NURS 617 EXAM II NEWEST 2024/2025 ACTUAL EXAM COMPLETE QUESTIONS AND 100% CORRECT VERIFIED, Exams of Nursing

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NURS 617 EXAM II NEWEST 2024/2025 ACTUAL EXAM

COMPLETE QUESTIONS AND 100% CORRECT VERIFIED

ANSWERS GRADED A

A direct result of anaerobic metabolism during hypoxic cell injury is: a. increased ATP b. metabolic acidosis c. tissue ischemia d. all of the above. b. metabolic acidosis Rationale: When oxygen is not available, cells switch to anaerobic metabolism, which yields an acid called lactate, or lactic acid. Accumulation of which of the following molecules results in irreversible cell injury? a. Calcium b. Melanin c. Lipids d. Water a. Calcium Rationale: The accumulation of calcium causes irreversible mitochondrial injury. Adaptive cellular mechanisms function to: a. speed up cellular death. b. prevent cellular aging. c. treat disease. d. protect cells from injury.

d.protect cells from injury. An individual with damage to the spinal cord may experience atrophy of which of the following organs? a. Skeletal muscles b. Skin c. Liver d. Brain a. Skeletal muscles Rationale: Lack of nerve stimulation to skeletal muscles results in muscle atrophy. Chronic infection of the cervix by the human papillomavirus results in cervical: a. hormonal hyperplasia. b. atrophy. c. dysplasia. d. metaplasia. c. dysplasia. Rationale: (Chronic infection or inflammation is a common cause of cervical dysplasia.) Ethanol (alcohol) causes cell injury by which of the following mechanisms? a. Cellular dehydration b. Intracellular sodium loss c. Lipid accumulation in hepatocytes d. Hypoxic injury c. Lipid accumulation in hepatocytes Rationale: Ethanol metabolism causes lipid accumulation in hepatocytes that decreases liver function and may result in liver cirrhosis.

In compensatory hyperplasia, growth factors stimulate cell division in response to: a. decreased hormonal stimulation. b. ischemia. c. tissue loss. d. puberty. c. tissue loss. Rationale: In response to tissue loss, surrounding cells are stimulated to replace the lost tissue. In response to an increased workload, such as that caused by high blood pressure (hypertension), myocardial cells in the left ventricle will adapt through the process of: a. hyperplasia. b. hypertrophy. c. atrophy. d. dysplasia. b. hypertrophy. Rationale: In response to the increased workload of hypertension, myocardial cells will hypertrophy in order to pump harder. Injury to the endoplasmic reticulum due to hypoxic injury results in: a. sodium accumulation. b. a decrease in protein synthesis. c. the release of enzymes. d. lactic acid production. b. a decrease in protein synthesis. Rationale: Ribosomes are the primary site for protein synthesis. Hypoxic injury and cellular swelling

result in dilation of the rough endoplasmic reticulum, causing the ribosomes to detach. Loss of the site for protein synthesis results in decreased protein production. Lead poisoning affects nervous system function by which of the following mechanisms? a. Lead blocks oxygen delivery to the brain by binding with hemoglobin. b. Lead interferes with neurotransmitter release. c. Lead inhibits fatty acid oxidation in the brainstem. d. Lead causes nervous tissue necrosis. b. Lead interferes with neurotransmitter release. Lysosomal rupture during hypoxic injury leads to: a. autodigestion of cells. b. cellular acidosis. c. sodium influx. d. cellular adaptation a. autodigestion of cells. Rationale: Lysosomal enzyme release during hypoxic injury causes autodigestion of cells. Metaplasia involves the replacement of normal cells by: a. cancer cells. b. scar tissue. c. abnormal cells of the same tissue type. d. another type of cell. d.another type of cell. Rationale: Metaplasia is the replacement of normal cells by another type of cell. Other than the liver, which of the following organs is most frequently affected by ethanol injury?

