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WGU D027 COURSE MATERIAL
QUESTIONS
Whichooofootheoofollowingooisoonotooaoocellularoofunction?oo-ooans--Combustionoo-oo Alloolivingoocellsoomustooabsorbooandoometabolizeoosourcesooofooenergy,ooexcreteoowaste ooandooby- productsooofoothoseooprocesses,ooandooreproduceootooocontinueoooffspring.ooPyrotechnic ooprocessesoo(i.e.oocombustion)ooareoogenerallyoometaphorical. Whatooareoomitochondriaooresponsibleoofor?oo-ooans--Energyooproductionoo-oo Mitochondriaooareootheooenergyooproductionooorganellesooofootheoocellooresponsibleooforo otheoomajoroometabolicooprocessesooofoocreatingoounitsooofooenergyoo(e.g.,ooATP). Whichooifootheoofollowingoocanoocauseooedema?oo-ooans-- Increasedoolymphaticoopressureoo-oo Decreasedoovascularooandoolymphaticoopressureoodoesoonotoogenerallyooresultooinootheoo movementooandooaccumulationooofoofluidoointoooextravascularoospaces.ooIncreasedooplas maoopressureooinootheoovascularooresultsooinoohypertension,oowhileooincreasedoolymphati coopressureoowillooreadilyooresultooinootheoopoolingooofoolymphaticoodrainageoointooothirdoo spacesoo(i.e.ooedema). Whichooofootheoofollowingoobestoodescribesootheooresultooofoocellularooreproduction?oo- ooans--Twooodiploidoocells,oocalledoodaughteroocells,ooareooproducedoo-oo Theooresultantoooffspringooofoocellularooreproductionooisootheoocreationooofootwooodaughte roocellsooafterootheoocompletionooofoomitosisoooroomeiosis.ooInterphaseooisootheoolongestoo periodoothatooaoocelloospendsooitsoolifeoocycleooandooisootheoopreparatoryoostageoobeforeoo cellularooreproduction.ooAnaphaseooisootheooseparationooofoogeneticoomaterialsootoootheoo opposingoocentromeresooofootheoocell,oofollowedoobyootelophase. Whatooindicatesoohypokalemia?oo-ooans--SerumooKoodecreasesootooolessoothanoo3.5oo-oo Normalooserumoopotassiumoo(K),ooalsoooknownooasooeukalemia,ooisoogenerallyoo3.5- 5.5oomEq/L,oowithoosomeoovariationsooofoo+/-oo0.1- 0.3oomEq/ Loodependingooonootheoolaboratoryootesting,ooage,ooandoootheroopotentialoopatient- specificooconditionsooandoovariations.ooAlterationsooinoofluidoovolumeooorootheooadministra
tionooofooaoosupplementooaloneoodooonotoonecessarilyoocontributeootoootheoodevelopmento oofoohypokalemia. Whatooisooanooexampleooofoobothoohyperplasiaooandoohypertrophy?oo-ooans-- Uterineooenlargementoodueootooopregnancyoo-oo Hyperplasiaooisootheooincreaseooinootheoonumberooofoocellsooofooanooorganooorootissue,oow hileoohypertrophyooisootheooenlargementooofootheoocellsooofooaoogivenooorganooorootissueoo withoutooaoochangeooinootheoonumberooofoocells.ooMuscleoocellsoogrowooandooenlargeoo(h ypertrophy)ooinooresponseootoooincreasedooworkoooroostressoofromooexerciseooorooincreas edoocardiovascularoopressures.ooWhenooaooliverooisoodamagedoooroopartooofooitooisooremo ved,ooitooisootheoooneoointernaloosolidooorganoocapableooofooregenerationootooorepairooitsel foocreatingoomoreoocellsoo(hyperplasia).ooDuringoopregnancy,ootheoouterusoomustoobothoo growootooocreateoomoreoocellsooandooenlargeoothoseooexistingoocellsooinoopreparationoofor ootheoosupportooofooaoofetus. Whatooregulatesootheoosodiumoobalance?oo-ooans--Aldosteroneoo-oo Aldosteroneooisooaooregulatoryoohormoneooproducedoobyootheooadrenalooglandsootoooaffe ctootheookidneys'ooregulationooofoosodium,oopotassium,ooandoowaterooexcretion. Whatooisootheooalterationooifootheooextracellularoofluidoovolumeooisoolessoothanoonormal?oo- ooans--Hypotonicoo-oo Inoohypotonicoostates,ootheoocelloosizeooisooincreasedooasooaooresultooofoowateroomovingoo fromootheooextracellularoofluidoo(ECF)oointoootheoocellootoooincreaseoointracellularoofluid.ooI so-oooroonormotonicoostatesooareooaoobalancedoostateoobetweenoointra- ooandooextracellularoofluidoovolumes.ooHypertonicoostatesoocauseoowaterootoooshiftoooutooo footheoocellootoooincreaseootheooECFooaboveoonormal. Whenooinooexcess,oowhatoodooobuffersooabsorb?oo-ooans--Hydrogenoo-oo Excessesooofooacidoooroobase,ooH+oooroohydroxylooionoo(OH−),ooareooabsorbedooforootheo opurposeooofoomaintainingoopHoohomeostasisoo(pHooofoo7.38-7.42) Whichooofootheoofollowingoowouldooaoopatientoowithoometabolicooacidosisoohave?oo-ooans-- pHoobelowoo7.35;ooBicarbonateooleveloobelowoo 22 oomEq/Loo-oo Theoodiagnosisooofoometabolicooacidosisoorequiresoothatootheootestingooofooarterialooblood oofindsoothatootheoopHooisoolessoothanoo7.35ooandootheoobicarbonateoolevelooisoolessoothan oo 22 oomEq/L. WhatooisootheooprocessoobyoowhichooRNAoodirectsootheoosynthesisooofoopolypeptides?oo- ooans--Translationoo-oo Translationoorefersootooothisooprocess.ooTranscriptionooisooanotherooprocessooinoowhichoo RNAooisoosynthesized.ooMutationoomeansoogeneticoomaterialoohasoobeenoomodifiedoothro ughooinheritance.ooCreationooisooaootermoothatoodoesoonotooapplyooinoothisoocontext. Whatooisootheoorecurrenceoorateooforooautosomaloodominantoodisease?oo-ooans--50%oo-oo
