MIDTERM PATHO

38. A patient presents to the emergency room with a K level of 6.5. What potentially life-threatening complication would you assess for? A) Cardiac dysrhythmias B) Decreased urine output C) Nausea and vomiting D) Ataxia

A) Cardiac dysrhythmias

18. Which of the following serum levels is the best measurement for evaluating the effectiveness of iron therapy and adequacy of iron stores? A) Ferritin B) Iron C) Red blood cell count D) Apoferritin

A) Ferritin

11. Which of the following is an example of the chemical barriers that are part of the innate immune system? A) Hydrochloric acid production in the stomach B) Production of immunoglobulins C) Release of interferon D) Killer cells releasing lymphokines

A) Hydrochloric acid production in the stomach

33. Which of the following statements regarding Legionnaires' disease is true? A) It is a bacterial infection. B) It is usually spread by direct skin-to-skin contact. C) It is a viral infection. D) It is treated with supportive care only.

A) It is a bacterial infection

15. Which of the following blood cells have a lifespan of approximately 10 days? A) Platelets B) Red blood cells C) Monocytes D) Lymphocytes

A) Platelets

44. The juxtaglomerular complex is the site of the production of which enzyme and hormone involved in blood pressure and fluid balance? A) Renin B) Angiotensin C) Nitric oxidase D) Antidiuretic hormone

A) Renin

25. What happens at the end of diastole? A) The atria contract to empty the remaining amount of blood into the ventricle. B) The ventricle dilates to accommodate the entry of blood. C) The atrial pressure becomes higher than the ventricular pressure. D) The inferior vena cava and pulmonary pressure increases.

A) The atria contract to empty the remaining amount of blood into the ventricle

30. Tuberculosis is: A) an airborne disease. B) a sexually transmitted disease. C) a disease transmitted through skin-to-skin contact. D) All of these are correct.

A) an airborne disease.

6. Tay-Sachs is caused by a(n): A) deficiency or absence of hexosaminidase A. B) defect on chromosome 17 or 22. C) mutation on chromosome 15. D) error in converting phenylalanine to tyrosine.

A) deficiency or absence of hexosaminidase A

36. A 15-year-old is diagnosed with infectious mononucleosis and is told to avoid contact sports because of the: A) risk for splenic rupture. B) risk for contaminating teammates. C) potential for the virus to spread to other organs. D) increased likelihood for the need for antivirals

A) risk for splenic rupture.

37. A patient needs an infusion of a hypertonic solution. Which of the following is an appropriate intravenous solution to administer? A) 5% dextrose lactate Ringer's (D5LR) B) 1

2 normal saline (0.45% NS) C) normal saline (0.9% NS) D) Ringer's lactate (RL)/A) 5% dextrose lactate Ringer's (D5LR)

7. Which of the following assessment findings is most concerning and would require immediate action? A) Speech delays in a 10-year-old with Fragile X syndrome B) A palpable lump in the left breast of an 18-year-old with Klinefelter syndrome C) Vision issues in a 14-year-old with Turner syndrome D) Bruise in a cancer patient receiving chemotherapy

B) A palpable lump in the left breast of an 18-year-old with Klinefelter syndrome

43. Which of the following is the main buffer in the extracellular fluid? A) Phosphate buffer system B) Bicarbonate-carbonic acid system C) Protein system D) Potassium-hydrogen exchange system

B) Bicarbonate-carbonic acid system

23. Which of the following laboratory tests would be indicative of worsening heart failure? A) Elevated hemoglobin B) Elevated b-type natriuretic peptide (BNP) C) Decreased myoglobin D) Decreased b-type natriuretic peptide (BNP)

B) Elevated b-type natriuretic peptide (BNP)

29. A nurse is providing group education about lipids to patients who have been diagnosed with hyperlipidemia. What does the best instruction include? A) High-density lipoprotein (HDL) is called good cholesterol because it increases the oxygen content in the arteries and stabilizes plaque buildup. B) High-density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from your body and gets rid of it in your liver. C) High-density lipoprotein (HDL) is called good cholesterol because it deceases cardiac workload by decreasing oxygen consumption by your heart. D) High-density lipoprotein (HDL) decreases low-density lipoprotein (LDL) and prevents it from converting to very low-density lipoprotein (VDRL), which is the worst kind of cholesterol in the body.

B) High-density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from your body and gets rid of it in your liver.

12. Which of the following describes the microbiome? A) The flora remains consistent throughout a lifetime. B) It consists of normal flora such as E. Coli in the intestines. C) It mainly consists of pathogenic flora such as Clostridium difficile. D) Increase in diversity is associated with disease development.

B) It consists of normal flora such as E. Coli in the intestines

40. Which of the following is the major effect produced by an increase in the rate and depth of respiration? A) Plasma PCO2 rises. B) Plasma PCO2 falls. C) Plasma PCO2 stays the same. D) The pH shifts to the alkaline side of the physiologic range.