a. Kidneys b. Heart c. Stomach d. Brain d. Brain Rationale: Alcohol directly affects the cells in the liver and the brain. The major mechanism of injury in drowning is: a. hypoxemia. b. absorption of fluid from the lungs. c. electrolyte imbalances. d. free radical injury. a. hypoxemia. The most common cause of hypoxic injury is: a. chemical toxicity. b. free radicals. c. malnutrition. d. ischemia. d. ischemia. Rationale: Hypoxic injury results from a lack of oxygen. The most common cause of this type of cell injury is ischemia, a decrease in blood flow to the tissue. The process of muscle hypertrophy involves an increase in: a. cell division. b. plasma membrane thickness. c. protein synthesis. d. water accumulation.

c. protein synthesis. Rationale: The process of muscle hypertrophy involves an increase in protein synthesis to produce larger, stronger muscle cells. Tissue ischemia and a decrease in mitochondrial oxygenation result in: a. cellular dehydration. b. calcium accumulation outside the cell. c. decreased ATP production. d. increased protein synthesis. c. decreased ATP production. Rationale: A decrease in oxygen delivery results in a decrease in ATP production. Vitamin E, vitamin C, and beta-carotene are molecules in food that act as: a. receptor blockers. b. antioxidants. c. poisons. d. free radicals. b. antioxidants. Rationale: Vitamin E, vitamin C, and beta-carotene are antioxidants that attract and neutralize unpaired electrons to protect against free radical injury. Which of the following molecules is likely to accumulate in any dead or dying tissues? a. Calcium b. Uric acid c. Melanin d. Protein

a. Calcium Rationale: When calcium pumps fail due to mitochondrial injury, calcium accumulates in the cytoplasm and contributes to irreversible cellular injury and cell death. Why is carbon monoxide exposure a life-threatening condition? a. Carbon monoxide causes the release of toxic amounts of iron from the tissues. b. Inhalation of carbon monoxide interferes with oxygen diffusion in the lungs. c. Carbon dioxide removal from the tissues is inhibited. d. Carbon monoxide binds to hemoglobin and prevents normal oxygen transport to tissues. d. Carbon monoxide binds to hemoglobin and prevents normal oxygen transport to tissues. Which of the following molecules accumulates in liver cells as a result of alcohol abuse? a. Fat (lipids) b. Water c. Iron d. Protein a. Fat (lipids) What are the primary factors contributing to oncosis from hypoxic injury? a. Increase in ATP production and potassium movement out of the cell b. Accumulation of lipids and pigments in the cell c. Injury to the endoplasmic reticulum and Golgi apparatus d. Decrease in ATP production and sodium movement into the cell d. Decrease in ATP production and sodium movement into the cell Pathologic hyperplasia can lead to: a. phagocytosis. b. stem cell activation.

c. enlargement of the uterus. d. metaplasia. d. metaplasia. Which of the following is a form of metaplasia that can occur in the human body? a. Epithelial cells of the bronchial lining are replaced with collagenous connective tissue. b. Adipose cells are replaced by cells that cannot store lipids. c. Squamous epithelial cells of the esophageal lining are replaced by glandular cells similar to those lining the stomach. d. Liver cells are replaced by squamous epithelial cells. c. Squamous epithelial cells of the esophageal lining are replaced by glandular cells similar to those lining the stomach. Free radicals directly injure cells by each of the following mechanisms except: a. DNA fragmentation. b. lipid peroxidation. c. activation of lysosomal enzymes. d. alteration of proteins. c. activation of lysosomal enzymes. Restoration of oxygen to oxygen-deprived tissues results in: a. chemical injury. b. establishment of normal cell metabolism. c. reperfusion injury. d. hypoxic injury. c. reperfusion injury. The process of cellular atrophy may be accomplished through which of the following processes? a. Decreased cell division

b. Loss of fluid c. Formation of autophagic vacuoles d. Inhibition of enzyme formation c. Formation of autophagic vacuoles A direct result of anaerobic metabolism during hypoxic cell injury is: a. metabolic acidosis. b. tissue ischemia. c. all of the above. d. increased adenosine triphosphate (ATP). a. metabolic acidosis. Which of the following cellular processes occurs during apoptosis? a. cell lysis b. cellular swelling c. cleavage of key cellular proteins d. activation of inflammation c. cleavage of key cellular proteins A healthcare professional is assessing a child who has complete trisomy of the twenty-first chromosome. What findings does the professional relate to this condition? a. High pitched voice, tall stature, gynecomastia, and an IQ of 60 to 90 b. Widely spaced nipples, reduced carrying angle at the elbow, and sparse body hair c. An IQ of 25 to 70, low nasal bridge, protruding tongue, and flat, low-set ears d. Circumoral cyanosis, edema, of the feet, short stature, and mental slowness c. An IQ of 25 to 70, low nasal bridge, protruding tongue, and flat, low-set ears Rationale: This child has Trisomy 21, also known as Down syndrome. These children typically present with IQs ranging from 25 to 70. The facial appearance is distinctive and exhibits a low nasal bridge,