Activeooimmuneooprocessesooareootheooself- originatingooprocessesooofootheooimmuneoosystemoothatoooccuroofromoo(acquired)oooroowit houtoo(innate)oopriorooexogenousoosimulationooorooexposureootoooforeignooantigens.ooPas siveooimmunityooisoostabilized.ooExistingooimmuneooresponsesoothatooareoopresentoowithoo oroowithoutoosimulationoocanooariseoooroobeoocreatedoofromoooneselfoo(innate)ooorooacquir edoofromooanoooutsideoosourceoo(e.g.oodonorooantibodies). WhatoodoesooT-cellooactivityoocauseooinooolderooadults?oo-ooans-- Increasedoosusceptibilityooforooinfectionoo-oo Asootheoohumanoobodyooages,ootheooimmuneoosystem'sooeffectivenessootooocoordinateoor esponsesootooopathogensooandoootherooforeignooantigensoowanesooandootheooriskooforoodi seaseooincreases. Whatooisooaoodermatitisoocausedoobyooprolongedooexposureootooochemicalsoosuchooasooa cidsoooroosoapsooalsoooknownooas?oo-ooans--Irritantoocontactoodermatitisoo-oo Prolonged,oosuperficialooskinooexposureootoooforeignooirritantsoo(e.g.,ooacidsoooroosoaps)o oisooaoomanifestationooofooanooinnate,oolocalooinflammatoryooresponse.ooTheooconditionso oofooallergic,oostasis,ooandooatopicoodermatitisooinvolveoomoreoosystemicooprocessesooofoo theooimmuneoosystemooandoovasculature. Whichooofootheoofollowingooisooaooself- limitingoodiseaseooassociatedoowithooHerpesootypeoovirusesooandooaooheraldoopatch?oo- ooans--Pityriasisooroseaoo-oo Lichenooplanus,ooacneoovulgaris,ooandooerythemaoomultiformeooareooconditionsoogenerall yooassociatedoowithoooroocausedoobyooautoimmuneoodysregulation,oobacteria,ooandoovari etiesooofooforeignooantigenoo(medications,oovirus,ooetc.).ooPityriasisooroseaooinooparticular ooisooassociatedoowithooandootriggeredoobyooHerpesooviruses,oomanifestingooitselfooasooao oheraldoopatch. Whatooisooaoofuruncle?oo-ooans-- Anooinfectionooofootheoohairoofollicleoothatooextendsootoootheoosurroundingootissueoo-oo Abscess,oodermis,ooandoofungalooinfectionsooareoogenerallyoomoreoowidespreadoooroolarg erooprocessesoothatoorequireoobroadoooroosystemicootreatment.ooAoofuruncle,oothoughooun comfortableootooopainful,ooisooaoogenerallyoolocalizedooinfectionoothatooisooself- resolvingoooroothatoorequiresoolocal,oominorootreatment. Whatootypeooofoolesionoomayoobeoomalignantooinootheooformooofoosquamousoocelloocarcino maoo(SCC)?oo-ooans--Actinicookeratosisoo-oo Actinicookeratosis,oowhichooisoocausedoobyooexposureootoooUVooradiation,ooisooaooprecurs oroolesionooofooSCC Whatootypeooofooabnormaloocelloogrowthoodoesoocarcinomaooreferooto?oo-ooans-- Epithelialoocellsoo-oo Carcinomaoorefersootooodysplasticooepithelialoocellsoothatoohaveoopenetratedootheooentireo othicknessooofootheooepitheliumoointoootheoobasementoomembrane.
Whatooisooaoocharacteristicooofooaoomalignantootumor?oo-ooans-- Absenceooofoonormalootissueooorganizationoo-oo Healthyootissueooisoomadeooupooofoonon-cancerousoocellsoothatooareoowell- differentiated,ooconnectedooviaooaoowell- organizedoostromaooandoothatoostayooput.ooMalignantootumorsoolackoothoseoocharacteristi csooasoowellooasoonormalootissueooorganization. Whichoolifestyleoofactoroohasoonotoobeenoolinkedootoootheoodevelopmentooofoocancer?oo- ooans--Extremeooexerciseoo-oo Tobaccooouse,ooobesity,ooandooalcoholooconsumptionooareoocausalooforoonumerousoocan cers,oowhichoocanoobeooprevented.ooExerciseoohelpsoopreventoocolonoocancerooandoolikel yoohelpsoopreventooendometrial,oobreast,ooandoootheroocancersooasoowell. Whichoopediatricoomalignancyooisoolinkedootoootheoofamilyooofooorigin?oo-ooans-- Wilmsootumoroo-oo Wilmsootumorooisookidneyoocancerooinoochildhoodoocausedoobyooinheritedoogenes.ooTheoo mainoocausesooofooliveroocancerooareoohepatitis,oofattyooliveroodisease,ooandooalcoholoous e.ooTheoomainoocauseooofoocervicaloocancerooisooHPVooinfection.ooLeukemiaooisoocausedo obyoomutationsootooohematopoieticoostemoocells. Whichooofootheoofollowingoodrugsooisooclassifiedooasoohormonalootreatmentooforoobreastoo cancer?oo-ooans--Tamoxifenoo-oo Lapatinibooisooaootyrosineookinaseooinhibitor.ooPaclitaxilooisooanooantimicrotubuleooagent.oo RituximabooisooaooCD20- directedoocytolyticoomonoclonalooantibody.ooTamoxifenooisooanooanti- estrogenoomedicationoousedooinootheootreatmentooofooestrogen-linkedoobreastoocancer. Whereoodoootheoocancersootreatedoowithooglucocorticoidsoostemoofrom?oo-ooans-- Lymphoidootissueoo-oo Glucocorticoids,ooalongoowithoootheroomedications,ooareoousedootoootreatoocancersooofoot heoolymphoidootissueoo(lymphocyticooleukemias,ooHodgkinoodisease,oonon- Hodgkinoolymphomas,ooandoomultipleoomyeloma). Aoo23-year- oldoowomanoocomesooinooforooprenataloocounseling.ooWhileoocompletingooheroofamilyoohis tory,oosheooreportsooheroobrotheroohasoocysticoofibrosis.ooSheoodoesoonotooknowooifoosheo oisooaoocarrier.ooSheooasksooifooheroochildrenoowilloobeooaffectedoobyootheoodisease. Whatooisooanooaccurateoowayootooodetermineootheoolikelihoodooofoothisoopatient'soochildre noobeingooaffected?oo-ooans--Aoogeneticooorooaoocarrierootestoo-oo Cysticoofibrosisooisooaoohereditaryoodiseaseoothatooimpactsootheoolungsooandoodigestiveoos ystem.ooItooisootheooresultooofootheoocysticoofibrosisootransmembraneooconductanceooregu latoroogeneoomutation.ooTheoodiseaseoooccursoowhenooanooindividualooinheritsootheoomut atedoogeneoofromooeachooparent.ooWhenooonlyoooneoomutatedoogeneooisooinherited,ootheo oindividualooisoolabeledooaoocarrier.
