1
Q
Which information is most correct regarding IgAs?
IgAs are
1. measurable in the blood in very low concentrations.
2. the largest immunoglobulins.
3. found in saliva and other body secretions.
4.effective against parasites and allergies
A
found in saliva and other body secretions
2
Q
Which of the following statements is correct regarding pathologic hyperplasia?
- Produces abnormal proliferation of abnormal cells.
- Is an adaptive mechanism that enables organ regeneration.
- Increases cell size.
- May occur in response to growth factors.
A
May occur in response to growth factors
3
Q
A nurse knows that free radicals may be produced by
- protein peroxidation.
- metabolism of exogenous chemicals or drugs.
- spontaneous decay of superoxide.
- vitamins E and C supplements
A
metabolism of exogenous chemicals or drugs.
4
Q
Which of the following is true about alcohol (ethanol)?
- Is metabolized via the microsomal P-450.
- Is primarily metabolized and excreted by the kidneys.
- Increases activation of methionine, an essential amino acid.
- Can produce hypermagnesemia with chronic use.
A
Is metabolized via the microsomal P-450.
5
Q
A nurse remembers that aging is associated with
- reduced cross-linking of collagen.
- reduced degradation of collagen.
- increased cross-linking of collagen.
- increased collagen synthesis.
A
increased cross-linking of collagen.
6
Q
Which information is correct regarding DNA polymerase?
DNA polymerase functions to
1. signal the end of a gene.
2. pull apart a portion of a DNA strand.
3. add the correct nucleotides to a DNA strand.
4. provide a template for the sequence of mRNA nucleotides.
A
- add the correct nucleotides to a DNA strand.
7
Q
At what site does protein synthesis occur? The site of protein synthesis is the 1. codon. 2. intron. 3. ribosome. 4. anticodon.
A
ribosome
8
Q
A female has one X chromosome. Which diagnosis will the nurse observe documented on the chart?
- Trisomy X syndrome
- Klinefelter syndrome
- Fragile X syndrome
- Turner syndrome
A
Turner syndrome
9
Q
Which information indicates that the nurse has a good understanding of X-linked recessive inheritance?
- The gene is passed from an affected father to all of his daughters.
- The trait is observed significantly more often in females than in males.
- Males are said to be heterozygous for the X chromosome.
- A sex-limited trait is one that occurs significantly more often in one sex than in the other.
A
- The gene is passed from an affected father to all of his daughters
10
Q
Ribosomes are nucleoproteins that
- are synthesized in the mitochondria and secreted into the cytosol.
- are synthesized in the cytoplasm.
- consist of a network of cisternae.
- synthesize a signal recognition sequence.
A
synthesize a signal recognition sequence.
11
Q
The plasma membrane of a cell is
- permeable to water soluble molecules’ movement into the cell.
- composed primarily of amphipathic molecules.
- dimpled because of peripheral membrane proteins.
- impermeable to lipid-soluble molecules.
A
composed primarily of amphipathic molecules.
12
Q
Which information is correct regarding neurotransmitters?
- Act on the cells that produce and secrete them.
- Act on nearby cells that also take them up and destroy them.
- Are produced by neurosecretory neurons and transmitted via the blood.
- Diffuse across the synaptic cleft and act on postsynaptic target cell.
A
Diffuse across the synaptic cleft and act on postsynaptic target cell.
13
Q
A nurse knows that active transport requires
- receptors capable of recognizing and binding with specific molecules.
- a hydrostatic pressure gradient between intracellular and extracellular regions.
- a molecule bound to a ligand that moves the substance down the gradient.
- the presence of pores in the cell membrane with no energy expenditure.
A
receptors capable of recognizing and binding with specific molecules.
14
Q
A nurse recalls depolarization occurs when the
- cell is more negatively charged and its polarity is negative.
- sodium–potassium (Na+/K+) pump removes sodium from the cell.
- voltage-regulated channels open and Na+ enters the cell.
- cell decreases by 25–30 millivolts and reaches threshold.
A
voltage-regulated channels open and Na+ enters the cell.
15
Q
Which statement is most correct regarding miRNAs?
miRNAs
1. result from the attachment of a methyl group to a cytosine base, followed by a guanine base.
2. enhance X-inactivation, silencing genes on the X chromosome.
3. become the hereditary transmission of epigenetic changes to successive generations.
4. are short nucleotides derived from introns of protein-coding genes.
A
are short nucleotides derived from introns of protein-coding genes.
16
Q
Which pathophysiologic process is occurring in a person with Beckwith-Wiedemann syndrome?
- Missing chromosome 15
- Missing gene product
- Downregulation of IGF2
- Extra copies of active IGF2
A
Extra copies of active IGF2
17
Q
Which statement by the nurse indicates an accurate understanding of epigenetics and cancer?
