Path 370 Quiz 8 (CH. 44, 45, 47, 51, 52)

What type of fracture generally occurs in children? A. Greenstick B. Stress C. Nightstick D. Colles

A. Greenstick Greenstick fractures occur most often in the growing bones of children. Stress fractures can occur at any age. Nightstick and Colles fractures occur most often in adults.

The physiologic change most likely to lead to an increase in intracranial pressure is A. cerebral vasodilation. B. hypernatremia. C. respiratory hyperventilation. D. REM sleep.

A. cerebral vasodilation.

A fracture in which bone breaks into two or more fragments is referred to as A. comminuted. B. open. C. greenstick. D. stress.

A. comminuted.

A patient diagnosed with diabetes, smokes a pack of cigarettes daily and eats very few green leafy vegetables. After experiencing a fractured toe, this patient is at risk for A. delayed healing. B. malunion. C. nonunion. D. dysunion.

A. delayed healing.

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called A. tophaceous gout. B. gouty arthritis. C. complicated gout. D. asymptomatic hyperuricemia.

A. tophaceous gout.

Compartment syndrome occurs secondary to A. bone infarction. B. soft-tissue damage. C. muscle necrosis. D. breakdown of RBCs.

B. soft-tissue damage.

Cerebral aneurysm is most frequently the result of A. embolic stroke. B. subarachnoid hemorrhage. C. subdural hemorrhage. D. meningitis.

B. subarachnoid hemorrhage.

Seizures that involve both hemispheres at the outset are termed A. partial. B. complex. C. focal. D. generalized.

D. generalized.

Intracranial pressure normally ranges from ______ mm Hg. A. 0 to 15 B. 10 to 20 C. 15 to 25 D. 20 to 30

A. 0 to 15

A level of ____ on the Glasgow Coma Scale indicates likely fatal damage. A. 3 B. 8 C. 12 D. 15

A. 3 On the GCS, the lowest total score of 3 indicates likely fatal damage, especially if both pupils fail to respond to light and oculovestibular responses are absent; however, the severity and prognosis are predicted more accurately by also considering diagnostic imaging and other factors. A GCS level of 8 indicates severe damage. A GCS level of 12 or higher indicates mild damage. A GCS level of 15 is considered to be normal.

________ occurs when a brainstem impaired patient exhibits a persistent rhythmic or jerky movement in one or both eyes. A. Nystagmus B. Dysconjugate movement C. Ocular palsy D. Doll's eye

A. Nystagmus

Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency? A. Osteomalacia B. Osteopenia C. Osteomyelitis D. Osteoporosis

A. Osteomalacia Osteomalacia is inadequate mineralization of bone tissue, most commonly caused by vitamin D deficiency, and it usually causes skeletal pain. Osteopenia, osteomyelitis, and osteoporosis are not caused by vitamin D deficiency.

What effect do demyelinating disorders such as multiple sclerosis have on neurotransmission? A. Slower rate of action potential conduction B. Increased rate of action potential conduction C. Facilitation of action potential initiation D. Faster rate of repolarization

A. Slower rate of action potential conduction

Pain is thought of as A. a subjective experience that is difficult to measure objectively. B. associated with changes in vital signs reflecting its intensity. C. experienced in the same way by all individuals. D. always the result of tissue damage that activates nociceptors.

A. a subjective experience that is difficult to measure objectively.

The most common source of osteomyelitis is A. an infection that migrates via the bloodstream. B. direct invasion from a fracture. C. surgical contamination. D. a joint prosthesis.

A. an infection that migrates via the bloodstream.

A unique characteristic feature of fibromyalgia is the presence of A. tender point pain. B. head pain. C. contractures. D. muscle atrophy.

A. tender point pain.

The dementia of Alzheimer disease is associated with structural changes in the brain, including A. deposition of amyloid plaques in the brain. B. degeneration of basal ganglia. C. hypertrophy of frontal lobe neurons. D. significant aluminum deposits in the brain.

