nephropathy. Treatment with an ACE inhibitor or angiotensin receptor blocker is the treatment of choice. Depending on the patient, more frequent blood glucose and blood pressure monitoring may be in order, but is not specific to this disorder and does not treat it. The patient may benefit from a moderate or even severe sodium restriction for several reasons (nephropathy, hypertension, etc.) but that is not as specific to nephropathy treatment as the medications are.

What causes the microvascular complications in patients with diabetes mellitus? a. The capillaries contain plaques of lipids that obstruct blood flow. b. Pressure in capillaries increases as a result of the elevated glucose attracting water. c. The capillary basement membranes thicken, and cell hyperplasia develops. d. Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries.

ANS: C Microvascular complications are a result of capillary basement membranes thickening and endothelial cell hyperplasia. They do not occur due to plaque accumulation, increased capillary pressure, or from proliferation of subendothelial smooth muscle.

A healthcare professional is caring for four patients. Which patient does the professional assess for neurogenic diabetes insipidus (DI)? a. Anterior pituitary tumor b. Thalamus hypofunction c. Posterior pituitary trauma d. Renal tubule disease

ANS: C Neurogenic DI is a result of dysfunctional antidiuretic hormone synthesis, caused by a lesion of the posterior pituitary, hypothalamus, or pituitary stalk. Injury of dysfunction of the anterior pituitary, the thalamus, or the renal tubules does not cause neurogenic DI.

Visual disturbances are a result of a pituitary adenoma because of what? a. Liberation of anterior pituitary hormones into the optic chiasm b. Pituitary hormones clouding the lens of the eyes c. Pressure of the tumor on the optic chiasm d. Pressure of the tumor on the optic and oculomotor cranial nerves

ANS: C Pressure on the optic chiasm is the only cause for visual disturbances resulting from a pituitary adenoma.

What does Graves' disease develop from? a. A viral infection of the thyroid gland that causes overproduction of thyroid hormone b. An autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue c. A thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones d. An ingestion of goitrogens that inhibits the synthesis of the thyroid hormones, causing a goiter

ANS: C The pathologic features of Graves' disease indicate that normal regulatory mechanisms are overridden by abnormal immunologic mechanisms resulting in the stimulation of excessive TH. Graves' disease is not caused by a viral infection, lymphocyte and fibrous tissue infiltration, or ingestion of goitrogens.

A patient had a thyroidectomy and now reports tingling around the mouth and has a positive Chvostek sign. What laboratory finding would be most helpful to the healthcare professional? a. TSH and T4 b. Serum sodium c. Serum calcium d. Urine osmolality

ANS: C The patient is displaying signs of hypocalcemia, which can be caused by hypoparathyroidism. The most common cause of hypoparathyroidism is damage caused during thyroid surgery. The healthcare professional would be more informed by a serum calcium test. Thyroid hormones, serum sodium, and urine osmolality will not provide information related to this condition.

What is the action of urodilatin? a. Urodilatin causes vasoconstriction of afferent arterioles. b. It causes vasodilation of the efferent arterioles. c. Urodilatin inhibits antidiuretic hormone secretion. d. It inhibits salt and water reabsorption.

ANS: D Urodilatin (a natriuretic peptide) inhibits sodium and water reabsorption from the medullary part of collecting duct, thereby producing diuresis. It is not involved in the actions described by the other options.

A patient chart notes the patient has amenorrhea, galactorrhea, hirsutism, and osteoporosis. What diagnostic test would the healthcare professional prepare the patient for? a. Water deprivation test b. Hemoglobin A1C c. CT scan of the head d. Ovarian biopsy

ANS: C The patient presents with characteristics of a prolactinoma: a pituitary tumor that secretes prolactin. The professional would prepare the patient for a CT scan of the head. A water deprivation test is used to diagnose diabetes insipidus. The hemoglobin A1C is used to measure blood glucose over time. Polycystic ovary disease can lead to increased level of prolactin, but this is not diagnosed with a biopsy.

The effects of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion include which solute? a. Sodium and water retention b. Sodium retention and water loss c. Sodium dilution and water retention d. Sodium dilution and water loss

ANS: C The symptoms of SIADH secretion are a result of dilutional hyponatremia and water retention. SIADH does not lead to sodium retention or water loss.

Which patient would the healthcare professional assess for other signs of thyrotoxic crisis? a. Constipation with gastric distention b. Bradycardia and bradypnea c. Hyperthermia and tachycardia d. Constipation and lethargy

ANS: C The systemic symptoms of thyrotoxic crisis include hyperthermia, tachycardia, diarrhea, and agitation or delirium, heart failure, dysrhythmias, nausea, and vomiting

What are the effects of aging on pancreatic cells? a. Pancreatic cells are replaced by fibrotic cells. b. Increased insulin production is typical. c. Beta cell function decreases. d. No appreciable change occurs on pancreatic cells.

ANS: C With aging, there is an associated decline in the functioning of pancreatic beta cells. There is no evidence to suggest that pancreatic cells are replaced with fibrotic tissue, or that insulin production increases.

Detrusor hyperreflexia develops from neurologic disorders that originate where? a. Spinal cord between C2 and C4 b. Spinal cord between S2 and S4 c. Above the pontine micturition center d. Below the cauda equina

ANS: C Above the pontine micturition center

Bladder cancer is associated with the gene mutation of which gene? a. c-erbB2 b. Human epidermal growth factor receptor 2 (HER2) c. TP53 d. myc

ANS: C TP53

Bacteria gain access to the female urinary tract by which means? a. Systemic blood that is filtered through the kidney b. Bacteria traveling from the lymph adjacent to the bladder and kidneys c. Bacteria ascending the urethra into the bladder d. Colonization of the bladder when urine is static

ANS: C- Bacteria ascending the urethra into the bladder

A patient who has a history of mildly decreased renal function is admitted to the hospital for IV antibiotics. Which antibiotics would the healthcare professional avoid in this patient? a. Penicillin and ampicillin b. Vancomycin and bacitracin c. Gentamicin and tobramycin d. Cefazolin and cefepime

ANS: C- Gentamicin and tobramycin

What initiates inflammation in acute poststreptococcal glomerulonephritis? a. Lysosomal enzymes b. Endotoxins from Streptococcus c. Immune complexes d. Immunoglobulin E (IgE)-mediated response

ANS: C- Immune complexes

Creatinine is primarily excreted by glomerular filtration after being constantly released from what type of tissue? a. Nervous system b. Kidneys c. Muscle d. Liver

ANS: C- Muscle

A patient exhibits symptoms including hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin as the major protein. What diagnostic test or treatment regime does the healthcare professional educate the patient on? a. Intravenous pyelogram b. Oral antibiotics c. Renal biopsy d. Cyclophosphamide

ANS: C- Renal biopsy

What process allows the kidney to respond to an increase in workload? a. Glomerular filtration b. Secretion of 1,25-dihydroxyvitamin D3 c. Increased heart rate d. Compensatory hypertrophy

ANS: D Compensatory hypertrophy allows the kidney to respond to an increase in workload throughout life. The remaining options are not relevant to accommodating an increased workload

When comparing the clinical manifestations of both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS), which condition is associated with only DKA? a. Fluid loss b. Weight loss c. Increased serum glucose d. Kussmaul respirations

ANS: D Kussmaul respirations are only observed in those with DKA. This is due to compensation by the lungs for the metabolic acidosis. Both DKA and HHNKS show fluid loss, weight loss, and hyperglycemia.

What effect do natriuretic peptides have during heart failure when the heart dilates? a. Stimulates antidiuretic hormones. b. Inhibits antidiuretic hormones c. Stimulates renin and aldosterone. d. Inhibits renin and aldosterone.

ANS: D Natriuretic peptides inhibit renin and aldosterone during heart failure when the heart dilates. These make up a group of peptide hormones, including atrial natriuretic peptide (ANP), secreted from myocardial cells in the atria and brain natriuretic peptide (BNP) secreted from myocardial cells in the cardiac ventricles. When the heart dilates during volume expansion or heart failure, ANP and BNP inhibit sodium and water absorption by kidney tubules, inhibit the secretion of renin and aldosterone, vasodilate the afferent arterioles, and constrict the efferent arterioles. The result is increased urine formation, leading to decreased blood volume and blood pressure.

What is the end-product of protein metabolism that is excreted in urine? a. Glucose b. Ketones c. Bile d. Urea

ANS: D Of the options available, only urea is an end-product of protein metabolism and is the major constituent of urine along with water.

What substance stimulates renal hydroxylation in the process of producing vitamin D? a. Erythropoietin b. Thyroid hormone c. Calcitonin d. Parathyroid hormone

ANS: D Parathyroid hormone stimulates renal hydroxylation in the process of producing vitamin D. The first step occurs in the liver with hydroxylation at the 25th carbon (calcifediol); the second step in hydroxylation occurs at the first carbon position in the kidneys. The other options are not involved in this process.

When renin is released, it is capable of which action? a. Inactivation of autoregulation b. Direct activation of angiotensin II c. Direct release of antidiuretic hormone (ADH) d. Formation of angiotensin I

ANS: D When renin is released, it cleaves an α-globulin (angiotensinogen produced by liver hepatocytes) in the plasma to form angiotensin I.

A patient is in severe shock and is receiving vasopressin. A student asks the health care professional to explain the rationale for this treatment. What response by the professional is most accurate? a. "Antidiuretic hormone conserves fluid when urine output is less than 20 mL/hr." b. "Antidiuretic hormone causes serum osmolality to be increased." c. "Antidiuretic hormone leads to better insulin utilization." d. "Antidiuretic hormone causes vasoconstriction to help increase blood pressure."

ANS: D ADH in high doses causes vasoconstriction and a resulting increase in arterial blood pressure which would be important to the patient in shock. It does not cause fluid conservation, changes in serum osmolality, or better insulin utilization.

What is the action of calcitonin? a. Increases metabolism b. Decreases metabolism c. Increases serum calcium d. Decreases serum calcium

ANS: D Calcitonin, also called thyrocalcitonin, acts to lower serum calcium levels by inhibiting bone-resorbing osteoclasts. Calcitonin does not alter metabolism.

When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an example of what type of effect by a hormone? a. Pharmacologic b. Permissive c. Synerg d. Direct

ANS: D Direct effects are the obvious changes in cell function that specifically result from the stimulation by a particular hormone. The term pharmacologic could be used to describe the effect of a medication on a hormone. Permissive effects encourage maximum response of functioning of a cell. Synergistic means that two separate entities work together to create a bigger result than either one would have alone; this is not a type of hormone effect.

A patient has a suspected thyroid carcinoma. What diagnostic test does the healthcare professional prepare the patient for? a. Measurement of serum thyroid levels b. Radioisotope scanning c. Ultrasonography d. Fine-needle aspiration biopsy

ANS: D Fine-needle aspiration of a thyroid nodule is generally performed to diagnose thyroid carcinoma. Serum thyroid levels probably will not be abnormal early in disease. Radioisotope scanning is not used and ultrasound is not specific enough for diagnosis.

A healthcare professional is palpating the neck of a person diagnosed with Graves' disease. What finding would the professional associate with this disorder? a. Parathyroids left of midline b. Thyroid small with discrete nodules c. Parathyroids normal in size d. Thyroid diffusely enlarged

ANS: D Graves' disease is characterized by a diffusely enlarged thyroid gland. The parathyroid glands are not involved.

A student asks the professor how a faulty negative-feedback mechanism results in a hormonal imbalance. What response by the professor is best? a. Hormones are not synthesized in response to cellular and tissue activities. b. Decreased hormonal secretion is a response to rising hormone levels. c. Too little hormone production is initiated. d. Excessive hormone production results from a failure to turn off the system.

ANS: D Negative-feedback systems are important in maintaining hormones within physiologic ranges. The lack of negative-feedback inhibition on hormonal release often results in pathologic conditions. Excessive hormone production, which is the result of the failure to turn off the system in response to changes in chemical, endocrine, or neurologic factors, can cause various hormonal imbalances and related conditions. Hormones are synthesized in response to cellular and tissue activities, but not appropriately

Which individual does the health care professional determine is obese? a. Body mass index 23 kg/m2 b. Body mass index 25 kg/m2 c. Body mass index 29 kg/m2 d. Body mass index 32 kg/m2

ANS: D Overweight is defined as a body mass index (BMI) of >25 kg/m2, while a BMI of >30 kg/m2 is considered obese. The individual with the BMI of 23 kg/m2 would be considered of normal weight, those with BMIs of 25 and 29 kg/m2 would be considered overweight, and the person with the BMI of 32 kg/m2 is obese.

Which substance is a water-soluble protein hormone? a. Thyroxine b. Aldosterone c. Follicle-stimulating hormone d. Insulin

ANS: D Peptide or protein hormones, such as insulin, pituitary, hypothalamic, and parathyroid, are water soluble and circulate in free (unbound) forms. All the remaining options are fat-soluble hormones.

How do the releasing hormones that are made in the hypothalamus travel to the anterior pituitary? a. Vessels of the zona fasciculata b. Infundibular process c. Pituitary stalk d. Portal hypophyseal blood vessels

ANS: D Releasing and inhibitory hormones are synthesized in the hypothalamus and are secreted into the portal blood vessels through which they travel to the anterior pituitary hormones. The initial stages of aldosterone synthesis occur in the adrenal zona fasciculata and zona reticularis. The infundibular process is part of the posterior pituitary. The pituitary stalk contains the axons of neurons that originate in the supraoptic and paraventricular nuclei of the hypothalamus.

A healthcare professional advises a person with diabetes mellitus to have an annual eye exam. When the person asks why this is necessary, the professional states that retinopathy develops in patients with diabetes mellitus because of what reason? a. Plaques of lipids develop in the retinal vessels. b. Pressure in the retinal vessels increase as a result of increased osmotic pressure. c. Ketones cause microaneurysms in the retinal vessels. d. Retinal ischemia and red blood cell aggregation occur.

ANS: D Retinopathy appears to be a response to retinal ischemia and red blood cell aggregation. None of the remaining explanations appropriately describe the relationship between retinopathy and diabetes mellitus.

Which second messenger is stimulated by epinephrine binding to a β-adrenergic receptor? a. Calcium b. Inositol triphosphate (IP3) c. Diacylglycerol (DAG) d. Cyclic adenosine monophosphate (cAMP)

ANS: D Second-messenger molecules are the initial link between the first signal (hormone) and the inside of the cell. For example, the binding of epinephrine to a β-adrenergic-receptor subtype activates (through a stimulatory G protein) the enzyme, adenylyl cyclase. Adenylyl cyclase catalyzes the conversion of adenosine triphosphate (ATP) to the second messenger, 3′, and 5′-cAMP. The remaining messengers are not stimulated by epinephrine to bind as described.

A person has acne, easy bruising, thin extremities, and truncal obesity. The healthcare professional assesses the person for which of these? a. Previous thyroid surgery b. Urine osmolality c. Serum electrolytes d. Use of glucocorticoids

ANS: D These symptoms are characteristic of Cushing disease (or Cushing-like syndrome) which can be caused by long-term use of glucocorticoids to treat other medical conditions. Thyroid surgery, urine osmolality, and serum electrolytes would not give information about the disorder.

A patient has been diagnosed with a renal stone. Based on knowledge of common stone types, what self-care measure does the healthcare professional plan to teach the patient when stone analysis has returned? a. Increase water intake. b. Decrease soda intake. c. Restrict animal protein in the diet. d. Ingest 1000 mg of calcium a day.

ANS: D Ingest 1000mg of calcium a day

A healthcare professional has taught a parent group about the causes of enuresis. What statement by a parent indicates the professional needs to give more information? a. A maturational lag may cause enuresis. b. Enuresis may be related to increased light sleep. c. Obstructive sleep apnea may be a symptom of enuresis. d. Elevated nocturnal levels of vasopressin may cause enuresis.