Oxygenatedoobloodooflowsoothroughoowhichoovessel?oo-ooans--Pulmonaryooveinoo-oo Theoosuperioroovenaoocavaoocarriesooallootheoodeoxygenatedoobloodoofromooperipheralooc irculationoobackootoootheooheartoowhereooitooentersootheoorightooatriumootooobeoopumpedooi ntoootheoorightooventricle.ooTheoorightooventricleoopumpsootoootheoolungsooforoooxygenatio nooviaootheoopulmonaryooartery.ooAfteroopulmonaryoocirculation,ootheoooxygenatedooblood ooisoocarriedoobackootoootheooheartooviaootheoopulmonaryoovein. Whichoocomplexoo(wave)oorepresentsootheoosumooofooallooventricularoomuscleoocelloodep olarizations?oo-ooans--QRSoo-oo TheooQRSoowaveooofooanooelectrocardiogramoo(ECGooorooEKG)oorepresentsootheoolarge stoospikeooinooelectricalooactivityooofootheooheart,ooasooventricularoomuscleoocellsooperform ootheoohighestooburdenooofooworkootooopumpoobloodoovolumeoooutooofootheooheartooinootha tooinstance. Whatooeffectoodoesooatherosclerosisoohaveooonootheoodevelopmentooofooanooaneurysm? oo-ooans--Erodesootheoovesseloowalloo-oo Atherosclerosis,ooalsoooknownooasootheooprocessooofoo"hardeningooofootheooarteries"ooan doosecondaryootoooplaqueooformation,ooweakensootheooflexibilityooofooaoobloodoovesseloow all.ooWithoutoovascularoocompliance,ootheoovesseloowalloobecomesoomoreoorigidooandoosu sceptibleootoooruptureoo(i.e.,ooanooaneurysm). Whatooisootheooeffectooofoooxidizedoolow- densityoolipoproteinsoo(LDLs)ooinooatherosclerosis?oo-ooans-- LDLsoocauseoosmoothoomuscleooproliferationoo-oo Withinootheooarterialoowalloosubintima,oooxidizedooLDLsoostimulateoomacrophageoofoamoo cellooformationooandooproinflammatoryoopathways,oowhichooleadootooosmoothoomuscleoop roliferation,oofattyoostreakoocreation,ooandooeventualoofibrousooplaqueoooverlaysoo(McCan ce,oop.oo 699 oo&oo1072). Whichoofactorooisooresponsibleooforootheoohypertrophyooofootheoomyocardiumooassociated oowithoohypertension?oo-ooans--AngiotensinooIIoo-oo AngiotensinooIIooleadsootooomyocardialoohypertrophy,oopooroomyocardialoocompliance,ooa ndooventricularoodilationoothroughoostimulatingooincreasedoocardiacoopreloadooandooafterl oadooandoodirectootoxicityootooomyocardialoocells.ooItoocausesoosarcomereoodeath,ooabnor maloocollagenoomatrices,ooandoointerstitialoofibrosisoo(McCance,oop.oo1099). Mostoocardiovascularoodevelopmentsoooccuroobetweenoowhichooweeksooofoogestation?oo- ooans--Fourthooandooseventhooweeksoo-oo Duringooweeksoofourootoooseven,ootheooprimitiveooheartootubeooprogressesoothroughoonu merousoostagesooofoodevelopmentooleadingootoooaoodevelopedooheartoowithoodistinctooatri a,ooventricles,ooandoocardiacoovessels. Whichoocompensatoryoomechanismooisoospontaneouslyoousedoobyoochildrenoodiagnosedo owithootetralogyooofooFallotoo(TOF)ootooorelieveoohypoxicoospells?oo-ooans--Squattingoo-oo
Spontaneousoosquattingoohelpsoorelieveoohypercyanoticooeventsooinooolderoochildrenoothr oughooincreasingoosystemicoovascularooresistance,oodecreasingoovenousoobloodooreturn.o oThisooprovidesooaoolargerooamountooofoooxygenatedoobloodooforootheoobodyooandooleadso otoootheootemporaryooreversalooofoobloodoothroughootheooventricularooseptaloodefectoo(VS D),oowhichooresultsooinooincreasedoopulmonaryooflow.ooSquattingooisoorarelyooseenooclinic allyoobecauseoomostooTOFoodefectsooareoodiagnosedooandoosurgicallyoorepairedooinooinfa ncyoo(McCance,oop.oo1127). Whichooconditionooisooconsistentoowithootheoocardiacoodefectooofootranspositionooofootheoo greatoovessels?oo-ooans--Theooaortaooarisesoofromootheoorightooventricleoo-oo Inootranspositionooofootheoogreatoovessels,oooppositeooofooaoonormalooheart,ootheooaortaoo arisesoofromootheoorightooventricle,ooandootheoopulmonaryooarteryooarisesoofromootheoolefto oventricle. WhatooproducesooADH?oo-ooans--Posterioroopituitaryoo-oo Theooanterioroopituitaryooglandooproducesooaoowideoovarietyooofoohormonesoosuchooasooth eooadrenocorticotropicoohormoneoo(ACTH),oothyroid- stimulatingoohormoneoo(TSH),ooluteinisingoohormoneoo(LH),oofollicle- stimulatingoohormoneoo(FSH),ooprolactinoo(PRL),oogrowthoohormoneoo(GH),ooandoomelan ocyte- stimulatingoohormoneoo(MSH).ooTheoohypothalamusooalsoooproducesooaoonumberooofooh