Download WGU D115 OBJECTIVE ASSESSMENT.pdf and more Exams Nursing in PDF only on Docsity!
WGU D115 OBJECTIVE ASSESSMENT (OA)
EXAM COMPLETE UNIT 1-UNIT 7
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES
(VERIFIED ANSWERS) |ALREADY
GRADED A+
How is transcription best defined? - ANSWER>>>RNA is synthesized from a DNA template Process where the information in a strand of DNA is copied into mRNA How is translation best defined? - ANSWER>>>Follows transcription mRNA leaves nucleus and enters cytoplasm RNA directs the synthesis of a polypeptides for protein synthesis An amniocentesis indicates a neural tube defect when an increase in which protein is evident? - ANSWER>>>Alpha fetoprotein Ex: spina bifida or anencephaly Amniocentesis is recommended for pregnant women with what history? - ANSWER>>>Have a family history of genetic disorders What is the technique for prenatal diagnosis of chromosomal abnormalities at 10-12 weeks gestation? - ANSWER>>>Chorionic villus sampling CVS Amniocentesis during the 15th week of pregnancy What is the term used for an error in which homologous chromosomes fail to separate during meiosis or mitosis? - ANSWER>>>Nondisjunction
What is the most common cause of Down Syndrome? - ANSWER>>>Maternal nondisjunction embryo now has three copies of chromosome 21 What syndrome, characterized by an absent homologous X chromosome with only a single X chromosome, exhibits features that include a short statue, widely spaced nipples, and webbed neck? - ANSWER>>>Turner A person with 47, XXY karyotype has the genetic disorder resulting in which syndrome? - ANSWER>>>Klinefelter: males When a child inherits a disease that is autosomal recessive, it is inherited from whom? - ANSWER>>>Both parents In order to have a disorder that is autosomal recessive a pt must inherit two mutated genes, one from each parent Cystic fibrosis is caused by what type of gene? - ANSWER>>>Autosomal recessive The BRCA1 and BRCA2 mutations increase the risk of which cancer in women? - ANSWER>>>Ovarian, breast, and pancreatic cancers Prader-Willi syndrome causes a chromosomal defect that is what? - ANSWER>>>Inherited from the father Deletion of a part of chromosome 15 Which type of immunity is produced by an individual after either natural exposure to the antigen or after immunization against the antigen? - ANSWER>>>Active-acquired immunity What type of immunity is produced when an immunoglobulin crosses the placenta? - ANSWER>>>Passive-acquired immunity Where are antibodies produced? - ANSWER>>>Plasma cells When B cells are activated from antigens they develop into plasma cells. Those plasma cells then create antibodies specific to said antigen
A 30-day-old infant presents to the ER with decreased oral intake, decreased UOP, and a fever of 101.8. The infant is admitted for further evaluation with a workup to include a blood culture, a urine culture, a spinal tap, and a CXR. Which issue of innate immunity, as it relates to neonates, is of concern? - ANSWER>>>Relative deficiency of factor B Factor B is a part of the complement (enhances) system which is part of the immune system Complement system increases ability of antibodies and phagocytic cells to kill pathogens and promotes inflammation A 12-year-old African American patient presents with unilateral eye swelling and lower lip swelling. The patient's parents reports that the swelling is spontaneous and resolves over several days. The patient does not have complaints of fever, hives, or vomiting. Serum lab results show hyperactivation of three plasma protein systems. The APRN suspects hereditary angioedema. What is the cause of the genetic defect suspected in this situation? - ANSWER>>>C1 esterase inhibitor The parent of a child dx with Down Syndrome expresses concerns about the child's recurrent respiratory tract infections to an APRN. The infections have occurred regularly since birth. What should the APRN tell the parent is the underlying cause of this illness? - ANSWER>>>Gastroesophageal reflux disease causes aspiration of thin fluids A 36-year-old patient is being seen by an APRN in a primary clinic for the first time. The patient reports feeling depressed due to a major life change. Additional symptoms include weight gain, sedentary activity, and insomnia. The APRN plans on providing the patient with several exercises to reduce the physiological effects of stress. Why is the APRN concerned about relieving this emotional response? - ANSWER>>>It decreases glucose uptake An 80-year-old pt brings her grandchildren with her to a routine medical appointment. The pt has moderate COPD and is concerned about developing PNA because of its increased incidence at the senior center. What should the NP recommend for this patient? - ANSWER>>>Getting an annual influenza vaccine