ANS: D- Elevated nocturnal levels of vasopressin may cause enuresis

A patient who has chronic kidney disease has hemoglobin of 7.2 mg/dL. What treatment does the healthcare professional prepare the patient for? a. Intrinsic factor b. Vitamin B12 c. Vitamin D d. Erythropoietin

ANS: D- Erythropoietin

Compared with an adult, an infant has a greater content of extracellular fluid, as well as a greater rate of fluid exchange. What effect does this have on the fluid balance of a child compared with that of an adult? a. Edema development is less of a problem. b. Overhydration is not difficult to manage. c. Daily fluid requirements are greater. d. The control of dehydration is more difficult.

ANS: D- The control of dehydration is more difficult

A healthcare professional is assessing a patient who could have either pyelonephritis or cystitis. Which differentiating sign would assist the professional in making this diagnosis? a. Difficulty starting the stream of urine b. Spasmodic pain that radiates to the groin c. Increased glomerular filtration rate d. Urinalysis confirmation of white blood cell casts

ANS: D- Urinalysis confirmation of white blood cells casts

A female patient has been diagnosed with an uncomplicated urinary tract infection. What self-care measure does the healthcare provider teach the patient that is specific to this type of infection? a. Drink at least eight glasses of water a day. b. Take medication if you have a fever. c. Rest as much as you can in the next few days. d. After using the bathroom, wipe from front to back.

ANS: D- after using the bathroom, wipe from front to back

What is a communicating hydrocephalus caused by an impairment of? a. Cerebrospinal fluid flow between the ventricles b. Cerebrospinal fluid flow into the subarachnoid space c. Blood flow to the arachnoid villi d. Absorption of cerebrospinal fluid

Absorption of cerebrospinal fluid

A professor has taught the students about the sources of increased ammonia in patients with hepatic encephalopathy. What statement by a student indicates the professor should review this material? a. End products of intestinal protein digestion are sources of increased ammonia. b. Digested blood leaking from ruptured varices is a source of increased ammonia. c. Accumulation of short-chain fatty acids are a source of increased ammonia. d. Ammonia-forming bacteria in the colon are sources of increased ammonia.

Accumlation of short-chain fatty acids are a source of increased ammonia

What does the student learn about the role of collagen in the clotting process? a. Initiates the clotting cascade b. Activates platelets c. Stimulates fibrin d. Deactivates fibrinogen

Activates platelets

A patient is diagnosed with septic shock. What action by the healthcare professional will address the main underlying pathophysiologic mechanism of this disorder? a. Administer antibiotics as soon as possible. b. Provide high volumes of isotonic fluid. c. Place patient on an intra-aortic balloon pump. d. Give the patient antihistamines and steroids.

Administer antibiotics as soon as possible

Which statement accurately describes a characteristic of osteosarcoma? a. Slow-growing tumor that begins in the bone marrow and infiltrates the trabeculae b. Solitary tumor that most often affects the metaphyseal region of the femur or tibia c. Aggressive tumor most often found in the bone marrow of long bones d. Tumor that infiltrates the trabeculae in spongy bone and implants in surrounding tissue by seeding

Aggressive tumor most often found in the bone marrow of long bones

What is the most abundant class of plasma protein? a. Globulins b. Albumin c. Clotting factors d. Complements proteins

Albumin

Hepatic fat accumulation is observed in which form of cirrhosis? a. Biliary b. Metabolic c. Postnecrotic d. Alcoholic

Alcoholic

How is erythroblastosis fetalis defined? a. Allergic disease in which maternal blood and fetal blood are antigenically incompatible b. Alloimmune disease in which maternal blood and fetal blood are antigenically incompatible c. Autoimmune disease in immature nucleated cells that are released into the bloodstream d. Autosomal dominant hereditary disease

Alloimmune disease in which maternal blood and fetal blood are antigenically incompatible

Which pancreatic enzyme is responsible for the breakdown of carbohydrates? a. Trypsin b. Amylase c. Lipase d. Chymotrypsin

Amylase

A student studying osteomyelitis and asks for an explanation of the term "sequestrum." What response by the professor is best? a. An area of devascularized and devitalized bone b. An enzyme that phagocytizes necrotic bone c. A subperiosteal abscess d. A layer of new bone surrounding the infected bone

An area of devascularized and devitalized bone

10. Which hospitalized patient does the healthcare professional assess as a priority for the development of delirium? a. An individual with diabetes celebrating a 70th birthday b. A depressed Hispanic woman c. An elderly male on the second day after hip replacement d. A man diagnosed with schizophrenia

An elderly male on the second day after hip replacement

For which type of shock would antihistamines and corticosteroids be prescribed? a. Septic b. Anaphylactic c. Hypovolemic d. Cardiogenic

Anaphylactic

Four patients are in the intensive care unit with different types of shock. Which patient would the healthcare professional assess as the priority? a. Septic b. Hypovolemic c. Anaphylactic d. Neurogenic

Anaphylactic

What is the anomaly in which the soft bony component of the skull and much of the brain is missing? a. Anencephaly b. Myelodysplasia c. Cranial meningocele d. Hydrocephaly

Anencephaly

A right hemisphere embolic CVA has resulted in left-sided paralysis and reduced sensation of the left foot and leg. Which cerebral artery is most likely affected by the emboli? a. Middle cerebral b. Vertebral c. Posterior cerebral d. Anterior cerebral

Anterior cerebral

A patient has chronic gastritis. What treatment does the healthcare professional educate the patient on? a. Antibiotic therapy b. Corticosteroids c. Vitamin B12 injections d. Pancreatic enzyme replacement

Antibiotic therapy

A patient in the clinic reports projectile vomiting without nausea or other gastrointestinal symptoms. What action by the healthcare professional is most appropriate? a. Provide antiemetic medications. b. Arrange a brain scan. c. Administer intravenous hydration. d. Schedule a GI consultation.

Arrange a brain scan

What is the type of vascular malformation that most often results in hemorrhage? a. Cavernous angioma b. Venous angioma c. Capillary telangiectasia d. Arteriovenous malformation

Arteriovenous malformation

Which vascular malformation is characterized by arteries that feed directly into veins through vascular tangles of abnormal vessels? a. Cavernous angioma b. Capillary telangiectasia c. Arteriovenous angioma d. Arteriovenous malformation

Arteriovenous malformation

Which part of an injured joint becomes insensitive to pain and regenerates slowly and minimally? a. Synovium b. Articular cartilage c. Bursa d. Tendon

Articular cartilage

A 7 months old in the clinic displays an intact tonic neck reflex. What action by the healthcare professional is most appropriate? a. Chart the finding as normal in the child's chart. b. Assess the baby for signs of malnutrition. c. Educate the parents on how to improve mobility. d. Assess the child's development further.

Assess the child's development further.

What is the most common primary central nervous system (CNS) tumor? a. Microglioma b. Neuroblastoma c. Astrocytoma d. Neuroma

Astrocytoma

Where are atheromatous plaques most commonly found? a. In larger veins b. Near capillary sphincters c. At branches of arteries d. On the venous sinuses

At branches of arteries

Gait disturbances and instability are characteristic of which form of cerebral palsy? a. Spastic b. Dystonic c. Ataxic d. Biochemical

Ataxic

A patient demonstrates rippling under the skin on the arms. The patient's spouse asks the healthcare professional to explain why this occurs. What response by the professional is most accurate? a. Loss of temperature regulation in distal, proximal, or midline muscles b. Atrophy of primary motor neurons c. Loss of sensation leading to flaccid paralysis d. Spastic movements due to increased deep tendon reflexes

Atrophy of primary motor neurons

A healthcare professional is caring for a patient who has a spinal cord injury at T5. The patient exhibits severe hypertension, a heart rate of 32 beats/min, and sweating above the spinal cord lesion. How does the professional chart this event? a. Craniosacral dysreflexia b. Parasympathetic dysreflexia c. Autonomic hyperreflexia d. Retrograde hyperreflexia

Autonomic hyperreflexia

The alpha- and beta-thalassemias are considered what types of inherited disorder? a. Autosomal recessive b. Autosomal dominant c. X-linked recessive d. X-linked dominant

Autosomal recessive

Which type of axon transmits a nerve impulse at the highest rate? a. Large nonmyelinated b. Large myelinated c. Small nonmyelinated d. Small myelinated

B A myelinated axon has a myelin sheath wrapped around it which functions as an insulating substance that speeds impulse propagation. The diameter of the myelinated axon also affects the speed of nerve impulse transmission with larger diameter axons transmitting at a faster speed than smaller ones.

Where is the region responsible for the motor aspects of speech located? a. Wernicke area in the temporal lobe b. Broca speech area in the frontal lobe c. Wronka area in the parietal lobe d. Barlow area in the occipital lobe

B Broca speech area is the only region responsible for the motor aspects of speech. Wernicke area is responsible for reception and interpretation of speech. Wronka and Barlow areas were not discussed in the text.

A patient is brought to the Emergency Department after being in an explosion. The patient was not seriously injured. Laboratory testing shows an elevated blood glucose (sugar) level, but the patient does not have diabetes. What does the healthcare professional tell the patient about this condition? a. "You should have a physical by your primary care provider." b. "Your blood sugar may be high because of the stress of the situation." c. "You actually may have undiagnosed diabetes mellitus." d. "You should be tested for underlying neurological problems."

B In general, sympathetic stimulation promotes responses that are concerned with the protection of the individual ("fight or flight" response), which include increased blood sugar levels, temperature, and blood pressure. The patient may need a physical and might have undiagnosed diabetes, but these are not the most specific answer to the question and do not give the patient any information. It is not likely that an underlying neurological disorder is the cause of the elevated blood glucose.

During a synapse, what change occurs after the neurotransmitter binds to the receptor? a. The permeability of the presynaptic neuron changes; consequently, its membrane potential is changed as well. b. The permeability of the postsynaptic neuron changes; consequently, its membrane potential is changed as well. c. The postsynaptic cell prevents any change in permeability and destroys the action potential. d. The presynaptic cell synthesizes and secretes additional neurotransmitters.

B The binding of the neurotransmitter at the receptor site changes the permeability of the postsynaptic neuron and, consequently, its membrane potential. The remaining options do not accurately describe the occurrence.

Which area of the brain assumes the responsibility for involuntary muscle control and for maintaining balance and posture? a. Cerebrum b. Cerebellum c. Diencephalon d. Brainstem

B The cerebellum is responsible for reflexive, involuntary fine-tuning of motor control and for maintaining balance and posture through extensive neural connections with the medulla and with the midbrain. The cerebrum is the site of higher brain function. The diencephalon controls vital functions and visceral activities and is closely associated with those of the limbic system. The brainstem contains the reticular formation which is a large network of diffuse nuclei that connect the brainstem to the cortex and control vital reflexes, such as cardiovascular function and respiration. It is essential for maintaining wakefulness and attention.

Where is the cerebrospinal fluid (CSF) produced? a. Arachnoid villi b. Choroid plexuses c. Ependymal cells d. Pia mater

B The choroid plexuses are the structures that produce CSF; they arise from the pia mater. The arachnoid villi reabsorb the CSF. The ependymal cells form sheets that line fluid filled cavities in the brain. The pia mater closely adheres to the surface of the brain and spinal cord. It provides support for blood vessels serving brain tissue.

A healthcare professional is assessing a patient who suffered a head trauma. The patient is not able to sense touch of a sharp pin and cannot distinguish a hot object from a cold one. What part of the patient's brain does the professional suspect is damaged? a. Midbrain b. Pons c. Medulla oblongata d. Lateral colliculi

B The nuclei of cranial nerves V through VIII are located in the pons. An inability to recognize pain from a sharp pin and inability to differentiate hot and cold signify dysfunction of cranial nerve V (trigeminal nerve). The healthcare professional would suspect an injury to the pons.

What name is given to a large network of neurons within the brainstem that is essential for maintaining wakefulness? a. Midbrain b. Reticular activating system c. Medulla oblongata d. Pons

B The reticular activating system is essential for maintaining wakefulness. The midbrain connects the forebrain with the hindbrain. The pons is in the Metencephalon and transmits information from the cerebellum to the brainstem between the two cerebellar hemispheres.

The ability of the eyes to track moving objects through a visual field is primarily a function of which colliculi? a. Inferior b. Superior c. Mid d. Posterior

B The superior colliculi are involved with voluntary and involuntary visual motor movements (e.g., the ability of the eyes to track moving objects in the visual field). The inferior colliculi accomplish similar motor activities but involve movements affecting the auditory system (e.g., positioning the head to improve hearing). The inferior colliculus also is a major relay center along the auditory pathway. There are no mid or posterior colliculi.

A patient has a spinal cord injury that included damage to the upper motor neurons. What assessment finding would the healthcare provider associate with this injury? a. Permanent paralysis below the level of the injury b. Initial paralysis, but gradual partial recovery later c. Hemiplegia on the contralateral side of the body d. Notable increase in the amount of cerebral spinal fluid (CSF)

B Upper motor neurons (i.e., corticospinal tract) are the classification of motor pathways completely contained within the CNS. Their primary roles include directing, influencing, and modifying reflex arcs, lower-level control centers, and motor and some sensory neurons. Damage or destruction to upper motor neurons generally results in partial paralysis that is followed by a gradual and partial recovery. Permanent paralysis is usually the result of lower motor neuron destruction. Hemiplegia is often due to an injury or obstruction of the anterior cerebral artery. Changes in CSF production are a known age-related change and are due to atrophy of epithelial cells and thickening of the basement membrane in the choroid plexus.

The nurse recognizes that a patient's diagnosis of a bacterial infection of the brain's meningeal layer is supported by which diagnostic laboratory result? a. Chloride 125 mEq/L b. Leukocytes 110/mm3 c. Protein 32 mg/dL d. Glucose 63 mg/dL

B Viral infections causing meningitis will produce a white blood cell (leukocyte) count greater than 10/mm3. The chloride level and protein levels are normal and the glucose level is observed in patients with acute viral meningitis.

Reed-Sternberg (RS) cells represent malignant transformation and proliferation of which of these? a. Interleukin (IL)-1, IL-2, IL-5, and IL-6 b. Tumor necrosis factor-beta c. B cells d. T cells

B cells

A professor explains to a class that the reason lymph nodes enlarge and become tender during infection is because of what reason? a. B lymphocytes proliferate. b. The nodes are inflamed. c. The nodes fill with purulent exudate. d. The nodes are not properly functioning.

B lymphocytes proliferate.

Approximately 80% of all hospital-acquired infections in children are a result of which type of organism? a. Bacteria b. Viruses c. Fungi d. Rickettsia

Bacteria

How are Kupffer cells best described? a. Natural killer cells that produce interferon-gamma (IFN-g) b. Contractile and therefore capable of regulating the sinusoid blood flow c. Bactericidal and therefore central to innate immunity d. Able to metabolize estrogen, progesterone, and androgens

Bactericidal and therefore central to innate immunity

Parkinson disease is a degenerative disorder of which part of the brain? a. Hypothalamus b. Anterior pituitary c. Frontal lobe d. Basal ganglia

Basal ganglia

What are granulocytes that contain granules of vasoactive amines, such as histamine, called? a. Neutrophils b. Eosinophils c. Monocytes d. Basophils

Basophils

A 2-year-old is in shock. The healthcare professional assesses the child's heart rate as 52 beats/min. What action by the healthcare professional is most appropriate? a. Get an ECG. b. Increase the intravenous rate. c. Sedate the child. d. Begin CPR.