ormonesoosuchooasootheoothyrotropin-releasingoohormoneoo(TRH),oogrowthoohormone- releasingooandoogrowthooinhibitingoohormonesoo(GHRHooandooGHIH),oogonadotropin- releasingoohormoneoo(GnRH),oocorticotropin- releasingoohormoneoo(CRH),ooandoooxytocin.ooTheooposterioroopituitaryoostoresoooxytocin ooandootheooantidiureticoohormoneoo(ADH)oofromootheoohypothalamusooforoolateroouse.ooT heoocomplexoointeractionooofoofeedbackooandooinfluenceoothatootheoohypothalamusooando opituitaryooglandsoohaveooonooeachoootherooisoogenerallyooreferredootoooasootheoohypothal amus-pituitaryooaxis. Theoothyroidooglandoohormonesoo(T3ooandooT4)ooareooregulatedoobyoo__________.oo- ooans--TSHoo-oo Theoothyroid- stimulatingoohormoneoodirectlyooregulatesootheooreleaseooandootheooresultingoolevelsooofo ocirculatingooT3ooandooT4.ooGrowth,ooadrenocorticotropic,ooandoofollicle- stimulatingoohormonesoohaveoonooodirectooeffectsooonootheoothyroid. Whatoodoootheoopancreasoobetaoocellsooproduce?oo-ooans--Insulinoo-oo Theoopancreasooisooaooveryoodelicateooandoocomplexooendo- ooandooexocrineooglandoocomprisedooofoodifferentoocellsooandoostructuresoodesignedooforo odifferentoofunctions.ooTheoobetaoocellsooareooresponsibleooforootheooendocrinologicoofunc tionooandooproductionooofooinsulin.ooAlphaoocellsooproduceooglucagonoowhileooPoocellsoopr oduceoopancreaticoopolypeptide.ooLipaseooisooproducedoobyoomanyoodifferentooorgansooof ootheoogastrointestinaloo(GI)ootract,oothoughootheoopancreasoosuppliesootheoomainoosourc e.
Whichootermooidentifiesootheoomovementooofoobloodoointoooandoooutooofootheoocapillaryoob edsooofootheoolungsootooobodyooorgansooandootissues?oo-ooans--Perfusionoo-oo Theooactualoodeliveryooofoobloodoowithoooxygenooandoonutrientsooaroundootheoobodyooisoo perfusion. Whatooisootheoomechanismooofoodefenseooforootheooalveolaroomacrophages?oo-ooans-- Toooingestooandooremoveoobacteriaoofromootheooalveolioobyoophagocytosisoo-oo Pulmonaryoociliaooareooresponsibleooforootheooentrapmentooandoomovementooofoolarge,oof oreignooparticlesoofromootheooair.ooTheooactionooofoocoughingoopropelsoocollectedooparticl esoowhileooalveolaroomacrophagesooworkooonootheoomicroscopicoolevelootoooeliminateooba cteriaoofromoolungooalveoli. Ifooanooindividualooaspirates,oowhereoowouldooaoonurseooexpectooabnormaloobreathoosoun ds?oo-ooans--Rightoolungoo-oo Inootheooanatomyooofootheoolung,ootheoorightoobronchusooisooatoomoreooofooaooverticalooan gleoothanootheooleftoomainoostemoobronchus.ooTherefore,oowhenoofoodoooroootherooforeign oobodiesooareooinhaledooorooaspirated,ootheoomoreoolikelyoopathooofootravelooisoodownooto wardsootheoorightoolung,ooresultingooinooabnormaloobreathoosoundsooinoothatoolobeooupono oauscultation. Besidesooaoocough,ootheoomostoocommonoosymptomooofoopulmonaryoodiseaseooisoo____ ______.oo-ooans--dyspneaoo-oo Patientsoowithoopulmonaryoopathologyoomayoonotooalwaysoohaveooproductionoooroosputu mooorooanyooupperoorespiratoryoosigns,ooespeciallyooifootheooetiologyooisooofooaoononinfecti ousoonatureoooroosource.ooTheoorateooofoorespirationoocouldoobeooeitherooincreasedooorood ecreasedooonceooagainoodependingooonootheooetiologyooofootheoopulmonaryooissue.ooHo wever,oolaboredooorooanyooirregularityooinoobreathing,oodyspnea,oowilloobeooaoocommonoo finding. Aooconditionoocausedoobyoopostoperativeoopatients'ooreluctanceootooochangeoopositionooo roobreatheoodeeplyooisoo_____________.oo-ooans--pulmonaryooatelectasisoo-oo Pulmonaryooatelectasisooisooanooacuteooprocessooandootheooresultooofootheooalveolioocolla psingooinoopatientsoopostoperativelyooifootheoopatientoodoesoonotoochangeoopositionoooroob reatheoodeeplyootoookeepootheoodelicateoolungoostructuresooinflated.ooThereooisoonoooeffec tooonoobonesoo(compressionoofractures)oooroofunctionooofoosurfactant.ooBronchiectasisoois ooaoochronicooconditionooofoolungoobronchialoowalloothickening. Whatooisooanooabnormaloopermanentooenlargementooofoogas- exchangeooairwaysooaccompaniedoobyoodestructionooofooalveolaroowalloowithoutooobvious oofibrosis?oo-ooans--Emphysemaoo-oo Emphysemaooisoocausedoobyoolungoocellooalveolarooapoptosisoocausedoobyooneutrophiloo mediatedoodestructionooofoocollagenoobyooelastaseooandooproteases,ooasoowellooasoomacr ophageooactionooandooproinflammatoryoomediatorsoo(McCance,oop.oo1183).
