Medical Terminology and Concepts, Exams of Pathophysiology

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Rasmussen Pathophysiology - Final Exam

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On an electrocardiogram (EKG), the P wave represents which of the following? A) Atrial depolarization B) Ventricular depolarization C) Atrial repolarization D) Ventricular repolarization - ANSWER- A) Atrial depolarization Select all that apply. Which lab values are incorrect? A. Na+ 135- B. K+ 2.3-2. C. Mg 1.8-2. D. Calcium 2-3 - ANSWER- B. K+ 2.3-2. D. Calcium 2- What electrolyte, if too high or low, can cause cardiac arrhythmias? A. Mg B. Na+ C. K+ D. Ca - ANSWER- C. K+ A patient has ABGS as follows: pH 7.28, PaC02 59, HC03 24, PaO2 85. This would be diagnosed as A. Respiratory acidosis with hypoxemia B. Respiratory alkalosis with hypoxemia C. Metabolic acidosis with hypoxemia D. Metabolic alkalosis with hypoxemia - ANSWER- A. Respiratory acidosis with hypoxemia

This type of cell is found in all the tissues of the body, and as part of the inflammatory response, releases histamine, prostaglandins and leukotrienes. A. Leukocyte B. Mast cell C. CD4 helper cell D. Macrophage - ANSWER- B. Mast cell An increase in the size of cells in an organ is known as A. Neoplasia B. Hyperplasia C. Atrophy D. Apoptosis - ANSWER- B. Hyperplasia The organelle in the cell that is responsible for producing ATP (Adenosine triphosphate) is the A. Golgi body B. Endoplasmic reticulum C. Ribosome D. Mitochondria - ANSWER- D. Mitochondria Homeostasis is defined as: A. A state of equilibrium in an organism B. A blood clotting mechanism C. Part of the inflammatory process D. Cellular adaptation - ANSWER- A. A state of equilibrium in an organism A benign tumor usually metastasizes. A. True B. False - ANSWER- B. False A malignant growth tends to produce (SAA) A. Anaplastic cells B. Metastatic tumors C. Undifferentiated cells D. Cells that invade the basement membrane of an organ - ANSWER- All of the above The ion imbalance that is responsible for raising or lowering the pH is: A. Potassium B. Hydrogen C. Calcium

D. Magnesium - ANSWER- B. Hydrogen This cell engulfs bacteria and destroys them: A. Phagocyte B. Neutrophil C. Granulocyte D. Eosinophil - ANSWER- A. Phagocyte This type of WBC is usually elevated with nasal allergies A. Basophil B. Mast cells C. Macrophage D. Neutrophil - ANSWER- A. Basophil The patient's WBC count is 18. This would indicate: A. Anemia B. Allergic reaction C. Infection D. Anemia - ANSWER- C. Infection The first stage of the GAS syndrome results in (Select all that apply) A. Epinephrine release B. Constriction of pupils C. Increased blood pressure D. Bradycardia E. Tachycardia - ANSWER- A. Epinephrine release C. Increased blood pressure E. Tachycardia An example of artificially acquired active immunity would be A. An influenza vaccination B. A tetanus antitoxin after stepping on rusty metal C. Taking an antibiotic for an infection D. An IV infusion of IgG - ANSWER- A. An influenza vaccination A low count of this type of cell may indicate that HIV has progressed to AIDS. A. T cells B. CD4 helper cells C. B cells D. Complement complexes - ANSWER- B. CD4 helper cells

B cells mature in the _________________, T cells mature in the ________________. A. Hypothalamus, thymus B. Thymus, Endocrine glands C. Bone marrow, thymus D. Cardiovascular system, respiratory system - ANSWER- C. Bone marrow, thymus This makes the body's temperature elevate in response to macrophages that have been exposed to bacteria. A. Leukocytes B. Pyrogens C. Interferons D. Inflammatory response. - ANSWER- B. Pyrogens The first WBC to arrive after injury A. Neutrophils B. Eosinophils C. Macrophages D. Monocytes - ANSWER- A. Neutrophils A patient has a serum creatinine level of 2.5 mg/dL, a serum potassium level of 6 mmol/L, an arterial pH of 7.32, and a urine output of 250 mL/day. Which phase of acute renal failure is the patient experiencing? A) Intrarenal B) Postrenal C) Oliguric D) Recovery - ANSWER- C) Oliguric The nurse monitors for which of the following definitive clinical manifestations in a patient with renal impairment associated with polycystic kidney disease? A) Flank pain B) Periorbital edema C) Low serum creatinine level D) Palpable kidneys - ANSWER- D) Palpable kidneys The nurse questions a female patient about perineal cleansing. Which statement by the patient indicates proper technique? A) "I douche monthly." B) "I use an alcohol-based product." C) "I wipe from back to front."