A. deposition of amyloid plaques in the brain.

Muscular dystrophy includes a number of muscle disorders that are A. genetically transmitted. B. easily prevented and managed. C. autoimmune in nature. D. demyelinating focused.

A. genetically transmitted. Muscular dystrophy includes a number of muscle disorders that are genetically transmitted. Muscular dystrophy is not easily prevented or managed. It is not an autoimmune disease or a demyelinating disease.

The most common type of osteomyelitis is A. hematogenous. B. contiguous focus. C. Brodie abscess. D. direct invasion.

A. hematogenous. Hematogenous osteomyelitis is the most common type of osteomyelitis. Contiguous focus osteomyelitis is not the most common type. Brodie abscess is when an infection becomes enclosed by fibrotic tissue. Osteomyelitis may be caused by a direct invasion of organisms into the bone, but this is not the most common cause.

Autonomic dysreflexia is characterized by A. hypertension and bradycardia. B. hypotension and shock. C. pallor and vasoconstriction above the level of injury. D. extreme pain below the level of injury.

A. hypertension and bradycardia.

The pathophysiology of rheumatoid arthritis involves A. immune cells accumulating in pannus and destroying articular cartilage. B. free radicals attaching to the synovial membrane and tunneling into articular cartilage. C. excessive wear and tear and microtrauma that damage articular cartilage. D. cysts developing in subchondral bone and creating fissures in articular cartilage.

A. immune cells accumulating in pannus and destroying articular cartilage.

Dopamine precursors and anticholinergics are all used in the management of Parkinson disease, because they A. increase dopamine activity in the basal ganglia. B. induce regeneration of neurons in the basal ganglia. C. prevent progression of the disease. D. produce excitation of basal ganglia structures.

A. increase dopamine activity in the basal ganglia. The mainstay of Parkinson therapy has been aimed at increasing the level of dopamine in the CNS. Anticholinergics and dopamine precursors are not related to regeneration of neurons. Preventing the progression of Parkinson disease is not the mechanism of action in medications used to treat the disease. Excitation of basal ganglia structures is not produced with dopamine precursors and anticholinergics.

It is true that scleroderma involves A. inflammation and fibrosis of connective tissue. B. autoantibodies against acetylcholine receptors. C. infection by beta-hemolytic streptococcus. D. inflammation caused by antigenic fragments of dead organisms.

A. inflammation and fibrosis of connective tissue.

Ankylosing spondylitis is characterized by A. inflammation, stiffness, and fusion of spinal joints. B. loss of articular cartilage in weight-bearing joints. C. excessive bone remodeling leading to soft bone. D. immune mechanisms leading to widespread joint inflammation.

A. inflammation, stiffness, and fusion of spinal joints. Ankylosing spondylitis is characterized by inflammation, stiffness, and fusion of spinal joints. Osteoarthritis involves loss of articular cartilage in weight-bearing joints. Paget's disease involves excessive bone remodeling leading to soft bone. RA involves immune mechanisms leading to widespread joint inflammation.

Ankylosing spondylitis causes A. intervertebral joint fusion. B. instability of synovial joints. C. costal cartilage degeneration. D. temporomandibular joint degeneration.

A. intervertebral joint fusion.

The stroke etiology with the highest morbidity and mortality is A. intracranial hemorrhage. B. intracranial thrombosis. C. intracranial embolization. D. cardiac arrest.

A. intracranial hemorrhage.

The most common site affected in Paget's disease is the A. lower spine. B. skull. C. pelvis. D. joints.

A. lower spine. The lower spine is the most common site affected in Paget's disease. The skull and pelvis are affected, but are not the most common sites. Joints are not affected in Paget's disease.

The initial treatment of an individual experiencing a seizure is concentrated on A. maintaining an airway. B. administering anticonvulsant medication. C. documenting the seizure pattern. D. obtaining an EEG.