Begin CPR

A healthcare professional educates parents to monitor their child's dietary intake for sufficient iron during which period of time as the priority? a. Between 2 months and 1 year b. Between 6 months and 2 years c. Between 12 months and 3 years d. Between 18 months and 4 years

Between 6 months and 2 years

Which glucoprotein is thought to transport essential elements such as hormones, ions, and other metabolites to and from the bone cells? a. Osteocalcin b. Osteonectin c. Laminin d. Bone albumin

Bone albumin

The health care professional teaches a group of seniors that the most common clinical manifestation of osteoporosis is which of these? a. Bone deformity b. Bone pain c. Pathologic fracture d. Muscle strain

Bone deformity

What does a Ewing sarcoma arise from? a. Bone marrow b. Bone-producing mesenchymal cells c. Metadiaphysis of long bones d. Embryonal osteocytes

Bone marrow

Parents bring their 1-year-old child to the emergency department, reporting that the child has been irritable and pounding on her head, has projectile vomiting, and seems very sleepy for most of the last 3 days. What diagnostic testing does the healthcare professional prepare the child and parents for as the priority? a. Brain scanning with either CT or MRI b. Lumbar puncture with CSF cultures c. Developmental assessment d. Ophthalmologic assessment

Brain scanning with either CT or MR

What event is most likely to occur when a person experiences a closed head injury? a. Brief period of vital sign instability b. Cerebral edema throughout the cerebral cortex c. Cerebral edema throughout the diencephalon d. Disruption of axons extending from the diencephalon and brainstem

Brief period of vital sign instability

What is the final outcome of impaired cellular metabolism? a. Cellular alterations in the heart and brain b. Buildup of cellular waste products c. Cellular alterations in the vasculature structures and kidneys d. Impairment of urine excretion

Buildup of cellular waste products

Which vitamin facilitates the absorption of iron by the epithelial cells of the duodenum and jejunum? a. B6 b. C c. E d. B12

C

Where is the neurotransmitter, norepinephrine, secreted? a. Somatic nervous system b. Parasympathetic preganglion c. Sympathetic postganglion d. Parasympathetic postganglion

C Most postganglionic sympathetic fibers release norepinephrine (adrenaline). Norepinephrine is not secreted in the somatic nervous system, sympathetic preganglion, or parasympathetic postganglion.

Which nerves are capable of regeneration? a. Nerves within the brain and spinal cord b. Peripheral nerves that are cut or severed c. Myelinated nerves in the peripheral nervous system d. Unmyelinated nerves of the peripheral nervous system

C Nerve regeneration is limited to only myelinated fibers and generally occurs only in the peripheral nervous system.

What is the collateral blood flow to the brain provided by? a. Carotid arteries b. Basilar artery c. Circle of Willis d. Vertebral arteries

C The arterial circle (circle of Willis) is a structure credited with the ability to compensate for reduced blood flow from any one of the major contributors (collateral blood flow). The remaining options are not considered sources of collateral blood flow. The brain derives its arterial supply from two systems: the internal carotid arteries (anterior circulation) and the vertebral art eries (posterior circulation) with the carotid arteries supplying the majority of the blood flow. The basilar artery gives rise to three major paired arteries that perfuse the cerebellum and brainstem. The basilar artery also gives rise to small pontine arteries.

The brain receives approximately what percentage of the cardiac output? a. 80% b. 40% c. 20% d. 10%

C The brain receives approximately 20% of the cardiac output, or 800 to 1000 mL of blood flow per minute.

Which of the meninges closely adheres to the surface of the brain and spinal cord and follows the sulci and fissures? a. Dura mater b. Arachnoid c. Pia mater d. Inner dura

C The delicate pia mater closely adheres to the surface of the brain and spinal cord and even follows the sulci and fissures. The dura mater (meaning literally "hard mother") is composed of two layers, with the venous sinuses formed between them. The outermost layer forms the periosteum (endosteal layer) of the skull. The inner dura (meningeal layer) provides rigid membranes that support and separate various brain structures. The arachnoid mater is a spongy, weblike structure just underneath the dura mater that loosely follows the contours of the cerebral structures. The inner dura (meningeal layer) provides rigid membranes that support and separate various brain structures.

A healthcare professional is assessing a patient for dysfunction of cranial nerve VII. What assessment finding would confirm the professional's suspicion? a. Patient is unable to open mouth against resistance. b. Patient does not display intact gag reflex. c. Patient is able to smile only on one side of the face. d. Patient's tongue deviates to the right when sticking out.

C The inability to smile symmetrically is a sign of cranial nerve VII dysfunction (facial nerve). The inability to open the mouth against resistance is related to a dysfunction of cranial nerve V (trigeminal nerve). Loss of a gag reflex correlates with dysfunction of cranial nerve IX (glossopharyngeal nerve). Deviation in tongue position when the patient extends it is a sign of cranial nerve XII (hypoglossal nerve) dysfunction.

Thought and goal-oriented behaviors are functions of which area of the brain? a. Cerebellum b. Limbic system c. Prefrontal lobe d. Occipital lobe

C The prefrontal area is responsible for goal-oriented behavior (i.e., ability to concentrate), short-term or recall memory, and the elaboration of thought and inhibition on the limbic (emotional) areas of the CNS. The cerebellum is responsible for reflexive, involuntary fine-tuning of motor control and for maintaining balance and posture through extensive neural connections with the medulla and with the midbrain. The limbic system mediates emotion and long-term memory through connections in the prefrontal cortex (limbic cortex). Its principal effects are involved in primitive behavioral responses, visceral reaction to emotion, motivation, mood, feeding behaviors, biologic rhythms, and the sense of smell. The occipital lobe lies caudal to the parietooccipital sulci and superior to the cerebellum. The primary visual cortex is located in this region and receives input from the retinas. Much of the remainder of this lobe is involved in visual association.

Norepinephrine produces what primary response? a. Increased contractility of the heart b. Release of renin from the kidney c. Vasoconstriction d. Sleep cycle disturbance

C The primary response from norepinephrine is the stimulation of the α1-adrenergic receptors that cause vasoconstriction. Increased contractility and renin release are the result of β-adrenergic receptors. Dopamine is involved in regulating the sleep cycle.

Which type of ion directly controls the contraction of muscles? a. Sodium b. Potassium c. Calcium d. Magnesium

Calcium

How is the work function of a muscle usually calculated? a. Muscle type b. Calculating force x distance c. Foot pounds d. Kilograms

Calculating force x distance

Autonomic hyperreflexia-induced bradycardia is a result of stimulation of what? a. Sympathetic nervous system to β-adrenergic receptors to the sinoatrial node b. Carotid sinus to the vagus nerve to the sinoatrial node c. Parasympathetic nervous system to the glossopharyngeal nerve to the atrioventricular node d. Bundle branches to the α-adrenergic receptors to the sinoatrial node

Carotid sinus to the vagus nerve to the sinoatrial node

The body compensates for a rise in intracranial pressure by first displacing what? a. Cerebrospinal fluid b. Arterial blood c. Venous blood d. Cerebral cells

Cerebrospinal fluid

What is the most common infratentorial brain disease process that results in the direct destruction of the reticulating activation system (RAS)? a. Cerebrovascular disease b. Demyelinating disease c. Neoplasms d. Abscesses

Cerebrovascular disease

Spinal cord injuries occur most frequently in which region? a. Cervical and thoracic b. Thoracic and lumbar c. Lumbar and sacral d. Cervical and thoracic lumbar

Cervical and thoracic lumbar

What stimulus causes posthyperventilation apnea (PHVA)? a. Changes in PaO2 levels b. Changes in PaCO2 levels c. Damage to the forebrain d. Any arrhythmic breathing pattern

Changes in PaCO2 levels

A child has osteosarcoma and the healthcare team is assessing for metastases. What diagnostic study would be the priority? a. Pancreatic enzyme analysis b. Liver biopsy c. Chest x-ray or CT scan d. Brain MRI

Chest x-ray or CT scan

A patient has ankylosing spondylitis. Which description of this condition by the health care professional is most accurate? a. Chronic inflammatory disease with stiffening and fusion of the spine and sacroiliac joints b. Chronic systemic inflammatory disease that affects many tissues and organs c. State of abnormal and excessive bone resorption and formation d. Wide-spread and deep chronic muscle pain, fatigue, and tender points

Chronic inflammatory disease with stiffening and fusion of the spine and sacroiliac joints

Incomplete fusion of the nasomedial and intermaxillary process during the fourth week of embryonic development causes which condition in an infant? a. Cleft palate b. Sinus dysfunction c. Cleft lip d. Esophageal malformation

Cleft lip

A patient has been admitted to the hospital with a possible bowel obstruction. Which assessment finding would alert the healthcare professional that the obstruction is in the small vs. large intestine? a. Profuse vomiting of clear gastric fluids b. Vague dull hypogastric pain without vomiting c. Colicky pain caused by distention, followed by vomiting d. Excruciating pain, vomiting, and fever

Colicky pain caused by distention, followed by vomitting

What anchors articular cartilage to the underlying bone? a. Sharpey fibers b. Collagen fibers c. Glycoproteins d. Elastin fibers

Collagen fibers

A patient had a seizure that consisted of impaired consciousness and the appearance of a dreamlike state. How does the healthcare professional chart this episode? a. Focal seizure b. Complex focal seizure c. Tonic-clonic seizure d. Atonic seizure

Complex focal seizure

Simple febrile seizures are rare in infants before 9 months of age or in children older than 5 years of age. The seizure occurs with a rise in temperature higher than 39°C (102.2°F). The seizure is short (15 min or less). A healthcare professional teaches a parenting class that benign febrile seizures are characterized by what? a. A temperature higher than 38.5°C (101.3°F) b. Concurrent respiratory or ear infections c. Onset after the fifth year of life d. Episodes lasting 30 min or longer

Concurrent respiratory or ear infections

The professor asks a student to describe the movement of a diarthrosis joint. What answer by the student is best? a. Immovable joint b. Slightly moveable c. Variable movement d. Freely moveable

Freely moveable

Which of these is the role of nitric oxide (NO) in hemostasis? a. Stimulates the release of fibrinogen to maintain the platelet plug. b. Stimulates the release of clotting factors V and VII. c. Causes vasoconstriction and stimulates platelet aggregation. d. Controls platelet activation through in concert with prostacyclin.

Controls platelet activation through in concert with prostacyclin.

A patient has microcytic, hypochromic anemia. Which type of treatment or procedure does the healthcare professional discuss as a potential cure with the patient? a. Cord blood transplantation b. Scheduled infusion of gamma globulins c. Massive blood transfusions d. Repeated injections of Rho-GAM

Cord blood transplantation

A healthcare professional reads in the patient's chart and notes the patient has Cheyne-Stokes respirations. What clinical finding would the professional correlate with this condition? a. Sustained deep rapid but regular pattern of breathing b. Crescendo-decrescendo pattern of breathing, followed by a period of apnea c. Prolonged pause after the inspiratory period with occasional end-expiratory pause d. Completely random, irregular breathing pattern with pauses

Crescendo-decrescendo pattern of breathing, followed by a period of apnea

In osteomyelitis, bacteria gain access to the subperiosteal space in the metaphysis. What factor makes this route the easiest for bacteria to gain access to this area? a. Cortex of the bone in this area is porous or mazelike. b. Blood supply to the metaphysis is easily compromised. c. Macrophages and lymphocytes have limited access to the subperiosteal space. d. Bacteria usually spread down the medullary cavity of the bone.

Cortex of the bone in this area is porous or mazelike

A healthcare professional wants to estimate the total mass of muscle in a patient's body. What serum laboratory test should the professional evaluate? a. Albumin b. Blood urea nitrogen c. Creatinine d. Creatine

Creatinine

An insufficient dietary intake of which vitamin can lead to rickets in children? a. C b. B12 c. B6 d. D

D

A patient has a defect in the arachnoid villi. What finding would the healthcare professional expect to note? a. Production of excess cerebrospinal fluid (CSF) b. Ischemia in the choroid plexuses c. Cloudy cerebral spinal fluid on analysis d. Absorption of too little cerebrospinal fluid

D CSF is reabsorbed by means of a pressure gradient between the arachnoid villi and the cerebral venous sinuses. CSF is produced in the choroid plexuses in the lateral, third, and fourth ventricles. The arachnoid villi do not provide perfusion to the choroid plexuses. Cloudy CSF can indicate infection (meningitis).

Maintenance of a constant internal environment and the implementation of behavioral patterns are main functions of which area of the brain? a. Thalamus b. Epithalamus c. Subthalamus d. Hypothalamus

D Hypothalamic function falls into two major areas: (1) maintenance of a constant internal environment and (2) implementation of behavioral patterns. The epithalamus forms the roof of the third ventricle and composes the most superior portion of the diencephalon, which controls vital functions and visceral activities. The subthalamus flanks the hypothalamus laterally and serves as an important basal ganglia center for motor activities.

Parkinson disease is associated with defects in which area of the brain? a. Thalamus b. Medulla oblongata c. Cerebellum d. Substantia nigra

D Parkinson disease is a condition associated with defects of the substantia nigra and destruction of dopamine-secreting neurons. No current research supports the role of the thalamus, medulla oblongata, or the cerebellum in Parkinson disease.

Reflex activities concerned with heart rate, blood pressure, respirations, sneezing, swallowing, and coughing are controlled by which area of the brain? a. Pons b. Midbrain c. Cerebellum d. Medulla oblongata

D The medulla oblongata makes up the myelencephalon and is the lowest portion of the brainstem. Reflex activities, such as heart rate, respiration, blood pressure, coughing, sneezing, swallowing, and vomiting, are controlled in this area. The pons transmits information from the cerebellum to the brainstem between the two cerebellar hemispheres. The cerebellum is responsible for reflexive, involuntary fine-tuning of motor control and for maintaining balance and posture through extensive neural connections with the medulla (through the inferior cerebellar peduncle) and with the midbrain. The midbrain connects the forebrain to the hindbrain.

A patient in the clinic is worried about having fibromyalgia. For which symptoms should the health care professional assess the patient for? a. Hot, tender, and edematous muscle groups bilaterally b. Fasciculations of the upper and lower extremity muscles c. Exercise intolerance and painful muscle cramps d. Sensitivity at tender points and profound fatigue

Densitivity at tender point and profound fatigue

A student asks the healthcare professional to explain reperfusion injuries. What explanation by the professional is best? a. Tissue damage that can occur with blood transfusions b. Tissue destruction during rewarming in frostbite c. Damage from restored blood flow and exposure to oxygen d. Fluid overload from intravenous therapy that is too rapid

Damage from restored blood flow and exposure to oxygen

What type of posturing exists when a person with a severe closed head injury has all four extremities in rigid extension with the forearms in hyperpronation and the legs in plantar extension? a. Decorticate b. Decerebrate c. Spastic d. Cerebellar

Decerebrate

A student learns that a fatal burn injury has what effect on interleukins (ILs)? a. Decreases levels of IL-2 b. Decreases levels of IL-4 lymphocytes c. Increases levels of IL-6 d. Increases levels of IL-12

Decreases levels of IL-2

A student asks the professor to explain the characteristic appearance of stools in people with cystic fibrosis. What explanation by the professor is best? a. Bile ducts obstructed with mucus, leading to clay colored stools b. Mechanical obstruction causes narrow, ribbon-like stool c. Deficiency of pancreatic enzymes leads to steatorrhea. d. Ischemia due to sodium blockages causes bloody stools.

Deficiency of pancreatic enzymes leads to steatorrhea

What is plasmin's role in the clotting process? a. Inhibiting thrombin and antithrombin III (AT-III) b. Preventing the conversion of prothrombin to thrombin c. Shortening the fibrin strands to retract the blood clot d. Degrading the fibrin within blood clots

Degrades the fibrin within blood clots.

A person has been diagnosed with multiple sclerosis and asks the healthcare professional to explain the disease. What description by the professional is most accurate? a. Myelination of nerve fibers in the peripheral nervous system (PNS) b. Demyelination of nerve fibers in the CNS c. Development of neurofibrillary tangles in the CNS d. Inherited autosomal dominant trait with high penetrance

Demyelination of nerve fibers in the CNS

A baby demonstrates asymmetric pathological reflexes and microcephaly at a 9-month checkup. The baby appeared normal at birth. What action by the healthcare professional is best? a. Determine the baby's risk for developing an HIV infection since birth. b. Assess the baby for other signs of child abuse or neglect. c. Ask the mother if she uses drugs or alcohol in excess. d. Perform spinal cord imaging and other diagnostic studies.

Determine the baby's risk for developing an HIV infection since birth.

