NR 507 MIDTERM EXAM 2024 | All QUESTIONS AND CORRECT ANSWERS | ALREADY GRADED A+, Exams of Pathophysiology

Download NR 507 MIDTERM EXAM 2024 | All QUESTIONS AND CORRECT ANSWERS | ALREADY GRADED A+ and more Exams Pathophysiology in PDF only on Docsity! NR 507 MIDTERM EXAM 2024 | All QUESTIONS AND CORRECT ANSWERS | ALREADY GRADED A+ | VERIFIED ANSWERS | LATEST EDITION Thalassemia is simple cell anemia in that the individual with thalassemia a. inherits an abnormal HB gene from mom b. inherits an abnormal Hb gene from dad c. inherits an abnormal Hb gene from one patient d. inherits an abnormal Hb gene from both parents ------CORRECT ANSWER---------------c. inherits an abnormal Hb gene from both parents Sickle cell anemia is an a. autosomal dominant genetic disorder b. idiopathic blood disorder c. autosomal recessive genetic disorder d. immunodeficiency disorder ------CORRECT ANSWER---------------c. Autosomal recessive genetic disorder True or False Cells that contain abnormal types of hemoglobin are more susceptible to infection by the parasite that causes malaria ------CORRECT ANSWER------ ---------False Which of the following statements are correct regarding thalassemia? a. characterized by acute and painful episodes b. maintains effective erythropoiesis c. may have many possible genetic mutations d. involves a double amino acid change on the beta change ------ CORRECT ANSWER---------------c. may have many possible genetic mutations True or False Cells that contain abnormal types of hemoglobin are more susceptive to infection by the parasite that causes malaria. ------CORRECT ANSWER----- ----------False True or False The patient with sickle cell anemia is at high risk for stroke. ------CORRECT ANSWER---------------True True or false There are four genes involved in encoding synthesis of the alpha protein chain for HB and are located on chromosome number 16. ------CORRECT ANSWER---------------False Which of the following is a primary immunodeficiency? a. pneumonia b. chronic granulomatous disease c. sinus infection d. human immunodeficiency virus ------CORRECT ANSWER---------------b. chronic granulomatous disease Which of the following is an autoimmune disease? a. osteoarthritis b. iron deficiency anemia c. systemic lupus erythematosus d. ABO incombatibility ------CORRECT ANSWER---------------c. systemic lupus erythematosus Allergic contact dermatitis is an example _________ hypersensitivity reaction. a. type 1 b. type 2 c. type 3 d. type 4 ------CORRECT ANSWER---------------d. type 4 Which of the following values is low for a client with a folate deficiency? ----- -CORRECT ANSWER---------------Reticulocyte count Which of the following will be elevated in a patient with pernicious anemia? ------CORRECT ANSWER---------------MCV In a patient with pernicious anemia, which of the following lab values can be normal? a. Reticulocyte count b. MCHC c. MCV d. Folate ------CORRECT ANSWER---------------d. Folate True or False The patient with thalassemia is at high risk for a stroke. ------CORRECT ANSWER---------------False A patient with mitral stenosis would most likely present with what sound. --- ---CORRECT ANSWER---------------Rumbling, decrescendo diastolic murmur heard at the apex of the heart True of False the pathophysiology of the sickle cell anemia involves a single amino-acid change on the beta-chain. ------CORRECT ANSWER---------------True Which of the following is a non-modifiable risk factor for coronary artery disease? a. obesity b. hyperlipidemia c. hypertension d. family history ------CORRECT ANSWER---------------d. family history True or False Sinusitis is considered a primary immunodefiency ------CORRECT ANSWER---------------true The transferrin deficiency will most likely result in a. aplastic anemia b. hemolytic anemia c. pernicious anemia d. iron deficiency anemia ------CORRECT ANSWER---------------d. iron deficiency anemia Sickle cell anemia and thalassemia are more prevalent in which geographical area? ------CORRECT ANSWER---------------Africa Primary or Secondary A patient with HIV was admitted to the acute care facility with difficulty breathing. He is diagnosed with pneumocystis carinii. ------CORRECT ANSWER---------------Secondary Which stage Patients with structural heart disease who have not yet developed symptoms. ------CORRECT ANSWER---------------Stage B Which stage Patients with refractory heart failure that require advanced intervention. ----- -CORRECT ANSWER---------------Stage D Which stage Patient who have developed clinical heart failure. ------CORRECT ANSWER---------------Stage C Which class There is marked limitation of physical activity. The