HLTH 314 Final Exam With correct answers., Exams of Nursing

Download HLTH 314 Final Exam With correct answers. and more Exams Nursing in PDF only on Docsity! HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers In Situ - correct answer -stays in place. Ductal carcinoma in situ and lobular carcinoma in situ Well-Differentiated Cancer - correct answer --Resemble a normal cell -Benign Poorly Differentiated Cancer - correct answer --Cells are abnormal -Malignant Mammogram - correct answer --Xrays are taking in two views in both breasts -Detects 2 years sooner than physical examination. -Sees fibrous vs glandular tissue -Less useful for dense breasts Dense Breast - correct answer --More fibroglandular vs fatty tissue -More likely if you are younger, pregnant/breastfeeding, taking hormone replacement therapy, or have a lower body weight -Breast ultrasounds or MRIs are best for those with dense breasts. Glandular Tissue - correct answer --Lobes and ducts -15 to 20 lobes -White on mammogram Stromal (supporting) Tissue - correct answer --Suspensory Ligaments of Cooper Fatty Tissue - correct answer --Dark on mammogram HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Benign - correct answer -Growth rate- slow Growth character- expansion Tumor spread- remains localized Cell differentiation- well-differentiated cells -"oma" typically used to designate -glandular and stromal tissue -white and well-circumscribed on mammogram Malignant - correct answer -Growth rate- rapid and not responsive to regulatory signals Growth character- infiltration Tumor spread- metastasis by bloodstream or lymphatic channels Cell differentiation- poorly-differentiated cells -Carcinoma, sarcoma, leukemia -Starts from a single cell that has sustained damage to its genome causing it to proliferate abnormally -irregular borders with flecks of calcium on mammogram Hormone Receptors - correct answer -ER, PR, HER2 Triple Negative Breast Cancer - correct answer --Accounts for 10-15% all breast cancers. -Lacks receptors to estrogen, progesterone, and HER2 protein. -Typically, responsive to chemotherapy but doesn't respond to receptor targeted treatments -Can be particularly aggressive and more likely to recur Breast Cancer Risk Factors - correct answer --Age: strongest risk, over 50 -Family History: first degree doubles or tripes -Breast Cancer Gene Mutation: BRCA1, BRCA2 -Personal History: in situ or invasive increases risk -Gynecologic History: early menarche, late menopause, late first pregnancy -Breast Changes: lesions, masses HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Long-Term use of Estrogen-Progestin Following Menopause - correct answer --Tumors have less favorable prognosis -Hormones increase breast density making tumors harder to identify by mammogram -Long term use poses greatest risk for breast carcinoma (8%) -1% without progestin Mutations in BRCA-1 Gene - correct answer --Breast cancer risk is 80% higher -Ovarian carcinoma risk is 20-40% higher Mutations in BRCA-2 Gene - correct answer --Breast cancer risk is 80% higher -Ovarian carcinoma risk is 10-20% higher Stage 0 Breast Cancer - correct answer --Noninvasive, carcinoma in situ Stage 1 Breast Cancer - correct answer --1 to 2 cm -No lymph nodes involved Stage 2 Breast Cancer - correct answer --Invasive Breast Cancer -2 to 5 cm -or spread to axillary node on same side as cancer Stage 3 Breast Cancer - correct answer --Locally advanced breast cancer -Greater than 2 inches in diameter -Extensive axillary lymph nodes -or spread to other lymph nodes or tissues Stage 4 Breast Cancer - correct answer --Metastatic Breast Cancer -Spread to other parts of the body HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Recurrent Breast Cancer - correct answer --Breast cancer that has returned in spite of initial treatment Carcinoma In Situ - correct answer --Lobular -Ductal Invasive Carcinoma - correct answer --Lobular (5-15%): normal, slightly firm tumor texture; most often ER+ and HER2- -Ductal (50-75%): Hard tumor texture, irregular, star-shaped, DCIS often present Most Common Site