The joint that contains a synovial membrane that lines the inner joint capsule is an example of which type of joint? a. Amphiarthrosis b. Diarthrosis c. Synarthrosis d. Biarthrosis

Diarthrosis

How can abdominal pain that is visceral in nature best be described? a. Diffuse, vague, poorly localized, and dull b. It travels from a specific organ to the spinal cord. c. The pain lateralizes from only one side of the nervous system. d. Associated with the peristalsis of the gastrointestinal tract

Diffuse, vague, poorly localized and dull

A patient has been admitted for a possible small intestinal obstruction. What is the first sign the healthcare professional assesses for that would indicate the presence of this condition? a. Vomiting b. Dehydration c. Electrolyte imbalances d. Distention

Distention

The healthcare professional notes that the patient's intracranial pressure is 12 mmHg. What action should the professional take? a. Do nothing; this is a normal finding. b. Give medications to immediately lower the pressure. c. Give medication to immediately raise the pressure. d. Repeat the reading because the first one was inaccurate.

Do nothing; this is a normal finding.

Antiemetic agents, such as domperidone and metoclopramide, are antagonists for which receptors? a. 5-Hydroxytryptamine (5-HT) serotonin b. Histamine-2 c. Acetylcholine d. Dopamine

Dopamine

Antipsychotic drugs cause tardive dyskinesia by mimicking the effects of an increase of what? a. Dopamine b. Gamma-aminobutyric acid c. Norepinephrine d. Acetylcholine

Dopamine

Clinical manifestations of Parkinson disease are caused by a deficit in which of the brain's neurotransmitters? a. Gamma-aminobutyric acid b. Dopamine c. Norepinephrine d. Acetylcholine

Dopamine

What is the result of a Chiari type II malformation associated with a myelomeningocele? a. Upward displacement of the cerebellum into the diencephalon b. Motor and sensory lesions below the level of the myelomeningocele c. Downward displacement of the cerebellum, brainstem, and fourth ventricle d. Generalized cerebral edema and hydrocephalus

Downward displacement of the cerebellum, brainstem, and fourth ventricle

A newborn baby displays jaundice 20 hours after birth. What action by the healthcare professional is most appropriate? a. Draw blood to measure total bilirubin. b. Teach the patient about phototherapy. c. Obtain consent for blood transfusions. d. Prepare to administer vitamin K.

Draw blood to measure total bilirubin

A person in the health care clinic has gout. In order to prevent a common complication, what self-care measure does the health care professional teach the person about? a. Drinking plenty of water b. Splinting affected joints c. Eating more protein d. Avoiding hot weather

Drinking plenty of water

Generally, what is the first symptom of facioscapulohumeral muscular dystrophy? a. Inability to open the eyes completely b. Difficulty standing c. Drooping shoulders d. Facial pain

Drooping shoulders

Which protein, absent in muscle cells of Duchenne muscular dystrophy, mediates the anchoring of skeletal muscle fibers to the basement membrane? a. Syntrophin b. Laminin c. Dystrophin d. Troponin

Dystrophin

A patient reports dumping syndrome after a partial gastrectomy. What does the healthcare professional teach this patient? a. Eat small, frequent high-protein meals. b. This will need surgical correction. c. Take antacids 30 min before meals. d. Drink plenty of water with your meals.

Eat small, frequent high-protein meals

Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in children? a. Atelectasis and pneumonia b. Edema of the hands and feet c. Stasis ulcers of the hands, ankles, and feet d. Splenomegaly and hepatomegaly

Edema of the hands and feet

Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke? a. Hemorrhagic b. Thrombotic c. Embolic d. Lacunar

Embolic

Which intracerebral disease process is capable of producing diffuse dysfunction? a. Closed-head trauma with bleeding b. Subdural pus collections c. Neoplasm d. Embolic infarct

Embolic infarct

As the innervation ratio of a particular organ increases, what other property also increases? a. Control b. Movement c. Coordination d. Endurance

Endurance

After a cerebrovascular accident, a patient has been diagnosed with anosognosia--ignorance or denial of the existence of disease. What action by the healthcare professional would be most helpful? a. Provide a white board for the patient to write on. b. Ensure the patient has a safe environment. c. Provide physical therapy for strengthening exercises. d. Practice naming colors using flash cards.

Ensure the patient has a safe environment.

Which cells in the stomach secrete histamine? a. Oxyntic b. Chief c. D d. Enterochromaffin-like

Enterochromaffin-like

Which virus is associated with Burkitt lymphoma in African children? a. Cytomegalovirus b. Adenovirus c. Human papillomavirus d. Epstein-Barr virus

Epstein-Barr virus

What does the student learn about erythrocytes? a. Erythrocytes contain a nucleus, mitochondria, and ribosomes. b. Erythrocytes synthesize proteins. c. Erythrocytes have the ability to change shape to squeeze through microcirculation. d. Erythrocytes are more abundant in women than men.

Erythrocytes have the ability to change shape to squeeze through microcirculation.

A patient has chronic anemia associated with chronic renal failure. What substance does the healthcare professional tell the patient is needed to treat this anemia? a. Iron b. Erythropoietin c. Cobalamin (vitamin B12) d. Folate

Erythropoietin

The most common clinical manifestation of portal hypertension is what type of bleeding? a. Rectal b. Duodenal c. Esophageal d. Intestinal

Esophageal

A child has phenylketonuria (PKU). The healthcare professional educates the parents on the special diet needed, telling them that children with PKU are unable to synthesize what? a. Essential amino acid, phenylalanine, to tyrosine b. Renin, erythropoietin, and antidiuretic hormone c. Aldosterone, cortisol, and androgens d. Neurotransmitters gamma-aminobutyric acid (GABA) and acetylcholine

Essential amino acid, phenylalanine, to tyrosine

Which hormone exerts antiapoptotic effects on osteoblasts but proapoptotic effects on osteoclasts? a. Parathyroid hormone b. Glucocorticoid c. Growth hormone d. Estrogen

Estrogen

An intestinal obstruction at the pylorus or high in the small intestine causes metabolic alkalosis by causing which outcome? a. Gain of bicarbonate from pancreatic secretions that cannot be absorbed b. Excessive loss of hydrogen ions normally absorbed from gastric juices c. Excessive loss of potassium, promoting atony of the intestinal wall d. Loss of bile acid secretions that cannot be absorbed

Excessive loss of hydrogen ions normally absorbed from gastric juices

Cystic fibrosis is characterized by which symptom? a. Excessive mucus production b. Elevated blood glucose levels c. Low sodium content in perspiration d. Abnormally thin exocrine secretions

Excessive mucus production

Which four-step process correctly describes muscle contraction? a. Coupling, contraction, relaxation, excitation b. Contraction, relaxation, excitation, coupling c. Relaxation, excitation, coupling, contraction d. Excitation, coupling, contraction, relaxation

Excitation, coupling, contraction, relaxation

When diagnosed with hemolytic disease of the fetus and newborn (HDFN), why does the newborn develop hyperbilirubinemia after birth but not in utero? a. Excretion of unconjugated bilirubin through the placenta into the mother's circulation is no longer possible. b. Hemoglobin does not breakdown into bilirubin in the intrauterine environment. c. The liver of the fetus is too immature to conjugate bilirubin from a lipid-soluble to water-soluble form. d. The destruction of erythrocytes producing bilirubin is greater after birth.

Excretion of unconjugated bilirubin through the placenta into the mother's circulation is no longer possible

A patient reports joint stiffness with movement and joint pain in weightbearing joints that is usually relieved by rest. What treatment option does the health care professional discuss with the patient? a. Ways to decrease serum uric acid b. Administration of oral methotrexate c. Exercise and weight reduction d. Rapid intravenous hydration

Exercise and weight reduction

Which characteristic of type II (white fast-motor) muscle fibers does the student learn? a. Slow contraction speed b. Fast conduction velocities c. Profuse capillary supply d. Oxidative metabolism

Fast conduction velocities

Which form of iron (Fe) can be used in the formation of normal hemoglobin? a. Fe+ b. Fe2+ c. Fe3+ d. Fe4+

Fe2+

Why does fetal hemoglobin have a greater affinity for oxygen than adult hemoglobin? a. The fetus does not have its own oxygen supply and must rely on oxygen from the maternal vascular system. b. The fetus has two y-chains on the hemoglobin, rather than two b-chains as in the adult. c. Fetal hemoglobin interacts less readily with diphosphoglycerate (DPG), which inhibits hemoglobin-oxygen binding. d. Fetal hemoglobin production occurs in the vessels and liver rather than in the bone marrow as in the adult.

Fetal hemoglobin interacts less readily with diphosphoglycerate (DPG), which inhibits hemoglobin-oxygen binding.

Cirrhosis causes intrahepatic portal hypertension in children as a result of which mechanism? a. Fibrosis that increases the resistance to blood flow within the portal system b. Increased pressure from the twisting of the common bile ducts c. Development of collateral circulation within the portal system d. Shunting of fluid to the spleen or abdomen

Fibrosis that increases the resistance to blood flow within the portal system

When does fetal erythrocyte production shift from the liver to the bone marrow? a. Fourth month of gestation b. Fifth month of gestation c. Eighth month of gestation d. At birth

Fifth month of gestation

A patient has damage to the lower pons and medulla. What finding does the healthcare professional associate with this injury? a. Flexion with or without extensor response of the lower extremities b. Extension response of the upper and lower extremities c. Extension response of the upper extremities and flexion response of the lower extremities d. Flaccid response in the upper and lower extremities

Flaccid response in the upper and lower extremities

Why is prolonged diarrhea more severe in children than it is in adults? a. Less water is absorbed from the colon in children. b. Fluid reserves are smaller in children. c. Children have a higher fluid volume intake. d. Children have diarrhea more often than adults.

Fluid reserves are smaller in children

A healthcare professional advises a pregnant woman to add supplements of which nutrient to her diet to prevent birth defects? a. Iron b. Vitamin C c. Zinc d. Folate

Folate

A blunt-force injury to the forehead would result in a coup injury to which region of the brain? a. Frontal b. Temporal c. Parietal d. Occipital

Frontal

A class of students has learned about contributing factors to duodenal ulcers. What statement indicates to the professor that the students need a review? a. Bleeding from duodenal ulcers causes hematemesis or melena. b. Gastric emptying is slowed, causing greater exposure of the mucosa to acid. c. The characteristic pain begins 30 min to 2 hours after eating d. Duodenal ulcers occur with greater frequency than other types of peptic ulcers.

Gastric emptying is slowed, causing greater exposure of the mucosa to acid

Hemoglobin S (HbS) is formed in sickle cell disease as a result of which process? a. Deficiency in glucose 6-phosphate dehydrogenase (G6PD) that changes hemoglobin A (HbA) to HbS. b. Genetic mutation in which two amino acids (histidine and leucine) are missing. c. Genetic mutation in which one amino acid (glutamate) is replaced by another (valine). d. Autoimmune response in which one amino acid (proline) is detected as an antigen by abnormal immunoglobulin G (IgG).

Genetic mutation in which one amino acid (glutamate) is replaced by another (valine)

A healthcare professional is educating an expectant parent class. Which skeletal deformity does the professional tell them is normal at birth but generally disappears by years of age? a. Genu varum (bowleg) b. Genu valgum (knock knee) c. Equinovarus (clubfoot) d. Pes planus (flat feet)

Genu varum (bowleg)

Which disorder is characterized by damage to the mucosa of the duodenum and jejunum and impaired secretion of secretin, cholecystokinin, and pancreatic enzymes? a. Wilson disease b. Cystic fibrosis c. Gluten-sensitive enteropathy d. Galactosemia

Gluten-sensitive enteropathy

Which type of joint holds teeth in the maxilla or mandible? a. Amphiarthrosis b. Diarthrosis c. Synarthrosis d. Gomphosis

Gomphosis

Which assessment finding marks the end of spinal shock? a. Return of blood pressure and heart rate to normal b. Gradual return of spinal reflexes c. Return of bowel and bladder function d. Evidence of diminished deep tendon reflexes and flaccid paralysis

Gradual return of spinal reflexes

How does hemolytic disease of the fetus and newborn (HDFN) cause acquired congenital hemolytic anemia? a. HDFN develops when hypoxia or dehydration causes the erythrocytes to change shapes, which are then recognized as foreign and removed from circulation. b. HDFN is an alloimmune disease in which the mother's immune system produces antibodies against fetal erythrocytes, which are recognized as foreign and removed from circulation. c. HDFN develops when the polycythemia present in fetal life continues after birth, causing the excessive number of erythrocytes to be removed from circulation. d. HDFN is an autoimmune disease in which the fetus's immune system produces antibodies against fetal erythrocytes, which are recognized as foreign and removed from circulation.

HDFN is an alloimmune disease in which the mother's immune system produces antibodies against fetal erythrocytes, which are recognized as foreign and removed from circulation

What is the basic structural unit in compact bone? a. Small channels called canaliculi b. Osteocytes within the lacunae c. Tiny spaces within the lacunae d. Haversian system

Haversian system

A student has learned about aging and the musculoskeletal system. What statement by the student indicates a need for more study on the topic? a. Haversian system erodes, the canals nearest the marrow cavity widen, and the endosteal cortex converts to spongy bone. b. The remodeling cycle increases because of a decreased ability of the basic multicellular units to resorb and deposit bone. c. Cartilaginous rigidity increases because of decreasing water content and decreasing concentrations of glycosaminoglycans. d. Muscle ribonucleic acid (RNA) synthesis declines, although the regenerative function of muscle tissue is reportedly normal in older adults.

Haversian system erodes, the canals nearest the marrow cavity widen, and the endosteal cortex converts to spongy bone

Which bones are affected in Legg-Calvé-Perthes disease? a. Heads of the femur b. Distal femurs c. Heads of the humerus d. Distal tibias

Heads of the femur

What is the most critical aspect in correctly diagnosing a seizure disorder and establishing its cause? a. Computed tomographic (CT) scan b. Cerebrospinal fluid analysis c. Skull x-ray studies d. Health history

Health history

The release of catecholamine by the adrenal glands provides which compensatory mechanism in hypovolemic shock? a. Interstitial fluid moves out of the vascular compartment. b. Systemic vascular resistance is decreased. c. Heart rate is increased. d. Water excretion is increased.

Heart rate is increased

What is the primary source of physiologic iron? a. Transferrin from plasma b. Pepsin form pepsinogen c. Bile from bilirubin d. Heme from animal protein

Heme from animal protein

A patient has thalassemia major. After receiving multiple blood transfusions over the last several months, what complication does the healthcare professional assess the patient for? a. Hemochromatosis b. Iron deficiency anemia c. Vitamin C depletion d. Rh autoimmunity

Hemochromatosis

A child has sickle cell disease (SCD). What treatment or therapy does the healthcare professional discuss with the parents and child? a. Hydroxyurea b. Low-dose daily aspirin c. Heparin injections d. Genetic testing

Hydroxyurea

Which condition does a burn injury create for an extended period? a. Hypervolemia b. Hypermetabolism c. Hyponatremia d. Hypotension

Hypermetabolism

A healthcare professional is planning a community event to reduce risk of cerebrovascular accident (CVA) in high risk groups. Which group would the professional target as the priority? a. Insulin-resistant diabetes mellitus b. Hypertension c. Polycythemia d. Smoking

Hypertension

What is the most common type of shock in children? a. Hypovolemic b. Cardiogenic c. Neurogenic d. Septic

Hypovolemic

A student has studied secondary multiple organ dysfunction syndrome (MODS). What substance does the student learn is least likely to stimulate the normal endothelial cells to change to a proinflammatory state? a. Interleukin (IL)-1 b. IL-4 c. IL 6 d. Tumor necrosis factor

IL-4

Hemophilia B is caused by a deficiency of which clotting factor? a. V b. VIII c. IX d. X

IX

A woman who is positive for hepatitis B is in labor. What action by the healthcare professional is most appropriate? a. Draw blood for a drug screen. b. Encourage the mother to bottle feed. c. Immunize the newborn within 12 hours. d. Discuss poor infant survival.

