NR 507 Advanced Pathophysiology Midterm Exam LATEST 2022/2023 GRADED A+, Exams of Nursing

Download NR 507 Advanced Pathophysiology Midterm Exam LATEST 2022/2023 GRADED A+ and more Exams Nursing in PDF only on Docsity! Page 1 of 36 NR 507 Midterm Exam. NR 507 Advanced Pathophysiology Midterm Exam LATEST 2022/2023 GRADED A+ Score for this quiz: 118 out of 120 The lung is innervated by the parasympathetic nervous system via which nerve? Vagus Phrenic Brachial Pectoral Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel only in the vagus nerve to the lung. What is the action of urodilatin? Urodilatin causes vasoconstriction of afferent arterioles. It causes vasodilation of the efferent arterioles. 1 Question 1 2 / 2 pts Question 2 2 / 2 pts Page 2 of 36 Urodilatin inhibits antidiuretic hormone secretion. Page 4 of 36 Which T-lymphocyte phenotype is the key determinant of childhood asthma? Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes CD4 T-helper Th2 lymphocytes CD8 cytotoxic T lymphocytes Memory T lymphocytes Asthma develops because the Th2 response (in which CD4 T-helper cells produce specific cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and allergic response in the airways. This selection is the only option that accurately identifies the appropriate T-lymphocyte phenotype. Perceived stress elicits an emotional, anticipatory response that begins where? Prefrontal cortex Anterior pituitary Limbic system Question 6 2 / 2 pts Question 7 2 / 2 pts Page 5 of 36 Hypothalamus Perceived stressors elicit an anticipatory response that begins in the limbic system of the brain, the only option responsible for emotions and cognition. Hypersensitivity is best defined as a(an): Disturbance in the immunologic tolerance of self-antigens Immunologic reaction of one person to the tissue of another person Altered immunologic response to an antigen that results in disease Undetectable immune response in the presence of antigens Hypersensitivity is an altered immunologic response to an antigen that results in disease or damage to the host. The other options are not accurate definitions of hypersensitivity. It has been determined that a tumor is in stage 2. What is the meaning of this finding? Cancer is confined to the organ of origin. Cancer has spread to regional structures. Question 8 2 / 2 pts Question 9 2 / 2 pts Question 10 2 / 2 pts Page 6 of 36 Cancer is locally invasive. Cancer has spread to distant sites Cancer confined to the organ of origin is stage 1; cancer that is locally invasive is stage2; cancer that has spread to regional structures, such as the lymph nodes, is stage 3; and cancer that has spread to distant sites, such as a liver cancer spreading to the lungor a prostate cancer spreading to bone, is stage 4. An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect? Atrial septal defect (ASD) Ventricular septal defect (VSD) Patent ductus arteriosus (PDA) Atrioventricular canal (AVC) defect On physical examination, a loud, harsh, holosystolic murmur and systolic thrill can be detected at the left lower sternal border. The intensity of the murmur reflects the pressure gradient across the VSD. An apical diastolic rumble may be present with a moderate-to-large defect, reflecting increased flow across the mitral valve. The Question 15 2 / 2 pts Page 9 of 36 Atelectasis and pneumonia Edema of the hands and feet Stasis ulcers of the hands, ankles, and feet Splenomegaly and hepatomegaly Symmetric, painful swelling of the hands and feet (hand-foot syndrome) caused by infarction in the small vessels of the extremities is often the initial manifestation of SCD in infants. This selection is the only option that accurately identifies the manifestations ofa vasoocclusive crisis associated with SCD in infancy. Which statement concerning benign tumors is true? The resulting pain is severe. Benign tumors are not encapsulated. Benign tumors are fast growing. The cells are well-differentiated. Page 10 of 36 Abenign tumor is well-differentiated with its tissue appearing similar to the tissue from which it arose. The other options are characteristic of a malignant tumor. Which primary characteristic is unique for the immune response? The immune response is similar each time it is activated. The immune response is specific to the antigen that initiates it. The response to a specific pathogen is short term. The response is innate, rather than acquired. Unlike inflammation, which is nonspecifically activated by cellular damage and pathogenic microorganisms, the immune response is primarily designed to afford long- term specific protection (i.e., immunity) against particular invading microorganisms; that is, it has a memory function. The other options are not unique characteristics of the immune response. Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child? Parental history of asthma Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels Question 16 2 / 2 pts Question 17 2 / 2 pts Plasma Icells Question 19 2 / 2 pts Page 11 of 36 Reduced expiratory flow rates confirmed by spirometry testing Improvement on a trial of asthma medication Confirmation of the diagnosis of asthma relies on pulmonary function testing using spirometry, which can be accomplished only after the child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities. For younger children, an empiric trial of asthma medications is commonly initiated. The remaining options are major historical and physical factors that contribute but do not confirm the diagnosis of asthma in children. Where are antibodies produced? Helper T lymphocytes Thymus gland Correct Answer Bone marrow An antibody or immunoglobulin is a serum glycoprotein produced only by plasma cells in response to a challenge by an immunogen. Question 18 0 / 2 pts Page 14 of 36 10 30 90 120 A platelet circulates for approximately 10 days and ages. Macrophages of the mononuclear phagocyte system, mostly in the spleen, remove platelets. What is the primary cause of respiratory distress syndrome (RDS) of the newborn? Immature immune system Small alveoli Surfactant deficiency Anemia RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange. None of the other options are related to the cause of RDS. Question 23 2 / 2 pts Page 15 of 36 What is the life span of an erythrocyte (in days)? 20 to 30 60 to 90 100 to 120 200 to 240 Because it cannot undergo mitotic division, the erythrocyte has a limited life span of approximately 120 days. Low plasma albumin causes edema as a result of a reduction in which pressure? Capillary hydrostatic Interstitial hydrostatic Plasma oncotic Question 24 2 / 2 pts Question 25 2 / 2 pts Question 26 2 / 2 pts Question 27 2 / 2 pts Page 16 of 36 Interstitial oncotic Losses or diminished production of plasma albumin is the only option that contributes toa decrease in plasma oncotic pressure. Which blood cell type is elevated at birth but decreases to adult levels during the first year of life? Monocytes Platelets Neutrophils Lymphocytes Only monocyte counts are high in the first year of life and then decrease to adult levels. Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)? Adrenal cortex Hypothalamus Page 19 of 36 Surfactant is secreted into fetal airways between 30 and 36 weeks. The other options are not true regarding the timeframe when the risk for RDS decreases. What is the functional unit of the kidney called? Glomerulus Nephron Collecting duct Pyramid The nephron is the functional unit of the kidney. Although the other options are alsolocated in the kidney, they are not its functional units. Which hepatitis virus is known to be sexually transmitted? A Question 31 2 / 2 pts Question 32 2 / 2 pts Page 20 of 36 B C Page 21 of 36 D Only hepatitis B virus (HBV) is known to be sexually transmitted. Which statement is true concerning the IgM? IgM is the first antibody produced during the initial response to an antigen. IgM mediates many common allergic responses. IgM is the most abundant class of immunoglobulins. IgM is capable of crossing the human placenta. Typically, IgM is produced first (primary immune response), followed by IgG against the same antigen. The other options are not true statements regarding IgM. Apoptosis is a(an): Question 33 2 / 2 pts Question 34 2 / 2 pts Page 24 of 36 Liver Endometrial Stomach Colon The World Cancer Research Fund summarizes the effects as convincingfor cancers of the colon and probable for postmenopausal breast cancer and endometrial cancer. The relationship is not supported for the remaining options. Why is nasal congestion a serious threat to young infants? Infants are obligatory nose breathers. Their noses are small in diameter. Infants become dehydrated when mouth breathing. Their epiglottis is proportionally greater than the epiglottis of an adult’s. Question 37 2 / 2 pts Question 38 2 / 2 pts Question 39 2 / 2 pts Page 25 of 36 Infants up to 2 to 3 months of age are obligatory nose breathers and are unable to breathe in through their mouths. Nasal congestion is therefore a serious threat to a young infant. This selection is the only option that accurately describes why nasal congestion is a serious threat to young infants. Between which months of age does sudden infant death syndrome (SIDS) most often occur? 