D) "I wipe from front to back." - ANSWER- D) "I wipe from front to back." The nurse is performing discharge teaching for a patient after a nephrectomy for renal carcinoma. Which statement by the patient indicates that teaching has been effective? A) "Because renal carcinoma usually affects both kidneys, I'll need to be watched closely." B) "I'll need to decrease my fluid intake to prevent stress to my remaining kidney." C) "My remaining kidney should provide me with normal renal function." D) "I'll eventually require some type of renal replacement therapy." - ANSWER- C) "My remaining kidney should provide me with normal renal function." The nurse correlates the decreased glomerular filtration rate in the client with acute glomerulonephritis to which pathophysiologic process? A) Decreased renal-induced constriction of the renal arteries B) Thickened capillary membranes secondary to immune complex deposition and cellular proliferation C) Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure D) Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis - ANSWER- B) Thickened capillary membranes secondary to immune complex deposition and cellular proliferation The RN has just received change-of-shift report. Which of the assigned patients should be assessed first? A) A patient with renal insufficiency who is scheduled to have a dialysis fistula inserted B) A patient with azotemia whose blood urea nitrogen and creatinine are increasing C) A patient receiving peritoneal dialysis who needs help changing the dialysate bag D) A patient with chronic renal failure who was just admitted with shortness of breath - ANSWER- D) A patient with chronic renal failure who was just admitted with shortness of breath A nurse observes tall, peaked T waves on the electrocardiogram (EKG) of a patient with end-stage kidney disease (ESKD). Which is the nurse's best action? A) Repeating the EKG B) Checking the serum potassium level C) Preparing to give sodium bicarbonate to correct the acidosis

D) Nothing; this is a normal finding for individuals with ESRD. - ANSWER- B) Checking the serum potassium level A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. Which finding would the nurse identify as the most common initial symptom? A) Fever B) Frequency C) Urinary retention D) Painless hematuria - ANSWER- D) Painless hematuria Epigastric pain that is relieved by food is suggestive of: A) pancreatitis. B) gastric ulcer. C) dysphagia. D) peritonitis. - ANSWER- B) gastric ulcer. The nurse is caring for a female patient with cholelithiasis. Which assessment findings from the patient's history and physical examination may have contributed to the development of the condition? A) The patient's body mass index (BMI) is 46. B) The patient is a vegetarian. C) The patient drinks 4 ounces of red wine nightly. D) The patient takes 81 mg of aspirin every morning. - ANSWER- A) The patient's body mass index (BMI) is 46. The nurse is caring for a patient with renal failure and chronic gastritis. The patient tells the nurse that he takes 2 teaspoons of sodium bicarbonate every night before bed to prevent heartburn. Which is the nurse's best response? A) "You should let the doctor know right away if you develop stomach cramps." B) "I will let your doctor know so that a safer antacid can be prescribed for you." C) "Do not take the sodium bicarbonate with milk, because it can cause kidney stones." D) "Make sure that you mix the sodium bicarbonate with at least 8 ounces of water." - ANSWER- B) "I will let your doctor know so that a safer antacid can be prescribed for you." The nurse is performing oral health screenings at a local community center. Which patients are at higher risk for developing oral cancer? (Select all that apply.) A) A female who has taken oral contraceptives for the last 4 years

B) An adult male with a history of alcoholism C) An adult female who eats spicy foods regularly D) A middle-aged male who smokes a pipe E) An older adult female who chews gum frequently - ANSWER- B) An adult male with a history of alcoholism D) A middle-aged male who smokes a pipe Which of the following infections would increase risk for cancer development in the genital region? A) Syphilis B) Chancroid C) Cytomegalovirus D) Human papillomavirus - ANSWER- D) Human papillomavirus Which of the following applies to benign prostatic hypertrophy? A) The tumor usually becomes malignant in time. B) The gland becomes small, nodular, and firm. C) Manifestations include hesitancy, dribbling, and frequency. D) Lower abdominal or pelvic pain develops. - ANSWER- C) Manifestations include hesitancy, dribbling, and frequency. Which of the following are common early significant signs of acute prostatitis? A) A hard nodule in the gland and pelvic pain B) Soft, tender, enlarged gland and dysuria C) Hesitancy and increased urinary output D) Mild fever, vomiting, and leucopenia - ANSWER- B) Soft, tender, enlarged gland and dysuria When assessing a woman with possible gonorrhea in the public health clinic, the nurse learns that the patient has the following symptoms. Which symptom is of most concern? A) Odorous vaginal discharge B) Abdominal tenderness C) Painful urination D) Anal itching - ANSWER- B) Abdominal tenderness The nurse is conducting a teaching plan for the client with gonorrhea. Which statement does the nurse include? A) "You are only infectious if the lesions are draining." B) "You are contagious even if you have no outward symptoms." C) "You will require close follow-up because treatment failure is common."