Immunize the newborn within 12hrs

In infectious mononucleosis (IM), what does the Monospot test detect? a. Immunoglobulin E (IgE) b. Immunoglobulin M (IgM) c. Immunoglobulin G (IgG) d. Immunoglobulin A (IgA)

Immunoglobulin M (IgM)

The student learns that which mechanism causes organ injury in primary multiple organ dysfunction syndrome (MODS)? a. Impaired immune response b. Impaired glucose use c. Impaired perfusion d. Impaired ventilation

Impaired perfusion

A hospitalized patient's lab work is as follows: WBC 2000, bands 14.8%, and segmented neutrophils 5. The healthcare professional calculates the patient's absolute neutrophil count (ANC). What action does the professional take next? a. Implements protocols to prevent life-threatening infections b. Encourages the patient to limit any visitors for the present time c. Does nothing; this is a normal ANC for the white cell count d. Holds the patient's medications until the ANC returns to normal

Implements protocols to prevent life-threatening infections

To assess for osteogenesis imperfecta, which laboratory result would the healthcare professional expect to find? a. Increased phosphorus b. Decreased calcium c. Increased alkaline phosphatase d. Decreased total protein

Increased alkaline phosphatase

What is the cause of polycythemia in the fetus? a. Fetal hemoglobin has a greater affinity for oxygen as a result of diphosphoglycerate (DPG). b. The fetus has a different hemoglobin structure of two a- and two b-chains rather than two a-and two b-chains. c. Increased erythropoiesis occurs in response to the hypoxic intrauterine environment. d. The lungs of the fetus are undeveloped and unable to diffuse oxygen adequately to the pulmonary capillaries.

Increased erythropoiesis occurs in response to the hypoxic intrauterine environment.

The healthcare professional explains to a student that the most serious outcome resulting from limited glycogen stores in children who have been seriously burned is which of these? a. Poor wound healing b. Increased morbidity c. Decreased immunity d. Loss of adipose tissue stores

Increased morbidity

A health care professional who works with older women understands that which changes are believed to play a significant role in the development of age-related bone loss? a. Increased oxidative stress and increased intracellular reactive oxygen species b. Hypoparathyroidism c. Increased body weight d. Decreased formation and short life span of osteoclasts

Increased oxidative stress and increased intracellular reactive oxygen species

Which clinical manifestation of septic shock confirms an elevation in immune system response? a. Tachycardia b. Increased white blood cell count c. Low respiratory rate d. Hypothermia

Increased white blood cell count

A child has a disorder that resulted in the failure of bones to ossify, resulting in soft bones and skeletal deformity. What treatment plan does the healthcare professional discuss with the parents? a. Extremely careful handling b. Increasing vitamin D intake c. Revascularization d. Containment and motion therapy

Increasing vitamin D intake

A student asks the healthcare professional to explain the pathophysiologic process of alcoholic cirrhosis. What statement by the professional would not be consistent with complete knowledge about this process? a. Inflammation and damage leading to cirrhosis begin in the bile canaliculi. b. Alcohol is transformed to acetaldehyde, which promotes liver fibrosis. c. Mitochondrial function is impaired, decreasing oxidation of fatty acids. d. Acetaldehyde inhibits export of proteins from the liver.

Inflammation and damage leading to cirrhosis begin in the bile canaliculi

What is the primary pathologic alteration resulting from ankylosing spondylitis (AS)? a. Inflammation of the bursa b. Inflammation of the long bones c. Inflammation of fibrocartilaginous joints of the vertebrae d. Inflammation of the small hand and feet bones

Inflammation of fibrocartilagnious joints of the vertebrae

In children, how are most intracranial tumors located? a. Infratentorially b. Supratentorially c. Laterally d. Posterolaterally

Infratentorially

A patient has primary immune thrombocytopenic purpura (ITP) and is hospitalized after a bleeding episode. What treatment does the healthcare provider anticipate being ordered for this patient? a. Blood transfusions b. Infusion of IVIG c. Anticoagulants d. Large doses of folic acid

Infusion of IVIG

A child has a burn injury. What does the healthcare provider assess for when determining the child's chance of surviving? a. Immunosuppression b. Hypermetabolism c. Inhalation injury d. Hypertrophic scarring

Inhalation injury

A healthcare professional is teaching a community group about inherited disorders. What pattern of inheritance does the professional describe for sickle cell disease? a. Inherited X-linked recessive disorder b. Inherited autosomal recessive disorder c. Disorder initiated by hypoxemia and acidosis d. Disorder that is diagnosed equally in men and women

Inherited autosomal recessive disorder

The drug heparin acts in hemostasis by which processes?

Inhibiting thrombin and antithrombin III (AT-III)

Which term is used to identify a condition in which the developing colon remains in the upper right quadrant instead of moving to its normal location? a. Intestinal malrotation b. Ileocecal displacement c. Duodenal obstruction d. Pyloric stenosis

Intestinal malrotation

A patient has an acute burn injury. What type of treatment for shock will the healthcare professional anticipate for this patient? a. Intravenous fluids b. Antibiotics c. Intra-aortic balloon pump d. Antihistamines and steroids

Intravenous fluids

What is the most common cause of insufficient erythropoiesis in children? a. Folic acid deficiency b. Iron deficiency c. Hemoglobin abnormality d. Erythrocyte abnormality

Iron deficiency

Which mother does the healthcare professional prepare to administer Rh immune globulin (RhoGAM) to? a. Is Rh-positive and the fetus is Rh-negative b. Is Rh-negative and the fetus is Rh-positive c. Has type A blood and the fetus has type O d. Has type AB blood and the fetus has type B

Is Rh-negative and the fetus is Rh-positive

In which type of contraction does the muscle maintain a constant tension as it moves? a. Isotonic b. Isometric c. Hypertonic d. Hypotonic

Isotonic

A 33-pound child is in shock. Which fluid bolus should the healthcare professional prepare to administer to this child? a. Hypotonic fluid, 150 mL b. Hypotonic fluid, 300 mL c. Isotonic fluid, 150 mL d. Isotonic fluid, 300 mL

Isotonic fluid 300ml

What does a healthcare professional explain to a student about myasthenia gravis? a. It is an acute autoimmune disease. b. It affects the nerve roots. c. It may result in adrenergic crisis. d. It causes muscle weakness.

It causes muscle weakness.

The professor is quizzing student on synovial fluid. Which statement shows the students need further instruction? a. It contains protein polysaccharides to repair the synovial membrane after injury. b. It lubricates the joint surfaces, allowing ease of movement. c. It nourishes the pad of the articular cartilage. d. It contains leukocytes to phagocytize joint debris and microorganisms.

It contains protein polysaccharides to repair the synovial membrane after injury

A patient has leukemia. The healthcare professional explains to a patient about the significance of hyperdiploidy. What statement by the professional is most accurate? a. It indicates a good prognosis. b. It indicates a poor prognosis. c. It limits treatment options. d. Hyperdiploidy demonstrates remission.

It indicates a good prognosis.

A patient has been diagnosed with Paget disease. What explanation of the disease does the health care professional provide the patient? a. "It is a severe infection in your bones." b. "It is a problem with bone resorption and formation." c. "It is a condition in which your bones become soft." d. "It's a disorder of altered energy production in muscle."

It is a problem with bone resorption and formation

What does the student learn about the pain experienced with Legg-Calvé-Perthes disease? a. Elbow and upper and lower arm pain is aggravated by activity and relieved by rest. b. Knee, inner thigh, and groin pain is described as a continuous ache and relieved by antiinflammatory drugs. c. Knee, inner thigh, and groin pain is aggravated by activity and relieved by rest. d. Elbow and upper and lower arm pain is described as a continuous ache and relieved by antiinflammatory drugs.

Knee, inner thigh, and groin pain is aggravated by activity relieved by rest

A patient has been hospitalized with Guillain-Barré syndrome (GBS). The patient asks how this could have occurred. What response by the healthcare professional is best? a. It is often preceded by a viral illness. b. It is due to a genetic defect in acetylcholine. c. It could be caused by a brain tumor. d. It is often transmitted by family pets.

It is often preceded by a viral illness.

The student wants to know how the clinical manifestations and onset of juvenile idiopathic arthritis (JIA) differ from those of rheumatoid arthritis (RA) in adults. What answer by the healthcare professional is best? a. JIA begins insidiously with systemic signs of inflammation. b. JIA predominantly affects large joints. c. JIA has more severe joint pain than adult RA. d. JIA has a rapid onset of generalized aches as the first symptom.

JIA predominantly affects large joints

The clinical manifestations of dyskinetic cerebral palsy include what? a. Increased muscle tone and prolonged primitive reflexes b. Exaggerated deep tendon reflexes, clonus, and rigidity of extremities c. Scoliosis, contractures, and stiffness of trunk muscles d. Jerky uncontrolled and abrupt fine musculoskeletal movements

Jerky uncontrolled and abrupt fine musculoskeletal movements

What term is used to identify an interlacing bundle of dense, white fibrous tissue that is richly supplied with nerves, blood vessels, and lymphatic vessels? a. Procallus b. Joint capsule c. Hematoma d. Elastin fibers

Joint capsule

What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in the brain? a. Kernicterus b. Icterus neonatorum c. Jaundice d. Icterus gravis neonatorum

Kernicterus

A herniation of which disk will likely result in motor and sensory changes of the lateral lower legs and soles of the feet? a. L2 to L3 b. L3 to L5 c. L5 to S1 d. S2 to S3

L5 to S1

Microinfarcts resulting in pure motor or pure sensory deficits are the result of which type of stroke? a. Embolic b. Hemorrhagic c. Lacunar d. Thrombotic

Lacunar

Where in the small intestines are lymphocytes, plasma cells, and macrophages produced? a. Brush border b. Microvilli c. Lamina propria d. Crypts of Lieberkühn

Lamina propria

Which component is found in synovial fluid? a. Protein polysaccharides b. Water c. Leukocytes d. Chondrocytes

Leukocytes

To quickly assess a patient's nervous system for dysfunction, what assessment should the healthcare professional perform as the priority? a. Size and reactivity of pupils b. Pattern of breathing c. Motor response d. Level of consciousness

Level of consciousness

A person comes to the healthcare clinic and reports night sweats and fever. The healthcare professional obtains a chest x-ray which shows a mediastinal mass. What other assessment or diagnostic test does the professional provide as a priority? a. Listen to heart sounds. b. Assess the patient's skin. c. Arrange for familial DNA testing. d. Test blood for anemia.

Listen to heart sounds.

Where are Kupffer cells located? a. Kidneys b. Liver c. Pancreas d. Spleen

Liver

Which structure synthesizes clotting factors and the vitamin K necessary for hemostasis? a. Colon b. Spleen c. Gallbladder d. Liver

Liver

Bone death as a result of osteomyelitis is due to what? a. Formation of immune complexes at the site of infection b. Localized ischemia c. Tumor necrosis factor-alpha (TNF-a) and interleukin 1 (IL-1) d. Impaired nerve innervation at the site of infection

Localized ischemia

A child is in cardiogenic shock and the parents ask why the child has hepatomegaly and periorbital edema. What explanation by the healthcare professional is best? a. Mass vasodilation as a result of chemical mediators released from the myocardium b. Low cardiac output and systemic venous congestion c. Tissue damage to the myocardium, causing increased capillary permeability d. Reduced renal perfusion, stimulating the RAAS system

Low cardiac output and systemic venous congestion

A professor has taught the students about the pathogenesis of abdominal pain. Which statement by a student indicates the professor needs to review the material? a. Chemical mediators, such as histamine, bradykinin, and serotonin, produce abdominal pain. b. Edema and vascular congestion produce abdominal pain by stretching. c. Ischemia, caused by distention of bowel obstruction or mesenteric vessel thrombosis, produces abdominal pain. d. Low concentrations of anaerobes, such as Streptococci, Lactobacilli, Staphylococci, Enterobacteria, and Bacteroides, produce abdominal pain.

Low concentrations of anaerobes, such as streptococci lactobacilli, Staphylococci, Enterobacteria and Bacteroids produce abdominal pain.

A patient has portal hypertension-induced splenomegaly. Which lab value would the healthcare professional associate with this condition? a. Low white blood cell count b. Low platelet count c. High red cell count d. High hemoglobin and hematocrit

Low platelet count

The existence of regular, deep, and rapid respirations after a severe closed head injury is indicative of neurologic injury to what? a. Lower midbrain b. Pontine area c. Supratentorial d. Cerebral area

Lower midbrain

What change to the hematologic system is related to age? a. Platelet adhesiveness decreases. b. Lymphocyte function decreases. c. Cellular immunity increases. d. Erythrocyte reproduction accelerates.

Lymphocyte function decreases.

At birth, the diagnosis of cerebral palsy (CP) may be made based on what factor? a. Brain trauma b. Prematurity c. Major brain malformation d. Genetic defect

Major brain malformation

The healthcare professional plans care for a child in shock. What are the primary goals for the treatment of shock? a. Maximizing oxygen delivery and minimizing oxygen demand b. Maintaining hydration and adequate urinary output c. Supporting all facets of the cardiovascular system d. Maintaining all vital signs within normal functioning ranges

Maximizing oxygen delivery and minimizing oxygen demand

An infant is brought to the emergency department by parents who report that the baby's fontanels seem to be bulging outward. What action by the healthcare provider is most appropriate? a. Assess the baby for recent trauma to the head. b. Measure the head circumference and plot it on a growth chart. c. Prepare the baby for a lumbar puncture and blood cultures. d. Determine how much fluid the baby had in the last 24 hours.

Measure the head circumference and plot it on a growth chart.

Which term is used to identify an intestinal obstruction caused by meconium formed in utero that is abnormally sticky and adheres firmly to the mucosa of the small intestine? a. Meconium cecum b. Meconium ileus c. Meconium obstruction d. Meconium vivax

Meconium ileus

Where in the brain is the vomiting center located? a. Hypothalamus b. Medulla oblongata c. Pons d. Midbrain

Medulla Oblongata

The ileum and jejunum are suspended by folds of the peritoneum that contain an extensive vascular and nervous network. What are these folds called? a. Ligament of Treitz b. Mesentery c. Auerbach folds d. Lamina propria

Mesentary

What is the role of the normal intestinal bacterial flora? a. Metabolizing bile salts, estrogens, and lipids b. Breaking down proteins into amino acids c. Facilitating the motility of the colon d. Metabolizing aldosterone and insulin

Metabolizing bile salts, estrogens, and lipids

The student learns that after puberty, the epiphyseal plate calcifies and the epiphysis merges with which structure? a. Epiphyseal line b. Epiphyseal plate c. Metaphysis d. Articular cartilage

Metaphysis

Which hemoglobin is made from oxidized ferric iron (Fe3+) and lacks the ability to bind oxygen? a. Deoxyhemoglobin b. Oxyhemoglobin c. Methemoglobin d. Glycosylated hemoglobin

Methemoglobin

What is the formation of water-soluble molecules to facilitate the absorption of the byproducts of lipid hydrolysis accomplished by? a. Micelles b. Phospholipase c. Chylomicrons d. Colipase

Micelles

Most aphasias are associated with cerebrovascular accidents involving which artery? a. Anterior communicating b. Posterior communicating c. Circle of Willis d. Middle cerebral

Middle cerebral

What is physiologic jaundice in a newborn caused by? a. Reabsorption of bilirubin in the small intestine b. Impaired hepatic uptake and excretion of bilirubin c. Increased bilirubin production d. Mild conjugated (indirect-reacting) hyperbilirubinemia

Mild conjugated (indirect-reaction) hyperbilirubemia

What are blood cells that differentiate into macrophages known as? a. Monocytes b. Neutrophils c. Eosinophils d. Basophils

Monocytes

Which blood cell type is elevated at birth and through the preschool years, but decreases to adult levels afterward? a. Monocytes b. Platelets c. Neutrophils d. Lymphocytes

Monocytes

Which statement indicates that a student needs more information about muscles? a. Muscle comprises 50% of an adult's body weight and 40% of a child's body weight. b. Muscle is 75% water, 20% protein, and 5% organic and inorganic compounds. c. Muscle contains 32% of all protein stores for energy and metabolism. d. Muscles are encased in fascia.