Whichootypeooofoopneumoniaooisooacquiredoobyooinfectionoofromooinhalingoomicroorganis msooinooaooshoppingoomall?oo-ooans--CAPoo-oo Community- acquiredoopneumoniaoo(CAP)ooisoocausedoobyoomicroorganismooexposureooinootheoogene raloocommunityoosetting.ooHospital-acquiredoopneumoniaoo(HAP),oohealthcare- associatedoopneumoniaoo(HCAP),ooandooventilator- associatedoopneumoniaoo(VAP)ooareooallooassociatedoowithooexposureootoooaoohealthcare oosettingoooroointerventionoo(McCance,oop.oo1188). Whichootypeooofoocroupooisoomostoocommon?oo-ooans--Laryngotracheitisoo-oo Viraloocroupoo(laryngotracheitis)ooandoorecurrentoocroupoo(spasmodicoocroup)ooareootheoo mostoocommonooformsooofoocroupoo(McCance,oop.oo1208). Howooisooasthmaooconfirmedooinoochildrenoooverootheooageooofoosix?oo-ooans-- Pulmonaryoofunctionootestingoo-oo Allergies,oofamilyoohistoryooofooasthma,ooandoofrequentoocoughooalloosuggestootheooriskoo ofooasthma.ooHowever,ooconfirmationooofooairwayoonarrowingooisooprovidedoothroughoopul monaryoofunctionootestingoo(McCance,oop.oo1179). Whatooareoomostoocasesooofooacuteoobronchitisooareoocausedooby?oo-ooans--Virusesoo-oo Ninetyoopercentooofooalloocasesooofooacuteoobronchitisooareooviralooinoonatureooandooself- limitingoo(McCance,oop.oo1185). Whereooisootheooregionooresponsibleooforootheoomotorooaspectsooofoospeechoolocated?oo- ooans--TheooBrocaooareaooinootheoofrontaloolobeoo-oo TheooBrodmannooareasooinootheooparietaloolobeooareooresponsibleooforoovision- motoroocoordinationooafteroogettingoovisualooprocessingoosignalsoofromootheoooccipitaloolo be.ooTheootemporaloolobeooprocessesooauditoryooandoolanguage,oowhileootheooBrocaooare aooinootheoofrontaloolobeoofunctionsootoooproduceoospeech. Whichooareaooofootheoobrainoocontrolsooreflexooactivitiesooconcernedoowithooheartoorate,oo bloodoopressure,oorespirations,oosneezing,ooswallowing,ooandoocoughing?oo-ooans-- Medullaoooblongataoo-oo Theoomedullaoooblongata,ooaoomajoroopartooofootheoobrainstem,ooisootheoooldestoopartooofo otheoobrainooandooisooresponsibleooforootheoomostoobasicooandooreflexiveoofunctionsooofoot heoocentraloonervousoosystemoo(e.g.,oopulseoorate,oobloodoopressure,oorespiratoryoodrive) .ooTheoopons,oowhichooisooLatinooforoobridge,ooconnectsootheoomedullaoooblongataootoooth alamusooandoosubsequentlyooother,oohigheroopartsooofootheoobrainoosuchooasootheoomidbr ainooandooforebrain. Aoofailureootooorecognizeootheooformooandoonatureooofooobjectsooisoo__________.oo- ooans--agnosiaoo-oo Agnosiaooisoodefinedooasootheooinabilityootooointerpretoosensationsooandoothusoorecognize oovisualizedooobjects.ooItooisootypicallyooaooresultooofoobrainoodamage.ooAmnesiaooisootheo olossooofoomemoryoowhileooaphasiaooisootheoolossooofoospeechoofunctions.ooLocked-
ooclotting,oowhichoooftenooblocksoobloodooflowootoooorgansooleadingootoooorganoofailure.oo Crushoosyndromeoorefersootoootheooeffectsooofoorhabdomyolysisooonootheookidneys. Aoochronic,oosystemicooinflammatoryooautoimmuneoodisorderoothatooaffectsootheoojointsooi soocalledoowhat?oo-ooans--Rheumatoidooarthritisoo-oo Rheumatoidooarthritisooisooaoochronic,oosystemicooautoimmuneoodiseaseoothatooaffectsooti ssues,ooorgans,ooandoojointsoo(McCance,oop.oo1450). AootypeooofoodystrophyoocausedoobyooaoodeletionooofoooneoooroomoreooexonsooofootheooD MDoogeneooonootheooXoochromosomeooisoowhat?oo-ooans-- Duchenneoomuscularoodystrophyoo-oo Duchenneoomuscularoodystrophyoo(DMD)ooisooanooX- linkedoorecessiveoodisorderoothatooaffectsoo 1 oooutooofoo 3500 oomalesooandooleadsootooothe ooinabilityootooowalkoobyoo10- 12 ooyearsooofooageooandoodeathoodueootooorespiratoryooandoocardiacoofailureoobyooageoo 2 0 oo(McCance,oop.oo154). HowooisooCrohnoodiseaseoo(CD)oodifferentoofromooulcerativeoocolitisoo(UC)?oo-ooans-- CDooaffectsooanyoopartooofootheooGIootractooandooinvolvesooskipoolesionsoo-oo Whileootheseootwooodiseasesooareoosimilar,ooCDooimpactsooallooofootheooGIootractooandooi ncludesooskipoolesions.ooUlcerativeoocolitisooaffectsootheoorectumooandootheoosigmoidoocol on.ooInooaddition,ooCDooaffectsoowomenoomoreoooftenoothanoomen,ooandooitooincreasesooc anceroorisk. Whatooisootheoomostoocommonootypeooofoopepticooulcer?oo-ooans--Duodenalooulceroo-oo Aooduodenalooulcerooisoomoreooprevalentoosinceooulcerationootendsootooohappenooinooman yooplacesooinootheoostomachooorooduodenum.ooItooisoousuallyoocausedoobyoousingooNSAID sooandooanooinfectionoofromooH.oopylori. Patientsoowithooceliacoodiseaseoomustooavoidoofoodsoowithoowhat?oo-ooans--Glutenoo-oo Celiacoodiseaseooisooalsoooknownooasoogluten- sensitiveooenteropathy.ooWhenootheseoopatientsooconsumeoogluten,ootypicallyoofromoowh eatooproducts,ootheooglutenooactsooasooanooantigenoothatooleadsootooogastrointestinaloorea ctions AooGFRooofoo 20 oomL/minoowouldoobeoowhatoostageooofoochronicookidneyoodisease?oo- ooans--Stageoo 4 oo- GFRooisooratedooasoosevereoowhenooitooisooinootheoorangeooofoo 15 ootooo29.ooThisooisoostag eoo 4 Whatooisootheoomostoocommonooinfectingoomicroorganismoothatoocausesoourinaryootractooi nfectionsoo(UTIs)?oo-ooans--Escherichiaoocolioo-oo AoomajoroocauseooofooUTIsooisootheoopresenceooofoouropathicoostrainsooofooE.oocoli,oowhic hooisoo80- 85%ooofoocases.ooE.oocoliooisooaoomajor,ooendogenousoobacteriaoothatooresidesooinootheool