A. maintaining an airway. Treatment of an individual experiencing a seizure is concentrated on maintaining an airway and protecting the individual from injury. If the seizures are because of irreversible or unidentifiable factors, anticonvulsant medications specific to the type of seizure are the best management. Recording the course of the seizure episode is useful, but is not the initial focus of care. EEG studies may be useful in determining abnormalities which elicit the pathologic mechanism.

Healing of a fractured bone with a poor alignment is called A. malunion. B. nonunion. C. disunion. D. delayed union.

A. malunion.

The physiologic mechanisms involved in the pain phenomenon are termed A. nociception. B. sensitization. C. neurotransmission. D. proprioception.

A. nociception. The physiologic mechanisms involved in the pain phenomenon are termed nociception. Sensitization is not the physiologic mechanism of pain phenomena. Neurotransmission is not related to the physiologic pain mechanism. The physiologic mechanisms involved in the pain phenomenon are not known as proprioception.

Pain with passive stretching of a muscle is indicative of A. noncontractile tissue injury. B. contractile tissue injury. C. vascular insufficiency. D. skeletal muscle damage.

A. noncontractile tissue injury.

The disease that is similar to osteomalacia and occurs in growing children is A. rickets. B. osteosarcoma. C. Paget disease. D. osteopenia.

A. rickets.

In the acute phase of stroke, treatment is focused on A. stabilization of respiratory and cardiovascular function. B. risk factor modification. C. prevention of bedsores and contractures. D. neurologic rehabilitation.

A. stabilization of respiratory and cardiovascular function. The primary consideration in the acute phase of stroke is assuring the patient's airway, respiratory, and cardiovascular function. In the acute phase of stroke, risk factor modification is not appropriate. Treatment aimed at preventing bedsores and contractions is not a typical consideration in the acute phase. Neurologic rehabilitation is not the focus of treatment in the acute phase.

_________ is a form of spina bifida in which a saclike cyst filled with CSF protrudes through the spinal defect but does not involve the spinal cord. A. Spina bifida occulta B. Meningocele C. Myelomeningocele D. Meningomyelocele

B. Meningocele In the meningocele form of spina bifida cystica, a saclike cyst filled with CSF protrudes through the spinal defect but does not involve the spinal cord. In spina bifida occulta, the posterior vertebral laminae have failed to fuse. A myelomeningocele or meningomyelocele deformity contains meninges, CSF, and a portion of the spinal cord that protrudes from the vertebral defect in a cystlike sac.

Most sensory afferent pain fibers enter the spinal cord by way of the ________ nerve roots. A. anterior B. posterior C. C fiber D. anterolateral

B. posterior

Most muscle strains are caused by A. a tear in an adjoining tendon. B. abnormal muscle contraction. C. muscle asymmetry. D. bleeding into the muscle.

B. abnormal muscle contraction.

A patient who experiences early symptoms of muscle twitching, cramping, and stiffness of the hands may be demonstrating signs of A. Guillain-Barré syndrome. B. amyotrophic lateral sclerosis. C. Parkinson disease. D. hydrocephalus.

B. amyotrophic lateral sclerosis.

Rheumatoid arthritis is commonly associated with the presence of rheumatoid factor autoantibodies in the bloodstream. This indicates that rheumatoid arthritis is likely to be A. caused by bacterial infection. B. an autoimmune process. C. an infective process. D. because of an enzymatic defect.

B. an autoimmune process.

The most important preventive measure for hemorrhagic stroke is A. anticoagulation. B. blood pressure control. C. thrombolytics. D. management of dysrhythmias.

B. blood pressure control. Hemorrhagic stroke is a hemorrhage that is usually the result of longstanding hypertension. Blood pressure control is the most important preventive measure. Anticoagulation would be useful for preventing embolic stroke. Risk reduction strategies for thrombotic stroke are aimed at reducing atherosclerosis. Dysrhythmias are not related to a risk of hemorrhagic stroke.