patient is comfortable at rest, but less than ordinary activity causes symptoms of HF ------CORRECT ANSWER---------------Class 3 Which class There is no limitation of physical activity ordinary physical activity does not cause symptoms of HF ------CORRECT ANSWER---------------Class 1 Which class Primary or Secondary Common Variable Immunodeficiency ------CORRECT ANSWER--------------- Primary True or False Cancer is a secondary immunodeficiency... ------CORRECT ANSWER------- --------True A patient with Chronic Granulomatous Disease of childhood has a... a. Primary Immune Disease b. Secondary Immune Disease ------CORRECT ANSWER---------------a. Primary Immune Disease Type 2 (Cytotoxic) hypersensitivity reactions are mediated by a. IgE or IgG b. IgA or IgE c. IgM or IgA d. IgG or IgM ------CORRECT ANSWER---------------d. IgG or IgM Anaphylaxis is a _________ hypersensitivity reaction. a. Type 1 b. Type 2 c. Type 3 d. Type 4 ------CORRECT ANSWER---------------a. Type 1 Hives (uticaria) are an example of a.. a. Type 1 b. Type 2 c. Type 3 d. Type 4 ------CORRECT ANSWER---------------a. Type 1 Which or the following are considered the 'first responders' of the innate immune system? a. T-cells b. Neutrophils c. Eosinophils d. IgM ------CORRECT ANSWER---------------b. Neutrophils The NP notes that a patients FEV1/FVC ratio is normal. Which of the following conditions is most likely to the pulmonary issue? a. Pneumonia b. Pulmonary Fibrosis c. Emphysema d. Chronis Asthma ------CORRECT ANSWER---------------b. Pulmonary Fibrosis Which is an example of a secondary immunodeficiency? a. Familial Mediterranean Fever b. Job Syndrome c. Pneumocystis Carinii d. Common Variable Immunodeficiency ------CORRECT ANSWER------------ ---c. Pneumocystis Carinii Patients at risk for heart failure who have not yet developed structural heart changes a. Stage A b. Stage B c. Stage C d. Stage D ------CORRECT ANSWER---------------a. Stage A What is an expected chest Xray finding for a patient with COPD? ------ CORRECT ANSWER---------------Flattened Diaphragm What are the four key diagnostic tests for interstitial lung disease? ------ CORRECT ANSWER---------------Pulmonary Function Test Resolution CT Scan Bronchoalveolar Lavage Lung Biopsy ________ labs values are normal for hemolytic anemia. ------CORRECT ANSWER---------------MCV The _______ lab value will be high in post-hemorrhagic anemia. ------ CORRECT ANSWER---------------Reticulocyte Count Select all that apply Which of following are causes for hemolytic anemia? a. Infection b. Transfusion Reaction c. Drugs d. All of the above ------CORRECT ANSWER---------------d. All of the above True or False Acute blood loss of anemia is usually associated with acute GI bleeding and labor and delivery complications. ------CORRECT ANSWER--------------- True A deficiency of intrinsic factor will result in a. aplastic anemia b. pernicious anemia c. iron deficiency anemia d. anemia of chronic disease ------CORRECT ANSWER---------------b. pernicious anemia What plays a major role in the maturing of RBCs? ------CORRECT ANSWER---------------Folic Acid Which lab values are normal in early stages of pernicious anemia? ------ CORRECT ANSWER---------------MCHC True or False One of the common precipitating factors to folate deficiency is alcohol abuse. ------CORRECT ANSWER---------------True The Np is examining a patient with a longstanding history of chronic bronchitis. a. hypoxia b. hypocapnia c. venous status ulcers d. splenomegaly ------CORRECT ANSWER---------------d. splenomegaly Which of the following pulmonary function test results are expected in a patient with chronic bronchitis? a. increased vital capacity b. decreased residual volume c. decreased FEV1/FVC ratio d. increased forced expiratory volume in one sec ------CORRECT ANSWER---------------c. decreased FEV1/FVC ratio Which of the following indicate that the patients iron stores depleted? a. total iron binding capacity b. vitamin B-12 level c. Ferritin level d. Total RBC count ------CORRECT ANSWER---------------Ferritin level Select all that apply Which of the following anemias can be categorized as microcytic- hypochromic? a. anemia of inflammation and chronic disease b. sideroblastic anemia c. iron deficiency anemia ------CORRECT ANSWER---------------b. sideroblastic anemia c. iron deficiency anemia True or False The basic pathophysiology of iron deficiency anemia is that there are insufficient iron levels or the inability of the cells mitochondria to utilize iron effectively ------CORRECT ANSWER---------------True A patient with chronic bronchitis is at risk for developing pneumonia due to a. inability to