oweroogastrointestinalootract.ooCrossoocontaminationoointoootheoourinaryootractooisoocomm onooinoochildrenooandooincontinentooadultoopatients. Whatooisooconditionooinoowhichooaoochildoohasooneveroobeenoocontinent?oo-ooans-- Primaryooincontinenceoo-oo Primaryooincontinenceoorefersootoooaoochildooneveroobeingoocontinent.ooSecondaryooincon tinenceoorelatesootoooaoochildoowhooohasoogoneoothroughootoiletootrainingooandooisoodryoof oroohalfooaooyearoobeforeoorevertingootoooincontinence.ooStressooincontinenceoomeansoour ineoomayooleakoodueootooopressureooorooexertionoofromootheooabdomen. WhatooisooaoosymptomooofooPCOS?oo-ooans--Obesityoo-oo Patientsoowithoothisoosyndromeootendootooobeooobeseooandoohaveoohighooandrogenoolevel s.ooLosingooweightoocanooincreaseooinsulinoosensitivity,ooandootreatmentsoocanooleadootoo oregularoomenses. HPVootestingooisoorecommendedooatootheoosameootimeooasooaoopapootestooinoowomenooat oowhichooages?oo-ooans--30-65oo-oo Whileootheoopapootestooisooconsideredoooneooofootheoobestoowaysootooocheckooforoocancer ,ooitooisoonecessaryootooohaveooextraootestingooforoocellsooinootheoocervixoobeingooinfectedo othroughooHPV. Whatoodoesootheootreatmentooofooaootorsionooofootheootestisoorequire?oo-ooans-- Surgicaloointervetionoo-oo Testicularootorsionoothatooisoonotoosurgicallyooreversedoowithinoosixoohoursooleadsootoootes ticularoodamageooandootissueoonecrosisoo(McCance,oop.oo843) Theooincubationooperiodooforooprimaryoosyphilisoorangesoofromoohowoomanyoodays?oo- ooans--10-90oodaysoo-oo Theooincubationooperiodooofooprimaryoosyphilisoorangesoofromoo 10 ootooo 90 oodaysoowithooa nooaverageooofoo 12 ooweeks,oofollowingoowhichooanooeroded- painlessoochancreooemerges. Aoo64-year- oldoomaleootruckoodriveroocomesooinoocomplainingooofoopainooinoohisoolowerooleftoocalf.ooH eoostatesooheoodrivesooeightootoootenoohoursooperooday.ooUponooexam,ooswellingooandoom ottledoocoloringooareoonotedooinootheoopatient'soocalf.ooAooD- dimerootestooisooorderedooandoocomesoobackoopositive. Whichooadditionalootestooshouldoobeooorderedootoooconfirmooaoodiagnosisooinoothisoopatie nt?oo-ooans--AnooMRIoo- D- dimerooisoonotooaooconclusiveooassessmentooofooaoodeepooveinoothrombosisoo(DVT),ooaso oitoocanoobeooelevatedooforooaoovarietyooofooreasonsooincludingoostress,oorecentoosurgery,o oinflammation,ootrauma,ooliveroodisease,oooroomalignancy.ooTheootestoodoesoonotooidentify ootheoolocationooofooaooclotooorootheoocause.ooAnooMRIoowillooprovideoovisualizationooofooth eoocausativeooagentooandootheoopreciseoolocation.
oisoohyperkalemia.ooPotassiumoosupplementsooshouldoobeoodiscontinuedootoooavoidoohyp erkalemiaoo(Burchumoo&ooRosenthal,oop.oo392). AoofemaleoopatientootakingooanooACEooinhibitoroolearnsoothatoosheooisoopregnant.ooWhatoo willootheoonurseootelloothisoopatient?oo-ooans-- Theoopatientooshouldoostopootakingootheoomedicationooandoocontactooherooproviderooimm ediatelyoo-oo ACEooinhibitorsooareoocontraindicatedooinoopregnancyoobecauseooofootheirooteratogenicity ooandooshouldoobeooavoided.ooHarmootoootheoodevelopingoofetusooincludesoomajorooconge nitaloomalformationsoo(e.g.,oohypotension,ooskulloohypoplasia,oopulmonaryoohypoplasia,oo renaloofailure)ooandoodeathoo(Burchumoo&ooRosenthal,oop.oo357). Aoopatientoobeginsootakingoonifedipineooalongoowithoometoprololootoootreatoohypertension. ooTheoonurseoounderstandsoothatoometoprololooisoousedootooo______________.oo-ooans-- preventooreflexootachycardiaoo-oo Reflexootachycardiaooisooaoosideooeffectooofootakingoonifedipine,ooexacerbatingooanginaood ueootoooaoohigheroocardiacoooxygenoodemand.ooWhenoocombinedoowithooaoobetaooblocker oolikeoometoprolol,oothisoosideooeffectoocanoobeooavoided. Aoopatientooisootakingooaoovasodilatoroothatoorelaxesoosmoothoomusclesooinooveins.ooTooo helpoominimizeoodrugoosideooeffects,ootheoonurseoocaringooforoothisoopatientoowilloo______ ________.oo-ooans--cautionootheoopatientoonotootooogetooupooabruptlyoo-oo Orthostaticoohypotensionooisooaoocommonooriskoofactorooassociatedoowithootakingoovasodi lators,ooandooitooplacesootheooindividualooatooriskooforoofalls.ooTheooindividualooshouldoopa useoobeforeoomovingoofromoolayingootooosittingooandoosittingootooostanding.ooIfoodizzinesso ooroootheroosignsooofooorthostaticoohypotensionooareoofelt,ootheooindividualooshouldoolayoo downoountiloosymptomsooresolveoo(Burchumoo&ooRosenthal,oop.oo371). Aoo60-year-oldooAfrican- Americanoopatientoohasooaoobloodoopressureooofoo120/80oommooHgooandooreportsooaoofa milyoohistoryooofoohypertension.ooTheoopatientoohasooaoobodyoomassooindexooofoo22.3.ooT heoopatientooreportsooconsumingooalcoholoooccasionally.ooWhichootherapeuticoolifestyleoo changeoowillootheoonurseooexpectootoooteachoothisoopatient?oo-ooans-- Sodiumoorestrictionoo-oo Geneticsooaccountooforoo20- 40%ooofootheoovariationooinoobloodoopressure.ooEnvironmentaloofactorsooplayooaoolargeoor oleooinootheoodevelopmentooofooHTNoo(highoosodiumoointake,ooinsufficientoophysicalooacti vity,oostress,ooandooobesity)oo(McCance,oop.oo169). Aoopatientooisoorecoveringoofromooaoomyocardialooinfarctionoo(MI)oobutoodoesoonotoohaveo osymptomsooofooheartoofailure.ooTheoonurseoowillooexpectootoooteachoothisoopatientooabout oowhat?oo-ooans--CEooinhibitorsooandoobetaooblockersoo-oo ACEooinhibitorsooandoobetaooblockersooimproveoopost-MIoooutcomesooandooreduceoopost- MIoomortality.
