Final Exam NUR 2024 QUESTION WITH CORRECT ANSWERS MOSTLY RECENTLY UPDATED, Exams of Nursing

Download Final Exam NUR 2024 QUESTION WITH CORRECT ANSWERS MOSTLY RECENTLY UPDATED and more Exams Nursing in PDF only on Docsity!

Final Exam NUR 2024 QUESTION WITH

CORRECT ANSWERS MOSTLY

RECENTLY UPDATED

Raynaud's disease - answers>-primary vasospastic disorder -blood vessels demonstrate endothelial dysfunction with imbalance between endothelium-derived vasodilators. -pallor, numbness, cold sensation in digits -followed by rubor -happens in Beurgers and DLE UTI symptoms in Elderly - answers>-confusion/ poorly localized abdominal pain -caused by e.coli usually Paget Disease (osteitis deformans) - answers>-increased metabolic activity in bon characterized by abnormal and excessive bone resorption and formation (remodeling) -affects often axial skeleton- vertebrae, skull, sacrum, sternum, pelvis, and femur. -usually diagnosed over 40, invasive procedures diagnose causes of stomach cancer - answers>-h.pylori infection -diet- salt, food additives (nitrates), and not eating fruits/veggies -alcohol/smoking HHV-8 - answers>-causes Kaposi Sarcoma (public health concern in africa) -accounts for 2% of infection-attributable cancers worldwide murmur in PDA - answers>continuous, machinery type murmur heard best at left upper sternal border throughout systole and diastole pg 1124 Koplik spots - answers>rubeola -pinpoint white spots surrounded surrounded by erythematous red ring

• found on buccal mucosa abducens nerve - answers>VI -lateral eye movement -leave inferior pons, exit skull, extend to eye -motor fibers to lateral rectus muscle and proprioceptor fibers from muscle to brain

Olfactory nerve - answers>I -smell -sensory for smell -fibers arise from nasal olfactory epithelium and form synapses with olfactory bulbs that transmit impulses to temporal lobe Hypoglossal nerve - answers>XII -stick out tongue -motor fibers to muscles of tongue and sensory impulse from tongue to brain -fibers arise from medulla and exit from skull and extend to tongue trigeminal nerve - answers>V -sensations of pain, touch, temperature, corneal reflex, clench teeth, open mouth, chew -motor and sensory. sensory from mouth, nose, eye surface, dura mater. motor stimulates chewing Meconium ileus and cystic fibrosis - answers>-results from abnormal mucus production in the intestine and/or impaired pancreatic enzymes -20% of infants with CF hormones responsible for ovulation - answers>Luteinizing Hormone Human Papillomavirus (HPV) - answers>STI -increases risk of cervical cancer -6 and 11= nononcogenic/genital warts -16 and 18=oncogenic-anogenital cancers/oropharyngeal cancers Hydrocele - answers>-collection of fluid within the tunica vaginalis -common cause of scrotal swelling Spermatocele - answers>-benign cystic collections of fluid of the epididymis located between the head of the epididymis and the testis -milky fluid containing sperm varicocele - answers>-abnormal dilation of the veins of the spermatic cord -bag of worms testicular torsion - answers>-rotation of a testis, twisting blood vessels in spermatic cord -causes acute scrotum=testicular pain and swelling Syphilis - answers>Treponema pallidum -transmission usually occurs in first years of infection -transmitted through exudate from lesions during small abrasions during sex -three stages