Muscle comprises 50% of an adults body weight and 40% of a child's body weight

In which disorder are acetylcholine receptor antibodies (IgG antibodies) produced against acetylcholine receptors? a. Guillain-Barré syndrome b. Multiple sclerosis c. Myasthenia gravis d. Parkinson disease

Myasthenia gravis

What causes renal failure after electrical burns in children? a. Cytokines are released after the damaged tissue. b. Immature kidneys are unable to compensate for the electrical burn. c. Cardiac output is reduced. d. Myoglobin is released from damaged muscles.

Myoglobin is released from damaged muscles

Which pathophysiologic alteration precedes crush syndrome after prolonged muscle compression? a. Muscle ischemia b. Myoglobinuria c. Volkmann contracture d. Neural injury

Myoglobinuria

Without prior exposure to an antigen, which cells are able to destroy some types of tumor cells and some virus-infected cells? a. Lymphocytes b. Plasma cells c. Megakaryocytes d. Natural killer (NK) cells

Natural killer (NK) cells

What is the cause of functional dysphagia? a. Intrinsic mechanical obstruction b. Extrinsic mechanical obstruction c. Tumor d. Neural or muscular disorders

Neural of muscular disorders

What stimulates the respiratory burst and production of highly toxic free radicals in the multiple organ dysfunction syndrome (MODS)? a. Neutrophils adhering to the endothelium b. Activation of the complement cascade c. Release of prostaglandins, thromboxanes, and leukotrienes d. Activation of the fibrinolytic system

Neutrophils adhering to the endothelium

A patient is in the intensive care unit and has intercranial pressure (ICP) monitoring. The patient's ICP is 17 mmHg. The healthcare professional notes that the chart indicates the patient is now in stage 1 intracranial hypertension--which causes compensation via vasoconstriction and external compression of the venous system occur in an attempt to decrease the ICP. What assessment finding does the professional associate with this condition? a. Rapid spike in measured ICP b. No significant change in ICP readings c. Restlessness and subtle breathing and pupil changes d. A widened pulse pressure and bradycardia

No significant change in ICP readings

A blunt-force injury to the forehead would result in a contrecoup injury to which region of the brain? a. Frontal b. Temporal c. Parietal d. Occipital

Occipital

Dilation of the ipsilateral pupil following uncal herniation is the result of pressure on which cranial nerve (CN)? a. Optic (CN I) b. Abducens (CN VI) c. Oculomotor (CN III) d. Trochlear (CN IV)

Oculomotor (CN III)

A patient reports feeling constipated. When assessing this patient, how often should the patient report bowel movements to be considered within the normal range? a. Once a day b. Once every 2 days c. Once a week d. Once every 2 weeks

Once a week

What is the most common malignant bone tumor diagnosed during childhood? a. Chondrosarcoma b. Fibrosarcoma c. Ewing Sarcoma d. Osteosarcoma

Osteosarcoma

An infant has been diagnosed with intussusception and the student asks the healthcare professional to explain the condition. What explanation by the professional is most accurate? a. Poor colonic motility due to a problem in the parasympathetic nervous system b. The colon stays in the upper right quadrant instead of moving to its normal location. c. One part of the intestine telescopes into another section of the intestine. d. Fibrosis increases the resistance to blood flow within the portal system.

One part of the intestine telescopes into another sections of the intestine

A patient has AIDS and reports fever, clumsiness, difficulty with balance and walking, and trouble speaking. What treatment does the healthcare professional educate the patient about? a. Radiation therapy b. Chemotherapy c. Oral pyrimethamine d. Surgery

Oral pyrimethamine

A patient is brought to the Emergency Department after being found by neighbors. The patient says she has been lying on the floor in the house for 3 days. What action by the health care professional is best? a. Order a serum creatine kinase (CK) level b. Obtain an x-ray of the patient's hips c. Arrange for the patient to have a DXA scan d. Perform the Fracture Risk Assessment

Order serum creatine kinase (CK) level

What type of diarrhea is a result of lactase deficiency? a. Motility b. Osmotic c. Secretory d. Small-volume

Osmotic

What is the effect of low plasma albumin? a. Clotting factors decrease, thus increasing the chance of prolonged bleeding. b. Fewer immunoglobulins are synthesized, thus impairing the immune function. c. Less iron is stored, thus increasing the incidence of iron deficiency anemia. d. Osmotic pressure decreases; thus water moves from the capillaries to the interstitium.

Osmotic pressure decreases; thus water moves from the capillaries to the interstitium.

Which bone cells produce osteocalcin when stimulated by 1,25-dihydroxyvitamin D and synthesize osteoid? a. Osteoclasts b. Osteocytes c. Fibrocytes d. Osteoblasts

Osteoblasts

Which glucoprotein is believed to inhibit calcium phosphate precipitation and play a part in bone resorption by recruiting osteoclasts? a. Osteocalcin b. Osteonectin c. Laminin d. Osteopontin

Osteocalcin

In osteoporosis, the receptor activator of nuclear factor kB (RANK) activates what? a. Osteoclast apoptosis b. Osteoblast survival c. Osteoprotegerin d. Osteoclast survival

Osteoclast survival

Which bone cell secretes hydrochloric acid to help dissolve bone minerals and collagenase, thus aiding in the digestion of collagen? a. Osteocytes b. Osteoblasts c. Osteoclasts d. Osteophytes

Osteoclasts

Which bone cells are large and multinucleated and contain lysosomes filled with hydrolytic enzymes? a. Osteoblasts b. Osteoclasts c. Osteocytes d. Fibrocytes

Osteoclasts

Which cells function to maintain bone matrix? a. Osteoclasts b. Osteocytes c. Osteoblasts d. Osteophytes

Osteocytes

A patient has a bone density T score of -2.8. What diagnosis does the health care professional educate the patient on? a. Osteoplasia b. Osteoporosis c. Osteopenia d. Osteomalacia

Osteoporosis

What causes the crystallization within the synovial fluid of the joint affected by gouty arthritis? a. Reduced excretion of purines b. Overproduction of uric acid c. Increase in the glycosaminoglycan levels d. Overproduction of proteoglycans

Overproduction of uric acid

Which sign or symptom is a very late indication of developmental dysplasia of the hip? a. Asymmetry of the gluteal or thigh folds b. Leg-length discrepancy c. Waddling gait d. Pain

Pain

A child has chronic hepatitis and the healthcare professional wants to assess the child for portal hypertension. What action by the professional is most appropriate? a. Listen to the child's lung sounds b. Assess for pedal edema c. Palpate the child's abdomen d. Inspect the skin for jaundice

Palpate the child's abdomen

What causes a person with cystic fibrosis to experience an exocrine pancreatic insufficiency? a. Pancreatic ducts are obstructed with mucus. b. Impaired blood supply to the pancreas causes ischemia. c. A genetically impaired pancreas is unable to produce digestive enzymes. d. The pancreas has a volvulus at the ampulla of Vater.

Pancreatic ducts are obstructed with mucus

A student learns what information about acute pancreatitis? a. Autoimmune process with IgG attacking pancreatic acinar cells b. It is usually a severe disease with a high mortality rate. c. Pancreatic enzymes autodigest pancreatic cells and tissues. d. Oversecretion of pancreatic enzymes and malnutrition

Pancreatic enzyme autodigest pancreatic cells and tissues

A child has cystic fibrosis (CF). Which medication does the healthcare professional teach the parents about? a. Salt tablets b. Pancreatic enzymes c. Antihypertensives d. Antibiotics

Pancreatic enzymes

Congenital aganglionic megacolon (Hirschsprung's disease) involves inadequate motility of the colon caused by neural malformation of which nervous system? a. Central b. Parasympathetic c. Sympathetic d. Somatic

Parasympathetic

Which gastric cells secrete hydrochloric acid and intrinsic factor? a. Parietal b. Chief c. G d. D

Parietal

Which enzyme breaks down protein-forming polypeptides in the stomach? a. Acetylcholine b. Pepsin c. Gastrin d. Secretin

Pepsin

Until the skeleton matures and adult stature is reached, where does growth in the length of bone occur? a. Epiphyseal line b. Physeal plate c. Epiphyseal cartilage d. Metaphyseal plate

Physeal plate

Which of these are formed elements of the blood that are not cells but are disk-shaped cytoplasmic fragments essential for blood clotting? a. Monocytes b. Platelets c. Macrophages d. Erythrocytes

Platelets

Which midbrain dysfunction causes pupils to be pinpoint size and fixed in position? a. Diencephalon dysfunction b. Oculomotor cranial nerve dysfunction c. Dysfunction of the tectum d. Pontine dysfunction

Pontine dysfunction

Which defect of neural tube closure is most common? a. Anterior b. Posterior c. Lateral d. Midline

Posterior

What area of the brain mediates the executive attention functions? a. Limbic b. Prefrontal c. Parietal d. Occipital

Prefrontal

Local signs and symptoms of Hodgkin disease-related lymphadenopathy are a result of what? a. Pressure and ischemia b. Pressure and obstruction c. Inflammation and ischemia d. Inflammation and pressure

Pressure and obstruction

A patient's chart notes receptive aphasia. What does the healthcare professional understand about this patient's abilities related to speech? a. Speak in made up words. b. Produce verbal speech, but not comprehend language. c. Comprehend speech, but not verbally respond. d. Neither respond verbally nor comprehend speech.

Produce verbal speech, but not comprehend language.

The stage of healing in the bone that involves procallus formation entails which process? a. Formation of a hematoma that allows the development of a fibrin network b. Production of granulation tissue by fibroblasts, capillary buds, and osteoblasts c. Development of a primitive bone matrix termed woven bone d. Remodeling of the periosteal and endosteal bone surfaces

Production of granulation tissue by fibroblasts, capillary buds, and osteoblasts

Exposure to which substance protects the mucosal barrier of the stomach? a. Prostaglandins b. Acetylcholine c. Helicobacter pylori d. Regurgitated bile

Prostaglandins

Which statement describes a neuroregulin? a. Chemical mediator that initiates signals from the anterior horn cell of the spinal card to the axon of motor nerve branches of groups of muscle fibers b. Neurotransmitter that provides a means of reporting changes in length, tension, velocity, and tone in muscles c. Proteoglycan secreted by neurons, which increases acetylcholine receptors d. Mechanoreceptor that lies parallel to muscle fibers and responds to muscle stretching

Proteoglycan secreted by neurons, which increases acetylcholine receptors

What controls the movement of synovial fluid through cartilage? a. Cartiloregulins b. Hyaluronate c. Proteoglycans d. Chondroitin

Proteoglycans

A healthcare professional is caring for a patient diagnosed with aphasia. What action by the professional would be best in working with this patient? a. Provide physical therapy. b. Provide speech therapy. c. Provide special thickened foods. d. Provide balance activities.

Provide speech therapy.

A patient is in status epilepticus. These seizures can last longer than 30 minutes resulting in hypoxia to the brain In addition to giving medication to stop the seizures, what would the healthcare professional place highest priority on? a. Facilitating a CT scan of the head b. Providing oxygen c. Assessing for brain death d. Assessing for drug overdose

Providing oxygen

The pathophysiologic presentation of gout is closely linked to the metabolism of which chemical? a. Purine b. Pyrimidine c. Vitamin E d. Amino acid

Purine

Increased gastrin secretion by the mother in the last trimester of pregnancy may cause which condition in the infant? a. Pyloric stenosis b. Meconium ileus c. Esophageal atresia d. Galactosemia

Pyloric stenosis

After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which mechanism? a. Excessive relaxation of gastric and vascular smooth muscles b. Postoperative hemorrhage c. Concentrated food bolus, causing hyperglycemia d. Rapid gastric emptying

Rapid gastric empyting

What do diffuse axonal injuries (DAIs) of the brain often result in? a. Reduced levels of consciousness b. Mild but permanent dysfunction c. Fine motor tremors d. Visual disturbances

Reduced levels of consciousness

A patient has a temporary displacement of two bones causing the bone surfaces to partially lose contact with each other. What treatment does the health care professional prepare the patient for? a. Internal fixation b. Reduction and immobilization c. Calcium phosphate cement d. Low-density ultrasound

Reduction and immobilization

An infant suddenly develops abdominal pain, becomes irritable, and draws up the knees. Vomiting occurs soon afterward. The mother reports that the infant passed a normal stool, followed by one that looked like currant jelly. What treatment does the healthcare professional prepare the infant for? a. Corrective surgery b. Reduction enema c. Gastric decompression d. Anal dilation

Reduction enema

What indicates that spinal shock is terminating? a. Voluntary movement below the level of injury b. Reflex emptying of the bladder c. Paresthesia below the level of injury d. Decreased deep tendon reflexes and flaccid paralysis

Reflex emptying of the bladder

Which type of osteoporosis would a person develop after having the left leg in a cast for 8 weeks to treat fracture of the tibia and fibula? a. Iatrogenic b. Regional c. Idiopathic d. Osteoblastic

Regional

A patient in the clinic has calcium crystals that are associated with chronic gout. How does the professional document this finding? a. Stones b. Spurs c. Tophi d. Nodes

Tophi

A student asks for an explanation of rhabdomyolysis. What response by the professor is best? a. Paralysis of skeletal muscles, resulting from an impaired nerve supply b. Smooth muscle degeneration, resulting from ischemia c. Lysis of skeletal muscle cells through the initiation of the complement cascade d. Release of myoglobin from damaged striated muscle cells

Release of myoglobin from damaged striated muscle cells

A healthcare professional suspects a patient is brain dead. How would the professional assess for brain death? a. Determine if the patient can make voluntary movements. b. Perform tests to assess if the patient is in a coma. c. Remove the patient's ventilator to see if spontaneous breathing occurs. d. Monitor the patient for eye movements that seem purposeful.

Remove the patient's ventilator to see if spontaneous breathing occurs.

An infant was born with hemolytic disease of the fetus and newborn (HDFN). What treatment does the healthcare professional anticipate for this baby? a. Administration of intravenous fluids to dilute the blood b. Replacement transfusion of Rh-positive blood not contaminated with anti-Rh antibodies c. Performance of a splenectomy to prevent the destruction of abnormal erythrocytes d. Replacement transfusion of Rh-negative erythrocytes

Replacement transfusion of Rh-positive blood not contaminated with anti-Rh antibodies

A patient has a spinal cord injury at C4. What should the healthcare professional assess as the priority in this patient? a. Blood pressure b. Respirations c. Pulse d. Temperature

Respirations

A child has Duchenne muscular dystrophy. What complication does the healthcare professional teach the parents is most important to control? a. Respiratory infection b. Joint contractures c. Urinary tract infection d. Fractures from falling

Respiratory infection

Multiple sclerosis and Guillain-Barré syndrome are similar in that they both do what? a. Result from demyelination by an immune reaction. b. Cause permanent destruction of peripheral nerves. c. Result from inadequate production of neurotransmitters. d. Block acetylcholine receptor sites at the myoneuronal junction.

Result from demyelination by an immune reaction.

Cognitive operations cannot occur without the effective functioning of what part of the brain? a. Pons b. Medulla oblongata c. Reticular activating system d. Cingulate gyrus

Reticular activating system

What does diagnostic criteria for a persistent vegetative state include? a. Absence of eye opening b. Lack of subcortical responses to pain stimuli c. Roving eye movements with visual tracking d. Return of vegetative autonomic functions: sleep-wake cycles, normalization of respiratory and digestive system functions

Return of vegetative autonomic functions: sleep-wake cycles, normalization of respiratory and digestive system functions

A healthcare professional gets an update on four children. Which one should the professional assess as the priority? a. 6-month old, respiratory rate of 42 breaths/min b. 2-year-old, respiratory rate of 39 breaths/min c. Preschooler, respiratory rate of 26 breaths/min d. School-aged child, respiratory rate of 38 breaths/min

School-aged child, respiratory rate of 38 breaths/min

A person who has cholera (Vibrio cholerae) would be expected to have which type of diarrhea? a. Osmotic b. Secretory c. Small volume d. Motility

Secretory

Which condition is best defined as a clinical syndrome involving a systemic response to infection, which is manifested by two or more of the systemic inflammatory response syndrome criteria? a. Bacteremia b. Sepsis c. Septicemia d. Septic shock

Sepsis

A patient is admitted to the hospital with multiple myeloma (MM). Which diagnostic test should the healthcare professional assess as the priority? a. Serum potassium level b. Serum calcium level c. Bone scan or limb x-rays d. Bone marrow biopsy

Serum calcium level

A patient has finally been diagnosed with amyotrophic lateral sclerosis (ALS) after seeing several physicians. The patient expresses frustration that the diagnosis has taken so long. What information can the healthcare professional give to the patient about this situation? a. Many diseases cause weakness and fatigue. b. Only upper motor neurons are involved. c. Several nerves are connected to each muscle. Both upper and lower motor neurons are involved. The disease involves a disturbance in motor, not sensory function. d. Lack of sensation makes it hard to describe.

