Chamberlain College of Nursing - NR 507 week 4 midterm Exam; 2019 > Attempt Score 116 Out of 120.

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NR 507 week 4 midterm Exam Question 1 Which hepatitis virus is known to be sexually transmitted? Only hepatitis B virus (HBV) is known to be sexually transmitted. Question 2 Which term is ... used to identify the movement of gas and air into and out of the lungs? Perfusion Ventilation Respiration Diffusion Of the options available, ventilation is the only term used to identify the mechanical movement of gas or air into and out of the lungs. Question 3 2 / 2 pts Between which months of age does sudden infant death syndrome (SIDS) most often occur? 0 and 1 2 and 4 5 and 6 6 and 7 The incidence of SIDS is low during the first month of life but sharply increases in the second month of life, peaking at 2 to 4 months and is unusual after 6 months of age. Question 4 2 / 2 pts Erythrocyte life span of less than 120 days, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiologic characteristics of which type of anemia? Aplastic Sideroblastic Anemia of chronic disease Iron deficiency Anemia of chronic disease results from a combination of (1) decreased erythrocyte life span, (2) suppressed production of erythropoietin, (3) ineffective bone marrow erythroid progenitor response to erythropoietin, and (4) altered iron metabolism and iron sequestration in macrophages. This result is not true of the other options. Question 5 2 / 2 pts How is most carbon dioxide (CO2) in the blood transported? Attached to oxygen In the form of bicarbonate Combined with albumin Dissolved in the plasma Approximately 60% of the CO2 in venous blood and 90% of the CO2 in arterial blood are carried in the form of bicarbonate. Question 6 2 / 2 pts The glomerular filtration rate is directly related to which factor? Perfusion pressure in the glomerular capillaries Diffusion rate in the renal cortex Diffusion rate in the renal medulla Glomerular active transport 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. Question 7 2 / 2 pts Which blood cell type is elevated at birth but decreases to adult levels during the first year of life? Monocytes Platelets Neutrophils Lymphocytes Only monocyte counts are high in the first year of life and then decrease to adult levels. Question 8 2 / 2 pts Perceived stress elicits an emotional, anticipatory response that begins where? Prefrontal cortex Anterior pituitary Limbic system Hypothalamus Perceived stressors elicit an anticipatory response that begins in the limbic system of the brain, the only option responsible for emotions and cognition. Question 9 2 / 2 pts It has been determined that a tumor is in stage 2. What is the meaning of this finding? Cancer is confined to the organ of origin. Cancer has spread to regional structures. Cancer is locally invasive. Cancer has spread to distant sites Cancer confined to the organ of origin is stage 1; cancer that is locally invasive is stage 2; cancer that has spread to regional structures, such as the lymph nodes, is stage 3; and cancer that has spread to distant sites, such as a liver cancer spreading to the lung or a prostate cancer spreading to bone, is stage 4. Question 10 2 / 2 pts Apoptosis is a(an): Normal mechanism for cells to self-destruct when growth is excessive Antigrowth signal activated by the tumor-suppressor gene Rb Mutation of cell growth stimulated by the TP53 gene Transformation of cells from dysplasia to anaplasia Normal cells have a mechanism that causes them to self-destruct when growth is excessive and cell cycle checkpoints have been ignored. Diverse stimuli, including normal development and excessive growth, trigger this self-destruct mechanism, called apoptosis. The remaining options do not describe apoptosis. Question 11 2 / 2 pts Which T-lymphocyte phenotype is the key determinant of childhood asthma? Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes CD4 T-helper Th2 lymphocytes CD8 cytotoxic T lymphocytes Memory T lymphocytes Asthma develops because the Th2 response (in which CD4 T-helper cells produce specific cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and allergic response in the airways. This selection is the only option that accurately identifies the appropriate T-lymphocyte phenotype. Question 12 2 / 2 pts Which cells have phagocytic properties similar to monocytes and contract like smooth muscles cells, thereby influencing the glomerular filtration rate? Principle cells Podocin cells Mesangial cells Intercalated cells 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. Question 13 2 / 2 pts What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn? Low birth weight Alcohol consumption during pregnancy Premature birth Smoking during pregnancy RDS of the newborn, also known as hyaline membrane disease (HMD), is a major cause of morbidity and mortality in premature newborns. None of the other options are considered