-congenital syphilis is spread in utero, usually results in neonatal death, can be prevented with penicillin. stage 1 at the site of invasion stage 2 spreads systemically to major organ systems, spontaneous resolution of lesions Secondary Syphilis lesions - answers>-Condylomata lata- highly contagious, develop on perineum, vulva, groin on women and inner thigh and anal area on both sexes -hypertrophied, flat, moist, wart-like or vegetative (cauliflower) ADH and function in kidney - answers>-controls final concentration of urine -increases water permeability in the last segment of the distal tubule and along entire length of collecting ducts -secreted from posterior pituitary or neurohypophysis megacolon - answers>Hirschsprung disease -functional obstruction of the colon -common in Downs and other congenital diseases -failure of neural crest cells to migrate into GI tract. -neural malformation of PNS -delayed passage of mec -poor feeding, poor weight gain, distended abdomen RDS causes in infants - answers>-surfactant deficiency -prematurity -it is atelactasis -decreases between 30 and 36 weeks gestation most reported side effect of cancer treatment other symptoms - answers>fatigue -anemia, bone density loss, cachexia, GI stuff (oral ulcers, malabsorption, diarrhea, infection risk), hair loss, skin breakdown/dryness, infection, infertility, leukopenia, thrombocytopenia, lymphedema, pain shock symptoms in newborns - answers>-jitteriness/lethargy -decreased tone -apnea -change in O2 requirements -bradycardia or decreased -variability in HR -hypothermia/unstable temp -hypoglycemia/unstable blood -glucose -feeding intolerance liquefactive necrosis - answers>-ischemic injury to neurons and glial cells of the brain

-can also be bacterial infection glossopharyngeal nerve - answers>IX -swallow/gag -motor fibers- salivary/pharync -sensory-carry impulse from pharynx, posterior tongue and pressure receptors of carotid artery -fibers emerge from midbrain and leave skill, extend to pharynx, salivary glands, tongue Vagus Nerve - answers>x -Throat muscles -fibers carry sensory and motor impulses for pharynx; PNS motor fibers, supply smooth muscles of abdominal organs, receive sensory impulses from viscera -fibers emerge from medulla, pass through skull, and descend through neck region into thorax and abdominal region vestibulocochlear nerve - answers>VIII -hearing and balance -sensory only- vestibular branch transmits impulses for sense of equilibrium, cochlear branch transmits impulses for sense of hearing -fibers run from inner ear to enter brainstem just below pons. cranial nerve III - answers>oculomotor pupils examined for size, shape, equality, pupillary reflex with pen light -fibers emerge from midbrain and exit from skull and extend to the eye Cranial Nerve 3 eye manifestations with herniation - answers>dilation of ipsilateral pupil Cancer associated with BRCA1 and BRCA2 - answers>Breast Ovarian Reed- Sterberg Cells - answers>Hodgkins Lymphoma -B cells -large, binucleate intussusception - answers>-telescoping of proximal part of intestines into distal part, causing obstruction, collapses through ileocecal valve -lead points (tumors diverticuli). CF, abdominal surgery -colicky abdominal pain, irritability, knees drawn to chest, abdominal mass, vomiting, currant jelly stools Celiac Sprue - answers>-autoimmune, damages small intestinal villous epithelium when gluten is ingested -DQ2 and HLA-DQ -malabsorptions- vit K= hypoprothrombinemia= bruise/bleed easy

-fat-soluble vitamins, iron, folic acid, B12 and iron deficiency increased risk of stomach cancer Bence Jones protein - answers>-Multiple myeloma -free immunoglobulin light chain present in the blood and urine when there is renal tubular cell damage multiple myeloma - answers>-clonal plasma cell cancer characterized by slow proliferation of tumor cell masses in the bone marrow

• associated with lytic bone lesions (punched out) -hypercalcemia, anemia, bone lesions, renal failure -bence jones protein -infection is leading cause of death Rickets/Vitamin D deficiency - answers>-insufficient vitamin d, insensitivity to vitamin D, kidneys wasting vitamin D, inability to absorb vitamin D and calcium in gut -soft bones, fail to become mineralized -children need 15-20 minutes of natural sun exposure a week to activate vitamin d pathologic fracture - answers>break at site of preexisting abnormality, such as a tumor or osteoporosis, by a force that would not fracture a normal, healthy bone any disease that weakens bone puts you at risk, commonly infections, tumors, osteoporosis, other metabolic bone disorders Osteosarcoma - answers>most common malignant bone tumor in childhood -occurs from bone producing mesenchymal cells -mainly in metaphyses of long bones -most tumors arise in bones involved with knee joint at distal end of the femur or proximal end of the tibia -disseminates through bloodstream, typically to lung -usually presents with pain, can have swelling, warmth, redness SRC gene ankylosing spondylitis - answers>-chronic, inflammatory joint disease characterized by stiffening and fusion of the spine and sacroiliac joints -inflammation of fibrocartilagenous joints of the vertebra -HLA-B -primary=adolescence - secondary- older age/inflammatory disease
• low back pain/stiffness -CD8+ t-cells presented with cartilage antigens role of estrogen in osteoporosis - answers>-postmenopausal osteoporosis -exert antiapoptotic effects on osteoblasts but exert proapoptotic effects on osteoclasts passive aquired immunity - answers>-host receives antibodies rather than making them