An APRN is working with a pt who is choosing to undergo breast removal due to family hx of breast cancer. The pt's genetic testing revealed an abnormal BRCA1. The pt shares with the APRN that she is relieved that she will not need to worry about cancer once the breast tissue is removed. The APRN proceeds to educate the patient about additional risks. Which other type of cancer is the patient at risk for developing? - ANSWER>>>Ovarian What does incidence measure? - ANSWER>>>New cases of a disease Which concept is data reporting that sickle cell disease affects approximately 1 in 600 black Americans an example of? - ANSWER>>>Prevalence Tells us how often a disease is seen in a population A patient undergoes surgical consultation for the removal of scar tissue related to facial trauma that resulted in keloid formation. Which phase of wound healing is represented in this patient? - ANSWER>>>Reconstruction Keloid formation occurs during reconstruction and is a dysfunctional collagen synthesis Keloid scares are likely to recur after surgical removal UNIT 2 Conductive hearing loss involves what part of the ear? - ANSWER>>>Middle ear A potential complication of streptococcal pharyngitis that leads to contralateral uvular deviation, asymmetric tonsillar hypertrophy, muffled voice on exam but no stridor, drooling, or dyspnea or dysphagia is recognized as what? - ANSWER>>>Peritonsillar abscess A 64 year old woman presents to the office with complains of vision loss. Funduscopic examination reveals cupping of the optic nerve. Which action should you take? - ANSWER>>>Send the pt to the ER
antifungals were rxed. What would be the most appropriate next step in the pt's plan of care? - ANSWER>>>Check vitamin B12 levels Most common cause is a fungal infection but can be from vitamin B deficiency and bacterial infections Which finding is most consistent with acute otitis externa? - ANSWER>>>Pruritis and hx of recent swimming Otitis externa is referred to as "swimmers ear" A 15 year old male pt presents to the clinic with abd pain and fatigue, and is dx with mono. Which is the most important part of this patient's plan of care? - ANSWER>>>Avoid contact sports for up to 4 weeks Splenomegaly is a complication of mono. Contact sports increase risk of spleen rupturing A 20 year old female reports a hx of "cold symptoms" for 12 days. Her physical exam reveals unilateral facial pain and purulent nasal discharge. Which dx are these findings consistent with? - ANSWER>>>Acute bacterial rhinosinusitis S/S are facial pain or pressure, postnasal drip, nasal congestion, upper jaw or tooth pain, nasal discharge, fever, cough Inflammation and swelling of the 7th cranial nerve with resultant unilateral facial muscle paralysis is called? - ANSWER>>>Bell's Palsy Caused by virus, sudden onset of facial paralysis usually resolves within 2 weeks The NP caring for a pt with a recent TIA understands that? - ANSWER>>>Long-term antiplatelet therapy is likely indicated-aspirin or clopidrogrel (plavix) A 22 yr old woman has a new onset of panic disorder. As part of her clinical presentation, you expect to find all of the following except? - ANSWER>>>Hx of thought disorder
thought disorders are like schizophrenia The NP is providing care for a pt with PTSD. The NP anticipates that all of the following will be report except - ANSWER>>>Poor recall of the precipitating event s/s: flashbacks, nightmares, anxiety, avoidance, detachment, and hyperarousal Physical examination findings in patients with bulimia nervosa often include? - ANSWER>>>Dental surface erosion swollen salivary glands, dehydration, electrolyte abnormalities, weight loss, irregular menstruation The NP examines a 29 year old women who has sudden onset of right sided facial asymmetry. She is unable to closer her right eyelid tightly, frown, or smile on the affected side. Her examination is otherwise unremarkable. Which represents the most appropriate dx