epicanthal folds, protruding tongue, and flay, low-set ears. Widely spaced nipples and edema of the newborn's feet are characteristic of Turner syndrome. The high-pitched voice and gynecomastia are characteristic of Klinefelter syndrome. What is the most common cause of Down syndrome? a. Paternal nondisjunction b. Maternal nondisjunction c. Paternal translocation d. Maternal translocations b. Maternal nondisjunction Rationale: Nondisjunction during the formation of one of the parent's gametes or during early embryonic development occurs in approximately 97% of infants born with Down syndrome. In approximately 90% to 95% of infants, the nondisjunction occurs in the formation of the mother's egg cell. Down syndrome is rarely caused by paternal nondisjunction. Robertsonian translocations are responsible for 3% to 5% of cases of Down syndrome. A high-pitched voice and gynecomastia are characteristic of Klinefelter syndrome. A person with 47, XXY karyotype has the genetic disorder resulting in which syndrome? a. Fragile X b. Turner c. Down d. Klinefelter d. Klinefelter Rationale: A disorder in the chromosome (47, XXY karyotype) results in a disorder known as Klinefelter syndrome. Turner syndrome has a karyotype of 45, X. Down syndrome is caused by Trisomy 21. Fragile X syndrome is caused by microscopically observable breaks and gaps in the X chromosome. Cystic fibrosis is caused by what type of gene?

a. Autosomal dominant b. X-linked dominant c. Autosomal recessive d.X-linked recessive c. Autosomal recessive Rationale: Cystic fibrosis is the most common lethal autosomal recessive disease in white children. It is not X linked of dominant. Males, having only one X chromosome, are said to be what? a. Heterozygous b. Homozygous c. Hemizygous d. Ambizygous c. Hemizygous Rationale: Males, having only one X chromosome, are said to be hemizygous for genes on this chromosome. Homozygous refers to two alleles being identical at a specific locus. When the alleles are not identical at that locus, the individual is said to be heterozygous. Ambizyous is not a term in the text. Which statement is true regarding X-linked recessive conditions? a. Cystic fibrosis is an example of such a condition. b. Such diseases use males as phenotypical carriers. c. 25% of an affected individual's grandsons will be affected. d. The conditions are passed from affected father to all of his female children. d. The conditions are passed from affected father to all of his female children. ationale: X-linked recessive conditions are passed from an affected father to all of his daughters, who, as phenotypically normal carriers, transmit it to approximately one half of their sons, who are affected. Cystic fibrosis is an autosomal recessive disease.

What is an individuals' genetic makeup called? a. Genotype b. Phenotype c. Heterozygous locus d.Homozygous locus a. Genotype Rationale: An individual's genotype is his or her genetic makeup. The outward appearance of an individual is the phenotype. A locus refers to the position a gene occupies on a chromosome. Which risk factor for hypertension is influenced by genetic factors and lifestyle? a. Physical inactivity b. Obesity c. Psychosocial stress d.Sodium intake b. Obesity Rationale: The most important environmental risk factors for hypertension are increased sodium intake, decreased physical activity, psychosocial stress, and obesity. However, obesity is, itself, influenced by genes and the environment. Studies have identified several genes that play a role in the prevention of obesity by affecting what? a. Absorption of fat b. Metabolizing of fat c. Regulation of appetite d. Altering the sense of satiety c. Regulation of appetite Rationale: clinical trials using recombinant leptin have demonstrated moderate weight loss in a subset of