-preformed antibodies or T lymphocytes transferred from donor to recipient -maternal antibodies or immunotherapy for a specific disease Dumping Syndrome - answers>rapid stomach emptying after stomach resection -10-20 minutes after eating -increased pulse, hypotension, weakness, pallor, sweating, and dizziness. -creation of a high osmotic gradient in the small intestine, causing a sudden shift of fluid from the blood vessels to the intestinal lumen Dystrophin - answers>-present in normal muscle cells -absent in Duchenne muscular dystrophy. -Dystrophin mediates anchorage of the actin cytoskeleton of skeletal muscle fibers to the basement membrane through a membrane glycoprotein complex Philadelphia chromosome - answers>chronic myeloid leukemia chromosome translocation Bacteria causing UTI - answers>E.coli is most common then Staph. Saprophyticus Compensatory Hyperplasia - answers>-adaptive mechanism that enables certain organs to regenerate -remove part of liver and liver undergoes compensatory hyperplasia Squatting in Tetralogy of Fallot - answers>-alleviates hyper-cyanotic spells -increases SVR and decreases venous return to heart from inferior vena cava. -decreased SVR makes O2 more available to the body Deafferentation pain - answers>-damage to a peripheral nerve (trauma) -severe burning pain triggered by cold, light touch, sound or other various stimuli -reflex sympathetic dystrophies-occur after peripheral nerve injury and are characterized by continuous, severe, burning pain associated with vasomotor changes and muscle wasting. IgE - answers>-allergic reactions -type 1 hypersensitivity -Only urticaria is mediated by the IgE - stimulated release of histamine, bradykinin, or kallikrein from mast cells or basophils, or both which causes the endothelial cells of skin blood vessels to contract. page IgA - answers>-found in secretions IgA1 molecules are predominantly found in the blood, whereas IgA2 is the predominant class of antibody found in normal body secretions.

IgG - answers>crosses the placenta IgM - answers>-Primary Immune Response -IgM is produced first (primary immune response), followed by IgG against the same antigen. onychomycosis - answers>fungal/dermatophyte infection of the nails -nail plates turns yellow or white and becomes elevated as result of hyperkeratotic debris within the plate -no pitting on nails-that is psoriasis Impetigo - answers>-superficial infection of skin -Skin lesions that rupture, creating a thin, flat, honey-colored crust, caused by S.aureus or alpha-hemolytic streptococci -common in children -high incidence in hot, crowded, poor conditions -anemia and malnutrition are predisposing factors -bullous and non-bullous -usually nose and mouth, sometimes hands Lichen Planus - answers>-benign, autoimmune inflammatory disorder of the skin and mucous membranes -onset 30-70 years -T cell adhesion molecules, inflammatory cytokines, perforin, and antigen presenting cells involved -pale pink lesions that evolve into dark violet lesions, can become thickened and red=hypertrophic lichens planus -oral lesions=lacy white -pruritis -thinning/splitting of nails -elevated, firm, circumscribed areas less than 1 cm in diamete eczema and dermatitis - answers>-Inflammatory conditions of the skin caused by allergy, infection, poor circulation, or exposure to chemical or environmental factors -skin can become thickened, leathery, and hyper pigmented from recurrent irritation -Pruritus, lesions with indistinct borders, and epidermal changes diabetes insipidus - answers>-insufficient ADH -large volumes of dilute urine=increases plasma osmolality -polyuria, nocturia, continuous thirst, polydipsia -SG <1.010 (LOW) -Urine osmolality <200 (LOW) -hypernatremia >145 sodium level -high serum osmolality >