The gate control theory of pain transmission predicts that activity in touch receptors will A. enhance perception of pain. B. decrease pain signal transmission in the spinal cord. C. activate opioid receptors in the CNS. D. increase secretion of substance P in the spinal cord.

B. decrease pain signal transmission in the spinal cord. The gate control theory is used to explain how stimulation of large "touch" neurons could inhibit the transmission of nociceptor impulses. Central to the gate control theory is the capacity for interneurons in the spinal cord to modify the transmission of nociceptor impulses. The gate control theory is not based on a theory that activity in touch receptors will enhance perception of pain. Opioid receptors are thought to be the mediators of presynaptic inhibition. One way to inhibit synaptic transmission is through presynaptic inhibition of substance P release from nociceptor neurons.

Steroids may be used in the management of acute exacerbation of symptoms in patients with multiple sclerosis, because A. viral damage can be inhibited. B. demyelination is mediated by immune mechanisms. C. steroids reverse the progression of the disease. D. steroids inhibit synaptic degradation of neurotransmitters.

B. demyelination is mediated by immune mechanisms.

Tophi are A. renal calculi composed of uric acid. B. deposits of urate crystals in tissues. C. painful edematous joints. D. spots that coalesce in a malar rash.

B. deposits of urate crystals in tissues.

A risk factor for osteoporosis is A. endometriosis. B. early menopause. C. late menopause. D. ovarian cysts.

B. early menopause.

Modulation of pain signals is thought to be mediated by the release of A. histamine. B. endorphins. C. cholecystokinin. D. glutamine.

B. endorphins.

In older women, osteoporosis is thought to be primarily because of A. dietary inadequacies. B. estrogen deficiency. C. malabsorption syndrome. D. inactivity.

B. estrogen deficiency.

Paget's disease is characterized by A. overactivity of osteoblasts leading to multiple bone tumors. B. excessive bone resorption followed by excessive formation of fragile bone. C. inflammatory disorder resulting in fusion of spine joints. D. failure of resorption by osteoclasts resulting in hard bones.

B. excessive bone resorption followed by excessive formation of fragile bone. Paget's disease is characterized by excessive bone resorption followed by excessive formation of fragile bone. Overactivity of osteoblasts that lead to multiple bone tumors is not the cause of Paget's disease. Paget's disease is not characterized by the fusion of spine joints. Fragile bone, not hard bone, is a characteristic of Paget's disease.

Enteropathic arthritis is associated with A. irritable bowel syndrome. B. inflammatory bowel disease. C. chronic constipation. D. chronic diarrhea.

B. inflammatory bowel disease. Enteropathic arthritis is associated with inflammatory bowel disease (Crohn disease and ulcerative colitis). Irritable bowel syndrome, chronic constipation, and chronic diarrhea are not symptoms of enteropathic arthritis.

Assessment of an extremity six hours after surgical alignment and casting demonstrates pulselessness and pallor. The priority action to take is to A. increase the administration his pain medication. B. initiate action to have the cast split or removed. C. note the increase in pain in his chart, and recheck the extremity in 30 minutes. D. elevate the extremity to relieve swelling.

B. initiate action to have the cast split or removed. The priority action is to have the cast split or removed because these are signs of compartment syndrome and emergent decompression is needed. While increasing pain medication may be appropriate, it is not the priority action. It is not the priority action to note pain increases in the chart. In compartment syndrome, extremity is not to be elevated above the heart, as that may lower venous pressure and slow arterial perfusion.

A college student living in a dormitory reports a stiff neck and headache and is found to have a fever of 102°F. This information is most consistent with A. encephalitis. B. meningitis. C. skull fracture. D. cerebral ischemia.

B. meningitis.

Anticholinesterase inhibitors may be used to manage A. muscular dystrophy. B. myasthenia gravis. C. fibromyalgia. D. rheumatoid arthritis.

B. myasthenia gravis.

Bone healing may be impaired by A. excessive vitamin C. B. nicotine use. C. a high-protein diet. D. immobilization.