of Breast Cancer - correct answer --Epithelium of ducts/ductal carcinoma (90%) -Lobules/lobular carcinoma (10%) Frequency of Breast Cancer at Anatomic Sites - correct answer -Upper outer quadrant- 60% Upper inner quadrant- 15% Lower outer quadrant- 15% Lower inner quadrant- 5% Nipple area- 5% Signs and Symptoms of Breast Cancer - correct answer --Early stage may be asymptomatic -Most common sign is painless lump -Lump usually hard with uneven edges, but can be tender, soft, or round -Lump in underarm area -Change in breast size/shape -Skin dimpling -Nipple inversion -Discharge - HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Simple or total mastectomy - correct answer -remove breast but leave axillary lymph nodes and chest muscles Halsted radical mastectomy - correct answer -Remove all breast, LN, chest muscles, and additional fat/skin Modified radical mastectomy with axillary lymph node dissection - correct answer -remove all breast and ALN but leave chest muscles Breast-conserving surgery - correct answer -Lumpectomy, partial mastectomy, lymph node dissection Reconstructive Breast Surgery - correct answer --Implant reconstruction: saline, silicone gel, or combination -Autologous or "fla" reconstruction: tissue transplanted from abdomen, back, thigh; may include implant HER2+ Treatment - correct answer --Herceptin is a monoclonal antibody designed to target HER2 -Block downstream signaling pathways -Flags tumor for destruction by immune system (antibody dependent cellular cytotoxicity) Adjuvant Therapy for Breast Carcinoma - correct answer --Cytotoxic drugs (adjuvant chemotherapy) -Anti-estrogen drugs (adjuvant hormonal therapy) -Combination of both Sarcoma of the Breast - correct answer --Rare tumor -Arises from fibrous tissue or blood vessels in breast -Large, bulky -May metastasize widely -Treated by surgical resection Predicting Recurrence - correct answer --Lymph node involvement HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers -Changes in personality and behavior -Trouble recognizing friends and family members Dementia Stage of Alzheimer's - correct answer --Severe -May last 1 to 5 years -Most of cortex seriously damage, brain shrinks because of widespread cell death -Loss of speech, appetite, bladder and bowel control -Total dependence on caregiver Dementia - correct answer --Neurocognitive disorder -Decline in intellectual fan -Not a disease but a group of symptoms -Cause: damage to brain cells (neurons) Types of Dementia - correct answer --Alzheimer's Disease -Lewy Body Dementia -Vascular Dementia -Frontal-Temporal Dementia Top 10 Causes of Death in the U.S. - correct answer -1. Heart Disease 2. Cancer 3. COVID-19 4. Accidents 5. Stroke 6. Chronic Lower Respiratory Disease 7. Alzheimer's Disease 8. Diabetes 9. Influenza/Pneumonia 10. Kidney Disease HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Primordial Level of Prevention - correct answer --Focus on population health and health promotion. -Target on underlying broad health determinants. -Examples: improving sanitation, developing health policy, promoting habits -Upstream is less costly Primary Level of Prevention - correct answer --Focus on individual. -Target is personal exposure and risk factors. -Goal is promoting health and preventing onset of disease. -Example: health education, maternal health programs, immunization programs, individual lifestyle choices Secondary Level of Prevention - correct answer --Focus is individual. -Goal is preventing development of disease once a person has been exposed. -Example: early detection via screenings, early diagnosis and treatment, control of disease transmission Tertiary Level of Prevention - correct answer --Focus is individual. -Goal is preventing return of disease, preventing worsening, and restore patient to a productive state of living. -Example: physical therapy, cardiac rehabilitation, modifying risk behaviors Quaternary Level of Prevention - correct answer --Focus is individual. -Goal is to avoid over medicalization. -Example: avoiding polypharmacy, drastic life-saving measures