cough b. overactive cilia in the lungs c. mucous plugs d. hypoxemia ------CORRECT ANSWER---------------c. mucous plugs Which of the following conditions could result in iron deficiency anemia? a. excessive bleeding b. increased absorption of iron containing foods c. reduced absorption of vitamin B-12 d. reduced intake of vitamin C ------CORRECT ANSWER---------------a. Excessive bleeding What am I? The oxygen carrying pigment of red cells a. normal for men is 13.5-17.5g/dl b. normal for women is 12-15.5g/dl ------CORRECT ANSWER--------------- Hb What am I? The number of erythrocytes in one cubic mm of whole blood a. normal for men 4.7-6.1mcl b. normal in women is 4.5-5.2mcl ------CORRECT ANSWER--------------- RBC Which of the following is a type of macrocytic anemia a. anemia of chronic disease b. thalassemia c. iron deficiency anemia d. vitamin B-12 deficiency ------CORRECT ANSWER---------------d. vitamin B-12 deficiency Which of the following normocytic anemias is characterized by hyperchromic RBCs a. iron deficiency b. Hereditary spherocytosis c. B12 deficiency True or False The characteristic finding on a chest xray of an individual with ILD is a honeycomb pattern ------CORRECT ANSWER---------------True True or False An objective finding in a patient with ILD include productive cough ------ CORRECT ANSWER---------------False True or false Interstitial lung disease refers to any disease affecting the pulmonary interstitial and typically excludes infectious and neoplastic diseases ------ CORRECT ANSWER---------------True True or False A subjective finding in interstitial lung disease is rhonchi in the upper posterior airways ------CORRECT ANSWER---------------False Which of the following can depress a persons normal immune function a. exercise b. psychological stress c. hypertension d. a high fiber diet ------CORRECT ANSWER---------------b. psychological stress The NP is seeing a patient with chronic bronchitis that needs spirometry on todays visit. What pulmonary function test findings are anticipated based on the diagnosis of chronic bronchitis a. decreased total lung b. increased lung compliance c. decreased diffusing capacity d. decreased forced expiratory flow ------CORRECT ANSWER---------------d. decreased forced expiratory flow Chronic bronchitis will decrease which of the following parameters? a. decreased diffusing capacity b. decreased total lung capacity c. increased lung compliance d. decreased forced expiratory flow ------CORRECT ANSWER---------------d. Decreased forced expiratory flow What cant simple spirometry measure? ------CORRECT ANSWER------------ ---Residual volume What is the major immune system change associated with Sjogrens Syndrome? ------CORRECT ANSWER---------------autoantibodies and autoreactive t-cells against apoptic cells What is the percentage in which a patient with normal lungs should be able to exhale of the forced vital capacity within the first second ------CORRECT ANSWER---------------80% What test is positive in 90% of patients diagnosed with systemic lupus erythematosus? ------CORRECT ANSWER---------------antinuclear antibody True or False Simple spirometry includes a measure of residual capacity ------CORRECT ANSWER---------------False Obstructive or restrictive FEV1 decreased FVC decreased TLC decreased FEV1/FVC normal ------CORRECT ANSWER---------------Restrictive Restrictive or Obstructive Pneumonia ------CORRECT ANSWER---------------restrictive Restrictive or Obstructive pulmonary fibrosis ------CORRECT ANSWER---------------restrictive Restrictive or Obstructive Chronic Asthma ------CORRECT ANSWER---------------Obstructive Restrictive or Obstructive Pulmonary hypertension ------CORRECT ANSWER---------------restrictive The NP reviews the results of a pateints pulmonary function tests and notes that the FEV FVC and TLC are reduced and the FEV1/ FVC ratio is normal. Based on interpretation this reflects... a. combined obstructive and restrictive lung disease b. the test is valid c. restrictive lung disease d. obstructive lung disease ------CORRECT ANSWER---------------c. restrictive lung disease d. activation of complement ------CORRECT ANSWER---------------b. mast cell degranulation The diagnosis fo an individual who presents to the office with swollen lips and eyes, SOB and throat tightness after a bee sting is... a. angioedema b. asthma c. reactive airway disease d. anaphylaxis ------CORRECT ANSWER---------------d. anaphylaxis Damage occurs with ABO incompatibility because a. mast cells degranulation b. complement damages RBC membrane causing cell lysis. c. antigen/antibody complexes attack the RBC d. autoantibodies specific for