0 and 1 2 and 4 5 and 6 6 and 7 The incidence of SIDS is low during the first month of life but sharply increases in the second month of life, peaking at 2 to 4 months and is unusual after 6 months of age. In which primary immune deficiency is there a partial-to-complete absence of T-cell immunity? Bruton disease DiGeorge syndrome Question 41 2 / 2 pts Page 26 of 36 Reticular dysgenesis Adenosine deaminase deficiency The principal immunologic defect in DiGeorge syndrome is the partial or complete absence of T-cell immunity. The other options are not the result of either a partial or complete absence of T-cell immunity. Blood vessels of the kidneys are innervated by the: Vagus nerve Sympathetic nervous system Somatic nervous system Parasympathetic nervous system The blood vessels of the kidney are innervated by the sympathetic noradrenergic fibers that cause arteriolar vasoconstriction and reduce renal blood flow. The other options are not involved in this process. An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody? Question 40 2 / 2 pts Page 29 of 36 Increased heart rate Compensatory hypertrophy Compensatory hypertrophy allows the kidney to respond to an increase in workload throughout life. The remaining options are not relevant to accommodating an increased workload. Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome? Coarctation of the aorta (COA) and pulmonary stenosis (PS) Tetralogy of Fallot and persistent truncus arteriosus Atrial septal defect (ASD) and dextrocardia Ventricular septal defect (VSD) and patent ductus arteriosus (PDA) Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18, and Down syndrome include VSD and PDA (see Table 33-2). The other defects are not associated with dysfunction of trisomy 13, trisomy 18, and Down syndrome. What is the trigone? Question 45 2 / 2 pts Question 46 2 / 2 pts Page 30 of 36 A smooth muscle that comprises the orifice of the ureter The inner mucosal lining of the kidneys A smooth triangular area between the openings of the two ureters and the urethra One of the three divisions of the loop of Henle The trigone is a smooth triangular area lying between the openings of thetwo uretersand the urethra. The other options do not accurately identify the trigone. The coronary ostia are located in the: Left ventricle Aortic valve Coronary sinus Aorta Coronary arteries receive blood through openings in the aorta, called the coronary ostia. Question 47 2 / 2 pts Question 49 2 / 2 pts Page 31 of 36 What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn? Low birth weight Alcohol consumption during pregnancy Premature birth Smoking during pregnancy RDS of the newborn, also known as hyaline membrane disease (HMD), is a major cause of morbidity and mortality in premature newborns. None of the other options are considered the chief predisposing factors for RDS. The most common site of metastasis for a patient diagnosed with prostate cancer is which location? Bones Brain Bladder Question 48 2 / 2 pts Page 34 of 36 Decreased dietary intake Chronic blood loss Vitamin deficiency Autoimmune disease The most common cause of IDA in well-developed countries is pregnancy and chronic blood loss. What effect do natriuretic peptides have during heart failure when the heart dilates? Stimulates antidiuretic hormones. Inhibits antidiuretic hormones. Stimulates renin and aldosterone. Inhibits renin and aldosterone. Natriuretic peptides inhibit renin and aldosterone during heart failure when the heart dilates. These make up a group of peptide hormones, including atrial natriuretic peptide Question 54 2 / 2 pts Page 35 of 36 (ANP), secreted from myocardial cells in the atria and brain natriuretic peptide (BNP) secreted from myocardial cells in the cardiac ventricles. When the heart dilates during volume expansion or heart failure, ANP and BNP inhibit sodium and water absorption by kidney tubules, inhibit the secretion of renin and aldosterone, vasodilate the afferent arterioles, and constrict the efferent arterioles. The result is increased urine formation, leading to decreased blood volume and blood pressure. What is the major concern regarding the treatment of gonococci infections? Development of antibiotic resistance Changes in virulence Changes in pathogenicity Mutations into different strains Several types of drug-resistant strains have been identified; they are penicillinase- producing Neisseria gonorrhoeae (PPNG), which is resistant to penicillin; tetracycline- resistant N. gonorrhoeae (TRNG), which is resistant to tetracycline; chromosomal control of mechanisms of resistance of N. gonorrhoeae (CMRNG), which is resistant to penicillin and tetracycline; and increasingly a fluoroquinolone-resistant N. gonorrhoeae (QRNG). The other options are not major concerns. Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction? I Question 55 2 / 2 pts Question 56 2 / 2 pts Question I58 Page 36 of 36 II III IV Hypersensitivity reactions have been divided into four distinct types: type I (IgE- mediated) hypersensitivity reactions, type II (tissue-specific) hypersensitivity reactions,type III (immune complex–mediated) hypersensitivity reactions, and type IV (cell- mediated) hypersensitivity reactions. Which cytokines initiate the production of corticotropin-releasing hormone (CRH)? IL–1 and IL-6 IL-2 and TNF-α IFN and IL-12 TNF-ß and IL-4 Although a number of stress factors initiate the production of CRH, of the optionsavailable, only high levels of IL-1 and IL-6 initiate such a response. Question 57 2 / 2 pts