B. nicotine use.

"Please explain the pathophysiology of osteoarthritis to me," says another nurse. "Is it just wear and tear so that the cartilage wears out?" Your best response is A. "Yes; repeated use just wears out the cartilage, until it becomes thin and denuded. That causes pain and will eventually cause joint inflammation." B. "Yes; with increasing age, the inflammation from repeated joint use accumulates and causes the cartilage to get thin and ragged until it disappears." C. "No; cells in bone, cartilage, and the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone." D. "No; autoimmune cells infiltrate the joint and collect on the cartilage in a mass called 'pannus' that eventually thins and destroys the cartilage."

C. "No; cells in bone, cartilage, and the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone."

The person at highest risk of a greenstick fracture from falling off a tall ladder is age A. 68. B. 44. C. 8. D. 23.

C. 8. Greenstick fractures occur primarily in children. The adults are not at high risk for greenstick fracture.

Which group of clinical findings indicates the poorest neurologic functioning? A. Spontaneous eye opening, movement to command, oriented to self only B. Eyes open to light touch on shoulder, pupils briskly reactive to light bilaterally C. Assumes decorticate posture with light touch, no verbal response D. No eye opening, responds to painful stimulus by withdrawing

C. Assumes decorticate posture with light touch, no verbal response Decorticate posturing is an abnormal flexor response of the arms and wrists, with legs and feet extended and internally rotated. This occurs as the neurologic functioning deteriorates. Normal response occurs with spontaneous eye opening, movement on command and orientation to self. Eye opening to touch is not indicative of poor neurologic functioning. A lower neurologic functioning is indicated by a patient who is able to withdraw from painful stimulus and localize the source of pain.

A tool used to assess levels of consciousness is A. magnetic resonance imaging (MRI). B. intracranial pressure (ICP) monitoring. C. Glasgow Coma Scale (GCS). D. central perfusion pressure (CPP).

C. Glasgow Coma Scale (GCS).

The most common symptom of multiple myeloma is A. pathologic fracture. B. fever. C. bone pain. D. osteomyelitis.

C. bone pain. The most common symptom of multiple myeloma is bone pain. Although pathologic fractures occur in multiple myeloma, bone pain is the most common symptom. Fever and osteomyelitis are not common in multiple myeloma.

The disorders characterized by softening and then enlargement of bones is referred to as A. osteomyelitis. B. osteoporosis. C. Paget disease. D. rickets.

C. Paget disease.

Orthostatic hypotension may be a manifestation of A. Alzheimer disease. B. multiple sclerosis. C. Parkinson disease. D. amyotrophic lateral sclerosis.

C. Parkinson disease. In patients with Parkinson disease, involvement of the autonomic nervous system may result in orthostatic hypotension. Alzheimer disease is not typically associated with orthostatic hypotension. Orthostatic hypotension is not associated with multiple sclerosis. Amyotrophic lateral sclerosis is not manifested by orthostatic hypotension.

The stage of spinal shock that follows spinal cord injury is characterized by A. reflex urination and defecation. B. autonomic dysreflexia. C. absent spinal reflexes below the level of injury. D. motor spasticity and hyperreflexia below the level of injury.

C. absent spinal reflexes below the level of injury.

Myasthenia gravis is an autoimmune disease in which A. neuronal demyelination disrupts nerve transmission. B. muscles become increasingly bulky but weakened. C. acetylcholine receptors are destroyed or dysfunctional. D. acetylcholine release from motor neurons is disrupted.

C. acetylcholine receptors are destroyed or dysfunctional.

Risk factors for hemorrhagic stroke include A. atherosclerosis. B. dysrhythmias. C. acute hypertension. D. sedentary lifestyle.

C. acute hypertension. Intracerebral hemorrhage is a hemorrhage within the brain parenchyma and usually occurs in the context of severe and often longstanding hypertension. Risk factors for stroke are similar to those for other atherosclerotic vascular disease. Cardiac disease complicated by atrial fibrillation is an important risk factor for embolic stroke. Sedentary lifestyle is not a risk factor for hemorrhagic stroke.