B) Plasma PCO2 falls

2. What is a key determinant of osmotic pressure? A) Water B) Sodium C) Albumin D) Glucose

B) Sodium

46. A man had a radical prostatectomy for prostate cancer. When teaching him about urine function, what would be one of the complications of this surgery that he may develop? A) Kidney stones B) Stress incontinence C) Overactive bladder D) Urinary obstruction

B) Stress incontinence

5. While discussing treatment options with a parent of a newly diagnosed monosomy X (Turner syndrome) child, the nurse practitioner should state which of the following? A) There is no treatment or cure. B) Symptoms of the condition are treated with estrogen. C) Symptoms of the condition are treated with testosterone. D) Institutionalization is the preferred method of managing care.

B) Symptoms of the condition are treated with estrogen

20. A patient receiving chemotherapy has a hemoglobin of 7.0 gdL. Which of the following complaints would be indicative of tissue hypoxia related to anemia? A) Apathy B) Syncope C) Bradycardia D) Warm, dry skin

B) Syncope

26. A patient comes to the emergency department complaining of coughing and difficulty breathing. The patient's diagnosis is heart failure. How does heart failure cause shortness of breath? A) The left side of the heart is weak and pumps blood too quickly. B) The left side of the heart is weak and pulmonary fluid accumulates. C) The right side of the heart is enlarged and cannot effectively pump blood. D) The right side of left heart is weak and blood enters the lungs.

B) The left side of the heart is weak and pulmonary fluid accumulates

24. What causes the aortic valve to open? A) The aortic pressure becomes higher than the left ventricle pressure. B) The left ventricle pressure becomes higher than the aortic pressure. C) The left atrial and left ventricle pressure forces the valve open. D) The left ventricle and aortic pressure equalizes.

B) The left ventricle pressure becomes higher than the aortic pressure

50. The definition and criteria used to diagnosis chronic kidney disease is the: A) serum creatinine. B) glomerular filtration rate. C) blood urea nitrogen to creatinine ratio. D) serum albumin levels.

B) glomerular filtration rate.

35. Latent tuberculosis infection means the: A) person is asymptomatic but can spread the infection. B) person is infected but asymptomatic. C) person will get tuberculosis later in life. D) person is immunocompromised and has tuberculosis.

B) person is infected but asymptomatic

17. A patient who has chronic kidney disease and a hemoglobin of 9 gdL will be receiving synthetic erythropoietin injections. The therapeutic effect of this medication is: A) prevention of red blood cell apoptosis. B) stimulation of red blood cell production. C) improvement of tissue oxygenation. D) improvement in blood circulation.

B) stimulation of red blood cell production

19. A patient is receiving a heparin infusion. After the second day of infusion, his platelets decrease to 50,000 cellsmL3. The next best action would be to: A) decrease the rate of the infusion. B) stop the infusion and switch to another anticoagulant. C) continue infusion but monitor the platelet count every 4 hours. D) transfuse the patient with platelets.

B) stop the infusion and switch to another anticoagulant

10. Education pertaining to prevention of human immunodeficiency virus (HIV) includes: A) proper use of mosquito repellant in areas with high rate of HIV. B) use of pre-exposure prophylaxis if engaging in high-risk sexual behavior. C) use of gloves by healthcare workers with every patient encounter. D) avoidance of kissing HIV-positive persons

B) use of pre-exposure prophylaxis if engaging in high-risk sexual behavior

27. Which of the following patients has the greatest risk of developing heart failure? A) A 50-year-old white female with asthma B) A 48-year-old black female who smokes C) A 69-year-old black male with hypertension D) A 75-year-old white male who smokes

C) A 69-year-old black male with hypertension

1. Which of the following cellular exchange mechanisms requires adenosine triphosphate (ATP) and the use of a carrier protein? A) Facilitated diffusion B) Osmosis C) Active transport D) Simple diffusion

C) Active transport

31. Which of the following differentiates chronic obstructive pulmonary disease (COPD) from asthma? A) COPD is an obstructive disease, and asthma is a restrictive disease. B) The FEV1FVC ratio is reduced in asthma but not in COPD. C) Airflow obstruction caused by chronic obstructive pulmonary disease is irreversible, whereas it is reversible in asthma. D) COPD is characterized by an immunoglobulin E response, whereas asthma involves other mediators/

C) Airflow obstruction caused by chronic obstructive pulmonary disease is irreversible, whereas it is reversible in asthma

16. Lymphoid progenitor stem cell lines differentiate into: A) basophils and mast cells. B) bands and neutrophils. C) B and T cells. D) platelets and white blood cells.