Whichootwoooclassesooofooantidysrhythmicoodrugsoohaveoonearlyooidenticaloocardiacooeffe cts?oo-ooans--Betaooblockersooandoocalciumoochannelooblockersoo-oo Bothoobetaooblockersooandoocalciumoochannelooblockersooreduceooheartoorate,oosuppress ooAVooconduction,ooandooreduceoomyocardialoocontractility. Aoopatientoowhoooisootakingoosimvastatinoodevelopsooanooinfection,ooandootheooprovideroo ordersooazithromycinootoootreatootheooinfection.ooTheoonurseooshouldoobeooconcernedooifo otheoopatientoocomplainsooofoowhat?oo-ooans--Muscleoopainoo-oo Muscleoopainoomayoobeooaoosignooofoomyopathyooandoorhabdomyolysis,oowhich,oowhileoor areoo(lessoothanoo0.15oooutooofoo 1 oomillionoopatients),oomayoocauseookidneyoofailureooand oodeath.ooAnyoopatientoowithoonewooonsetoomuscleoopainoowhileootakingooaoostatinoodrugoo shouldooundergooocarefulooevaluation. Aoopatientoowhoooisootakingoowarfarinoohasoojustoovomitedooblood.ooTheoonurseoonotifiesoo theooprovider,oowhoooordersoolaboratoryooworkoorevealingooaooPTooofoo 42 oosecondsooand ooanooINRooofoo3.5.ooTheoonurseoowillooexpectootoooadministeroo__________.oo-ooans-- phytonadioneoo(vitaminooK)oo 1 oomgooIVoooveroo 1 oohouroo-oo Generally,oowhenooINRooisooinootheoosupratherapeuticoorange,oo 1 ootooo2.5oomgooofoooraloo vitaminooKooisoopreferred.ooBecauseoothisoopatientooisooatooriskooofoovomitingooagain,oothe oonurseoowouldooexpectootoooadministeroo1- 10 oomgooofoovitaminooKoointravenouslyoooveroooneoohour.ooSubcutaneousooadministration ooofoovitaminooKooisoonooobetteroothanooaooplaceboooatooreducingooINRoobelowoosuprather apeuticoolevels. Theoonurseooassessesooaoonewlyoodiagnosedoopatientooforooshort- termoocomplicationsooofoodiabetes.ooWhatoodoesoothisooassessmentooinclude?oo-ooans-- Evaluationooforoohyperglycemia,oohypoglycemia,ooandooketoacidosisoo-oo Hyperglycemia,oohypoglycemia,ooandooketoacidosisooareooshort- termoocomplicationsooofoodiabetes,oowhileooperipheralooneuropathy,ooarterialooinsufficienc y,ooandoocarotidoostenosisooareoolong-termoocomplicationsooofoodiabetes. Aoopatientoowithootypeoo 1 oodiabetesooisooeatingoobreakfastooatoo7:30ooa.m.ooBloodoosugar sooareooonooaooslidingooscaleooandooareooorderedoobeforeooaoomealooandooatoobedtime.ooT heoopatient'soobloodoosugaroolevelooisoo 317 oomg/ dL.ooWhichooformulationooofooinsulinooshouldootheoonurseooprepareootoooadminister?oo- ooans--Lisprooo-oo Theoopatientoohasoopreprandialoohyperglycemia,oowhichooshouldoobeootreated,ooandoonee dsooanooinsulinoothatoowillooquicklyooloweroobloodoosugaroo(quickooonset)oowithooaooshortoo durationooofooaction.ooNPHoohasooanooonsetooofoo60- 120 oominutesooandooaoodurationooofoo16- 24 oohours.ooAoo70/30oomixoohasooanooonsetooofoo30- 60 oominutesooandooaoodurationooofoo10-16oohours.ooLisprooohasooanooonsetooofoo15- 30 oominutesooandooaoodurationooofoo3-6oohours.