The complication which is not likely to result from a compound, transverse fracture of the tibia and fibula is A. bone infection. B. fat emboli. C. air embolus. D. compartment syndrome.

C. air embolus. Air embolus is not likely to occur secondary to this fracture. Bone infection is likely, because it is an open fracture. Fat emboli are likely because the fracture is in a long bone. Compartment syndrome is likely because of the extent of soft-tissue injury.

Rheumatoid arthritis involves joint inflammation caused by A. bacterial infection. B. trauma. C. autoimmune injury. D. congenital hypermobility.

C. autoimmune injury.

Leakage of CSF from the nose or ears is commonly associated with A. epidural hematoma. B. temporal skull fracture. C. basilar skull fracture. D. cerebral aneurysm.

C. basilar skull fracture.

Secondary injury after head trauma refers to A. brain injury resulting from the initial trauma. B. focal areas of bleeding. C. brain injury resulting from the body's response to tissue damage. D. injury as a result of medical therapy.

C. brain injury resulting from the body's response to tissue damage. Secondary injury is a consequence of the body's response to the primary injury. Injury that is directly related to the initial impact is primary injury. A focal area of bleeding is related to primary injury. Injury that results from medical therapy is not known as secondary injury.

The chief pathologic features of osteoarthritis are A. stress fractures of the epiphysis, inflammation of the diaphysis, and accumulation of excessive synovial fluid. B. autoimmune damage to the synovium, destruction of articular cartilage by pannus, and thickening of synovial fluid. C. degeneration of articular cartilage, destruction of the bone under the cartilage, and thickening of the synovium. D. thinning of the joint capsule, resorption of bone, excessive formation of new bone, and formation of bone spurs.

C. degeneration of articular cartilage, destruction of the bone under the cartilage, and thickening of the synovium.

Pain that waxes and wanes and is exacerbated by physical exertion is likely related to A. neuralgia. B. intermittent claudication. C. fibromyalgia syndrome. D. neuropathy.

C. fibromyalgia syndrome.

Prosthetic joint infection is most often because of A. defective replacement material. B. injury to the joint. C. hematogenous transfer. D. arthritis.

C. hematogenous transfer.

An example of inappropriate treatment for head trauma would be A. head elevation. B. free water restriction. C. hypoventilation. D. bed rest.

C. hypoventilation.

The pathophysiology of osteomalacia involves A. increased osteoclast activity. B. collagen breakdown in the bone matrix. C. crowding of cells in the osteoid. D. inadequate mineralization in the osteoid.

C. inadequate mineralization in the osteoid.

It is useful to conceptualize pain physiology according to the four stages because each stage provides an opportunity for A. education. B. stimulation. C. intervention. D. documentation.

C. intervention.

A bone disorder that results from insufficient vitamin D is referred to as A. rickets. B. osteoporosis. C. osteomalacia. D. subluxation.

C. osteomalacia.

Before making a diagnosis of Alzheimer disease A. a brain biopsy demonstrating organic changes is necessary. B. biochemical tests for aluminum toxicity must be positive. C. other potential causes of dementia must be ruled out. D. increased protein is found in a lumbar puncture.

C. other potential causes of dementia must be ruled out.

It is true that Bell palsy is a A. permanent facial paralysis after stroke. B. painful neuropathic pain affecting the trigeminal nerve. C. paralysis of the muscles innervated by the facial nerve. D. herpetic outbreak in a facial dermatome.

C. paralysis of the muscles innervated by the facial nerve. Bell palsy is an acute idiopathic paresis or paralysis of the facial nerve involving an inflammatory reaction. Bell palsy patients generally recover facial nerve function spontaneously within 3 weeks. Patients with Bell palsy may complain of a heavy sensation in their face. Bell palsy is not related to a herpetic outbreak.