diabetes insipidus and ADH - answers>insufficient ADH hypoglycemia in type 1 diabetes and symptoms - answers>-less than 70 -exogenous- caused by medications, alcohol, exercise -endogenous- pancreatic tumor, inherited disorder -functional-hyperallimentation, spontaneous, liver disease -insulin shock or insulin reaction

• neurogenic sx (SNS)= tachycardia, palpitations, diaphoresis, tremors, pallor, arousal anxiety -headache, dizziness, blurred vision, fatigue, irritability, poor judgement, confusion, hunger, seizure, coma Duchenne muscular dystrophy and genetics - answers>-X-linked recessive, typically affects boys for this reason -no dystrophin (mediates anchorage of actin cytoskeleton of skeletal muscle fibers to the basement membrane) -lack of dystrophin=poorly anchored muscle fibers that are torn apart under repeated stress of contraction -death usually occurs from respiratory infection and a compromised respiratory system hormonal hyperplasia - answers>-uterus/breasts -after ovulation, estrogen stimulates endometrium to grow and thicken -hypertrophy of uterus in pregnancy arachnoid villi function - answers>-Absorb cerebrospinal fluid into the cerebral venous sinuses -Allow drainage of CSF into venous system in dural sinuses -Maintains normal intracranial pressure Circle of willis - answers>-provides alternative route of blood flow when one of the contributing arteries is obstructed -collateral blood flow testicular cancer screening - answers>-palpation- firm, non-tender mass or diffuse enlargement. abnormal consistency, induration, nodularity -most common in men from 15-35 years of age. cryptorchidism and cancer - answers>-testicular maldescent -risk of testicular cancer is 35-50% greater Hemophilia A and genetics - answers>-changes in F8 gene which is responsible for making coagulation VIII protein -X-linked recessive-mainly in males

causes of pernicious anemia - answers>B12 deficiency -autoimmune against gastric parietal cells -Dietary Vitamin B12 is a large molecule that requires a protein secreted by parietal cells into the stomach (intrinsic factor IF) to transport across the ileum. Defects in IF, production lead to decreased B12 absorption and pernicious anemia Marasmus/kwashiorkor - answers>Kwashiorkor-MEALS- malnutrition, edema, anemia, liver dysfunction, skin lesions. edematous malnutrition and usually occurs in infants and children 1-4 y.o. who have weaned from breast milk to a high-starch, protein deficient diet. kwashiorkor has a higher death rate than marasmus protein deficiency Marasmus- any age, starvation due to lack of protein and carbs all nutrients and can have a psychogenic basis in neglected children. Attributed to overdiluted commercial formulas in developing countries malrotation and periduodenal band - answers>congenital anomaly of small intesting -small intestine lacks normal posterior fixation because it has only a rudimentary attachment near the original origin of the superior mesentaric artery. When rotation doesnt occur, colon remains in URQ where abnormal membrane or band called a periduodenal band/ladd pand may press or obstruct the duodenum bile-stained vomitting after feeding, epigastric distention, fever, pain, scant stools Gout and Renal Stones - answers>gout- overproduction of uric acid, producing crystals in joints -closely linked to purine metabolism TOPHI-uric acid crystals. Renal stones are 1000 times more prevalent in individuals with primary gout autosomal dominant disease occurence - answers>50% Affected heterozygous individuals transmit the trait to approximately one half of their children; however, because gamete transmission is subject to chance fluctuations, it is possible that all or none of the children of an affected parent may have the trait. Nevertheless, when large numbers of matings of this type are studied, the proportion of affected children closely approach one half. Digestive Enzymes and Meconium Ileus - answers>Meconium ileus occurs in 20% of cases of Cystic Fibrosis and is thought to be because of impaired pancreatic enzymes or abnormal mucus production in intestine