obese individuals. In addition, leptin participates in important interactions with other components of appetite control, such as neuropeptide Y and a-melanocyte-stimulating hormone and its receptor, the melanocortin-4 receptor (MC4R). The BRCA1 and BRCA2 mutations increase the risk of which cancer in women? a. Ovarian b. Pancreatic c. Uterine d. Lung a. Ovarian Rationale: BRCA1 mutations increase the risk of ovarian cancer among women (20% to 50% lifetime risk), and BRCA2 mutations also confer an increased risk of ovarian cancer (10% to 20% lifetime prevalence). BRCA1 and BRCA2 mutations are not currently believed to be linked with risks of lung, uterine, or pancreatic cancers. Traits caused by the combined effects of multiple genes are referred to by which term? a. Modifiable b. Polygenic c. Involuntary d. Multifocal b. Polygenic Rationale: Traits in which variation is thought to be caused by the combined effects of multiple genes are polygenic, meaning many genes. Multifocal means relating to or arising from many points. Modifiable refers to the changeability of something. Involuntary suggests being out of the control of someone or something. What is currently believed about the risk for developing Alzheimer disease? a. It occurs less among Hispanics than in Asians

b. It is not directly related to genetic predisposition c. It is higher among men than it is among women d. It doubles among those with an affected first-degree relative d. It doubles among those with an affected first-degree relative Rationale: The risk of developing Alzheimer disease doubles in individuals who have an affected first- degree relative. There is a genetic link to the disease. It is not true that the risk is higher among men than it is among women. Hispanics have relatively low risk of developing this disease. What genes are responsible for an autosomal dominant form of breast cancer? (Select all that apply.) a. BRCA b. LCAT c. CHK d. CHK e. BRCA a. BRCA e. BRCA Rationale: Women who inherit a mutation in BRCA1 or BRCA2 experience a 50% to 80% lifetime risk of developing breast cancer. What genetic process is likely responsible for the occurrence of asthma in only one of a pair of identical twins? a. Transgenerational inheritance b. Genomic imprinting c. Epigenetic modifications d. Methylation c. Epigenetic modifications Rationale: Epigenetic modifications can cause individuals with the same DNA sequences (such as

identical twins) to have different disease profiles. Imprinting means that wither the copy of the gene inherited through the sperm or the copy inherited through the egg is inactivated and remains in this inactive state in all of the somatic cells of the individual. The heritable transmission to future generations of epigenetic modifications is called transgenerational inheritance. DNA methylation is called transgenerational inheritance. DNA methylation occurs through the attachment of methyl group to the carbon-5 position of a cytosine. Prader-Willi syndrome causes a chromosomal defect that is what? a. Initiated by postnatal exposure to a virus b. Inherited from the father c. Related to maternal alcohol abuse d. Transferred from mother to child b. Inherited from the father Rationale: Prader-Willi syndrome can be caused by a 4 Mb deletion of chromosome 15q when inherited from the father. This disorder is not caused by a virus, or related to maternal alcohol abuse. The same gene deletion causes Angelman syndrome when inherited from the mother. What can a malfunction in DNA methylation lead to? a. Hypothyroidism b. Cancer c. Blindness d. Diabetes mellitus b. Cancer Rationale: Aberrant methylation can lead to silencing of tumor-suppressor genes in the development of cancer. What is the difference between DNA sequence mutations and epigenetic modifications? a. Epigenetic modifications potentially can be reversed

b. Leukemia is a result of only DNA sequence mutation c. DNA sequence mutations can be directly altered. d. No known drug therapies are available for epigenetic modifications. a. Epigenetic modifications potentially can be reversed Rationale: Unlike DNA sequence mutations, which cannot be directly altered, epigenetic modifications can be reversed. Which term refers to the silenced gene of a gene pair? a. Mutated b. Activated c. Altered d. Imprinted d. Imprinted Rationale: Gene silencing, a process during which genes are predictably silenced, depending on which parent transmits them, is known as imprinting. What is most likely the shape of the face of a child diagnosed with Russell-Silver syndrome? a. Square b. Round c. Triangular d. Elongated c. Triangular Rationale: Growth retardation, proportionate short stature, leg-length discrepancy, and a small, triangular-shaped face characterizes Russell-Silver syndrome. What are genes responsible for the maintenance of all cells referred to as? a. Executive