D) "You are restricted from engaging in sexual activity until your blood tests are negative. - ANSWER- B) "You are contagious even if you have no outward symptoms." Which statement made by the patient who has recently had a mammogram indicates a need for clarification regarding the importance or purpose of this procedure? A) "Now that I have had a mammogram, my risk for getting breast cancer is reduced." B) "Now that I've had a mammogram, I will still do a breast self-examination monthly." C) "Yearly mammograms can reduce my risk of dying from breast cancer." D) "The amount of radiation exposure from a mammogram is very low." - ANSWER- A) "Now that I have had a mammogram, my risk for getting breast cancer is reduced." The nurse is teaching a local women's group about health promotion and maintenance measures for prevention of gynecologic cancers. Which preventive factors should the nurse stress? (Select all that apply.) A) Annual endometrial biopsy B) Annual HPV vaccination C) Annual Pap test and cervical examination D) Safe sex E) Well-balanced diet - ANSWER- C) Annual Pap test and cervical examination E) Well-balanced diet Which sexually transmitted diseases are vaginal infections? (Select all that apply.) A) Chlamydia B) Epididymitis C) Gonorrhea D) Syphilis E) Proctitis - ANSWER- A) Chlamydia C) Gonorrhea A patient with diabetes has retinopathy, nephropathy, and peripheral neuropathy. What should the nurse teach this patient about exercise? A) "The type of exercise that would most efficiently help you to lose weight, decrease insulin requirements, and maintain cardiovascular health would be jogging for 20 minutes 4 to 7 days each week."

B) "Considering the complications you already have, vigorous exercise for 1 hour every day is needed to prevent progression of disease." C) "Considering the complications you already have, you should avoid engaging in any form of exercise." D) "Swimming or water aerobics 30 minutes each day would be the safest exercise routine for you." - ANSWER- D) "Swimming or water aerobics 30 minutes each day would be the safest exercise routine for you." The patient on an intensified insulin regimen consistently has a fasting blood glucose level between 70 and 80 mg/dL, a postprandial blood glucose level below 200 mg/dL, and a hemoglobin A1c level of 5.5%. Which of the following is the correct interpretation of these findings? A) Signs of insulin resistance B) Good control of blood glucose C) Increased risk for developing ketoacidosis D) Increased risk for developing hyperglycemia - ANSWER- B) Good control of blood glucose A patient is admitted with newly diagnosed type 2 diabetes. Which of the nursing actions included in the patient's plan of care will be most appropriate for the RN to delegate to the LPN/LVN? A) Admission assessment B) Inserting an IV and initiating IV fluids C) Administering routine PO antidiabetic medications D) Developing a teaching plan - ANSWER- C) Administering routine PO antidiabetic medications Which of the following patients with diabetes should the endocrine unit charge nurse assign to an RN who recently graduated and finished orientation yesterday? A) A 58-year-old with newly diagnosed diabetic neuropathy who needs teaching about foot care B) A 68-year-old with diabetic ketoacidosis who has an IV Insulin infusion C) A 70-year-old who needs blood glucose monitoring and insulin before each meal D) A 76-year-old who was admitted with fatigue and shortness of breath - ANSWER- C) A 70-year-old who needs blood glucose monitoring and insulin before each meal