Several nerves are connected to each muscle. Both upper and lower motor neurons are involved. The disease involves a disturbance in motor, not sensory function.

The healthcare professional is caring for a woman whose baby died of hydrops fetalis. How does the professional explain this condition to a student? a. Inherited condition where the RBC skeletal membrane is abnormal b. Hyperbilirubinemia that occurs shortly after birth and can affect the brain c. Hemolytic disease of the fetus and newborn d. Severe intrauterine anemia that leads to edema of the entire body

Severe intrauterine anemia that leads to edema of the entire body

A patient in the Emergency Department has either a tendon or ligament injury. What pain description from the patient would the health care professional associate with these injuries? a. Dull and diffuse, persisting over the distribution of the tendon or ligament b. Sharp and localized, persisting over the distribution of the tendon or ligament c. Pins-and-needle sensations that occur distal to the injury with movement d. Intermittent and aching, occurring over the distribution of the tendon or ligament

Sharp and localized, persisting over the distribution of the tendon or ligament

The student learns that Langerhans cells are only found in which organ? a. Skin b. Intestinal lining c. Kidney d. Thyroid

Skin

Glucose transport enhances the absorption of which electrolyte? a. Sodium b. Phosphate c. Potassium d. Chloride

Sodium

Which gastric hormone inhibits acid and pepsinogen secretion, as well as decreases the release of gastrin? a. Motalin b. Histamine c. Somatostatin d. Acetylcholine

Somatostatin

By which structure are mature erythrocytes removed from the bloodstream? a. Liver b. Lymph nodes c. Thymus d. Spleen

Spleen

Fetal hematopoiesis occurs primarily in which structure? a. Gut b. Spleen c. Bone marrow d. Thymus

Spleen

What is the tear in a ligament referred to as? a. Fracture b. Strain c. Disunion d. Sprain

Sprain

A newborn is diagnosed with osteomyelitis. What organism does the healthcare professional prepare to treat? a. Staphylococcus aureus b. Escherichia coli c. Group B streptococcus d. Bacillus anthracis

Staphylococcus aureus

What is the most common cause of obstructive hydrocephalus in infants? a. Obstructed arachnoid villi b. Stenosis of the aqueduct of Sylvius c. Excessive production of cerebrospinal fluid d. Impaired cerebrospinal fluid circulation in the subarachnoid space

Stenosis of the aqueduct of Sylvius

What is the role of thromboxane A (TXA2) in the secretion stage of hemostasis? a. Stimulates the synthesis of serotonin. b. Promotes vasodilation. c. Stimulates platelet aggregation. d. Promotes formation of cyclooxygenase.

Stimulates platelet aggregation.

A health care professional is providing education to a group of seasonal athletes. What type of fracture does the professional warn them to avoid? a. Stress b. Greenstick c. Insufficiency d. Pathologic

Stress

Rhabdomyosarcoma can develop in which type of muscle? a. Cardiac b. Smooth c. Involuntary d. Striated

Striated

What is a primary defect in osteoarthritis? a. Stromelysin and acid metalloproteinase breakdown articular cartilage. b. Immunoglobulin G (IgG) destroys the synovial membrane. c. Synovial membranes become inflamed. d. Cartilage-coated osteophytes create bone spurs.

Stromelysin and acid metalloproteinase breakdown articular cartilage

Which cerebral vascular hemorrhage causes meningeal irritation, photophobia, and positive Kernig and Brudzinski signs? a. Intracranial b. Subarachnoid c. Epidural d. Subdural

Subarachnoid

What does the student learn distinguishes kwashiorkor from marasmus? a. All nutrients, proteins, fats, and carbohydrates are reduced in kwashiorkor. b. Physical growth of children is stunted in kwashiorkor but not in marasmus. c. Muscle wasting, diarrhea, low hemoglobin, and infection characterize kwashiorkor. d. Subcutaneous fat, hepatomegaly, and fatty liver are present in kwashiorkor.

Subcutaneous fat, hepatomegaly, and fatty liver are present in kwashiorkor

What diagnosis is given to parents when their infant's hip maintains contact with the acetabulum but is not well seated within the hip joint? a. Dislocatable hip b. Subluxated hip c. Dislocated hip d. Subluxable hip

Subluxated hip

Tremors at rest, rigidity, akinesia, and postural abnormalities are a result of the atrophy of neurons in which part of the brain? a. Caudate that produces serotonin b. Putamen that produces gamma-aminobutyric acid c. Substantia nigra that produces dopamine d. Hypothalamus that produces acetylcholine

Substantia nigra that produces dopamine

After a cerebrovascular accident, a man is unable to either feel or identify a comb with his eyes closed. What is this an example of? a. Agraphia b. Tactile agnosia c. Anosognosia d. Prosopagnosia

Tactile agnosia - result of damage to the parietal lobe

In adults, how are most intracranial tumors located? a. Infratentorially b. Supratentorially c. Laterally d. Posterolaterally

Supratentorially

The hyaline cartilage joints between the ribs and sternum are examples of which type of joint? a. Synchondrosis b. Symphysis c. Gomphosis d. Syndesmosis

Synchrondrosis

A healthcare professional working with children learns that which is the most common congenital skeletal defect of the upper extremity? a. Vestigial tabs b. Paget disease c. Rickets d. Syndactyly

Syndactyly

Which patient finding would lead the health care professional to assess the patient for inflammatory joint disease? a. Unilateral joint involvement b. Normal joint synovial fluid c. Absence of synovial membrane inflammation d. Systemic symptoms of inflammation

Systemic symptoms of inflammation

Which clinical finding is considered a diagnostic indicator for an arteriovenous malformation (AVM)? a. Systolic bruit over the carotid artery b. Decreased level of consciousness c. Hypertension with bradycardia d. Diastolic bruit over the temporal artery

Systolic bruit over the carotid artery

The mutation of which gene is an early event associated with the pathogenetic origin of esophageal cancer? a. KRAS b. TP53 c. myc d. HER2

TP53

A patient who sustained a cervical spinal cord injury 2 days ago suddenly develops severe headache and blurred vision. What should the healthcare professional do? a. Give the patient a glass of cool water. b. Give the patient some pain medication. c. Take the patient's blood pressure and pulse. d. Facilitate the patient having a head CT scan

Take the patient's blood pressure and pulse.opriate.

Which dyskinesia involves involuntary movements of the face, trunk, and extremities? a. Paroxysmal b. Tardive c. Hyperkinesia d. Cardive

Tardive

A healthcare professional wants to volunteer for a community education project to help prevent spinal cord injury. What activity would the professional most likely volunteer for? a. Teaching school aged children bicycle safety b. Teaching stretching to high school athletes c. Teaching adults good body mechanics for lifting d. Teaching older adults how to prevent trip-and-fall events

Teaching older adults how to prevent trip-and-fall events

By what mechanism does intussusception cause an intestinal obstruction? a. Telescoping of part of the intestine into another section of intestine b. Twisting the intestine on its mesenteric pedicle c. Loss of peristaltic motor activity in the intestine d. Fibrin and scar tissue that attaches to the intestinal omentum

Telescoping of part of the intestine into another section of intestine

The healthcare professional directs a student to assess a teen who has Osgood-Schlatter disease. What assessment finding does the student anticipate for this disorder? a. Lateral epicondylitis of the elbow b. Inflammation of the anterior cruciate ligament c. Bursitis of the subscapular bursa in the glenohumeral joint d. Tendinitis of the anterior patellar tendon

Tendinitis of the anterior patellar tendon

Which structure attaches skeletal muscle to bone? a. Tendon b. Ligament c. Bursa d. Mesentery

Tendon

Soon after birth, a newborn has cord blood drawn which shows hemoglobin of 28.2 mg/dL. What does the healthcare professional understand about this finding? a. The baby suffered from hypoxia in utero. b. This is a normal finding from cord blood. c. The newborn needs a blood transfusion. d. The infant's bone marrow is immature.

The baby suffered from hypoxia in utero.

Improper reduction or immobilization of a fractured femur can result in which outcome after cast removal? a. The muscles around the fracture site are weak. b. The fracture requires 6 to 8 weeks of physical therapy. c. The skin under the cast is dry and flaky. d. The bone is not straight.

The bone is not straight

The student asks the professor why water and electrolytes are transported in both directions through tight junctions and intercellular spaces rather than across cell membranes. What response by the professor is best? a. The intercellular hydrostatic pressure is inadequate to push the water and electrolytes across the cell membranes. b. A balance of cations and ions among the electrolytes on each side of the cell membranes cannot be maintained. c. The epithelial cell membranes are formed of lipids that are hydrophobic and therefore repel water. d. Receptors on those cell membranes are occupied with a diffusion of amino acids and monosaccharides.

The epithelial cell membranes are formed of lipids that are hydrophobic and therefore repel water

Which statement best describes the gastrointestinal tract? a. The gastrointestinal tract is a muscular tube that transports food from the mouth to the stomach. b. The gastrointestinal tract is a hollow tube that extends from the mouth to the anus. c. The gastrointestinal tract is a baglike structure that propels partially digested food (chyme). d. The gastrointestinal tract is 5 m long and consists of three segments.

The gastrointestinal tract is a hollow tube that extends from the mouth to the anus

When does uncal herniation occur? a. The hippocampal gyrus shifts from the middle fossa through the tentorial notch into the posterior fossa. Results in compression of ipsilateral third cranial nerve impairing parasymptomatic function b. The diencephalon shifts from the middle fossa straight downward through the tentorial notch into the posterior fossa. c. The cingulate gyrus shifts under the falx cerebri. d. A cerebellar tonsil shifts through the foramen magnum

The hippocampal gyrus shifts from the middle fossa through the tentorial notch into the posterior fossa. Results in compression of ipsilateral third cranial nerve impairing parasymptomatic function

Why does a person who has a spinal cord injury experience faulty control of sweating? a. The hypothalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system. b. The thalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system. c. The hypothalamus is unable to regulate body heat as a result of damage to the parasympathetic nervous system. d. The thalamus is unable to regulate body heat as a result of damage to spinal nerve roots.

The hypothalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system.

Which statement, made by a student, is correct regarding the state of the intestinal tract at birth? a. The intestinal tract is colonized by Escherichia coli. b. The intestinal tract is sterile. c. Clostridium welchii is present in but in very small numbers. d. Streptococcus colonization in the intestinal tract has begun.

The intestinal tract is sterile

A child has scoliosis with a 40-degree curvature of the spine, and the parent is worried about pulmonary involvement. What statement by the healthcare professional is most appropriate? a. "Scoliosis is a bone disorder and does not affect the lungs." b. "Yes, we should obtain pulmonary function studies soon." c. "Scoliosis severe enough to involve the lungs would be fatal." d. "The lungs aren't affected until the curvature is over 80 degrees."

The lungs aren;t affected until the curvature is over 80 degrees

What is the consequence of a splenectomy? a. The level of iron in circulation increases. b. Antibody production increases to improve immune function. c. The number of defective cells in circulation increases. d. The number of clotting factors increases.

The number of defective cells in circulation increases.

What happens to the original bone during the second phase of bone remodeling? a. The original bone is replaced. b. It hardens. c. The original bone is resorbed. d. It is synthesized.

The original bone is resorbed

A healthcare professional reads in a patient's chart that the patient shows behaviors suggestive of neurofibrillary tangles. What information does the healthcare professional plan to provide the spouse? a. The patient will probably develop seizures. b. The patient will lose all motor function. c. The patient will have a gradual decline in function. d. The patient's intracranial pressure will rise.

The patient will have a gradual decline in function.

Which description is consistent with chronic myelogenous leukemia (CML)? a. Defects exist in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein. b. Leukocytosis and a predominance of blast cells characterize the bone marrow and peripheral blood. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes. c. B cells fail to mature into plasma cells that synthesize immunoglobulins. d. The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL1.

The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL1.

A professor has taught the class about giant cell bone tumors. Which statement by a student would require the professor to review the material? a. Giant cell tumors are an overexpression of genes including osteoprotegerin ligand (OPGL). b. The tumors are malignant, solitary, and irregularly shaped. c. Giant cell tumors are typically located in the epiphysis in the femur, tibia, radius, and humerus. d. They are slow-growing tumors that extend over the articular cartilage.

The tumore are malignant, solitary and irregularly shaped

What is the significance of a high level of interleukin 1 (IL-1) in a patient who has experienced severe burns? a. Prognosis is poor. b. Antibiotic therapy is required. c. Urinary function is improved. d. They are less at risk for death.

They are less at risk for death

A healthcare professional assesses that a child's capillary refill time is 4 sec. What does the healthcare professional evaluate that finding to mean? a. The child is in shock. b. The child must have septic shock. c. The child has compensated shock. d. This finding is normal.

This child is in shock

How many stools per day are considered the upper limits of normal? a. Two b. Three c. Five d. Seven

Three

Cerebral edema is an increase in the fluid content of what part of the brain? a. Ventricles b. Tissue c. Neurons d. Meninges

Tissue

What is the function of erythrocytes? a. Tissue oxygenation b. Hemostasis c. Infection control d. Allergy response

Tissue oxygenation

What is the function of Sharpey fibers? a. To anchor the outer layer of the periosteum to the inner layer b. To contain blood vessels and nerves on the outer layer of the periosteum c. To help attach tendons and ligaments to the periosteum d. To attach muscles to the periosteum

To help attach tendons and ligaments to the periosteum

What is the function of the synovial membrane's type A cells within the intima? a. To release mast cells, initiating the inflammatory process after joint injury b. To ingest and remove bacteria and debris by phagocytosis in the joint cavity c. To secrete hyaluronate, a binding agent that gives synovial fluid its viscous quality d. To store fat cells and glycogen, providing adenosine triphosphate for joint activity

To ingest and remove bacteria debris by phagocytosis in the joint cavity

A student is perplexed that in a patient with multiple organ dysfunction syndrome (MODS), no infectious source has been found. What statement by the healthcare professional best describes this phenomenon? a. Death of organs b. Translocation of bacteria c. Maldistribution of blood flow d. Massive inflammatory response

Translocation of bacteria

A patient has been diagnosed with reflux esophagitis (GERD). What instruction by the healthcare professional is most appropriate? a. Exercise soon after eating to increase gastric emptying. b. Try these proton-pump inhibitors for 2 weeks. c. You need to schedule an upper GI endoscopy soon. d. Over-the-counter antiemetics work well for this condition.