test for this patient? - ANSWER>>>Lyme disease antibody titer Late symptoms of lyme disease are HA, neck stiffness, facial palsy, joint pain and swelling, dizzy, SOB, and nerve pain An 18 year old college freshman is brought to the student health center with a chief complaint of a 3 day hx of progressive headache and intermittent fever. Positive kernig and positive brudzinski sign are noted. What is the dx? - ANSWER>>>Bacterial meningitis A 32 year old woman is seen in the ED complaining of severe headache and NAUSEA. She reports a hx of HAs off and on for the past several months, typically unilaterally and without warning. In addition, she reports that the HA occur at varing times of the day. Based on this brief hx, the NP suspects that the woman may have? - ANSWER>>>Migraine Throbbing in one particular area that can vary in intensity Nausea and photosensitivity
A NP is caring for 4 post-surgical patients. based on understanding of the physiologic process of nociceptors, the NP expects to rx more pain medication for which pt? - ANSWER>>>Repair of several crushed fingers Nociceptors are free nerve endings in the afferent PNS. Fingers have more nociceptors than internal organs Pain sensitivity differs according to location A pt presents to the hospital complaining of blurred vision, muscle weakness, impaired gait, and fatigue lasting more than 24 hours. the pt has a hx of smoking and vit d deficiency. Extensive dx testing and a comprehensive neurological assessment reveals a dx of MS. Which pathological mechanism will support this dx? - ANSWER>>>A loss of myelin sheaths, causing a disruption of nerve conduction A child presents to a clinic with a white pupillary reflex noted in the right eye. The child is constantly crying and rubbing her eyes. An APRN performs a complete ophthalmologic exam andorders several dx tests. based on the findings, a dx of retinoblastoma is confirmed. What is the pathological mechanism of this disorder? - ANSWER>>>Mutations of a gene on chromosome 13p14 lead to neoplastic proliferation of cells A pt is seen by an APRN at a primary clinic for follow-up to discuss abnormal results of testing for peripheral nervous system impairment. Which dx should the APRN suspect? - ANSWER>>>Demyelinating polyneuropathy This disease is guillain barre syndrome A pt is seen in the clinic after being a restrained passenger in a car accident the previous week. The pt continues to have intermitten HA and has noticed periods of forgetfulness. An APRN is concerned that the symptoms might stem from a specific process. Which process should the APRN be concerned about? - ANSWER>>>Cerebral concussion An APRN is examining an adolescent pt who describes hearing voices telling her to gather weapons because the government is trying to control her. the patient also describes feelings of happiness related to a tragic personal event. What is the probable dx? - ANSWER>>>Schizophrenia
A pt is seeing an APRN in an occupational health setting. the pt has been referred by employee assistance for reckless and self-destructive behaviors and a violent incident at work regarding a fellow employee. The APRN suspects PTSD. Which dx cluster of PTSD is the patient exhibiting? - ANSWER>>>Arousal: difficulty sleeping, irritable/anger, overly alert Avoidance: loss interest, avoid thoughts/feelings/activities, detached, changing future plans/hopes Reexperiencing: flashbacks, nightmares A 45 year old male pt with altered test levels needs tx. An APRN is aware that 3 factors affect hormone target cell responses when determining a tx approach. Which factor should be considered by the APRN? - ANSWER>>>Affinity of receptor for the hormones A pt is being admitted to an ICU after a traumatic brain injury. During the first few hours, the pt develops polydipsia, and his urinary cateter is draining large volumes of dilute urine. An APRN runs some tests, and the serum lab values show hypernatremia and hyperosmolarity. Which dx should the APRN identify for this pt? - ANSWER>>>Syndrome of inappropriate antidiuretic hormone secretion causes water RETENTION and HYPONATREMIA, not peeing enough Diabetes Insipidous: extreme thirst (polydipsia) and excessive urination, peeing too much, HYPERNATREMIA The answer is DI An APRN examines a pt and notes the following findings:
- Adipose tissue in the trunk, facial, and cervical areas
