MN551 midterm [2021]

MN551 midterm Saved A patient is experiencing impaired circulation secondary to increased systemic arterial pressure. Which of the following statements is the most relevant phenomenon? Question 1 options: Increased pr ...

MN551 midterm Saved A patient is experiencing impaired circulation secondary to increased systemic arterial pressure. Which of the following statements is the most relevant phenomenon? Question 1 options: Increased preload due to vascular resistance High afterload because of backpressure against the left ventricle Impaired contractility due to aortic resistance Systolic impairment because of arterial stenosis Question 2 (2 points) Saved A nurse practitioner employed in a hospitalist notices that a patient is experiencing muscle atrophy following 2 weeks in traction after a motor vehicle accident. Which of the following factors has most likely contributed to the atrophy of the patient's muscle cells? Question 2 options: High levels of insulin and IGF-1 in the patient's blood during immobilization Denervation of the affected muscles during the time of traction A reduction of skeletal muscle use secondary to the traction treatment Reduced oxygen consumption and cellular function that ensures muscle cell survival Question 3 (2 points) Saved An older adult female patient has presented with a new onset of shortness of breath, and the patient's nurse practitioner has ordered measurement of her BNP levels along with other diagnostic tests. What is the most accurate rationale for the nurse practitioner's choice of blood work? Question 3 options: BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the patient's dyspnea from a respiratory pathology. BNP is an indirect indicator of the effectiveness of the RAA system in compensating for heart failure. BNP levels correlate with the patient's risk of developing cognitive deficits secondary to heart failure and consequent brain hypoxia. BNP becomes elevated in cases of cardiac asthma, Cheyne-Stokes respirations, and acute pulmonary edema, and measurement can gauge the severity of pulmonary effects. Question 4 (2 points)Saved A nurse practitioner is performing patient teaching about the influenza virus with each patient who has come to the clinic to receive that year's vaccine. Which of the following statements by patients best reflects an accurate understanding of the flu virus? Question 4 options: “I could come down with viral or bacterial pneumonia as a result of a bad flu bug.” “I know my vaccination is especially important since there aren't any drugs that can treat the flu once I get sick with it.” “The emphasis on bundling up, staying warm, and drinking lots of fluids is outdated and actually ineffective.” “Like all vaccines, it is ideal if everyone in a population gets immunized against the flu.” Question 5 (2 points) Saved A 71-year-old woman is dependent on oxygen therapy and bronchodilators due to her diagnosis of emphysema. Which of the following processes would her care team be most justified in ruling out? Question 5 options: Decreased elastic recoil due to alveolar damage Decreased residual lung volume due to impaired alveolar ventilation Increased anatomic dead space due to reduced tidal volume Increased alveolar dead space due to incorrect intrapleural pressure Question 6 (2 points) Saved A 66-year-old patient's echocardiogram reveals a hypertrophied left ventricle, normal chamber volume, and a normal ejection fraction from the heart. What is this patient's most likely diagnosis? Question 6 options: Mitral valve regurgitation Aortic valve stenosis Mitral valve stenosis Aortic valve regurgitation Question 7 (2 points) SavedWhich of the following statements most accurately conveys an aspect of lymphatic system activity? Question 7 options: B and T lymphocyte development begins in the bone marrow and ends in the peripheral lymphoid structures. B cells and macrophages are released from the bone marrow in their completed state. Stem cells in the lymph nodes initiate and regulate the process of white cell synthesis. Leukocytes bypass vascular circulation and are distributed instead by the lymphatic system. Previous PageNext Page Page 1 of 2 Submit Quiz Page 2 of 2 Question 8 (2 points) Saved An 81-year-old male resident of a long-term care facility has a longstanding diagnosis of heart failure. Which of the following short-term and longer-term compensatory mechanisms is least likely to decrease the symptoms of his heart failure? Question 8 options: An increase in preload via the Frank-Starling mechanism Sympathetic stimulation and increased serum levels of epinephrine and norepinephrine Activation of the renin-angiotensin-aldosterone (RAA) system and secretion of brain natriuretic peptide (BNP) AV node pacemaking activity and vagal nerve suppression Question 9 (2 points) Saved A nurse practitioner student is familiarizing herself with the overnight admissions to an acute medical unit of a university hospital. Which of the following patients would