Which of the following nursing actions can the home health nurse delegate to a home health aide who is making daily visits to a patient with newly diagnosed type 2 diabetes? A) Evaluate the patient's use of a home blood glucose monitor. B) Assist the patient's spouse in choosing appropriate dietary items. C) Clean the patient's feet and apply moisturizing lotion. D) Inspect the extremities for evidence of poor circulation. - ANSWER- C) Clean the patient's feet and apply moisturizing lotion. An incoherent female patient with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of: A) Hashimoto's thyroiditis. B) Cushing's syndrome. C) myxedema coma. D) thyroid storm. - ANSWER- C) myxedema coma. A 22-year-old obese female patient comes into the clinic complaining of an ear ache and hearing loss in the right ear. Assessment reveals temperature 101.2ºF, low-set ears, a wide neck, and droopy eyelids. Patient reports a history of "kidney and heart problems" as well as "being born different." Based on these findings, what chromosomal disorder does this patient likely have? A) Down syndrome B) Turner's syndrome C) Klinefelter's syndrome D) Fragile X syndrome - ANSWER- B) Turner's syndrome Metaplasia is: A) the disorganization of cells into various sizes, shapes, and arrangements. B) the replacement of one differentiated cell type with another. C) the transformation of a cell type to malignancy. D) an irreversible cellular adaptation. - ANSWER- B) the replacement of one differentiated cell type with another. Which of the following assessment findings indicates an alteration in homeostatic control mechanisms? A) Fever B) Throat pain

C) Joint stiffness D) Positive throat culture - ANSWER- A) Fever What information should parents be given about the consequences of phenylketonuria (PKU)? A) Mental retardation is inevitable. B) PKU is commonly associated with other congenital anomalies. C) High dietary tyramine may help induce enzyme production. D) Failure to treat properly results in progressive mental retardation. - ANSWER- D) Failure to treat properly results in progressive mental retardation. Injury that occurs when blood flow is diminished to tissue is called _____ injury. A) hypoxic B) ischemic C) hyperemic D) neoplastic - ANSWER- B) ischemic Characteristics of X-linked recessive disorders include which of the following? A) The son of a carrier mother has a 25% chance of being affected. B) Affected fathers transmit the gene to all of their sons. C) All daughters of affected fathers are carriers. D) Boys and girls are equally affected. - ANSWER- C) All daughters of affected fathers are carriers. Which type of gangrene is usually a result of arterial occlusion? A) Necrosis B) Dry C) Wet D) Gas - ANSWER- D) Gas The cancer growth continuum is divided into which of the following stages? A) Stage 1, stage 2, stage 3 B) Initiation, progression, promotion C) Preliminary, evolutionary, metastasis D) Initiation, promotion, progression - ANSWER- B) Initiation, progression, promotion The activities of the cell are directed by which cell structure? A) Cytoplasm B) Organelles C) Cell membranes

D) Nucleus - ANSWER- D) Nucleus Enzymes that use oxidation to convert food materials into energy are found in sausage-shaped structures called: A) endoplasmic reticulum. B) ribosomes. C) mitochondria. D) Golgi apparatus. - ANSWER- C) mitochondria. Mitochondria, endoplasmic reticulum, Golgi apparatus, lysosomes, and centrioles are all examples of: A) cell membranes. B) organelles. C) enzymes. D) None of these is correct. - ANSWER- B) organelles. DNA is composed of base chemicals called: A) adenine, thymine, guanine, and cytosine. B) nucleotide, deoxyribose, and base. C) chromosomes and proteins. D) None of these is correct. - ANSWER- A) adenine, thymine, guanine, and cytosine. Which of the following terms does not describe a method by which cells adapt to changing conditions? A) Hypertrophy B) Hyperplasia C) Increased enzyme synthesis D) Necrosis - ANSWER- D) Necrosis Dysplasia of epithelial cells sometimes results from which of the following? A) Excessive sodium intake B) Chronic irritation or inflammation C) Increased enzyme synthesis D) Apoptosis - ANSWER- B) Chronic irritation or inflammation The function of lysosomes is to: A) break down particles or worn-out cellular components. B) convert food materials into energy. C) produce digestive enzymes and antibody proteins.

D) aid in cell division. - ANSWER- A) break down particles or worn-out cellular components. A __________ gene is one that produces an effect only in the homozygous state. A) dominant B) recessive C) sex-linked D) hemizygous - ANSWER- B) recessive A __________ gene expresses itself in either the heterozygous or the homozygous state. A) dominant B) recessive C) sex-linked D) hemizygous - ANSWER- A) dominant Genes carried on sex chromosomes are called __________ genes. A) dominant B) recessive C) sex-linked D) hemizygous - ANSWER- C) sex-linked A common abnormality in females, __________ syndrome results from an absence of one X chromosome. A) triple X B) Turner's C) Klinefelter's D) Down - ANSWER- B) Turner's __________ syndrome occurs in males when there is an extra X chromosome. A) Triple X B) Turner's C) Klinefelter's D) XYY - ANSWER- C) Klinefelter's A metastatic tumor is one that: A) has spread to a location away from its site of origin. B) shows slow expansion and well-differentiated cells. C) cannot be classified easily. D) invades deeply into the tissue where it arose. - ANSWER- A) has spread to a location away from its site of origin.