b. Managerial c. Housekeeping d. Universal c. Housekeeping Rationale: A small percentage of genes, termed housekeeping genes are necessary for the function and maintenance of all cells. The remaining options do not accurately refer to these cells. When microRNA (miRNA) are methylated their messenger RNA (mRNA) targets are over-expressed, the resulting effect on existing cancer would be: a. Cell death b. Metastasis c. Remission d. Relapse b. Metastasis A monocyte is a circulating white blood cell that transforms into which of the following cells once it enters the tissue during an inflammatory response? a. Neutrophil b. Macrophage c. Mast cell d. Fibroblast b. Macrophage Rationale: Monocytes must mature into macrophages once they enter the tissues to become active phagocytes. An elevation of which cell accounts for a "left shift" in the white blood cell count differential? a. Lymphocytes b. Bands and PMNs

c. Monocytes d. Basophils b. Bands and PMNs Rationale: In the typical presentation of the white blood cell differential, bands (immature neutrophils) and PMNs (polymorphonucleocytes) are placed to the left. During an acute inflammatory response, the rise in these immature and mature neutrophils creates what is known in the clinical environment as a "left shift." Prostaglandins differ from histamine in which of the following ways? a. All of the above b. Site of production c. Duration of effect d. Vascular effect c. Duration of effect Rationale: Histamines are released immediately during degranulation and have short-acting effects. Prostaglandins are later synthesized and are responsible for maintaining a long-term inflammatory response. The first vascular response in inflammation is: a. Brief vasoconstriction. b. Brief vasodilation c. Decreased vascular permeability d. Increased vascular permeability. a. Brief vasoconstriction. Rationale: The first response during inflammation is vasoconstriction, which limits bleeding at the site of tissue injury.

Which of the following inflammatory chemicals is blocked by non-steroidal anti-inflammatory drugs such as ibuprofen? a. Leukotrienes b. Histamine c. All of the above d. Prostaglandins d. Prostaglandins Rationale: Nonsteroidal anti-inflammatory drugs block prostaglandins by inhibiting the cyclooxygenase (COX) 1 and 2 pathway. If a person is exposed to antigen X and is later exposed to antigen X again, which of the following immune responses will occur? a. Determinant b. Secondary c. Immunosuppressive d. Primary b. Secondary Rationale: This person mounted a primary immune response after his/her first exposure to antigen X and a secondary immune response after the second exposure. When a person has an allergic reaction to bee stings, which antibody causes the life-threatening hypersensitivity response? a. IgM b. IgE c. IgG d.IgA b. IgE

Which cell stimulates both the cell-mediated and humoral immune responses? a. Plasma cell b. Helper T cell c. Cytotoxic T cell d. B lymphocyte b. Helper T cell Rationale: Helper T cells stimulate the proliferation and differentiation of B and T cells, thus exerting control over both the cell-mediated and humoral immune responses. Which is the main antibody transferred from a mother to an infant in breast milk? a. IgM b. IgE c. IgA d. IgG c. IgA Rationale: IgA, also known as secretory IgA, is found in the secretions from any mucosal surface, including the mammary glands. It is the primary antibody found in breast milk and confers passive acquired immunity to the breast-feeding infant. Which of the following cells has the capacity to produce antibodies during an immune response? a. Pluripotent cells b. Plasma cells c. Memory cells d. T cells b. Plasma cells

Rationale: Plasma cells are B lymphocytes that have developed the ability to produce antibodies during an immune response. A positive tuberculin skin test for detecting the presence of tuberculosis is indicative of which type of hypersensitivity reaction? a. Type IV b. Type II c. Type I d. Type III a. Type IV Rationale: Because this reaction takes 24 to 72 hours to appear, it is a classic example of a type IV hypersensitivity reaction. Disease characteristics of SLE include: a. Autoantibody destruction of the thyroid gland. b. Deposition of immune complexes in the kidneys, brain, and heart. c. Tc cell damage to the liver. d. Tc cell destruction of lung tissue and the gastrointestinal lining. b. Deposition of immune complexes in the kidneys, brain, and heart. Rationale: SLE is a type II hypersensitivity reaction involving deposition of immune complexes in the kidneys, brain, and heart. Transfusion of A-negative blood to an O-positive individual will have which of the following results? a. Agglutination and lysis of red blood cells b. Improved red blood cell counts c. Production of anti—B antibodies d. An Rh incompatibility reaction