A laboratory test result that helps confirm the diagnosis of systemic lupus erythematosus (SLE) is A. elevated serum calcium level. B. elevated monoclonal antibody titer. C. positive antinuclear antibodies. D. positive microsomal antibodies.

C. positive antinuclear antibodies.

The first indication of brain compression from increasing intracranial pressure (ICP) may be A. decorticate posturing. B. absence of verbalization. C. sluggish pupil response to light. D. Glasgow Coma Scale score of 13.

C. sluggish pupil response to light.

Slow pain sensation is transmitted primarily by A. group Ia afferents. B. α motor neurons. C. unmyelinated C fibers. D. Aδ fibers.

C. unmyelinated C fibers.

"Tell me again the name of that chemical that makes crystals when my gout flares up," asks the client. The nurse's best response is A. calcium phosphate. B. urea. C. uric acid. D. beta-hydroxybutyric acid.

C. uric acid.

Referred pain may be perceived at some distance from the area of tissue injury, but generally felt A. on the same side of the body. B. with slightly less intensity. C. within the same dermatome. D. within 10 to 15 cm area.

C. within the same dermatome.

Which neurologic disorder is commonly referred to as Lou Gehrig disease? A. Multiple sclerosis B. Parkinson disease C. Alzheimer disease D. Amyotrophic lateral sclerosis

D. Amyotrophic lateral sclerosis ALS is also known as Lou Gehrig disease, after the famed "Iron Man" of the New York Yankees, who died from the disease. Multiple sclerosis, Parkinson disease, and Alzheimer disease are not named after Lou Gehrig.

________ edema occurs when ischemic tissue swells because of cellular energy failure. A. Interstitial B. Osmotic C. Vasogenic D. Cytotoxic

D. Cytotoxic

The earliest manifestation of scleroderma is A. thick, tight, shiny skin. B. skin hyper/hypopigmentation. C. renal impairment. D. Raynaud phenomenon.

D. Raynaud phenomenon.

Although skin manifestations may occur in numerous locations, the classic presentation of systemic lupus erythematosus (SLE) includes A. lesions affecting the palms of hands and the soles of feet. B. dry, scaly patches in the antecubital area and behind the knees. C. cracked, scaly areas in the webs of fingers. D. a butterfly pattern rash on the face across the bridge of the nose.

D. a butterfly pattern rash on the face across the bridge of the nose.

Parkinson disease is associated with A. demyelination of CNS neurons. B. a pyramidal nerve tract lesion. C. insufficient production of acetylcholine in the basal ganglia. D. a deficiency of dopamine in the substantia nigra.

D. a deficiency of dopamine in the substantia nigra.

Upper extremity weakness in association with degeneration of CNS neurons is characteristic of A. multiple sclerosis. B. Guillain-Barré syndrome. C. myasthenia gravis. D. amyotrophic lateral sclerosis.

D. amyotrophic lateral sclerosis.

Systemic lupus erythematosus (SLE) is a rheumatic disease attributed to A. wear and tear on weight-bearing joints. B. septic joint inflammation and necrosis. C. unknown etiologic factors. D. autoimmune mechanisms.

D. autoimmune mechanisms. Systemic lupus erythematosus (SLE) is a rheumatic disease attributed to autoimmune mechanisms. Wear and tear on weight-bearing joints and septic joint inflammation and necrosis do not lead to SLE. SLE is known to be attributed to autoimmune mechanisms.

People who have osteoporosis are at risk for A. rhabdomyolysis. B. osteomyelitis. C. osteomalacia. D. bone fractures.

D. bone fractures.

A compound, transverse fracture is best described as a bone that is A. broken in two or more pieces. B. cracked but not completely separated. C. broken along the long axis. D. broken and protruding through the skin.

D. broken and protruding through the skin. The type of fracture described is broken and protruding through the skin. A comminuted fracture is one that is broken in two or more pieces. An incomplete fracture is cracked but not completely separated. A longitudinal fracture is broken along the long axis.