the chief predisposing factors for RDS. Question 14 2 / 2 pts During an IgE-mediated hypersensitivity reaction, which leukocyte is activated? Neutrophils Monocytes Eosinophils T lymphocytes Of the options provided, only eosinophils are activated during IgE-mediated hypersensitivity reactions. Question 15 2 / 2 pts Which statement is true concerning the IgM? IgM is the first antibody produced during the initial response to an antigen. IgM mediates many common allergic responses. IgM is the most abundant class of immunoglobulins. IgM is capable of crossing the human placenta. Typically, IgM is produced first (primary immune response), followed by IgG against the same antigen. The other options are not true statements regarding IgM. Question 16 2 / 2 pts What is the functional unit of the kidney called? Glomerulus Nephron Collecting duct Pyramid 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. Question 17 2 / 2 pts Phagocytosis involves neutrophils actively attacking, engulfing, and destroying which microorganisms? Bacteria Fungi Viruses Yeasts Invasion is the direct confrontation with an individual’s primary defense mechanisms against only bacteria, which include the complement system, antibodies, and phagocytes, such as neutrophils and macrophages. Question 18 2 / 2 pts What is the most important negative inotropic agent? Norepinephrine Epinephrine Acetylcholine Dopamine Chemicals affecting contractility are called inotropic agents. The most important negative inotropic agent is acetylcholine released from the vagus nerve. The most important positive inotropic agents produced by the body are norepinephrine released from the sympathetic nerves that supply the heart and epinephrine released by the adrenal cortex. Other positive inotropes include thyroid hormone and dopamine. Many medications have positive or negative inotropic properties that can have profound effects on cardiac function. This selection is the only option that accurately identifies the regulation that is involved in the described process. Question 19 2 / 2 pts Which term is used to describe a muscle cell showing a reduced ability to form new muscle while appearing highly disorganized? Dysplasia Hyperplasia Myoplasia Anaplasia Anaplasia is defined as the loss of cellular differentiation, irregularities of the size and shape of the nucleus, and the loss of normal tissue structure. In clinical specimens, anaplasia is recognized by a loss of organization and a significant increase in nuclear size with evidence of ongoing proliferation. The remaining options refer to specific changes in the cell. Question 20 2 / 2 pts What is the role of caretaker genes? Maintenance of genomic integrity Proliferation of cancer cells Secretion of growth factors Restoration of normal tissue structure Caretaker genes are responsible for the maintenance of genomic integrity. The other options are not roles assumed by caretaker genes. Question 21 2 / 2 pts Which organism is a common sexually transmitted bacterial infection? Staphylococcus aureus Clostridium perfringens Helicobacter pylori Treponema pallidum Treponema pallidum (spirochete, syphilis) is a sexually transmitted disease. Staphylococcus aureus is commonly ingested, causing food poisoning; Clostridium perfringens (gas gangrene) is a skin or wound infection; and Helicobacter pylori (gastritis, peptic ulcers) is found in the gastrointestinal tract. Question 22 2 / 2 pts The function of the foramen ovale in a fetus allows what to occur? Right-to-left blood shunting Left-to-right blood shunting Blood flow from the umbilical cord Blood flow to the lungs The nonfused septum secundum and ostium secundum result in the formation of a flapped orifice known as the foramen ovale, which allows the right-to-left shunting necessary for fetal circulation. The foramen ovale is not involved in the blood flow described by the other options. Question 23 2 / 2 pts How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness? 75 to 100 ml 100 to 150 ml 250 to 300 ml 350 to 400 ml 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). Question 24 2 / 2 pts The lung is innervated by the parasympathetic nervous system via which nerve? Vagus Phrenic Brachial Pectoral Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel only in the vagus nerve to the lung. Question 25 2 / 2 pts What is the trigone? A smooth muscle that comprises the orifice of the ureter The inner mucosal lining of the kidneys A smooth triangular area between the openings of the two ureters and the urethra One of the three divisions of the loop of Henle 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. Question 26 2 / 2 pts What is the action of urodilatin? Urodilatin causes vasoconstriction of afferent arterioles. It causes vasodilation of the efferent arterioles. Urodilatin inhibits antidiuretic hormone secretion. It inhibits salt and water reabsorption. 