Try these proton-pump inhibitors for 2 weeks

The process of conjugation of bilirubin in the liver is best described as which transformation? a. Unconjugated (fat-soluble) bilirubin into urobilinogen b. Unconjugated (fat-soluble) bilirubin into conjugated (water-soluble) bilirubin c. Conjugated (water-soluble) bilirubin into unconjugated (fat-soluble) bilirubin d. Conjugated (water-soluble) bilirubin into urobilinogen

Unconjugated (fat-soluble) bilirubin into conjugated (water-soluble) bilirubin

What assessment finding would indicate to the healthcare professional that the patient is no longer in burn shock? a. Blood pressure 100/58 mmHg b. Pulse rate 98 beats/min c. Respiratory rate 24 breaths/min d. Urine output 35 mL/hour for 4 hours

Urine output 35 ml/hr for 4hrs

To determine a child's response to fluid therapy for shock, the healthcare professional should monitor which measurements as the priority? a. Hematocrit and hemoglobin levels b. Urine output and specific gravity c. Blood pressure and pulse d. Arterial blood gases and heart rate

Urine output and specific gravity

What process is capable of increasing both intrathoracic and intraabdominal pressure, thereby facilitating defecation? a. Relaxation of the internal anal sphincter b. Intestinal peristalsis c. Valsalva maneuver d. Ileogastric reflex

Valsalva maneuver

An adolescent has been diagnosed with osteochondrosis. How does the healthcare professional describe the pathophysiology to the teen? a. Imbalance between calcitonin and parathyroid hormone b. Nutritional deficiency of calcium and phosphorus c. Bacterial infection of the bone d. Vascular impairment and trauma to bone

Vascular impairment and trauma to bone

What is the clinical hallmark of neurogenic shock as a result of the overstimulation of the parasympathetic nervous system? a. Vasoconstriction b. Vasodilation c. Increased metabolism d. Respiratory distress

Vasodilation

A student asks the professor to explain the basics of vasogenic shock. What statement by the professor is best? a. The outcome of widespread hypersensitivity to an allergen b. Bacteremia combined with systemic inflammatory response c. Inability to get adequate blood to tissues and end organs d. Vasodilation from an imbalance between the two nervous systems

Vasodilation from an imbalance between the two nervous systems

What type of cerebral edema occurs when permeability of the capillary endothelium increases after injury to the vascular structure? a. Cytotoxic b. Interstitial c. Vasogenic d. Ischemic

Vasogenic

A student asks what the cause of structural scoliosis is. What explanation by the professor is accurate? a. Poor posture b. Vertebral rotation c. Poor calcium absorption d. Intrauterine trauma

Vertebral rotation

Vomiting is associated with central nervous system (CNS) injuries that compress which of the brain's anatomic locations? a. Vestibular nuclei in the lower brainstem b. Floor of the third ventricle c. Any area in the midbrain d. Diencephalon

Vestibular nuclei in the lower brainste,

A professor has taught a class of students about the characteristics of vitamin B12. Which statement by a student demonstrates a need for more education? a. Vitamin B12 is absorbed in the terminal ileum. b. Vitamin B12 is absorbed in its free (unbound) form in small amounts. c. Vitamin B12 is necessary for platelet maturation. d. Vitamin B12 binds to intrinsic factor.

Vitamin B12 is necessary for platelet maturation

Which water-soluble vitamin is absorbed by passive diffusion? a. Vitamin B6 b. Vitamin B1 c. Vitamin K d. Folic acid

Vitamin B6

A child has iron deficiency anemia. In addition to iron supplements, what else does the healthcare professional educate the parents on giving the child? a. Vitamin A b. Magnesium c. Vitamin C d. Zinc

Vitamin C

An infant has gluten-sensitive enteropathy and the parents ask the healthcare professional to explain why the baby bruises so easily. The professional explains that the baby has which deficit? a. Vitamin K deficiency from fat malabsorption b. Bone marrow function depression c. Iron, folate, and B12 deficiency anemias d. Prescribed daily warfarin

Vitamin K deficiency from fat malabsorption

The outer layer of the periosteum contains blood vessels and nerves that penetrate the inner structures of the bone by way of which structure? a. Volkmann canals b. Canaliculi c. Sharpey canals d. Trabeculae

Volkmann canals

A professor has been teaching a class on gastrointestinal function. Which statement by a student indicates the need for more education? a. Within 30 min of eating, the gallbladder forces bile into the stomach. b. Cholinergic branches of the vagus nerve mediate gallbladder contraction. c. Cholecystokinin provides hormonal regulation of gallbladder contraction. d. The sphincter of Oddi controls the flow of bile from the gallbladder.

Within 30min of eating, the gallbladder forces bile into the stomach

A student asks the professor why hemophilia A is seen mostly in men. The professor explains that hemophilia A is considered to be what type of inherited disorder? a. Autosomal dominant b. Autosomal recessive c. X-linked recessive d. X-linked dominant

X-linked recessive

The healthcare professional explains to a student that glucose 6-phosphate dehydrogenase (G6PD) deficiency is what type of inherited disorder? a. X-linked dominant b. X-linked recessive c. Autosomal dominant d. Autosomal recessive

X-linked recessive

A child has Duchenne muscular dystrophy and the parents want to know how this occurred. Which statement by the healthcare professional is most accurate? a. X-linked recessive inheritance b. Common SMN1 gene abnormality c. Autosomal dominant inheritance d. Inheritance is not well defined

X-linked recessive inheritance

A patient has pernicious anemia and asks the healthcare professional to explain the disease. Which statement by the professional is most accurate? a. The lack of certain foods in your diet b. Your body cannot absorb vitamin B12. c. You are not getting enough vitamin C. d. Your bone marrow has stopped working.

Your body cannot absorb vitamin B12.

A patient asks the healthcare professional to describe the cause of gastroesophageal reflux disease (GERD). What response by the professional is best? a. Excessive production of hydrochloric acid b. Zone of low pressure of the lower esophageal sphincter c. Presence of Helicobacter pylori in the esophagus d. Reverse muscular peristalsis of the esophagus

Zone of low pressure of the lower esophageal sphincter

A pregnant woman is seen for the first time at 6 months' gestation and has not taken prenatal vitamins. The healthcare professional educates the woman on the need for a blood test specifically to assess what substance? a. Total protein b. Culture c. a-Fetoprotein d. C-reactive protein

a-Fetoprotein

A student asks the professor what the most common pathophysiologic process is that triggers aplastic anemia (AA). What response by the professor is most accurate? a. Autoimmune disease against hematopoiesis by activated cytotoxic T (Tc) cells b. Malignancy of the bone marrow in which unregulated proliferation of erythrocytes crowd out other blood cells c. Autoimmune disease against hematopoiesis by activated immunoglobulins d. Inherited genetic disorder with recessive X-linked transmission

a. Autoimmune disease against hematopoeisis by activated cytotoxic T (Tc) cells

A healthcare professional is reviewing a patient's laboratory results and sees that the patient has a low reticulocyte count and a high iron level. Which type of anemia does the professional associate these findings with? a. Folate deficiency anemia b. Iron deficiency anemia c. Hemolytic anemia d. Anemia of chronic disease

a. Folate deficiency anemia

A healthcare professional has educated a student on folic acid. Which statement by the student indicates that more teaching is needed? a. Folic acid absorption is dependent on the enzyme folacin. b. Folic acid is stored in the liver. c. Folic acid is essential for RNA and DNA synthesis within erythrocytes. d. Folic acid is absorbed in the upper small intestine.

a. Folic acid absorption is dependent on the enzyme folacin

Which of these describes how the body compensates for anemia? a. Increasing rate and depth of breathing b. Decreasing capillary vasoconstriction c. Hemoglobin holding more firmly onto oxygen d. Kidneys releasing more erythropoietin

a. Increase rate and depth of breathing

A patient is 8 hours postoperative after a long orthopedic procedure. The student asks why this patient is at particular risk of developing a thromboembolism. What response by the healthcare professional is best? a. Patients tend to have venous stasis from orthopedic operations. b. Anesthetic agents often cause an immune response against clotting factors. c. Endothelial damage occurs and repair is slowed by postoperative pain. d. Atherosclerotic build up causes turbulent blood flow leading to clots

a. Patients tend to have venous stasis from orthopedic operations

How is the effectiveness of vitamin B12 therapy measured? a. Reticulocyte count b. Serum transferring c. Hemoglobin d. Serum vitamin B12

a. Reticulocyte count

An adult patient has been hospitalized with thrombocytopenia with a platelet count of 8000/mm3 . What action by the healthcare professional is most appropriate? a. Tell the patient not to get out of bed without assistance. b. Prepare the patient for transfusions of whole blood. c. Educate the patient on side effects of heparin. d. Nothing; this finding is normal in an adult.

a. Tell the patient not to get out of bed without assistance

What does treatment for polycythemia vera involve? a. Therapeutic phlebotomy and radioactive phosphorus b. Restoration of blood volume by plasma expanders c. Administration of cyanocobalamin d. Blood transfusions

a. Therapeutic phlebotomy and radioactive phosphorus

A healthcare professional in an urban clinic is seeing a patient who has iron deficiency anemia (IDA). What question by the professional is most appropriate to assess for the cause of IDA? a. "How many times a week do you have iron-rich foods?" b. "Have you ever noticed any blood in your stool?" c. "Do you have a history of heart valve replacement?" d. "Have you had any recent viral infections?"

b. "Have you ever noticed any blood in your stool?"

What term is used to describe the capacity of some erythrocytes to vary in size, especially in relationship to some anemias? a. Poikilocytosis b. Isocytosis c. Anisocytosis d. Microcytosis

c. Anisocytosis

A patient has been hospitalized for a large deep vein thrombosis and states he is the third person in his family to have this condition in the last 2 years. What response by the healthcare professional is most appropriate? a. "This condition is not transmitted genetically." b. "We can test your blood for factor V Leiden." c. "Were they all men or both men and women?" d. "Familial thromboses tend to be very severe."

b. "We can test your blood for factor V Leiden."

An allogenic bone marrow transplantation remains the preferred method for treating which anemia? a. Polycythemia vera b. Aplastic c. Sideroblastic d. Anemia of chronic disease (ACD)

b. Aplastic

A healthcare professional works with recent refugees. A mother brings in her children who have been diagnosed with iron deficiency anemia. What action by the professional is most appropriate? a. Educate the mother on an iron-rich diet. b. Arrange to test for parasitic infections. c. Explain the weekly iron infusions. d. Teach the mother to give iron supplements.

b. Arrange to test for parasitic infections

A student asks the professor to explain the jaundice that accompanies hemolytic anemia. Which statement is by the professor is most accurate? a. Erythrocytes are destroyed in the spleen. b. Heme destruction exceeds the liver's ability to conjugate and excrete bilirubin. c. The patient has elevations in aspartate transaminase (AST) and alanine transaminase (ALT). d. The erythrocytes are coated with an immunoglobulin.

b. Heme destruction exceeds the liver's ability to conjugate and excrete bilirubin

The paresthesia that occurs in vitamin B12 deficiency anemia is a result of which of these? a. Reduction in acetylcholine receptors in the postsynaptic nerves b. Myelin degeneration in the spinal cord c. Destruction of myelin in peripheral nerves d. Altered function of neurons in the parietal lobe

b. Myelin degeneration in the spinal cord

A patient in the healthcare clinic reports fatigue, weakness, and dyspnea, as well as pale conjunctiva of the eyes and brittle, concave nails. What assessment by the healthcare professional is most appropriate for the suspected anemia? a. Blood pressure and apical pulse b. Oral mucus membranes and tongue c. Ability to swallow foods and liquids d. Skin and sclera for normal coloration

b. Oral mucus membranes and tongue

Which of these classified as a megaloblastic anemia? a. Iron deficiency b. Pernicious c. Sideroblastic d. Hemolytic

b. Pernicious

In aplastic anemia (AA), pancytopenia develops as a result of what? a. Suppression of erythropoietin to produce adequate amounts of erythrocytes b. Suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes c. Lack of DNA to form sufficient quantities of erythrocytes, leukocytes, and thrombocytes d. Lack of stem cells to form sufficient quantities of leukocytes

b. Suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes

A patient has defective secretion of the intrinsic factor leading to anemia. What treatment option does the healthcare professional discuss with the patient? a. Increasing iron sources in the diet such as red meat. b. Vitamin B12 injections initially given once a week. c. Having relatives tested for bone marrow donation. d. Better control of the patient's underlying disorder.

b. Vitamin B12 injections initially given once a week

Which anemia produces small, pale erythrocytes? a. Folic acid b. Hemolytic c. Iron deficiency d. Pernicious

c. Iron deficiency

A health care professional determines that the student needs more education when the student makes which statement about treating bone infection? a. Bone contains multiple microscopic channels that are impermeable to the cells and biochemicals of the body's natural defenses. b. Microcirculation of bone is highly vulnerable to damage and destruction by bacterial toxins, leading to ischemic necrosis of bone. c. Bone cells have a limited capacity to replace bone destroyed by infections. d. Bacteria are walled off by macrophages and T lymphocytes; consequently, the antibiotics cannot penetrate the infected area.

bacteria are walled off by macrophages and T lymphocytes; consequently, the antibiotics cannot penetrate the infected area

Shortened erythrocyte life span, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiologic characteristics of which type of anemia? a. Aplastic b. Sideroblastic c. Anemia of chronic disease d. Iron deficiency

c. Anemia of chronic disease

The students learn that deficiencies in folate and vitamin B12 alter the synthesis of which of these? a. RNA b. Cell membrane c. DNA d. Mitochondria

c. DNA

What does the student learn about warm autoimmune hemolytic anemia? a. Warm autoimmune hemolytic anemia occurs primarily in children. b. It is self-limiting and rarely produces hemolysis. c. Erythrocytes are bound to macrophages and sequestered in the spleen. d. Immunoglobulin M coats erythrocytes and binds them to receptors on monocytes

c. Erythrocytes are bound to macrophages and sequestered in the spleen

Which condition resulting from untreated pernicious anemia (PA) is fatal? a. Brain hypoxia b. Liver hypoxia c. Heart failure d. Renal failure

c. Heart Failure

A patient has hepatomegaly, bronze-colored skin, and cardiac dysrhythmias. What condition does the healthcare professional prepare to teach the patient about? a. Aplastic anemia b. Pernicious anemia c. Hereditary hemochromatosis d. Immune thrombocytopenia purpura

c. Hereditary hemochromatosis

What is the fundamental physiologic manifestation of anemia? a. Hypotension b. Hyperesthesia c. Hypoxia d. Ischemia

c. Hypoxia

A patient has polycythemia vera and presents to the Emergency Department with plethora and neurological changes. The student asks the healthcare professional to explain the primary cause of these symptoms. What response by the professional is best? a. Decreased erythrocyte count b. Destruction of erythrocytes c. Increased blood viscosity d. Tissue destruction by macrophages

c. Increased blood viscosity

A patient in the hospital has been receiving heparin injections. The platelet count on admission was 222,000/mm3 and four days later is 113,000/mm3 . What action by the healthcare professional is best? a. Prepare to transfuse the patient with platelets. b. Do nothing; this is an expected side effect. c. Switch the heparin to lepirudin d. Stop all the patient's medications

c. Switch the heparin to lepirudin

Parents report their 3-week-old infant who eats well and has gained weight began to vomit forcefully for no apparent reason. What treatment option does the healthcare professional prepare to educate the parents on? a. A gastric feeding tube b. Wheat-free diet c. Corrective surgery d. Lactose-free diet

corrective surgery

After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result? a. Iron deficiency b. Aplastic c. Folic acid d. Pernicious

d. Pernicious

A patient has frank bleeding of the rectum. How does the healthcare professional document this finding? a. Melena b. Hematochezia c. Occult bleeding d. Hematemesis

hematochezia

Which term is used to identify a functional muscle contraction in which the muscle contracts but the limb does not move? a. Isotonic b. Isometric c. Eccentric d. Concentric

isometric

A peptic ulcer may occur in all of these areas except which? a. Stomach b. Duodenum c. Jejunum d. Esophagus

jejunum

A patient seen in the clinic has tissue degeneration or irritation of the extensor carpi radialis brevis tendon. What diagnosis does the health care professional document? a. Lateral epicondylopathy b. Medial epicondylopathy c. Bursitis d. Lateral tendinitis

lateral epicondylopathy

A patient in the clinic had a femur x-ray that was read as having a "moth-eaten" appearance. What treatment option does the health care professional discuss with the patient? a. Limb-salvaging surgery b. Amputation c. Oral bisphosphonates d. Calcium and vitamin D supplements

limb-salvaging surgery

What event is associated with the beginning of bone loss in women? a. Puberty b. Sexual activity c. Childbirth d. Menopause

menopause

Blistering of the skin within minutes occurs in which type of burn injury? a. First degree b. Superficial partial thickness c. Deep partial thickness d. Full thickness

superficial partial thickness

Molecular analysis has demonstrated that osteosarcoma is associated with which gene? a. TP53 b. src c. myc d. TSC2

src

Which disease is an autosomal dominant inherited hemorrhagic disease? a. Hemophilia A b. von Willebrand disease c. Christmas disease d. Hemophilia B

von Willebrand disease