thyroid tissue impairs the receptors for TSH -- ----CORRECT ANSWER---------------b. complement damages RBC membrane causing cell lysis What is the main cause of coronary artery disease? ------CORRECT ANSWER---------------longstanding atherosclerosis Which of the following statements correctly describes the flow of blood between the heart and lungs? a. the pulmonary arteries carry oxygenated blood from the lungs to the heart b. oxygenated blood is transported from the lungs to the heart via the pulmonary veins c. oxygenated blood is transported from the lungs to the right atrium of the heart d. deoxygenated blood is transported from the left ventricle to the lungs via the pulmonary arteries ------CORRECT ANSWER---------------b. oxygenated blood is transported from the lungs to the heart via the pulmonary veins True or false In coronary artery disease pumpability of the heart can be impaired due to the deprivation of oxygen ------CORRECT ANSWER---------------True Which of the following is a modifiable risk factor for coronary artery disease? a. family history b. obesity c. age d. menopause ------CORRECT ANSWER---------------b. obesity Choose the types of interstitial lung disease that are commonly associated with smoking? a. hypersensitivity pneumonitis b. respiratory bronchiolitis- interstitial lung disease c. sarcoidosis d. pulmonary langerhans cell histiocytosis e. Desquamative interstitial pneumonia ------CORRECT ANSWER------------ ---e. Desquamative interstitial pneumonia f. pulmonary langerhans cell histocytosis b. respiratory bronchiolisis- interstitial lung disease Bronchitis or Emphysema Cor pulmoale- common ------CORRECT ANSWER---------------Bronchitis Bronchitis or Emphysema productive cough- classic sign ------CORRECT ANSWER--------------- Bronchitis Bronchitis or Emphysema polycythemia- late in course ------CORRECT ANSWER--------------- Emphysema Bronchitis or Emphysema dyspnea- late in course ------CORRECT ANSWER---------------Bronchitis Bronchitis or Emphysema chronic hypoventilation- late in course ------CORRECT ANSWER-------------- -Emphysema Bronchitis or Emphysema cyanosis- uncommon ------CORRECT ANSWER---------------Emphysema Bronchitis or Emphysema Barrel Chest- classic ------CORRECT ANSWER---------------Emphysema Bronchitis or Emphysema Wheezing-intermittent ------CORRECT ANSWER---------------Bronchitis Bronchitis or Emphysema Barrel chest- occasional ------CORRECT ANSWER---------------Bronchitis Bronchitis or Emphysema Right or Left Heart Failure decreased ejection fraction ------CORRECT ANSWER---------------Left Right or Left Heart Failure jugular vein distention ------CORRECT ANSWER---------------Right Right or Left Heart Failure increased Left ventricular preload ------CORRECT ANSWER---------------Left Right or Left Heart Failure hepatosplenomegaly ------CORRECT ANSWER---------------Right Right or Left Heart Failure peripheral edema ------CORRECT ANSWER---------------Right Right or Left Heart Failure cor pulmonale ------CORRECT ANSWER---------------Right Right or Left Heart Failure pulmonary edema ------CORRECT ANSWER---------------Left Right or Left Heart Failure Tricuspid valve damage ------CORRECT ANSWER---------------Right Right or Left Heart Failure Dypsnea ------CORRECT ANSWER---------------Left Type 1-4 Pathology Mast Cell Degranulation results in an inflammatory response ------ CORRECT ANSWER---------------Type 1 Type 1-4 Pathology Complement damages RBC membrane and cell lyse Autoantibodies specific for thyroid tissue impair receptor for TSH ------ CORRECT ANSWER---------------Type 2 Type 1-4 Pathology Complex deposited in small peripheral vessels in cool temperatures leading to vasoconstriction and blocked circulation ------CORRECT ANSWER-------- -------Type 3 Type 1-4 Pathology T cells attack tissue directly (no antibody) ------CORRECT ANSWER--------- ------Type 4 Type 1-4 Example Hay Fever ------CORRECT ANSWER---------------Type 1 Type 1-4 Example ABO incompatibility Graves Disease ------CORRECT ANSWER---------------Type 2 Type 1-4 Example contact dermatitis ------CORRECT ANSWER---------------Type 4 Type 1-4 Example Raynauds Phenomenon ------CORRECT ANSWER---------------Type 3 Type 1-4 Mechanism Cytotoxic T cell-Mediated ------CORRECT ANSWER---------------Type 4 Type 1-4 Mechanism IgE action on mast cells ------CORRECT ANSWER---------------Type 1 Type 1-4 Mechanism Antigen-antibody complex deposited in tissues ------CORRECT ANSWER-- -------------Type 3 Immune System Changes Autoantibodies and auto-active T-cells against DNA and nucleoprotein antigens ------CORRECT ANSWER- --------------Systemic Lupus Erythematosus Immune System Changes