- “Hypomethylation of the promoter region of the RB1 gene is often observed in retinoblastoma.”
- “Hypomethylation increases as tumors progress from benign neoplasms to malignancy.”
- “Hypomethylation of specific subgroups of miRNAs is associated with tumorigenesis.”
- “Hypomethylation occurs when HDAC inhibitors are administered for cancer.”
A
Hypomethylation increases as tumors progress from benign neoplasms to malignancy.”
18
Q
- This disease does not follow the inheritance patterns of single-gene disease. This type of disease is considered to be
A. multifactorial.
B. congenital.
C. following a bell-shaped distribution model.
D following a liability of threshold model
A
following a liability of threshold model
19
Q
Although the mother is staying with the child after surgical correction, her husband comes to visit and brings their other child. This child has Prader-Willi syndrome. This disease is an example of A. imprinting. B. trisomy. C. hypermethylation. D. nondisjunction.
A
imprinting
20
Q
Which is a common characteristic of Beckwith-Wiedemann syndrome? A. Omphalocele B. Leg-length discrepancy C. Hyperglycemia D. Obesity
A
Omphalocele
21
Q
The infant with Beckwith- Wiedemann syndrome is at an increased risk for which disorder? A. Mental retardation B. Wilms tumor C. Triangular-shaped face D. Hypotonia
A
Wilms tumor
22
Q
Which statement indicates the nurse has an accurate understanding concerning passive immunity?
Passive immunity
1. “is produced after exposure to an antigen.”
2. “is the result of an attenuated immunization.”
3. “can last for years.”
4. “can be transferred from a donor to a recipient
A
“can be transferred from a donor to a recipient
23
Q
Which information is most correct regarding IgAs?
IgAs are
1. measureable in the blood in very low concentrations.
2. the largest immunoglobulins.
3. found in saliva and other body secretions.
4. effective against parasites and allergies.
A
found in saliva and other body secretions.
24
Q
A nurse is asked about NK cells. How should the nurse respond?
NK cells
1. only work alone to cause apoptosis.
2. destroy abnormal cells with MHC class I markers.
3. lack antigen-specific receptors.
4. mature in the thymus.
A
lack antigen-specific receptors.
25
```
A person arrives at the clinic and reports mild tiredness and discomfort after exposure to a family member with the flu. The nurse suspects the person is in the
1. convalescence period.
2. incubation period.
3. prodromal period.
4invasion period
```
prodromal period
26
Which information is correct regarding parasitic infections?
1. These types of infections attach through pili (fimbriae).
2. C. albicans is an example of a parasitic infection.
3. Parasitic infections are transmitted from human to human.
4. Malaria is a common parasitic infection.
malaria s a common parasitic infection
27
A person who is HIV positive is hospitalized with pneumonia caused by Pneumocystis jiroveci. The nurse understands that this development indicates the person
1. has adequate amounts of Th cells.
2. is serologically positive for asymptomatic HIV disease.
3. is in the early stages of HIV disease.
4. has progressed from HIV to AIDS.
has progressed from HIV to AIDS.
28
A nurse is asked how antibiotics work. How should the nurse reply?
One of the actions of antibiotics includes
1. protection of the bacterial cell wall.
2. inhibition of protein synthesis.
3. enhancement of DNA replication.
4. support for folic acid synthesis.
inhibition of protein synthesis.
29
Alloimmunity occurs when
1. the immune system produces a response to tissues of another individual.
2. a disturbance occurs in the immunologic tolerance of self-antigens.
3. antigens are in the environment.
4. an anaphylactic reaction occurs.
the immune system produces a response to tissues of another individual.
30
A person has a type I allergic reaction. Which pathophysiologic response is occurring?
1. Antibody binds to tissue-specific antigen.
2. Immune complexes are deposited in vessel walls.
3. T lymphocytes, not antibodies, mediate the process.
4. IgE and products of tissue mast cells are released.
IgE and products of tissue mast cells are released.
31
Autoimmunity occurs when
1. self-antigens stimulate molecular mimicry.
2. transplanted tissues are rejected.
3. the immune system recognizes self-antigens as foreign.
4. an acute rejection of a transplanted organ or tissue occurs.
the immune system recognizes self-antigens as foreign.
32
Which information is correct regarding secondary immune deficiencies?
Secondary immune deficiencies may be the result of
1. increased dietary zinc intake.
2. caring for an older parent with Alzheimer disease.
3. aspirin therapy that is prescribed by the physician.
4. congenital or genetic defects in the neonate.
caring for an older parent with Alzheimer disease.
33
The characteristic vascular changes at the site of an injury produce
1. blood vessel constriction after dilation .
2. increased permeability and leakage.