- Striae of skin
- Easy bruising
- Thin extremities
- HTN
- Cardiac hypertrophy
- Increased facial hair
- Hypercortisolism
Increased fat mobilization with release of fatty acids While grandson is in the hospital, the 60 year old granny has been drinking coffee in an attempt to stay awake. She beings to c/o severe ha. She informs the staff that the HA is usually related to an increase in her BP. Although she has been prescribed a med and has been taking it regularly, she continues to have issues. She is sweating and feels her heart racing. she is transported to the ED. She undergoes a barrage of tests, 2 days later, physician is ready to discuss her dx of pheochromocytoma. Her symptoms are caused by an excessive production of... - ANSWER>>>Norepi and or epinephrine Which statement is true regarding the thyroid hormone and they thyroid- stimulating hormone? - ANSWER>>>TSH secretion is regulated by thyrotropin-releasing hormone Hypothalamus TSH-releasing hormone (TRH) tells the anterior pituitary to release TSH. TSH then tells the thyroid to release TH T3 and T Obvious changes in cell function that are the result of stimulation by a particular hormone describe which factor? - ANSWER>>>Direct effects Permissive effects are the less obvious changes Low concentrations of a hormone increased the number of receptors per cell called UPREGULATION High concentrations of a hormone decrease the number of receptors per cell called DOWNREGULATION When an individual experiences N, V, fatigue, anorexia, weakness, and hypotension, which hormone deficiency is the most likely cause? - ANSWER>>>Adrenocorticotropic hormone (ACTH) can be congenital or acquired what is a symptom of graves disease? - ANSWER>>>Graves disease is a HYPER secretion of thyroid hormones T3 and T
Symptoms are anxiety, hand tremor, heat sensitivity, weight loss, puffy eyes, lid lag (upper eyelid is higher than normal when looking down), and enlarged thryoid (goiter) everything is increased Which is a s/s of SIADH? - ANSWER>>>Hyponatremia Urine retention Describe the Somogyi effect? - ANSWER>>>Hypoglycemia, followed by rebound hyperglycemia List the classic signs of diabetes - ANSWER>>>Polyuria Polydipsia Polyphagia Weight loss Tired/fatigue Vision problems Numbness and tingling in hands and feet Which single lab result may be used as a dx for DM1? - ANSWER>>>Hemoglobin A1C Obesity is associated with what? - ANSWER>>>Decreased PYY levels Peptide YY PYY is an appetite suppressing hormone Low levels: fat High levels: skinny What are consequences of anorexia of aging? - ANSWER>>>Increased oxidative stress Malnutrition Imbalanced hormones
What are the three deteriorations in abilities that commonly characterize dementia? - ANSWER>>>Decision-making Speech Memory UNIT 3 An APRN nurse recalls that the acinus contains? - ANSWER>>>Acinus are the gas-exchange airways They are made up of alveolar ducts, alveoli, and bronchioles J-receptors are what? - ANSWER>>>Sensitive to alterations in pulmonary capillary pressure When stimulated they initiate rapid, shallow breathing What does surfactant do? - ANSWER>>>Reduces surface tension Produced by type 2 alveolar cells Ultimately prevents lung collapse (alectasis) Which conditions cause a shift to the left in the oxyhemoglobin dissociation curve? - ANSWER>>>High pH (alkaline) and hypocapnia Shift to the right would be low pH (acidic) and hypercapnia What is the most common cause of hypoxemia? - ANSWER>>>V/Q mismatch Pt has pneumoconiosis. What info would the APRN find in the hx of the pt?
- ANSWER>>>Inhaled inorganic dust particles, resulting in a change in the lung Usually happens in the workplace. Long-term inhalation
Ex: coal, asbestos, silica, talc, mica, fiberglass What are the phases of ALI/ARDS? - ANSWER>>>Exudative (inflammatory), proliferative, and fibrotic Child has asthma. The APRN understands that which pathophysiologic process occurs in this disease? - ANSWER>>>Chronic inflammatory disorder that causes mucosal edema and REVERSIBLE airflow obstruction Causes bronchial hyperresponsiveness, constriction of airways Episodic attacks What is NOT a risk factor for COPD? - ANSWER>>>Excessive alpha 1 antitripsyn A decrease in this makes one susceptible to COPD Other risk factors are air pollution, smoking, inhalation of occupational dusts Pt has pneumococcal PNA. Which pathophysiologic process has occurred?