An increase in cardiac size and function due to increased workload is termed: A) atrophy. B) functional. C) hypertrophy. D) inflammation. - ANSWER- C) hypertrophy. Children with PKU must avoid phenylalanine in the diet. Phenylalanine is most likely to be a component of: A) fat. B) sugar. C) protein. D) carbohydrate. - ANSWER- C) protein. A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of: A) primary prevention. B) secondary prevention. C) tertiary prevention. D) disease treatment. - ANSWER- A) primary prevention. A routine ultrasound of a 38-year-old women of 26 weeks' gestation reveals a fetus with a small square head, upward slant of the eyes, and low set ears. The nurse recognizes that these findings are consistent with which of the following? A) Fragile X syndrome B) Monosomy X (Turner's syndrome) C) Trisomy 21 (Down's syndrome) D) Trisomy X (Klinefelter's syndrome) - ANSWER- C) Trisomy 21 (Down's syndrome) While discussing treatment options with a parent of a newly diagnosed monosomy X (Turner's syndrome) child, the nurse should include which of the following? A) "There is no treatment or cure." B) "Symptoms of the condition are treated with estrogen." C) "Symptoms of the condition are treated with testosterone." D) "Institutionalization is the preferred method of managing care." - ANSWER- B) "Symptoms of the condition are treated with estrogen." Tay-Sachs is caused by which of the following? A) A deficiency or absence of hexosaminidase A

B) A defect on chromosome 17 or 22 C) A mutation on chromosome 15 D) An error in converting phenylalanine to tyrosine - ANSWER- A) A deficiency or absence of hexosaminidase A An obese but otherwise healthy teen goes to a health fair and has her blood pressure checked. This is an example of: A) primary prevention. B) secondary prevention. C) tertiary prevention. D) disease treatment. - ANSWER- B) secondary prevention. A factor associated with risk of Down syndrome is: A) maternal age. B) maternal alcohol intake. C) family history of heritable diseases. D) exposure to TORCH syndrome organisms. - ANSWER- A) maternal age. A disease in which the principal manifestation is an abnormal growth of cells leading to formation of tumors is called a __________ disease. A) congenital B) degenerative C) metabolic D) neoplastic - ANSWER- D) neoplastic Which of the following assessment findings is most concerning to the nurse and would require immediate action? A) Speech delays in a 10-year-old with fragile X syndrome B) A palpable lump in the left breast of an 18-year-old with Klinefelter's syndrome C) Vision issues in a 14-year-old with Turner's syndrome D) Bruise in a cancer patient receiving chemotherapy - ANSWER- B) A palpable lump in the left breast of an 18-year-old with Klinefelter's syndrome Which of the following assessment findings indicates an alteration in homeostatic control mechanisms? A) Fever B) Throat pain C) Joint stiffness D) Positive throat culture - ANSWER- A) Fever

The ability to respond to and maintain physiologic and psychological stability during rapidly changing conditions in the internal and external environments is called: A) morphogenesis. B) homeostasis. C) adaptation. D) stress. - ANSWER- B) homeostasis. After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering medication. This is an example of: A) primary prevention. B) secondary prevention. C) tertiary prevention. D) disease treatment. - ANSWER- C) tertiary prevention. Routine application of sunblock to skin would be an example of: A) primary prevention. B) secondary prevention. C) tertiary prevention. D) palliative care. - ANSWER- A) primary prevention. The nurse conducts group education for patients with seasonal allergies and teaches about the role of histamine. The nurse evaluates that the education has been effective when the patients make which response? A) "Histamine dilates the vessels in the nose, so it is congested and stuffy." B) "Histamine is inhibited by allergies, therefore leading to the signs and symptoms." C) "Histamine constricts vessels, causing capillaries to become more permeable." D) "Histamine is primarily stored in phagocyte cells in the skin." - ANSWER- A) "Histamine dilates the vessels in the nose, so it is congested and stuffy." Which of the following is an example of passive immunity? A) Immunizations B) Transplant rejection C) Response to a disease D) Placental transfer of antibodies - ANSWER- D) Placental transfer of antibodies Although skin manifestations may occur in numerous locations, the classic presentation of systemic lupus erythematosus includes: A) lesions affecting the palms of hands and soles of feet.