the student recognize as being least likely to have a diagnosis of antiphospholipid syndrome in his or her medical history? Question 9 options: A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic attacks A 30-year-old female with a diagnosis of left leg DVT and a pulmonary embolismA 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use Question 10 (2 points) Saved The nurse practitioner is seeing a client who has an acute exacerbation of Crohn’s disease. The NP recognizes the fact that the disease involves the inflammation and irritation of the intestinal lining. Which of the following types of tissue is most likely involved in the patient's pathology? Question 10 options: Simple columnar epithelium Glandular epithelium Simple cuboidal epthelium Stratified epithelium Question 11 (2 points) Saved A 22-year-old female with a history of intermittent flank pain, repeated UTIs, and hematuria has been diagnosed with autosomal dominant polycystic kidney disease (ADPKD). Which of the following phenomena has most likely contributed to the development of her health problem? Question 11 options: UTIs coupled with an impaired immune response have caused her ADPKD. She has inherited a tendency for epithelial cell in her tubules to proliferate inappropriately. Severe hypertension and portal hypertension are likely precursors. She has inherited undersized kidneys that are prone to calculi formation. Question 12 (2 points) Saved A community health nurse practitioner is teaching a group of female high school students about the importance of regular Papanicolaou (Pap) smears. The nurse recognizes that which of the following items underlies the rationale for this teaching? Question 12 options: The active substitution of normal cells in the cervix correlates to cancer risk. Undifferentiated stem cells are an early indicator of cervical cancer. Cancer of the uterine cervix develops incrementally at a cellular level.Dysplasia in the connective tissue of the cervix is a strong precursor to cancer. Question 13 (2 points) Saved A new older female patient at a long-term care facility has a diagnosis of type 1 neurofibromatosis (NF-1). As part of the intake assessment protocol for the facility, the clinical educator is teaching the care staff about the diagnosis. Which of the following statements most accurately conveys an aspect of neurofibromatosis? Question 13 options: “The neurofibroma lesions are unsightly for the patient, but they are not painful. “Her diagnosis puts her at higher risk of developing a malignant neoplasm.” “She is living with an example of an autosomal recessive disorder.” “The patient is likely to be photosensitive as a result of the disease.” Question 14 (2 points) Saved A 21-year-old male patient has suffered a head injury during a crash on his motorcycle, and a deficit that assessments have revealed is an impaired swallowing mechanism. He has also developed aspiration pneumonia. Which of the following statements most accurately capture an aspect of his condition? Question 14 options: His oropharynx is obstructed. His epiglottis is covering his larynx His vocal folds have been compromised. His tracheobronchial tree is intermittently obstructed. Question 15 (2 points) Saved A male lifetime smoker has died as a result of chronic obstructive pulmonary disease. Which of the following phenomena regarding his alveoli would his care team have most reasonably expected in the weeks prior to his death? Question 15 options: Proliferation of natural killer (NK) cells in the alveolar lumen Large numbers of alveolar macrophages in septal connective tissue The presence of tubercles in the intra-alveolar spaces Compensatory regeneration of type I alveolar cellsQuestion 16 (2 points) Saved A 62-year-old female smoker is distraught at her recent diagnosis of small cell lung cancer (SCLC). How can her nurse practitioner most appropriately respond to her? Question 16 options: “I'm sure this is very hard news to hear, but be aware that with aggressive treatment your chances of beating this are quite good.” “This is very difficult to hear, I'm sure, and we have to observe to see if it spreads because that often happens.” “I'm very sorry to have to give you this news; I'd like to talk to you about surgical options, however.” “This is a difficult diagnosis to receive, but there is a chance that the cancer may go into remission.” Question 17 (2 points) Saved Which of the following patients on a medical unit of a hospital is most likely to be experiencing health problems that may be attributable to kidney disease? Question 17 options: An 81-year-old female patient with osteoporosis and anemia A 77-year-old patient with urinary retention due to benign prostatic hyperplasia (BPH) A 55-year-old woman with a recent stroke secondary to long-standing hypertension A 60-year-old man with a systemic fungal infection requiring intravenous antibiotics Question 18 (2 points) Saved A 44-year-old woman developed calf pain during a transatlantic flight followed by