Social Determinants of Health - correct answer --Conditions in which people are born, grow, live, work, and age -Shaped by distribution of power, money, and resources -Mostly responsible for health inequities- the unfair and avoidable differences in health status HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Goal in Public Health - correct answer -To change behavior Health Belief Model - correct answer --Perceived susceptibility -Perceived severity -Perceived benefits -Perceived barriers -Cues to action -Self efficacy Theory of Planned Behavior - correct answer --Attitudes -Behavioral intention -Subjective norm: do most people approve? -Social norm: customary behavior -Perceived power: presence of factors that help or hurt -Perceived behavioral control: ease or difficulty -Key component is behavioral intent and the subjective evaluation of risks and benefits -Purpose is to predict and explain health behaviors Life Course Theory - correct answer -1. Lifelong development and aging 2. Historical time and place 3. Timing in lives 4. Linked lives 5. Human agency Oakland Growth Study - correct answer -Children succeeded in rising above childhood disadvantages and achieving a full life HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers -Looks at factors before, during, and after an injury or death -Pre event, event, post event Industrial Hygiene Process - correct answer -Anticipate, Recognize, Evaluate, Control Routes of Entry - correct answer --Absorption -Ingestion -Ingestion -Inhalation Types of Hazards - correct answer -Chemical, biological, physical, ergonomic Herd Immunity - correct answer -Resistance of a disease that results in a population is a certain number are immune (especially via vaccination) R0 - correct answer -the number of cases one case can cause Modes of Transmission - correct answer --Direct Contact -Indirect Contact (fomite) -Droplet (big particles) -Airborne (small particles) -Vehicle Borne (contaminated food/water) -Vector Borne (insect or animal)E Epidemiologic Triangle - correct answer -agent, host, environment Chain of Infection - correct answer -infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Natural (innate) Immunity - correct answer -Immunity from genetic factors Adaptive (acquired) Immunity - correct answer -Develops after exposure Active Immunity - correct answer -Own Antibodies -Natural: exposure to infectious agent -Artificial: immunization Passive Immunity - correct answer -Ready-made antibodies -Natural: maternal antibodies -Artificial: antibodies from other sources Live-Attenuated Vaccines - correct answer --"Mostly dead" -Less virulent than completely live pathogen -MMR and Varicella Killed Vaccines - correct answer --Completely dead pathogen, inactivated -Hepatitis A, Polio, Flu, Rabies Toxoid Vaccines - correct answer --Made from a toxin that is harmless but still initiates an immune response -Diphtheria and Tetanus Component Vaccine - correct answer --Includes part of a pathogen, not whole pathogen The Big Three - correct answer -Malaria, TB, HIV/AIDS Latent Tuberculosis - correct answer --Lives but doesn't grow inside body -Doesn't make a person sick/feel symptoms HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers -Can't spread -Can advance to TB disease -MTB in body -Positive skin/blood test -Negative sputum smear/culture -NEEDS TREATMENT Tuberculosis Disease - correct answer --TB is active and grows in the body -Makes a person sick/have symptoms -Can spread -Can cause death if not treated -Positive skin/blood test and sputum smear/culture -NEEDS TREATMENT Tuberculosis Symptoms - correct answer --Productive cough -Cough with increasing mucus -Cough with blood -Chest pain -Fever -Weakness -Night sweats First-Line Anti-TB Drugs - correct answer -Isoniazid, rifamycin, pyrazinamide, ethambutol, streptomycin Second-Line Anti-TB Drugs - correct answer -Only used to treat disease that is resistant to first line therapy. Streptomycin, kanamycin & amikacin, capreomycin, fluoroquinolones, ethionamide, cycloserine, and paraaminosalicylic acid Tuberculosis