B) dry, scaly patches in the antecubital area and behind the knees. C) cracked, scaly areas in webs of fingers. D) a butterfly pattern rash on the face across the bridge of the nose. - ANSWER- D) a butterfly pattern rash on the face across the bridge of the nose. The nurse recognizes that which of the following is required for a diagnosis of AIDS (acquired immunodeficiency syndrome)? A) Lymphocytopenia B) Abnormally functioning macrophages C) CD4+ cell count of less than 200 cells/mm D) Increased production of incomplete and nonfunctional antibodies - ANSWER- C) CD4+ cell count of less than 200 cells/mm In the context of aging, tertiary prevention refers to: A) prevention of incident diseases and geriatric conditions. B) early detection, treatment, and management of prevalent and recurrent conditions. C) reducing the impact of comorbidity on physical functioning and premature mortality. D) public health promotion of preventive health care. - ANSWER- C) reducing the impact of comorbidity on physical functioning and premature mortality. What happens when the vasodilator histamine is released by the mast cells? A) The inflammatory process is ended. B) Blood platelets adhere to collagen fragments and begin the healing process. C) Blood vessels expand and become more permeable. D) Blood vessels constrict and become less permeable. - ANSWER- C) Blood vessels expand and become more permeable. Which of the following is an immunoglobin E (IgE)-mediated hypersensitivity reaction? A) A transfusion reaction resulting from an infusion of incompatible blood into a person who has preexisting antibodies directed against the transfused cells B) Organ or tissue damage resulting from deposition of antigen-antibody complexes in the organs or tissues of an affected person C) An area of swelling and tenderness in the skin after an intradermal injection of protein material derived from the tubercle bacillus D) A penicillin reaction characterized by fall in blood pressure and respiratory distress after an injection of penicillin in a person who has become sensitized to penicillin as a result of a previous penicillin injection - ANSWER- D) A penicillin reaction characterized by fall in blood pressure and respiratory distress after an

injection of penicillin in a person who has become sensitized to penicillin as a result of a previous penicillin injection Autoimmune diseases are caused by: A) autoantibodies. B) non-self-antigens. C) self-antigens. D) None of these is correct. - ANSWER- A) autoantibodies. Lupus erythematosus is a common connective tissue disease that is most frequently seen in: A) young women. B) young men. C) older women. D) older men. - ANSWER- A) young women. An important and serious infection in AIDS patients is a pneumonia caused by a small parasite that grows within pulmonary alveoli, called: A) Pneumocystis carinii. B) chlamydia. C) toxoplasma. D) the EB virus. - ANSWER- A) Pneumocystis carinii. Which of the following is NOT one of the common agents that causes opportunistic infections in AIDS patients? A) Pneumocystis carinii B) Cytomegalovirus C) Mycobacterium avium-intracellulare D) Corynebacterium diphtheriae E) Toxoplasma gondii - ANSWER- D) Corynebacterium diphtheriae Which of the following situations represents a break in the "first line of defense" against infection? A) An abnormally low total white blood cell (WBC) count B) A "shift to the left" on the WBC differential C) Use of an indwelling bladder catheter D) Poor nutritional status - ANSWER- C) Use of an indwelling bladder catheter HIV infection causes immunodeficiency because it: A) blocks the ability of macrophages to present antigens. B) causes excessive production of cytotoxic T cells.

C) directly inhibits antibody production by B cells. D) causes the destruction of T helper cells. - ANSWER- D) causes the destruction of T helper cells. With which patient is it most important for the nurse to take special precautions because of an increased susceptibility to infection as a result of medical therapy? A) The 38-year-old woman taking contraceptives B) The 38-year-old man with diabetes mellitus taking insulin C) The 58-year-old woman with rheumatoid arthritis taking corticosteroids daily D) The 58-year-old man 5 years after a myocardial infarction taking aspirin daily - ANSWER- C) The 58-year-old woman with rheumatoid arthritis taking corticosteroids daily Which statement made by the patient newly diagnosed with systemic lupus erythematosus indicates a need for further teaching about the course and management of this disease? A) "I will take my medication even if my symptoms improve." B) "I will report any fever to my healthcare provider immediately." C) "I will sunbathe as often as possible to ensure I get enough vitamin D." D) "I will not have my hair dyed, frosted, or permed unless I am in a period of remission." - ANSWER- C) "I will sunbathe as often as possible to ensure I get enough vitamin D." Which of the following findings is a systemic sign of inflammation? A) Pain B) Loss of function C) Edema D) Elevated erythrocyte sedimentation rate - ANSWER- D) Elevated erythrocyte sedimentation rate Which type of immunity is developed following injection of antibodies synthesized by another human or animal? A) Adaptive B) Active C) Innate D) Passive - ANSWER- D) Passive The major disadvantage of passive immunization is that it: A) is ineffective. B) is expensive. C) interferes with active immunization.