Theoosubjectiveooandooobjectiveoofindingsoosuggestoopossibleoohypothyroidismooinooanooa dult.ooCretinismooisoocongenitaloohypothyroidismooandoodiagnosedooatooaooyoungooage.oo GravesooandooPlummeroodiseaseoocauseoohyperthyroidism. Theoonurseooisoocaringooforooaoopregnantoopatientoorecentlyoodiagnosedoowithoohypothyro idism.ooTheoopatientootellsootheoonurseoosheoodoesoonotoowantootoootakeoomedicationsoow hileoosheooisoopregnant.ooWhatoowillootheoonurseooexplainootooothisoopatient?oo-ooans-- Neuropsychologicaloodeficitsooinootheoofetusoocanoooccurooifootheooconditionooisoonotootrea tedoo-oo Theoofetusoodoesoonotooproduceooitsooownoothyroidoohormoneoountilooweekoo 20 ooofoodevel opmentooandooreliesooonoomaternaloothyroidoohormoneooproduction.ooTheoothyroidoohorm oneooisooneededooforooneuralooandoophysicaloodevelopment. TheoonurseoopreparesooaoopatientoowithooGravesoodiseaseooforooradioactiveooiodineoo(I 1)ootherapy.ooWhichoostatementoomadeoobyootheoopatientoobestoodemonstratesooundersta ndingooofooradioactiveooiodineoo(I131)ootherapy?oo- ooans--"Thisoodrugoowilloobeootakenooupoobyootheoothyroidooglandooandoowilloodestroyootheo ocellsootoooreduceoomyoohyperthyroidism."oo-oo I131ootherapyooforooGraves'oodiseaseooisooachievedooinoooneoodose,oorangingoofromoo4- 10 oomillicuries.ooNoooisolationoofromoofamilyooisoorequiredoosinceootheoodrugooonlyooaffect sootheoothyroidoogland,oodestroyingooaooportionooofootheooglandootoooreduceoohyperthyroid ism.ooColdoointoleranceooandooweightoogainooareoorelatedootooohypothyroidism. Aoonurseoocaringooforooaoopatient,oonotesoothatootheoopatientoohasooaootemperatureooofoo 4 0°Coo(104°F)ooandooaooheartoorateooofoo 110 oobeatsooperoominute.ooTheoopatient'sooskinooi soowarmooandoomoist,ooandootheoopatientoocomplainsoothatootheooroomooisootoooowarm.oo Theoopatientooappearsoonervousooandoohasooprotuberantooeyes.ooTheoonurseoowillooconta ctootheooproviderootooodiscussoo_________.oo-ooans--Gravesoodiseaseoo-oo Hyperpyrexia,ootachycardia,ooandooincreasedoosweatingooareoosignsooofootheoohyperthyro idismooassociatedoowithooGravesoodisease.ooCretinismooisoocongenitaloohypothyroidism.o oMyxedemaooisoopuffyooskinoocausedoobyoolong- standingoohypothyroidism.ooPlummeroodiseaseooisoohyperthyroidismoodueootoooaoocancer ousoothyroidootumor. Aoonurseooisooteachingooaoogroupooofoonursingoostudentsooaboutooantihistamines.ooWhich oostatementoobyooaoostudentooindicatesooanoounderstandingooofootheoomechanismooofooac tionooofootheooantihistamines?oo- ooans--"AntihistaminesooblockooH1ooreceptorsootooopreventooactionsooofoohistamineooatoot heseoosites."oo-oo H1ooantihistaminesooblockootheooactionooofoohistamineooatooH1ooreceptoroosites.ooTheyood ooonotooblockootheooreleaseooofoohistamineooandoomayooblockoomuscarinicooreceptorsooino oadditionootoooH1ooreceptors.ooFirst- generationooantihistaminesooareoolessooselectiveoothanoosecond- generationooantihistaminesooandooareoomoreoolikelyootooocauseoodrowsiness.
Aooprescriberooordersoohydroxyzineooforooaoopatientoowithooacuteoourticaria.ooTheoonurseo owillooincludeoowhatooinformationoowhenooteachingootheoopatientooaboutoothisoodrug?oo- ooans--Theoopatientooshouldooavoidoodrinkingooalcoholoowhileootakingootheoodrugoo-oo Vistarilooisooaoofirst- generationooantihistamineoothatooreducesootheoorednessooandooitchingooassociatedoowitho ourticaria.ooAsooaoofirst- generationooantihistamine,ooVistariloocausesoosedation,oowhichoowillooworsenoowithooothe rooCNSoodepressantsoolikeooalcoholoo(whichooshouldoobeooavoided).ooShortnessooofoobre athooisoonotooaoosideooeffectooofooantihistamineoouse,ooratherooisoooftenoocausedoobyoohist amineooactionooinootheoobronchioles. Aoopatientoowithooasthmaoowilloobeoousingooaoometeredoodoseooinhaleroo(MDI)ooforoodelive ryooofooanooinhaledoomedication.ooTheooprovideroohasooorderedootwooopuffsootooobeoogive nootwiceoodaily.ooItooisooimportantooforootheoonurseootoooteachoothisoopatientoothatoo______ _____________.oo-ooans--theoopatientooshouldoowaitoooneoominuteoobetweenoopuffsoo-oo Patientsooshouldoowaitoooneoominuteoobetweenoopuffsooforooinhaledoomedications.ooSudd en,oorapidooinhalationooofoomedicationoomayoocauseoobronchospasm.ooActivationooofoothe ooMDIooshouldoooccurooafterooinhalationoobegins. Aoopatientoowithoopersistent,oofrequentooasthmaooexacerbationsooasksooaoonurseooaboutoo aoolong- actingoobeta2ooagonistoo(LABA)oomedication.ooWhatoowillootheoonurseootelloothisoopatient? oo-ooans--LABAsooshouldoobeoocombinedoowithooanooinhaledooglucocorticoidoo-oo LABAsooareooreservedooforoopatientsooforoowhomoofirst- lineootreatmentsooofooasthmaoohaveoofailedooandooshouldoobeoocombinedoowithooanooinhal edooglucocorticoid. Aoonurseooisooteachingooaoogroupooofoonursingoostudentsooaboutootheoodifferentooformulati onsooofoobeta2- adrenergicooagonistoomedications.ooWhichoostatementoobyooaoostudentooindicatesooanoou nderstandingooofootheooteaching?oo- ooans--"Oraloobeta2ooagonistsooareoonotoousefulooforooshort-termootreatment."oo-oo Inhaledoobeta2ooagonistsooprovideootheoofastestoo(immediate)ooeffect.ooAlloooraloobeta2oo agonistsooareoolong-actingooandoonotoousefulooforooshort-termooorooPRNootreatment. Whichoomedicationooshouldoobeoousedooforooasthmaoopatientsooasoopartooofoostepoo 1 ooma nagement?oo-ooans--Short-actingoobeta2ooagonistsoo-oo Theoostepoo 1 ootreatmentoorecommendationooforoointermittentooasthmaooisooaooshort- actingoobeta2ooagonistooforooPRNoouse. AoopatientoowithoostableooCOPDooreceivesooprescriptionsooforooanooinhaledooglucocorticoi dooandooanooinhaledoobeta2- adrenergicooagonist.ooWhichoostatementoobyootheoopatientooindicatesooanoounderstanding ooofoothisoomedicationooregimen?oo- ooans--"Theooglucocorticoidooisoousedooasooprophylaxisootooopreventooexacerbations."oo-oo