a. Agglutination and lysis of red blood cells Rationale: An individual with type O blood has anti-A antibodies. The result will be a transfusion reaction with agglutination and lysis of red blood cells. When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs? a. Anaphylaxis b. Allergic c. Alloimmune d. Autoimmune c. Alloimmune Rationale: Alloimmune responses involve reactions against the tissue of another individual. One example is when the mother produces antibodies against fetal red blood cells. Which of the following is not a known mechanism for the development of an immune disease? a. Alterations in regulatory T-cell function and decreased suppression of autoreactive lymphocytes b. Spontaneous alteration of the self-antigen of a mature cell c. The development of a neoantigen that involves binding a hapten to a cell in the body d. Complication of a viral infection in which the antibody to the virus cross-reacts with the body's own cells b. Spontaneous alteration of the self-antigen of a mature cell A differential rise in which blood cell is typically seen with parasitic infections? a. Eosinophils b. Lymphocytes c. Neutrophils d. Basophils a. Eosinophils

A differential rise in which white blood cell is typically seen with viral infections? a. Lymphocytes b. Eosinophils c. Monocytes d. Neutrophils a. Lymphocytes An elevation of which cells accounts for a "left shift" in the white blood cell count differential? a. Lymphocytes b. Polymorphonucleocytes (PMNs) c. Basophils d. Monocytes b. Polymorphonucleocytes (PMNs) Rationale: In the typical presentation of the white blood cell differential, PMNs are placed to the left. During an acute inflammatory response, the rise in neutrophils creates what is known in the clinical environment as a "left shift." Through what mechanism do bacteria cause injury to the host? a. Release of bacterial toxins b. Production of free radicals c. Capsule formation d. Phagocytosis a. Release of bacterial toxins Rationale: Bacteria cause injury to host cells through the release of bacterial toxins. When gram-negative bacteria are lysed, lipopolysaccharide fragments from the cell membranes become inflammatory stimuli called endotoxins.

Why are fungal infections resistant to most antibiotic therapies? a. Fungi can mutate quickly to avoid the effects of antibiotics. b. Fungi release toxins that neutralize most antibiotics. c. Fungi have thick polysaccharide walls that resist antibiotics. d. All fungi are anaerobes. c. Fungi have thick polysaccharide walls that resist antibiotics. Which of the following microorganisms often resist phagocytosis because of their extremely small size, but induce a strong antibody response that usually results in neutralization of the pathogen? a. Gram-positive bacteria b. Gram-negative bacteria c. Fungi d. Viruses d. viruses Rationale: Viruses are often too small to be recognized by phagocytes but are major inducers of the immune response that involve production of antibodies against the pathogen. Which of the following statements about viruses is true? a. Viruses are intracellular parasites that take over the metabolic machinery of host cells b. Viruses are prokaryocytes. c. viruses can be classified as gram-positive or gram-negative. d. viruses do not contain their own DNA or RNA. a. Viruses are intracellular parasites that take over the metabolic machinery of host cells Rationale: Viruses do not possess any of their own organelles and have no metabolism. Instead, they insert their DNA or RNA into a host cell and use the host cell's metabolic machinery to replicate. Endotoxin is formed from:

a. viral secretions. b. fragments of cell membranes from lysed gram-negative bacteria. c. lysosomal enzymes released by fungi. d. poisons released by gram-positive bacteria. b. fragments of cell membranes from lysed gram-negative bacteria. Rationale: When gram-negative bacteria are lysed, lipopolysaccharide fragments from the cell membranes become inflammatory stimuli called endotoxins. Vaccines help protect individuals against disease by inducing which of the following immune responses? a. alloimmunity b. passive immunity c. primary immunity d. secondary immunity c. primary immunity Rationale: Most vaccinations involve injecting a small amount of antigen to induce a primary immune response. On subsequent exposure to the microorganism, the individual is able to mount a fast and effective secondary immune response. Which cancer originates from the connective tissue? a. Basal cell carcinoma b. Adenocarcinoma c. Osteogenic sarcoma d. Multiple myeloma c. Osteogenic sarcoma Rationale: Cancers arising from connective tissue usually have the suffix - sarcoma. Carcinomas arise in epithelial tissue. Myeloma arises in the bone marrow.