D) induces only short-term protection. - ANSWER- D) induces only short-term protection. Which of the following is true about inflammation? A) It is a specific response to an insult. B) It requires previous exposure. C) It is the second level of response to injurious agents. D) It only lasts for short periods of time. E) It exists in almost all chronic illness in the body. - ANSWER- E) It exists in almost all chronic illness in the body. Which of the following is not a part of the inflammation process? A) Contraction of vascular smooth muscle B) Increased blood flow C) Increased permeability of vessels D) Dilation of vessels E) Intracellular gaps in vessels that allow passage of large proteins - ANSWER- A) Contraction of vascular smooth muscle Which of the following is a systemic effect from an inflammatory response? A) Elevated temperature B) Redness and swelling C) Blisters D) Pus - ANSWER- A) Elevated temperature Which discharge teaching is essential to include for the patient with acute myelogenic leukemia (AML)? (Select all that apply.) A) Avoid intercourse. B) Avoid contact sports. C) Avoid crowds. D) Limit fluid intake. E) Limit cholesterol intake. - ANSWER- B) Avoid contact sports. C) Avoid crowds. Which of the following is indicative of hemolytic anemia? A) Increased total iron-binding capacity B) Increased heart rate C) Hypovolemia D) Jaundice - ANSWER- D) Jaundice

Mary Ann, a 14-year-old high school freshman, presents to her pediatrician's office with severe fatigue, swollen glands, and a low-grade fever. Which blood test would confirm her diagnosis of infectious mononucleosis? A) An elevated total white blood cell count B) An elevated erythrocyte sedimentation rate C) A decreased eosinophils count D) A decreased monocyte count - ANSWER- A) An elevated total white blood cell count A chemotherapy patient has a hemoglobin of 7.0 g/dL. Which of the following complaints would be indicative of tissue hypoxia related to anemia? A) Apathy B) Syncope C) Bradycardia D) Warm, dry skin - ANSWER- B) Syncope Causes of thrombocytopenia include: A) hypoxemia. B) chemotherapy. C) reduced erythropoietin. D) secondary polycythemia. - ANSWER- B) chemotherapy. Iron-deficiency anemia is characterized by red blood cells that are: A) normocytic and normochromic. B) microcytic and hypochromic. C) macrocytic and normochromic. D) microcytic and normochromic. - ANSWER- B) microcytic and hypochromic. von Willebrand factor is directly involved in: A) platelet adhesion and aggregation. B) platelet production. C) formation of the fibrin clot. D) clot dissolution. - ANSWER- A) platelet adhesion and aggregation. Which of the following treatments is not suitable for aplastic anemia? A) Splenectomy B) Blood transfusions C) Bone marrow transplant D) Immunosuppressive drugs that block the functions of cytotoxic lymphocytes that are destroying bone marrow stem cells - ANSWER- A) Splenectomy

A 3-year-old boy who exhibits prolonged bleeding after minor trauma and prolonged clotting time, but normal platelet count, likely has: A) hemophilia. B) liver dysfunction. C) thrombocytopenia. D) disseminated intravascular coagulation. - ANSWER- A) hemophilia. What does leukocytosis frequently indicate? A) Immunosuppression B) Bone marrow damage C) An allergic or autoimmune reaction D) Presence of inflammation or infection - ANSWER- D) Presence of inflammation or infection What is a deficit of all types of blood cells called? A) Leukopenia B) Neutropenia C) Pancytopenia D) Erythrocytosis - ANSWER- C) Pancytopenia Which of the following is a neoplasm of blood cells? A) Hematoma B) Leukemia C) Carcinoma of the blood D) Sarcoma of the blood - ANSWER- B) Leukemia Over 80% of all lymphomas arise in: A) T cells. B) Reed-Sternberg cells. C) B cells. D) NK cells. - ANSWER- C) B cells. A 5-year-old male child has a bleeding disease that is characterized by areas of hemorrhage in the joints and muscles after minor injuries. Laboratory tests reveal a deficiency of a coagulation factor active in the early phase of blood coagulation (formation of intrinsic thromboplastin). What is the most likely diagnosis? A) Thrombocytopenia (platelet deficiency) B) Hemophilia C) Disseminated intravascular coagulation syndrome D) Ingestion of a drug such as Coumadin, which functions as an anticoagulant - ANSWER- B) Hemophilia