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. Question 27 2 / 2 pts The generation of clonal diversity occurs primarily during which phase of life? Fetal Neonatal Infancy Puberty Generation of clonal diversity primarily occurs in the fetus and probably continues to a low degree throughout most of adult life. Question 28 2 / 2 pts Which substance has been shown to increase the risk of cancer when used in combination with tobacco smoking? Alcohol Steroids Antihistamines Antidepressants Alcohol interacts with smoke, increasing the risk of malignant tumors, possibly by acting as a solvent for the carcinogenic chemicals in smoke products. No current research supports the remaining options as having an increased effect on the incidence of cancer when used in combination with tobacco smoking. Question 29 2 / 2 pts Which type of immunity is produced by an individual after either natural exposure to the antigen or after immunization against the antigen? Passive-acquired immunity Active-acquired immunity Passive-innate immunity Active-innate immunity An individual produces active-acquired immunity (active immunity)after natural exposure to an antigen or after immunization, whereas passive-acquired immunity (passive immunity) does not involve the host’s immune response at all. The innate immune system, also known as nonspecific immune system and the first line of defense, is composed of the cells and mechanisms that defend the host from infection by other organisms in a nonspecific manner, which means that the cells of the innate system recognize and respond to pathogens in a generic way. Question 30 2 / 2 pts The only surface inside the nephron where cells are covered with microvilli to increase the reabsorptive surface area is called the: Proximal convoluted tubules Distal tubules Ascending loop of Henle Descending loop of Henle 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. Question 31 2 / 2 pts Causes of hyperkalemia include: Hyperparathyroidism and malnutrition Vomiting and diarrhea Renal failure and Addison disease Hyperaldosteronism and Cushing disease Hyperkalemia should be investigated when a history of renal disease, massive trauma, insulin deficiency, Addison disease, use of potassium salt substitutes, or metabolic acidosis exists. The other options are not known to be causes of hyperkalemia. Question 32 2 / 2 pts When a patient has small, vesicular lesions that last between 10 and 20 days, which sexually transmitted infection is suspected? Genital herpes Chancroid Syphilis Chlamydia If symptoms occur, the individual may have small (1 to 2 mm), multiple, vesicular lesions that are generally located on the labia minora, fourchette, or penis. They may also appear on the cervix, buttocks, and thighs and are often painful and pruritic. These lesions usually last approximately 10 to 20 days. The other options do not demonstrate these symptoms. Question 33 2 / 2 pts An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody? IgG IgM IgA IgE The IgA molecules found in bodily secretions are dimers anchored together through a J-chain and secretory piece. This secretory piece is attached to the IgA antibodies inside the mucosal epithelial cells and may function to protect these immunoglobulin antibodies against degradation by enzymes also found in the secretions, thus decreasing the risk of infections in the mucous membrane. The other options do not accurately identify the immunoglobulin antibody involved in mucous membrane infections. Question 34 2 / 2 pts Which of the following is classified as a megaloblastic anemia? Iron deficiency Pernicious Sideroblastic Hemolytic Pernicious anemia is the most common type of megaloblastic anemia. The remaining options are not classified as megaloblastic anemias. Question 35 2 / 2 pts Blood vessels of the kidneys are innervated by the: Vagus nerve Sympathetic nervous system Somatic nervous system Parasympathetic nervous system 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. Question 36 2 / 2 pts Which statement best describes a Schilling test? Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency Measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia Measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia Administration of folate and measurement in 2 hours of its level in a blood sample to test for folic acid deficiency anemia. The Schilling test indirectly evaluates vitamin B12 absorption by administering radioactive B12 and measuring excretion in the urine. This selection is the only option that accurately describes a Schilling test. Question 37 2 / 2 pts Which laboratory test is considered adequate for an accurate and reliable diagnosis of gonococcal urethritis in a symptomatic man? Ligase chain reaction (LCR) Gram-stain technique Polymerase chain reaction (PCR) DNA testing Microscopic evaluation of Gram-stained slides of clinical specimens is deemed positive for Neisseria gonorrhoeae if gram-negative diplococci with the typical “kidney bean” morphologic