Vaccine - correct answer -BCG HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers P. Malariae -Infection may persist for life -Nephrotic syndrome P. Vivax and P. Ovale -Latency and relapses and irregular intervals for up to 5 years Immunity to Malaria - correct answer --Persons living in endemic areas (young children are still at high risk) -Slow to develop and requires multiple exposures -Premunition (partial immunity) Cerebral Malaria - correct answer --Case fatality 15 to 30% -Day 1-3: fever, seizures, un-arousable coma and brainstem signs -Seizures -Impairment of consciousness -Meningismus -Neuro-opthalmologic signs -Retinal hemorrhage -Focal neurologic signs -Neurological sequelae -AMP (abnormal motor posturing) Malaria Diagnosis - correct answer --Capillary blood or venous blood obtained -Blood smears (2 thick, 2 thin) prepared -Schuffner's dots -RBCs are normal in size -Only rings and gametocytes are seen HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers -Trophozoites: older ring stage -Ring like shape Resistance to Malaria - correct answer -1. Absence of Duffy Factor (duffy-negative) 2. Sick cell trait 3. G6PD deficiency 4. Thalassemia 5. Ovalocytosis Malaria in Pregnancy - correct answer --Symptoms and complications vary based on intensity of transmission and level of immunity -Risk greatest for women in low endemic areas -Anemia, parasites in placenta, low birth weight, poor infant survival, compromised growth and development Malaria in Children - correct answer --1 in 5 child deaths in Africa -Vulnerable starting at 4 months -Low birth weight, anemia, epilepsy, neurological problems -Peak season 70% of 1 year old children have parasite -Malnutrition -Loss of school time Prophylaxis - correct answer -Indicated in two circumstances 1. Non-immune travelers 2. Pregnant women living in endemic areas Norovirus - correct answer -Incubation- 1 to 2 days Symptoms- diarrhea, vomiting, nausea, stomach pain Foods- leafy greens, fruits, shellfish, ready-to-eat foods HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Outbreaks- healthcare facilities, long-term care facilities (>50%), hospitals. November to April -Direct contact with infected person (not multiplied in food) -"Cruise Ship Virus" Salmonella - correct answer -Incubation- 1 to 3 days Symptoms- diarrhea, fever, vomiting, stomach cramps Foods- eggs, poultry, meat, cheese, unpasteurized milk products -Divided into serotypes -O antigen (outermost portion of bacteria) -H antigen (slender, thread-like) -Nontyphoidal and Typhoidal Salmonella Typhi - correct answer -Incubation- 1 to 2 days Symptoms- diarrhea, vomiting, nausea, stomach pain Foods- leafy greens, fruits, shellfish, ready-to-eat foods Outbreaks- healthcare facilities, long-term care facilities (>50%), hospitals. November to April -Direct contact with infected person Clostridium Perfringens - correct answer -Incubation- 6 to 24 hours Symptoms- diarrhea, abdominal cramps, illness begins suddenly and lasts <24 hours Foods- raw meat and poultry, beef, gravies, pre-cooked foods Outbreaks- most common foodborne illness in U.S. Spore-forming gram + Diagnosis- requires 106 C.perfringens spores per gram of stool within 48 hours. Treatment- oral rehydration or IV -Anaerobic, some produce toxin in intestines -Can survive high temperatures Campylobacter - correct answer -Incubation- 2 to 5 days and lasts 1 week Symptoms- diarrhea (often bloody), fever and stomach cramps HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Sufficient Cause - correct answer --Combination of necessary and contributing causes -The "whole pie" Emphysema - correct answer -shortness of breath due to destruction and dilatation of the alveoli "Pink Puffer" - correct answer --Suffers from emphysema -Leads to weight loss and muscle wasting -Reddish complexion "Blue Bloater" - correct answer --Blue (cyanosis) and overweight -Shortness of breath and chronic cough -Low oxygen levels Chronic Bronchitis - correct answer --Type of COPD -Inflammation of the bronchi over long period of time Prevalence - correct answer --How many cases