NR507 Patho Final Exam, Exams of Nursing

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NR 507 WEEK 8 FINAL EXAM

Patho Final Examination

• Due Dec 16 at 11:59pm
• Points 150
• Questions 75
• Available Dec 10 at 12am - Dec 16 at 11:59pm 7 days
• Time Limit 90 Minutes

Instructions

• The Week 8 final exam counts toward the final grade. It is comprehensive and covers material from Weeks 1–8.

• The final exam consists of 75 questions and is worth 2 points each.
• You have one attempt to take the exam with a 90 minute time limit. Good luck!

Attempt History

Attempt Time Score

Score for this quiz: 146 out of 150

Submitted Dec 16 at 11:15pm This attempt took 75 minutes.

Question 1

2 / 2 pts

What period follows depolarization of the myocardium and represents a period during which no new cardiac potential can be propagated? Correct! Refractory Threshold Sinoatrial (SA) Hyperpolarization During the refractory period, no new cardiac action potential can be initiated by a stimulus. This selection is the only option that accurately identifies the period described in the question.

106/58 mm Hg 104/55 mm Hg 112/62 mm Hg 121/70 mm Hg The suggested mean blood pressure for an 8- to 9- year-old child is 106/58 mm Hg. For a child of 6 to 7 years old, 104/55 mm Hg is appropriate; for a 12- to 13-year-old child, 112/62 mm Hg is appropriate, and for a 16- to 18-year-old young man, 121/70 mm Hg is appropriate. Question 3

2 / 2 pts

Which is an example of an endogenous antigen? Yeast Correct! Cancer cells

Fungus Bacteria Of the options provided, endogenous antigens include only those uniquely produced by cancerous cells. Question 4

2 / 2 pts

An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border. A wide fixed splitting of the second heart sound is also found. These clinical findings are consistent with which congenital heart defect? Atrioventricular canal (AVC) defect Patent ductus arteriosus (PDA) Ventricular septal defect (VSD) Correct! Atrial septal defect (ASD)

Because most children with ASD are asymptomatic, diagnosis is usually made during a routine physical examination by the auscultation of a crescendo-decrescendo systolic ejection murmur that reflects increased blood flow through the pulmonary valve. The location of the murmur is between the second and third intercostal spaces along the left sternal border. A wide fixed splitting of the second heart sound is also characteristic of ASD, reflecting volume overload to the right ventricle and causing prolonged ejection time and a delay of pulmonic valve closure. The presentations of other congenital heart defects are not consistent with the described symptoms. Question 5

2 / 2 pts

Chvostek and Trousseau signs indicate which electrolyte imbalance? Correct! Hypocalcemia Hypercalcemia Hyperkalemia Hypokalemia Two clinical signs of hypocalcemia are the Chvostek sign and Trousseau sign. These clinical signs are not indicative of any of the other options.

An adult’s chest wall compliance is the same as an infant’s. An adult’s chest wall compliance is dissimilar to that of an infant’s. Correct! An adult’s chest wall compliance is lower than an infant’s. An adult’s chest wall compliance is higher than an infant’s. Chest wall compliance is higher in infants than it is in adults, particularly in premature infants. Nausea Weight loss Correct! Fatigue

Fatigue is the most frequently reported symptom of cancer and cancer treatment. Although patients report the other options, they are not as frequently experienced as fatigue. Correct! Gas exchange shifts from the placenta to the lung. Systemic resistance and pulmonary resistance fall. Systemic resistance and pulmonary resistance rise. Systemic resistance falls and pulmonary resistance rises. From the available options, the only change that takes place in the circulation at birth is the shift of gas exchange from the placenta to the lungs. Correct Answer Vitamin B 12 by injection Cyanocobalamin by oral intake You Answered

Folate by oral intake Ferrous fumarate by Z-track injection Replacement of vitamin B 12 (cobalamin) is the treatment of choice for PA. Initial injections of vitamin B 12 are administered weekly until the deficiency is corrected, followed by monthly injections for the remainder of the individual’s life. The other options are not treatments for PA. Correct! Rocky Mountain spotted fever Sleeping sickness Candida Rocky Mountain spotted fever is a result of a rickettsiae. Cholera is a bacterial infection, candida is a fungal infection, and sleeping sickness is a protozoal infection. Question 11

2 / 2 pts

Which statement is true regarding maternal antibodies provided to the neonate?

Correct! The antibodies enter into the fetal circulation by means of active transport. The antibodies are transferred to the fetus via the lymphatic system. The antibodies reach protective levels after approximately 6 months of age. The antibodies are directly related to the mother’s nutritional intake. To protect the child against infectious agents both in utero and during the first few postnatal months, a system of active transport facilitates the passage of maternal antibodies into the fetal circulation. The antibodies are transmitted via the placenta and are related to the mother’s immune system. The infant’s own IgG-related antibodies reach protective levels by 6 months of age. Pain is primarily a result of pressure caused by the tumor. Correct! Pain is generally associated with late-stage cancer. Pain indicates the metastasis of a cancer.

Pain is usually the initial symptom of cancer. Pain is generally associated with the late stages of cancer. Pressure, obstruction, invasion of a structure sensitive to pain, stretching, tissue destruction, and inflammation can cause pain. Pain is not the initial symptom of cancer nor does it indication that the cancer has metastasized. Correct! B lymphocytes proliferate. The nodes are not properly functioning. The nodes are inflamed. The B lymphocyte proliferation in response to significant antigen (e.g., during infection) may result in lymph node enlargement and tenderness (reactive lymph node). This description is not accurate for the other options.