appearance are found inside polymorphonuclear leukocytes. Such a finding is considered adequate for the diagnosis of gonococcal urethritis in a symptomatic man. The other options are not relevant to the diagnosis of this condition. Question 38 2 / 2 pts Continuous increases in left ventricular filing pressures result in which disorder? Mitral regurgitation Mitral stenosis Pulmonary edema Jugular vein distention Pressure changes are important because increased left ventricular filling pressures back up into the pulmonary circulation, where they force plasma out through vessel walls, causing fluid to accumulate in lung tissues (pulmonary edema). This selection is the only option that accurately identifies the disorder described in the question. Question 39 2 / 2 pts What substance stimulates renal hydroxylation in the process of producing vitamin D? Erythropoietin Thyroid hormone Calcitonin Parathyroid hormone 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. Question 40 2 / 2 pts What are the abnormalities in cytokines found in children with cystic fibrosis (CF)? Deficit of interleukin (IL)–1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-α) Deficit of IL-6 and an excess of IL-2, IL-8, and granulocyte colony-stimulating factor (G-CSF) Deficit of IL-10 and an excess of IL-1, IL-8, and TNF-α Deficit of IL-3 and an excess of IL-14, IL-24, and colony-stimulating factor (CSF) Abnormal cytokine profiles have been documented in CF airway fluids, including deficient IL-10 and excessive IL-1, IL-8, and TNF-α, all changes conducive to promoting inflammation. This selection is the only option that accurately identifies the abnormalities in cytokines observed in children with CF. Question 41 2 / 2 pts What is the primary problem resulting from respiratory distress syndrome (RDS) of the newborn? Consolidation Pulmonary edema Atelectasis Bronchiolar plugging The primary problem is atelectasis, which causes significant hypoxemia and is difficult for the neonate to overcome because a significant negative inspiratory pressure is required to open the alveoli with each breath. None of the other options are considered a primary problem associated with RDS. Question 42 2 / 2 pts What is the most common cause of insufficient erythropoiesis in children? Folic acid deficiency Iron deficiency Hemoglobin abnormality Erythrocyte abnormality Similar to the anemias of adulthood, ineffective erythropoiesis or premature destruction of erythrocytes causes the anemias of childhood. The most common cause of insufficient erythropoiesis is iron deficiency. The other options may be causes but are not common ones. Question 43 2 / 2 pts Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction? I II III IV Hypersensitivity reactions have been divided into four distinct types: type I (IgE-mediated) hypersensitivity reactions, type II (tissue-specific) hypersensitivity reactions, type III (immune complex–mediated) hypersensitivity reactions, and type IV (cell-mediated) hypersensitivity reactions. Question 44 2 / 2 pts Causes of hyperkalemia include: Hyperparathyroidism and malnutrition Vomiting and diarrhea Renal failure and Addison disease Hyperaldosteronism and Cushing disease Hyperkalemia should be investigated when a history of renal disease, massive trauma, insulin deficiency, Addison disease, use of potassium salt substitutes, or metabolic acidosis exists. The other options are not known to be causes of hyperkalemia. Question 45 2 / 2 pts Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge? Trachea Left lung Bronchus Bronchioles Approximately 75% of aspirated foreign bodies lodge in a bronchus. The other options are not locations where children aspirate the majority of foreign objects. Question 46 2 / 2 pts What effects do exercise and body position have on renal blood flow? Exercise and body position activate renal parasympathetic neurons and cause mild vasoconstriction. They activate renal sympathetic neurons and cause mild vasoconstriction. Both activate renal parasympathetic neurons and cause mild vasodilation. They activate renal sympathetic neurons and cause mild vasodilation. 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. Question 47 2 / 2 pts Which complex (wave) represents the sum of all ventricular muscle cell depolarizations? PRS QRS QT interval P Only the QRS complex represents the sum of all ventricular muscle cell depolarizations. Question 48 2 / 2 pts What is the ratio of coronary capillaries to cardiac muscle cells? 