C) B and T cells

45. Which of the following is not a function of the kidney? A) Secretion of hydrogen ions B) Conversion of vitamin D to its active form C) Conversion of ammonia into urea D) Production of uromodulin

C) Conversion of ammonia into urea

48. A patient has a serum creatinine level of 2.5 mgdL, a serum potassium level of 6 mEq/L, an arterial pH of 7.32, and a urine output of 250 mL/day. Which phase of acute kidney injury is the patient experiencing? A) Intrarenal B) Postrenal C) Oliguric D) Recovery/

C) Oliguric

28. Which of the following is the most serious complication of an aortic aneurysm? A) Dilation of the aorta, which may compress adjacent abdominal organs B) Formation of the thrombi on the rough intimal surface on the aneurysm wall C) Rupture of the aneurysm D) Degeneration and calcification of the aneurysm wall

C) Rupture of the aneurysm

22. The order of impulse conduction in the heart is from the: A) AV node to SA node to bundle of His to Purkinje system. B) bundle of His to SA node to AV node to Purkinje system. C) SA node to AV node to bundle of His to Purkinje system. D) Purkinje system to SA node to AV node to bundle of His.

C) SA node to AV node to bundle of His to Purkinje system

9. Which of the following situations represents a break in the "first line of defense" against infection? A) An abnormally low total white blood cell (WBC) count B) A "shift to the left" on the WBC differential C) Use of an indwelling bladder catheter D) Poor nutritional status

C) Use of an indwelling bladder catheter

49. Progression of chronic kidney disease is thought to occur as a result of: A) hypofiltration with accumulation of toxic chemicals and decrease urine output. B) prevention of water and solutes crossing the capillary membrane and large molecules allowed to cross. C) intraglomerular hypertension and glomerular hypertrophy. D) tubulointerstitial constriction with decreased blood flow.

C) intraglomerular hypertension and glomerular hypertrophy

4. A routine ultrasound of a 38-year-old woman of 26 weeks' gestation reveals that the fetus has trisomy 21 (Down syndrome). Most cases of Down syndrome are due to: A) translocation. B) inversion. C) nondisjunction. D) duplication.

C) nondisjunction

32. The forced expiratory volume (FEV1) measures: A) how much air you can breathe out of your lungs after a deep inspiration. B) the amount of air left in your lungs after you breathe it all out. C) the amount of air you can forcibly exhale in one second. D) how much force you can generate when breathing into a spirometer.

C) the amount of air you can forcibly exhale in one second.

34. Which of the following individuals has a positive tuberculin skin test reaction? A) A 25-year-old woman with an induration of 7 mm B) A 30-year-old man with an induration of 5 mm who just arrived from a country with a high prevalence of tuberculosis C) A nurse who works on a pulmonary unit with an induration of 4 mm D) A 2-year-old with an induration of 11 mm

D) A 2-year-old with an induration of 11 mm

42. Which of the following is the primary regulator of water excretion? A) Sodium B) Blood volume C) Aldosterone D) Antidiuretic hormone

D) Antidiuretic hormone

14. A 5-year-old female takes a hike through the woods during a school field trip. Upon returning home, she hugs her father, and he later develops poison ivy. Which of the following immune reactions is he experiencing? A) IgE mediated B) Tissue specific C) Immune complex D) Cell mediated

D) Cell mediated

3. A 58-year-old man was gardening and mowing his lawn for a few hours in the heat. He started developing cramps and feeling dizzy. He has no significant past medical history and is in generally good health. He was transported to the emergency room. His serum osmolality is high. What is the likely explanation for this finding? A) Hyperglycemia B) Excess fluid intake C) Diabetes Insipidus D) Dehydration

D) Dehydration

21. Which of the following statements regarding disseminated intravascular coagulation syndrome is not true? A) It results from rapid release of thromboplastic material into the circulation. B) It may result from any condition associated with extensive tissue destruction, such as shock or sepsis. C) Levels of blood platelets and concentration of blood coagulation components are subnormal. D) It is a frequent complication of pulmonary embolism

D) It is a frequent complication of pulmonary embolism

41. Which of the following is responsible for most of the osmotic pressure? A) Urea B) Water C) Potassium D) Sodium

D) Sodium

13. The effects of histamine 1 release during mast cell degranulation includes: A) increased gastric secretion. B) decreased vascular permeability. C) bronchial dilation. D) edema.

D) edema

47. A woman is complaining that she often gets a strong need to urinate and then she sometimes "wets herself" because she cannot make it to the bathroom in time. The type of incontinence she is describing is: A) transient. B) mixed. C) stress. D) urge.

D) urge

39. A patient presents to the emergency room with nausea, vomiting, and diarrhea for three days. The patient's lab values are as follows: K = 3.8, Na = 149, pH = 7.32, HCO3- = 20, and PaCO2 = 40. Which of the following intravenous fluids should be ordered? A) 0.45% normal saline with 100 mEq

L of sodium bicarbonate B) 0.9% normal saline with 40 mEq/L of potassium C) 0.9% normal saline D) 2.5% dextrose/A) 0.45% normal saline with 100 mEq/L of sodium bicarbonate

8. Which of the following human immunodeficiency virus positive patients has AIDS (acquired immunodeficiency syndrome)? A) A 28-year-old woman with advanced cervical cancer B) A 30-year-old man with the common cold C) A 35-year-old woman with trichomoniasis vaginal infection D) A 40-year-old man with a CD4+ cell count of 400 cells

mm3/A) A 28-year-old woman with advanced cervical cancer