Cardiovascular disease Correct! Infectious disease Traumatic injury Despite the wide-scale implementation of progressive public health and immunization policies, infectious disease remains a significant cause of morbidity and mortality. The other options are not significant causes. Decrease in urine output

Sharp decline in renal blood flow Correct! Decrease in the number of nephrons With aging, the number of nephrons decreases. The other options are not necessarily related to aging. Question 16

2 / 2 pts

After sexual transmission of HIV, a person can be infected yet seronegative for how many months? 24 to 36 18 to 20 Correct! 6 to 14 1 to 2 Antibody appears rather rapidly after infection through blood products, usually within 4 to 7 weeks. After sexual transmission, however, the individual can be infected yet seronegative for 6 to 14 months or, in at least one case, for years.

Treponema pallidum Chlamydia trachomatis Haemophilus ducreyi T. pallidum is the only cause of syphilis. Question 18

2 / 2 pts

The common hay fever allergy is expressed through a reaction that is mediated by which class of immunoglobulins? Correct! IgE IgG T cells

IgM Type I reactions are mediated by antigen-specific IgE and the products of tissue mast cells (see Figure 9-1). The most common allergies (e.g., pollen allergies) are type I reactions. In addition, most type I reactions occur against environmental antigens and are therefore allergic. The other options do not accurately identify the mediation factor related to hay fever. Blood cells that differentiate into macrophages are known as: Neutrophils Basophils Eosinophils Correct! Monocytes Only monocytes migrate into a variety of tissues and fully mature into tissue macrophages and myeloid dendritic cells (see Table 27-3).

Regional lymph nodes Thymus gland Correct! Bone marrow B lymphocytes mature and become B cells in specialized (primary) lymphoid organs— the thymus gland for T cells and the bone marrow for B cells. Neither regional lymph nodes nor the spleen are involved in changing B lymphocytes into B cells. Correct! IX

X

VIII

Only factor IX deficiency causes hemophilia B (Christmas disease). Human papillomavirus (HPV) Herpes simplex virus 1 (HSV-1) Chlamydia Adenovirus Genital warts are quite contagious and are a result of only HPV.

Correct! Adaptation Flight or fight Arousal Exhaustion occurs if stress continues and adaptation is not successful, ultimately causing impairment of the immune response, heart failure, and kidney failure, leading to death. The other stages occur before the adaptation stage. Left ventricle Left atrium not

Right ventricle Right atrium Pressure is greatest in the systemic circulation, driven by the left ventricle. Question 25

2 / 2 pts

Which glycoprotein protects against urolithiasis and is a ligand for lymphokines? Correct! Uromodulin Urodilatin Cystatin Nephrin Tamm-Horsfall glycoprotein, also known as uromodulin, is the most abundant urinary protein, protects against bacterial adhesion and urolithiasis, and is a ligand for lymphokines. This statement is not true of the other options.

Thecal follicle Atretic follicle Correct! Corpus luteum Having ejected a mature ovum, the only resulting structure is the corpus luteum. Health history Computed tomographic (CT) scan

Skull x-ray studies Cerebrospinal fluid analysis Although the history may be supplemented with the remaining options, it remains the pivotal tool for establishing the cause of a seizure disorder. Question 28

2 / 2 pts

Which serum laboratory test is elevated in all forms of osteogenesis imperfecta? Correct! Alkaline phosphatase Calcium Total protein Phosphorus Of the available options, serum alkaline phosphatase is elevated in all forms of the disease.

The release of epinephrine causes shivering. Correct! It raises the metabolic rate. It affects muscle tone. Epinephrine and norepinephrine produce a rapid transient increase in heat production by raising the body’s basal metabolic rate. The other options are not correct descriptions of the effects of epinephrine on body heat. Correct! Dysfunctional uterine bleeding

Primary dysmenorrhea Polycystic ovary syndrome Unpredictable and variable bleeding, in terms of amount and duration, characterize dysfunctional uterine bleeding. Especially during perimenopause, dysfunctional bleeding also may involve flooding and the passage of large clots, which often indicate excessive blood loss. Excessive bleeding can lead to iron-deficiency anemia. This option is the only answer that demonstrates the clinical manifestations described. Correct! It becomes thicker. It assumes a neutral pH. It undergoes atrophy.

Before puberty, vaginal pH is approximately 7 (neutral) and the vaginal epithelium is thin. At puberty, the pH becomes more acidic (4 to 5) and the squamous epithelial lining thickens. Cell atrophy is not associated with puberty. Children have diarrhea more often than adults. Less water is absorbed from the colon in children. Correct! Fluid reserves are smaller in children. Children have a higher fluid volume intake. Infants have low fluid reserves and relatively rapid peristalsis and metabolism. Therefore the danger of dehydration is great. This selection is the only option that correctly identifies the reason prolonged diarrhea is more severe in children. Autoantibodies and human leukocyte antigen associations HLA associations and positive family history

Autoantibodies and obesity Correct! Obesity and positive family history The two most important risk factors for type 2 diabetes are positive family history and obesity. The other options are not believed to be important risk factors for this form of diabetes. Polycystic ovary syndrome Endometriosis Pelvic inflammatory disease Salpingitis Polycystic ovary syndrome remains one of the most common endocrine disturbances affecting women, especially young women, and is a leading cause of infertility in the United States.

Question 35

2 / 2 pts

Adoption studies have shown that the offspring of an alcoholic parent when raised by nonalcoholic parents have what amount of an increased risk of developing alcoholism? Tenfold Correct! Fourfold Threefold Twofold Adoption studies have shown that the offspring of an alcoholic parent, even when raised by nonalcoholic parents, have a fourfold increased risk of developing the disorder. Correct! Tendon