acute shortness of breath upon arrival at her destination. She was subsequently diagnosed with a pulmonary embolism (PE), which resolved with anticoagulant therapy. Which of these statements best characterizes the underlying problem of her PE? Question 18 options: She was short of breath because ventilation was occurring but perfusion was inadequate. The combination of normal perfusion but compromised ventilation caused hypoxia. She developed a transient anatomic shunt resulting in impaired oxygenation. Impaired gas diffusion across alveolar membranes resulted in dyspnea and hypoxia.Question 19 (2 points) Saved Which of the following patients would be considered to have a significant risk of developing the prerenal form of acute renal failure? Question 19 options: A 22-year-old male who has lost a large amount of blood following a workplace injury A 41-year-old female who is admitted for intravenous antibiotic treatment of pyelonephritis A 79-year-old male with diagnoses of poorly controlled diabetes mellitus and congestive heart failure A 20-year-old male who is admitted for treatment of an overdose of a nephrotoxic drug A 68-year-old male with a diagnosis of benign prostatic hyperplasia (BPH) An 80-year-old female who has been admitted for treatment of dehydration, hyponatremia, and malnutrition Question 20 (2 points) Saved A group of researchers has identified that the prevalence of two particular genetic disorders share a statistical correlation. Which of the following statements best conveys the genetic rationale for this situation? Question 20 options: There is likely a cause-and-effect relationship between the two genes responsible. The chromosomes containing each gene are likely closely situated. The genes causing each disorder are likely in the same section of the same chromosome. The disorders likely share the same locus. Question 21 (2 points) Saved Which of the following individuals would be considered to be at risk for the development of edema? Question 21 options:An 81-year-old man with right-sided heart failure and hypothyroidism A 60-year-old obese female with a diagnosis of poorly controlled diabetes mellitus A 34-year-old industrial worker who has suffered extensive burns in a job-related accident A 77-year-old woman who has an active gastrointestinal bleed and consequent anemia A 22-year-old female with hypoalbuminemia secondary to malnutrition and anorexia nervosa Question 22 (2 points) Saved A tourist presented to a primary care health clinic complaining of malaise, fever, and headache. She has subsequently been diagnosed with Rocky Mountain spotted fever, a pathology caused by Rickettsiaceae. Which of the followed statements best captures a characteristic trait of Rickettsiaceae? Question 22 options: They are eukaryotic. They have both RNA and DNA. They have a distinct spiral-shaped morphology. They are neither gram-negative nor gram-positive. Question 23 (2 points) Saved A female patient is requiring supplementary oxygen by facemask due to her reduced lung compliance. Which of the following pathophysiologic processes is most likely to be a contributor to her low lung compliance? Question 23 options: The woman's lungs have more recoil than a healthy person's. Her type II alveolar cells are producing a slight excess of surfactant. Turbulent airflow is taking place in the patient's large airways. Her thoracic cage is less flexible than when she was healthy. Question 24 (2 points) SavedA 60-year-old male patient with an acute viral infection is receiving interferon therapy. The nurse practitioner is teaching the family of the patient about the diverse actions of the treatment and the ways that it differs from other anti-infective therapies. Which of the following teaching points should the nurse practitioner exclude? Question 24 options: “Interferon can help your father's unaffected cells adjacent to his infected cells produce antiviral proteins that limit the spread of the infection.” “Interferon can help limit the replication of the virus that's affecting your father.” “Interferon helps your father's body recognize infected cells more effectively.” “Interferon can bolster your father's immune system by stimulating natural killer cells that attack viruses.” Question 25 (2 points) Saved A 68-year-old male complains to his nurse practitioner that when he tests his blood pressure using a machine at his pharmacy, his heart rate is nearly always very low. At other times, he feels that his heart is racing, and it also seems to pause at times. The man has also occasionally had lightheadedness and a recent syncopal episode. What is this patient's most likely diagnosis and the phenomenon underlying it? Question 25 options: Sick sinus syndrome as a result of a disease of his sinus node and atrial or junctional arrhythmias Ventricular arrhythmia as a result of alternating vagal and sympathetic stimulation Torsades de pointes as a result of disease of the bundle of His Premature atrial contractions that vacillate between tachycardic and bradycardic episodes as a consequence of an infectious process Question 26 (2 points) Saved A nurse practitioner is explaining to a 40-year-old male patient the damage that Mycobacterium tuberculosis could do to lung tissue. Which of the following phenomena would underlie the nurse practitioner's explanation? Question 26 options: Tissue destruction results from neutrophil deactivation. Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis. Macrophages are unable to digest the bacteria, resulting in immune granulomas. Neutrophils are ineffective against the Mycobacterium tuberculosis antigens. Question 27 (2 points)Saved A child has been diagnosed with thalassemia. Which of the following other health problems is the child at risk for? Question 27 options: Hypocoagulation Iron and ferritin deficiencies Splenomegaly and hepatomegaly Neutropenia Question 28 (2 points) Saved A patient has been admitted to an inpatient medical unit of a hospital with an acute viral infection. The health care team providing care for the patient would recognize which of the following statements as an accurate description of the role of viruses in human infections? Question 28 options: Viruses have limited or absent genetic material of their own. Some viruses are capable of transforming normal host cells into malignant cells. Viruses are often implicated in cases of transmissible neurodegenerative disease. Viruses require stimulation after a latent period before they are able to produce symptoms. Question 29 (2 points) Saved A 6-year-old girl with a diagnosis of Marfan syndrome is being assessed at a community health clinic. Which of the following assessments would be the health care professional's lowest priority? Question 29 options: A test of the child's visual acuity A musculoskeletal assessment Tests of kidney function Cardiovascular assessment Question 30 (2 points) Saved A 7-year-old boy is admitted to the hospital with a suspected diagnosis of lead toxicity. Which of the following assessment findings is most congruent with the patient's diagnosis? Question 30 options: Decreased deep tendon reflexesHemoglobin 9.9 g/dL Diffuse muscle pain White blood cells (WBC) 11,000/mm3 Question 31 (2 points) Saved A 45-year-old patient who experienced exposure to radiation during an industrial accident several years prior is being assessed. Which of the following phenomena may underlie the genetic changes that have been noted in the patient? Question 31 options: Base pairs may have been rearranged by the radiation exposure. Endonucleases may have influenced the DNA structure following exposure. Two paired bases may have exchanged helical positions after the accident. The radiation may have produced redundant or degenerate genetic code. Question 32 (2 points) Saved A 77-year-old lifetime smoker has been diagnosed with a tumor in his lung at the site of an old tubercle scarring site, located in a peripheral area of his bronchiolar tissue. What is this patient's most likely diagnosis? Question 32 options: Squamous cell carcinoma Small cell lung cancer Large cell carcinoma Adenocarcinoma Question 33 (2 points) Saved Which of the following patients is most likely to benefit from transplantation of thymic tissue or major histocompatibility complex (MHC)- compatible bone marrow? Question 33 options: A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells A 9-year-old girl who has a diagnosis of IgA deficiencyQuestion 34 (2 points) Saved A 68-year-old woman with a new onset of vascular dementia has recently begun retaining urine. Which of the following physiological phenomena would her care providers most realistically expect to be currently occurring as a result of her urinary retention? Question 34 options: Hypertrophy of the bladder muscle and increased bladder wall thickness Decreased urine production and nitrogenous wasted excretion by the kidneys Decompensation, bladder stretching, and high residual urine volume Overflow incontinence and loss of contraction power Question 35 (2 points) Saved A physical assessment of a 28-year-old female patient indicates that her blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which of the following possibilities would her care provider be most likely to suspect? Question 35 options: Pheochromocytoma Essential hypertension Coarctation of the aorta An adrenocortical disorder Question 36 (2 points) Saved An 81-year-old female has long-standing hypocalcemia secondary to kidney disease and will shortly be moving into an assisted living facility from her own apartment. Which of the following findings should staff at the facility be instructed to observe for? Question 36 options: Loss of appetite and complaints of nausea Muscular spasms and complaints of cramps High fluid intake and urine output Lethargy and stuporQuestion 37 (2 points) Saved As a result of dehydration, a patient's epithelial cells are producing insufficient amounts of mucus. Consequently, the patient's mucociliary blanket is compromised. Which of the