are present -Rate Incidence - correct answer --How many new cases occur -Rate Obesity - correct answer -Exaggeration of normal adipose tissue levels and distribution, leading to complex and widespread effects Dysregulation - correct answer --Cellular metabolism and energy regulation -Lipotoxicity: metabolic syndrome from lipids in non-adipose tissue, leading to cellular disfunction and death HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Obesity Increased Risks - correct answer --Insulin resistance (diabetes) -Increased blood pressure/atherosclerosis -CVD Apple Shape - correct answer --Carry weight above the hips -Linked to metabolic syndrome and CVD -Have more visceral fat Pear Shape - correct answer --Carry weight below the hips -Not linked to health problems Visceral Fat - correct answer --Surrounds organs -Affected by diet and exercise Subcutaneous Fat - correct answer --Below the skin -Stubborn fat Obesity Epidemiology - correct answer --39% adults overweight -13% obese -42% adults obese in U.S. BMI Formula - correct answer -[weight/(height^2)]*703 -if using inches and lbs BMI Ranges - correct answer -Underweight- Below 18.5 Normal 18.5 - 24.9 Overweight 25.0 - 29.9 Obese Class I 30.0 - 34.9 Obese Class II 35.0 - 39.9 HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Morbidly Obese (III) ≥40 Obesity Procedures - correct answer --Gastric bypass (sleeve gastrectomy or roux-en-Y) -Gastric banding -Jaw wiring -Stomach balloons -Liposuction ABCs of diabetes - correct answer -A stands for A1C B stands for Blood Pressure C stands for Cholesterol S stop smoking Actions of Insulin on Glucose - correct answer -1. Facilitates glucose transport into cells 2. Stimulates glycogenesis 3. Inhibits glycogenolysis 4. Inhibits gluconeogenesis Actions of Insulin on Fat - correct answer -1. Transport of glucose into adipose tissue 2. Entry of FA into adipose tissue 3. Promotes triglyceride synthesis 4. Inhibits lypolysis Actions of Insulin on Proteins - correct answer -1. Transport of AA into muscles and tissues 2. Protein synthesis 3. Inhibits protein degradation Metabolic Syndrome - correct answer -3 of the following conditions: -High blood pressure ≥ 130/85 HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers HDL Cholesterol - correct answer -good cholesterol LDL Cholesterol - correct answer -Bad cholesterol, will build up in arteries Clotting Steps - correct answer -1. Foam cells 2. Cells in the intima and media multiply 3. Lipid, cholesterol crystals, micro-vessels create necrotic core 4. Cap fractores, being exposed to coagulation factors in the blood and forms a clot Blood Pressure Categories - correct answer -Normal: <120/80 elevated: 120-129/ less than 80 Hypertension stage 1: 130-139/80-89 Hypertension stage 2: 140 or higher / 90 or higher Hypertensive crisis: over 180and or /over 120 Hypertension - correct answer --"The Silent Killer" -Diagnosis: 2 or more readings on 2 separate occasions Primary Hypertension - correct answer -High blood pressure, the cause of which is unknown; also known as essential hypertension Secondary Hypertension - correct answer -high blood pressure caused by the effects of another disease Isolated Systolic Hypertension - correct answer --Same effects as primary and secondary -mild to moderate rise in SBP but low or normal DBP BP of 120-139/80-89 mm Hg - correct answer --50% will develop HPN in 4 years -Must be monitored annually even low-risk pre-HPN HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Complications of Hypertension - correct answer -1.Stroke 2.CHD 3.End-stage kidney disease 4.Heart failure Excessive vasoconstriction of small arterioles - correct answer --Increased peripheral resistance; increased diastolic pressure -Increased force of ventricular contraction Renin-Angiotensin-Aldosterone System - correct answer --series of reactions designed to help regulate blood pressure Risk Factors for Heart Disease and Stroke - correct answer --Age -Gender -Family History -High blood cholesterol -High blood pressure -Physical inactivity -Obesity -Smoking -Diabetes -Cocaine -Homocysteine Lifestyle Modification to Reduce Blood Pressure - correct answer --Reduce weight (highest reduction: 5- 20) -Modify eating plan/DASH (dietary approaches to stop hypertension: 8-14) -Increase aerobic physical activity (4-9) -Moderation in alcohol consumption (2-4) -Restrict sodium intake HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Million Hearts Initiative - correct answer -- to prevent 1 million heart attacks and strokes from 2011- 2017 - co-led by the CDC and Centers for Medicare and Medicade services Life's Simple 7 - correct answer -1. Get active 2. Control cholesterol 3. Eat better 4. Manage blood pressure 5. Lose weight 6. Reduce blood sugar 7. Don't smoke Angina - correct answer --Less than 30 minutes Stable Angina - correct answer -chest pain that occurs when a person is active or under severe stress Unstable Angina - correct answer -no pattern of pain, pain usually occurs at rest - Pain lasts longer & more severe than stable angina - Rest and medication do not completely relieve the pain - Caution: impending heart attack Management for Angina - correct answer --Drugs (nitrates, beta-blockers, calcium channel blockers, antiplatelet drugs) Angina Patient Evaluation - correct answer --Identify comorbidities -Identify aggravating factors Reduce Risk of Angina - correct answer -Lower LDL to 100 mg/dL or less HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers "Stroke Belt" - correct answer -Southeast US Stroke Risk Factors - correct answer --Age (over 65) -African American, American Indian, Alaskan Native -Gender (male) -Family history -High blood cholesterol -High blood pressure -Smoking -Diabetes -Cardiac disease -Carotid artery disease -AIDS -Drug use -Alcohol -Weight -Gout Transient Ischemic Attack (TIA) - correct answer --Interruption of blood supply to the brain, spinal cord, or retina -Stroke symptoms but no permanent damage -Leads to stroke (1/3) -Less than 24 hours -Clot is fragmented and dissolved -Treatment: carotid endarterectomy, drugs -Cause: build up in internal carotid artery Thrombus - correct answer -stationary blood clot HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Embolus - correct answer -moving blood clot Stroke in Right Hemisphere of Brain - correct answer --"left hemiplegia" -Impairs judgement -Problems with short term memory -One sided neglect -Affects spatial abilities -Loss of sensation -Difficulty controlling emotion -Dysarthria Stroke in Left Hemisphere of Brain - correct answer --"right hemiplegia" -Aphasia -Highly specific problems -Difficulty learning new info, logic, problem solving Aneurysm - correct answer --Result of weakened artery wall Arteriosclerotic Aneruysm - correct answer --causes narrowing, thrombosis, & weakening of vessel wall -Most common in distal part of aorta; may rupture leading to massive & fatal hemorrhage Dissecting Aneurysm - correct answer -splitting of middle layer consisting of elastic & muscle tissues; degenerative changes cause layers to lose cohesiveness and separate; severe chest & back pain Congenital Aneurysm - correct answer -Among middle aged males (die as a result of aneurysm) Acquired Aneurysm - correct answer -not born with it but there could already be a defect present in the vessel in cerebral artery HLTH 314 Final Exam With correct answers HLTH 314 Final Exam With correct answers Classification of Cerebral Aneurysm - correct answer -Small- less than 15mm Large- 15 to 25mm Giant- 25 to 50mm Super Giant- over 50mm Saccular (berry) aneurysm- most common Fusiform- without a neck or stem Where do most Aneurysms Happen? - correct answer --Most happen in tight areas because they're easier to damage -Anterior communicating artery -Posterior communicating artery -Middle cerebral artery Prognosis of Aneurysm - correct answer --20% alive and well in a year -20% alive but disabled -60% die FAST - correct answer -F: Facial drooping A: Arm weakness S: Speech difficulties T: Time BEFAST - correct answer -B: balance E: eye trouble F: facial droop A: arm drift S: crooked smile HLTH 314 Final Exam With correct answers