Inflammation of the sacs that overlie bony prominences is called A. epicondylitis. B. arthritis. C. tendinitis. D. bursitis.

D. bursitis.

Pain in fibromyalgia involves A. muscle inflammation. B. autoimmune destruction of muscle tissue. C. nerve inflammation. D. changes in pain transmission in the spinal cord.

D. changes in pain transmission in the spinal cord.

It is true that epidural bleeding is A. associated with widespread vascular disruption. B. located between the arachnoid and the dura mater. C. usually because of venous leakage. D. characterized by a lucid interval immediately after injury.

D. characterized by a lucid interval immediately after injury.

The pain of nonarticular rheumatism ("growing pain") is worse A. during activity. B. following strenuous exercise. C. upon awakening. D. during the night.

D. during the night. Growing pains are worse at night in the calves, shins, and thighs. Growing pains are not worse during activity or following strenuous exercise. Growing pains are worse at night, not upon awakening.

Acceleration-deceleration movements of the head often result in polar injuries in which A. injury is localized to the site of initial impact. B. widespread neuronal damage is incurred. C. bleeding from venules fills the subdural space. D. focal injuries occur in two places at opposite poles.

D. focal injuries occur in two places at opposite poles. Polar injuries occur as a consequence of the brain shifting within the skull and meninges during the course of an acceleration-deceleration movement resulting in local injury at two opposite poles of the brain. Focal injuries are those that are localized to the site of impact to the skull. Diffuse injuries occur when movement of the brain causes widespread neuronal damage. An intracranial hematoma is a localized collection of blood within the cranium.

Gouty arthritis is a complication of A. group A streptococcal infection. B. autoimmune destruction of joint collagen. C. excessive production of urea. D. inadequate renal excretion of uric acid.

D. inadequate renal excretion of uric acid. Gouty arthritis is a complication of inadequate renal excretion of uric acid. Rheumatic fever-related arthritis is related to group A streptococcal infection. Gout is not an autoimmune disorder. Gout is because of inadequate renal excretion of uric acid, not excessive production of urea.

Systemic disorders include A. adhesive capsulitis. B. verrucae. C. osteoarthritis. D. rheumatoid arthritis.

D. rheumatoid arthritis. Systemic manifestations of rheumatoid arthritis include fever, malaise, and lymphadenopathy. Adhesive capsulitis and osteoarthritis are not systemic diseases. Verrucae are warts, and they are not systemic.

Rupture of a cerebral aneurysm should be suspected if the patient reports A. ringing in the ears. B. transient episodes of numbness. C. transient episodes of vertigo. D. sudden, severe headache.

D. sudden, severe headache. Warning leaks may occur before an aneurysm ruptures and often produce severe headache, which is typically described by the patient as "the worst headache I have ever had." Ringing in the ears is not a symptom associated with rupture of a cerebral aneurysm. Transient episodes of numbness are not indicative of a cerebral aneurysm rupture. Transient episodes of vertigo are not indicative of a cerebral aneurysm rupture.

In contrast to osteoarthritis, rheumatoid arthritis may be associated with A. debilitating joint pain and stiffness. B. improvement in symptoms with aspirin therapy. C. changes in activities of daily living. D. systemic aching in the musculoskeletal system.

D. systemic aching in the musculoskeletal system.

The primary reason that prolonged seizure activity predisposes to ischemic brain damage is that A. neurons are unable to transport glucose. B. cardiovascular regulation is impaired. C. the brainstem is depressed. D. the lack of airway maintenance can lead to hypoxia.

D. the lack of airway maintenance can lead to hypoxia.

The ________ is the level of painful stimulation required to be perceived. A. perception B. tolerance C. expression D. threshold

D. threshold

Rickets is characterized by soft, weak bones resulting from a deficiency of A. calcium. B. estrogen. C. phosphate. D. vitamin D.

D. vitamin D.