following changes would a care provider most reasonably anticipate as a direct result of this change? Question 37 options: Impaired function of the patient's cilia Decreased levels of oxygen saturation Increased amounts of bacteria in the lungs Increased carbon dioxide levels Question 38 (2 points) Saved A formerly normotensive woman, pregnant for the first time, develops hypertension and headaches at 26 weeks' gestation. Her blood pressure is 154/110 mm Hg and she has proteinuria. What other labs should be ordered for her? Question 38 options: Plasma angiotensin I and II and renin Urinary sodium and potassium Platelet count, serum creatinine, and liver enzymes Urinary catecholamines and metabolites Question 39 (2 points) Saved Which of the following patients are NOT displaying known risk factors for the development of pulmonary emboli? Question 39 options: A patient who is immobilized following orthopedic surgery A patient who has impaired Cl– and Na+ regulationA patient who is taking amiodarone for the treatment of a cardiac arrhythmia A patient who is a smoker and takes oral contraceptives A patient who is undergoing radiation therapy for the treatment of breast cancer Question 40 (2 points) Saved A 34-year-old male patient has diagnoses of liver failure, ascites, and hepatic encephalopathy secondary to alcohol abuse. The patient's family is questioning the care team about why his abdomen is so large even though he is undernourished and emaciated. Which of the following statements most accurately underlies the explanation that a member of the care team would provide to the family? Question 40 options: An inordinate amount of interstitial fluid is accumulating in the patient's abdomen. The transcellular component of the intracellular fluid compartment contains far more fluid than normal. The normally small transcellular fluid compartment, or third space, is becoming enlarged. Gravity-dependent plasma is accumulating in the patient's peritoneal cavity. Question 41 (2 points) Saved A number of patients have presented to the emergency department in the last 24 hours with complaints that are preliminarily indicative of myocardial infarction. Which of the following patients is least likely to have an STsegment myocardial infarction (STEMI)? Question 41 options: A 70-year-old woman who is complaining of shortness of breath and vague chest discomfort A 66-year-old man who has presented with fatigue, nausea and vomiting, and cool, moist skin A 43-year-old man who woke up with substernal pain that is radiating to his neck and jaw A 71-year-old man who has moist skin, fever, and chest pain that is excruciating when he moves but relieved when at rest Question 42 (2 points)Saved A male patient of a nurse practitioner has an autosomal dominant disorder. The patient and his partner are considering starting a family. Which of the patient's following statements indicates the patient has an adequate understanding of the genetic basis of this health problem? Question 42 options: “I know there's no way of accurately determining the chance that my child will inherit the disease.” “My children who don't have the disease still run the risk of passing it on to their children.” “I know that new genetic mutations won't occur between generations.” “I know that a single mutant allele is to blame for the health problem.” Question 43 (2 points) Saved A 16-year-old female has been brought to her primary care nurse practitioner by her mother due to the girl's persistent sore throat and malaise. Which of the following facts revealed in the girl's history and examination would lead the nurse practitioner to rule out infectious mononucleosis? Question 43 options: The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes. Her liver and spleen are both enlarged. Blood work reveals an increased white blood cell count. Chest auscultation reveals crackles in her lower lung fields bilaterally. Question 44 (2 points) Saved A nurse educator is orientating new nurses to a renal unit of a hospital. Which of the following teaching points should the nurse include as part of a review of normal glomerular function? Question 44 options: “Nephrons are delicate structures that cannot endure the high pressure that exists in capillary beds elsewhere in the body.” “Glomerular filtrate is very similar in composition to blood plasma found elsewhere in circulation.” “Dilation of the afferent arteriole allows more blood into the nephron and increases the glomerular filtration rate.” “The glomerulus is located between an arteriole and a venule that work together to regulate blood flow.” Question 45 (2 points) SavedWhich of the following phenomena would be least likely to result in activation of the complement system? Question 45 options: Recognition of an antibody bound to the surface of a microbe The binding of mannose residues on microbial glycoproteins Activation of Toll-like receptors (TLRs) on complement proteins Direct recognition of microbial proteins Previous PageNext Page Page 2 of