1:1 (one capillary per one muscle cell) 1:2 (one capillary per two muscle cells) 1:4 (one capillary per four muscle cells) 1:10 (one capillary per ten muscle cells) The heart has an extensive capillary network, with approximately 3300 capillaries per square millimeter (ca/mm2) or approximately one capillary per one muscle cell (muscle fiber). Question 49 2 / 2 pts Low plasma albumin causes edema as a result of a reduction in which pressure? Capillary hydrostatic Interstitial hydrostatic Plasma oncotic Interstitial oncotic Losses or diminished production of plasma albumin is the only option that contributes to a decrease in plasma oncotic pressure. Question 50 2 / 2 pts Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot to relieve hypoxic spells? Lying on their left side Performing the Valsalva maneuver Squatting Hyperventilating Squatting is a spontaneous compensatory mechanism used by older children to alleviate hypoxic spells. Squatting and its variants increase systemic resistance while decreasing venous return to the heart from the inferior vena cava. The other options would not result in these changes. Question 51 2 / 2 pts How is most of the oxygen in the blood transported? Dissolved in plasma Bound to hemoglobin In the form of carbon dioxide (CO2) Bound to protein Oxygen is transported in the blood in two forms. A small amount dissolves in plasma, and the remainder binds to hemoglobin molecules. The other options are not involved in this process. Question 52 2 / 2 pts Why is nasal congestion a serious threat to young infants? Infants are obligatory nose breathers. Their noses are small in diameter. Infants become dehydrated when mouth breathing. Their epiglottis is proportionally greater than the epiglottis of an adult’s. Infants up to 2 to 3 months of age are obligatory nose breathers and are unable to breathe in through their mouths. Nasal congestion is therefore a serious threat to a young infant. This selection is the only option that accurately describes why nasal congestion is a serious threat to young infants. Question 53 2 / 2 pts What is the major concern regarding the treatment of gonococci infections? Development of antibiotic resistance Changes in virulence Changes in pathogenicity Mutations into different strains Several types of drug-resistant strains have been identified; they are penicillinase-producing Neisseria gonorrhoeae (PPNG), which is resistant to penicillin; tetracycline-resistant N. gonorrhoeae (TRNG), which is resistant to tetracycline; chromosomal control of mechanisms of resistance of N. gonorrhoeae (CMRNG), which is resistant to penicillin and tetracycline; and increasingly a fluoroquinolone-resistant N. gonorrhoeae (QRNG). The other options are not major concerns. Question 54 2 / 2 pts Which drug may be prescribed orally for outbreak management of herpes simplex viral (HSV) infections? Acyclovir (Zovirax) 5-Fluorouracil (5-FU) Zidovudine (AZT) (Retrovir) Bichloroacetic acid (BCA) Although no curative treatment for HSV infection is known, only oral acyclovir, valacyclovir, penciclovir, and famciclovir are used for primary and periodic outbreaks and to prevent recurrences. Question 55 2 / 2 pts Decreased lung compliance means that the lungs are demonstrating which characteristic? Difficult deflation Easy inflation Stiffness Inability to diffuse oxygen A decrease in compliance indicates that the lungs or chest wall is abnormally stiff or difficult to inflate. This selection is the only option that accurately identifies the meaning of decreased compliance. Question 56 2 / 2 pts The most common site of metastasis for a patient diagnosed with prostate cancer is which location? Bones Brain Bladder Kidney The bone, especially the lumbar spine area, is the most common metastasis site for prostate cancer. Question 57 2 / 2 pts Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child? Parental history of asthma Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels Reduced expiratory flow rates confirmed by spirometry testing Improvement on a trial of asthma medication Confirmation of the diagnosis of asthma relies on pulmonary function testing using spirometry, which can be accomplished only after the child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities. For younger children, an empiric trial of asthma medications is commonly initiated. The remaining options are major historical and physical factors that contribute but do not confirm the diagnosis of asthma in children. Question 58 2 / 2 pts Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)? Adrenal cortex Hypothalamus Anterior pituitary Limbic system The alarm phase of the GAS begins when a stressor triggers the actions of the hypothalamus and the sympathetic nervous system (SNS) (see Figure 11-1). The other organs are not stimulated by the alarm phase of GAS. Question 59 2 / 2 pts Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct? Antidiuretic hormone Aldosterone Cortisol Adrenocorticotropin hormone 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. Question 60 2 / 2 pts What is the primary cause of respiratory distress syndrome (RDS) of the newborn? Immature immune system Small alveoli Surfactant deficiency Anemia RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange. None of the other options are related to the cause of RDS. [Show More]

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