transudative pleural effusion - answers>-caused by high blood pressure from CHF and decreased capillary oncotic pressure from hypoproteinemia.. fluid in pleural space -clear or slightly discolored containing few cells and little protein -CHF, liver and kidney disorders causing hypoproteinemia cause of SLE - answers>autoimmune disease -Tissue damage caused by the deposition of circulating immune complexes containing an antibody against the host DNA is the cause Goodpasteur's - answers>also known as anti-glomerular basement membrane disease, is a rare autoimmune disease in which antibodies attack the basement membrane in lungs and kidneys, leading to bleeding from the lungs and kidney failure. IgE mediated hypersensitivity - answers>type 1 -most occur against environmental antigens -allergic -histamine- contracts bronchial smooth muscle, causing bronchial constriction; increases vascular permeability, causing edema; causes vasodilation, increasing blood flow to area. -mediates IgE and products of mast cells -Histamine bound to H2 results in the degranulation of mast cells during an IgE- medicated hypersensitivity reaction calcium and phosphate balance influencers - answers>PTH Calcitonin Vitamin D Hypercalcemia and multiple myeloma - answers>infiltration of the bone by malignant plasma cells and stimulation of osteoclasts to reabsorb bone results in release of calcium (causing hypercalcemia) and "lytic lesions" jaundice causes - answers>Heme destruction exceeds the liver's ability to conjugate and excrete bilirubin caused by hyperbilirubinemia -extrahepatic obstruction to bile flow (gallstone -intrahepatic obstruction (cirrhosis/hepatitis) -prehepatic excessive production of unconjugated bilirubin (excessive RBC hemolysis) -in newborns- impaired uptake and conjugation -physiologic - 1day to two weeks old -pathologic- anything beyond that jaundice and hemolytic anemia - answers>present when heme destruction exceeds the liver's ability to conjugate and excrete bilirubin

hyperkalemia and insulin - answers>When insulin transports glucose into the cell, it also carries potassium with it. Right heart failure - answers>-inability of right ventricle to provide adequate blood flow to pulmonary circulation -results from severe LHF or pulmonary hypertension (COPD, CF) -results from pulmonary disease and increased pulmonary vascular resistance -pressure in the pulmonary circulation rises, the resistance to right ventricular emptying increases ADH synthesis and location - answers>synthesized in renal tubules and acts in renal collecting ducts. Determines final concentration of urine Complement cascade and neutrophils - answers>opsonins tag microorganisms for destruction by cells of inflammatory system (neutrophils) shingles (herpes zoster) - answers>-follows years after chickenpox when immunity declines -caused by varicella-zoster virus -usually lesions do not cross midline epstein barr virus/ mononucleosis - answers>-acute viral disease of B lymphocytes -85% of mono cases are due to EBV -carcinogenic relationship -The strongest association between viruses and the development of cancer in children has been the Epstein-Barr virus (EBV), Burkitt lymphoma, nasopharyngeal carcinoma, and Hodgkin disease. conditions associated with prerenal injury - answers>inadequate kidney perfusion -hypotension -hypovolemia from hemorrhage or fluid loss (burns) -sepsis -inadequate cardiac output

• MODS -renal vasoconstriction by NSAIDS or contrast dye -renal artery stenosis -kidney edema restricting blood flow. hyperparathyroidism and renal failure - answers>secondary hyperparathyroidism -compensatory response to chronic hypocalcemia -elevated secretion of PTH, but calcium levels cannot be normal because there is insufficient activation of vitamin d. neuropathic pain - answers>-chronic pain initiated or caused by a lesion or dysfunction of nervous system and leads to long term changes in pain pathway structures