- ANSWER>>>Inflammatory cytokines cause alveolar edema, which creates a medium for microorganisms that lead to consolidation A pt has PE. What will the APRN find upon assessment? - ANSWER>>>Chest pain, dyspnea, and unexplained anxiety also tachypnea and tachycardia A newborn has a blunted ventilatory response to hypoxia. What process causes this to occur? - ANSWER>>>Reduced activity of the peripheral chemoreceptors Can happen up to 3 weeks of age A child has laryngotracheobronchitis. Which info should the APRN remember when planning care for this child? - ANSWER>>>It is caused by subglottic edema from infection
Tertiary: death d/t permanent organ damage Which disease is associated with the bacterium Haemophilus ducreyi? - ANSWER>>>Chancroid which is a bacterial infection that causes open sores/ulcers on or around the genitals A thin, gray malodorous discharge that adheres to the vaginal walls characterizes which medical condition? - ANSWER>>>Bacterial vaginosis Which STI is likely to cause small punctate marks on the cervix? - ANSWER>>>Trichomoniasis caused by a parasite What is true of hepatitis? - ANSWER>>>Each type causes icteric liver formation Hepatitis=inflammed liver An APRN is caring for a pt complaining of pelvic pain. Assessment pt has a fever, vaginal discharge, low bilateral abd pain that is dull and steady with developed during menstruation and worsens with walking, and dysuria. Lab studies were positive for chlamydia. Which dx should the APRN assign to this patient based on these findings? - ANSWER>>>PID Gonorrhea is often seen by an accompanying infection of chlamydia An adolescent male is suffering from sever, sudden pain in his genital region during football practice. He is embarrassed to seek emergency tx. However, he is finding the pain unbearable. His coach appropriately recommends he seek emergency tx. What is the plausible cause of the pain? - ANSWER>>>Testicular torsion An older adult pt presents to a clinic with complaints of penile pain and discomfort when attempting to pee and states that problem bean the morning after a HH nurse assisted him with cleansing the genital area. An APRN assesses an uncircumcised glans penis, which is reddened and edematous with the foreskin behind the corona. Which condition should the APRN suspect from these findings? - ANSWER>>>Paraphimosis: foreskin so tight unable to advance back over the glans this is the answer
Phimosis: foreskin too tight to retract over glans Priapism: erection lasting longer than 4 hrs that happens without sexual stimulation Peyronie: "bent nail syndrome" caused from fibrous scar tissue, painful erections A 29 year old female pt presents with concerns about fertility. The pt states she has had amenorrhea every other month and weight gain, and her labs show a decreased FSH, decreased estrogen, and altered TSH. Which female reproductive disorders should be considered for this pt? - ANSWER>>>Hyperprolactinemia and PCOS ovarian tumor An APRN is caring for a toddler in an ED who presented with fever, irritability, inspiratory stridor, drooling, dysphagia, and sitting in the tripod position. The toddler's parents report no significant medical history and clain that the child has been so healthy that they have fallen behind on immunizations. Which pathological mechanism of the pulmonary system is most likely causing this problem. - ANSWER>>>The dx process that is being explained is acute epiglotitis. Do not examine the child's throat and have respiratory emergency equipment at the bedside. Infection of epiglottis by haemophilus influenxzae type B An APRN is evaluating a 12 month old pt in a clinic. the child's parents are worried that the child has had frequent respiratory problems including persistent cough, wheezing, and thick sputum production. They also report frequent greasy-looking, bulky stools and constipation. The APRN finds that the child has been to the clinic with chronic bacterial infections every month since birth. Which abnormal pathological finding of the pulmonary system should be of concern to the APRN? - ANSWER>>>The disease is cystic fibrosis: increased secretion of mucus in respiratory and gi Defective chloride secretion and excess sodium absoprtion Chloride and CF go hand in hand A pt present to an emergency department c/o coughing, salty-tasking skin, bulky stools, and frequent respiratory infections. On examination, an APRN