Which of the following statements regarding disseminated intravascular coagulation syndrome is not true? A) It results from rapid release of thromboplastic material into the circulation. B) It may result in from any condition associated with extensive tissue destruction, such as shock or sepsis. C) Levels of blood platelets and concentration of blood coagulation components are subnormal. D) It is a frequent complication of pulmonary embolism. - ANSWER- D) It is a frequent complication of pulmonary embolism. A decrease in platelets is called: A) hemophilia. B) von Willebrand's disease. C) thrombocytopenia. D) None of these is correct. - ANSWER- C) thrombocytopenia. What causes infectious mononucleosis? A) Epstein-Barr (EB) virus B) Herpes simplex virus C) Beta streptococci D) Pathogenic fungi - ANSWER- A) Epstein-Barr (EB) virus A middle-aged man has a hypochromic, microcytic anemia. What is the most likely cause? A) Vitamin B12 or folic acid deficiency B) Hemolysis of red blood cells due to autoantibodies C) Iron deficiency resulting from chronic blood loss D) Replacement of bone marrow by metastatic tumor - ANSWER- C) Iron deficiency resulting from chronic blood loss The order of impulse conduction in the heart is from the: A) AV node to SA node to bundle of His to Purkinje system. B) bundle of His to SA node to AV node to Purkinje system. C) SA node to AV node to bundle of His to Purkinje system. D) Purkinje system to SA node to AV node to bundle of His. - ANSWER- C) SA node to AV node to bundle of His to Purkinje system. Pregnancy-induced hypertension (PIH) is characterized by: A) hypertension, proteinuria, and edema that is detected for the first time during pregnancy.

B) exaggeration of preexisting hypertension that occurs during pregnancy. C) hypertension and seizures that are detected for the first time during pregnancy. D) hypertension that persists after pregnancy. - ANSWER- A) hypertension, proteinuria, and edema that is detected for the first time during pregnancy. Which of the following is most likely to contribute to thrombus development? A) Overhydration B) Ambulation C) Immobility D) Infection - ANSWER- C) Immobility A patient comes to the emergency department complaining of coughing and difficulty breathing. The patient's diagnosis is heart failure. He asks you how difficulty breathing could be a heart problem. What is the best response? A) "The left side of your heart is weak and pumps blood too quickly." B) "The left side of your heart has weakened and blood has entered your lungs." C) "The right side of your heart has enlarged and cannot effectively pump blood." D) "The right side of your heart has weakened and blood has entered your lungs."

• ANSWER- B) "The left side of your heart has weakened and blood has entered your lungs." Which type of cardiomyopathy is characterized by progressive cardiac hypertrophy, dilation, and impaired pumping with heart enlargement and thinning walls? A) Dilated B) Hypertrophic C) Restrictive D) Peripartum - ANSWER- A) Dilated Which type of valvular heart disease causes obstruction of the ejection of blood from the left atrium to the left ventricle? A) Aortic stenosis B) Aortic regurgitation C) Mitral stenosis D) Mitral regurgitation - ANSWER- A) Aortic stenosis A 19-year-old athlete went out for his first day of football practice. He experienced sudden cardiac death. The cause of death was determined to be cardiomyopathy. Which form of cardiomyopathy was it most likely to be? A) Dilated

B) Hypertrophic C) Restrictive D) Dystrophic - ANSWER- B) Hypertrophic The nurse will monitor a patient for which clinical manifestation as a compensatory mechanism to the initial stage of shock? A) Decreased mean arterial pressure B) Elevated body temperature C) Vascular vasodilation D) Increased heart rate - ANSWER- D) Increased heart rate The nurse recognizes the patient with which condition is at greatest risk for hypovolemic shock? A) Burns B) Sepsis C) Pericarditis D) Myopathies - ANSWER- A) Burns Which of the following patients has the greatest risk of developing heart failure? A) A 50-year-old white female with asthma B) A 48-year-old black female who smokes C) A 69-year-old black male with hypertension D) A 75-year-old white male who smokes - ANSWER- C) A 69-year-old black male with hypertension Which of the following is a modifiable risk factor for coronary artery disease? A) Family history B) Smoking C) Gender D) Age - ANSWER- B) Smoking Your patient with a history of stable angina states that he has recently experienced an increase in the number of attacks and the intensity of the pain. What should you suspect? A) The patient continues to have stable angina. B) The patient has developed unstable angina. C) The patient has experienced an acute MI. D) The patient has a subendocardial necrosis. - ANSWER- A) The patient continues to have stable angina. Interferons help to prevent cells from what type of infection?