-abnormal processing of sensory information -burning, tingling, shock like, tingling myofascial pain syndrome - answers>-muscle spasms, tenderness, and stiffness and leads to muscle guarding that limits muscle motion -acute muscle injury to muscle, fascia, and tendons, including myositis, fibrositis, myofibrositis, myalgia, and muscle pain Treponema pallidum - answers>organism is responsible for the development of syphilis PCOS - answers>-POS is a result of a combination of conditions that include oligo- ovulation or anovulation, elevated levels of androgens, or clinical signs of hyperandrogenism and polycystic ovaries -dysfunctional bleeding, amenorrhea, hirsutism, acne, infertility -leading cause of infertility in women Hypomethylation and effect on oncogenes - answers>-increase in tumor progression -Tumor cells typically exhibit hypomethylation (decreased methylation), which can increase the activity of oncogenes. - ------ --Hypomethylation increases as tumors progress from benign neoplasms to malignancy. glomerulus basement membrane and IgG - answers>-IgG deposited in glomerulus basement membrane in glomerulonephritis -Glomerulonephritis develops with the deposition of antigen-antibody complexes (IgG, immunoglobulin A [IgA] and C3 complement) in the glomerulus, or the antigen may be trapped within the glomerulus and immune complexes formed in situ. Immunofluorescence microscopy shows lumpy deposits of IgG and C3 complement on the glomerular basement membrane protein energy malnutrition - answers>Kwashiorkor and Marasmus -severe, long-term starvation Obesity and Type 2 Diabetes - answers>-increased resistance to insulin -increased adipokines (leptin/adiponectin) -elevated FFA's -release of inflammatory cytokines -alterations in oxidative phosphorylation -correlated with hyperinsulinemia cervical intraepithelial neoplasia cause - answers>HPV chronic anemia in renal failure - answers>-corrected with erythropoietin -failure to increase erythropoietin in response to decrease numbers of eythrocytes -damage to kidneys affects secretion of erythropoietin

Cystic Fibrosis - answers>-A genetic disorder that is present at birth and affects both the respiratory and digestive systems. -autosomal recessive -abnormal expression of protein-producing viscous mucous obstructing airways, pancreas, sweat ducts, vas deferens -Deficit of IL-10 and an excess of IL-1 , IL-8 and TNF α -associated with meconium illeus -pancreatic enzymes deficiency -cervical inflammation -portal hypertension multiple sclerosis - answers>-chronic inflammatory disease involving degeneration of CNS myelin, scarring, and loss of axons. -demyelination of nerve fibers in the CNS -autoimmune response to self or microbial antigens in genetically susceptible individuals metabolic acidosis labs - answers>decreased pH- less than 7. normal PaCO2- 35- decreased bicarb- less than 22 Chondolamata Acumulata - answers>gential warts caused by HPV Pyloroplasty can lead to - answers>rapid gastric emptying -increased pulse, hypotension, weakness, pallor, sweating, and dizziness -creates high osmotic gradient in small intestine, causing sudden shift of fluid from blood vessels to intestinal lumen estrogen effects on osteoclasts and osteablasts - answers>antiapoptic effects- osteoblasts proapoptotic- osteoclasts Condyomata lata - answers>syphilis Chlamydia - answers>Chlamydia trachomatis parallel gonorrhea primary defense against parasites - answers>eosinophils IgE increases which diabetes is auto-immune - answers>type 1 (insulin dependent) Complement Cascade how it impacts destruction of neutrophils and macrophage - answers>opsonization- tags pathogenic microorganisms for destruction by neutrophils and macrophages

electrolyte imbalance in multiple myeloma - answers>hypercalcemia from infiltration of bone by malignant plasma cells and stimulation of osteoclasts to reabsorb bone- leafs to hypercalcemia and lytic, or punched out, lesions. urticaria - answers>allergic reaction. elevated irregular shaped areas of cutaneous edema solid and transient variable diameter Varicella/Herpes Zoster - answers>elevated, circumscribed, superficial lesions filled with serous fluid less than 1 cm sebhorrheic keratosis and actinic keratosis - answers>large firm rough elevated warts - answers>verruca less than 1 cm elevated firm a problem with this valve could lead to right ventricular hypertrophy - answers>triscupid stress response of adrenal medulla - answers>release catecholemines (epi/norepi) decreased GH