3. tightening of the capillary endothelial cell junctions.
4. pallor and swelling where the injury occurred.
increased permeability and leakage.
34
Which statement indicates the nurse has an accurate understanding of mast cells?
Mast cells
1. “can be activated through an intrinsic or extrinsic pathway.”
2. “degranulate in response to chemical agents.”
3. “reduce blood flow after activation.”
4. “can be blocked by the therapeutic use of aspirin.”
degranulate in response to chemical agents.”
35
Which information is correct regarding phagocytosis?
Phagocytosis involves
1. opsonization, engulfment, and formation of a phagosome.
2. a reduction in nitric oxide production.
3. formation of a phagosome by mast cells.
4. a respiratory burst produced by the release of the primary lysosomal granules
opsonization, engulfment, and formation of a phagosome.
36
A person has a large open wound that has formed scar tissue. The nurse knows which type of healing has occurred?
1. Primary
2. Secondary
3. Debridement
4. Regeneration
secondary
37
Which parameter will the nurse monitor to best determine the systemic perfusion in a child?
1. Urinary output
2. Partial pressure of arterial oxygen (Pao2)
3. Serum lactate
4. Systolic hypotension
serum lactate
38
An adolescent is in neurogenic shock. Which finding would the nurse typically find when taking the history?
1. Spinal cord injury
2. Recent cardiac surgery
3. Loss of blood
4. Pulmonary embolus
spinal cord injury
39
In a child 3 years old, which information is correct regarding a burn injury?
1. Decreased intraabdominal pressure can impair hemodynamics and renal function.
2. Pulmonary edema is the main cause of morbidity and mortality.
3. Mucosal hypertrophy and diarrhea are common after major burns.
4. Intraosseous cannulation can be effective for fluid replacement
Intraosseous cannulation can be effective for fluid replacement
40
```
1. Neurogenic shock is a form of hypovolemic and
A. cardiogenic shock.
B. vasogenic shock.
C. multiple organ dysfunction syndrome.
D. reperfusion injury.
```
vasogenic
41
```
2. In all types of shock, cells do not receive adequate amounts of oxygen because of decreased delivery or increased cellular consumption. Decreased oxygen and nutrient delivery to cells impairs the cells’ ability to compensate and maintain normal function. Organ failure is caused by the depletion of
A. fat.
B. glycogen.
C. protein.
Dcalcium.
```
protein
42
A person with hypertension and heart failure has edema in the lower legs and sacral area. The nurse suspects this condition is due to a(n)
1. increase in plasma oncotic pressure.
2. decrease in capillary hydrostatic pressure.
3. decrease in lymph obstruction pressure.
4. increase in capillary hydrostatic pressure.
increase in capillary hydrostatic pressure.
43
A person reports severe diarrhea for 2 days. The nurse understands this stimulates a(n)
1. reduction in aldosterone secretion.
2. reduction in renin secretion.
3. increase in antidiuretic hormone secretion.
4. increase in natriuretic peptide secretion.
increase in antidiuretic hormone secretion.
44
A person arrives in the emergency department after a loss of consciousness and the development of Kussmaul respirations. The individual has a history of diabetes and 2 days of vomiting and diarrhea. The nurse suspects the person has which of the following primary disorders?
1. Respiratory alkalosis
2. Respiratory acidosis
3. Metabolic alkalosis
4. Metabolic acidosis
metabolic acidosis
45
A person with a history of chronic lung disease arrives in the clinic with a 1-week history of a productive cough, hypoventilation, and headache. The nurse suspects the person is experiencing
1. respiratory acidosis.
2. respiratory alkalosis.
3. metabolic acidosis.
4. metabolic alkalosis.
respiratory acidosis.
46
```
1. The sacral area is covered with which type
of tissue?
A. Muscle
B. Neural
C. Epithelial
D. Connective
```
epithelial
47
```
2. A large portion of the area is removed because of ischemia and cell death. The teen suffers from tissue
A. apoptosis.
B. necrosis.
C. catabolism.
D. metabolism.
```
necorosis
48
```
The nurse notices that the patient has generalized deteriorated muscle mass and decreased strength in the extremities. This condition is called
A. senescence.
B. autophagy.
C. apoptosis.
D. sarcopenia.
```
sarcopenia
49
```
The patient dies from an aneurysm and the nurse assesses the changes occurring in the patient’s body immediately after death. The nurse notices that the patient’s lower legs are turning purple. This is referred to as
A. algor mortis.
B. livor mortis.
C. rigor mortis.
D. postmortem autolysis.
```
liver mortis
50
A person develops cardiogenic shock after an acute MI. The nurse understands this will produce a(an)
1. inhibition of the sympathetic nervous system.
2. stimulation of the renin-angiotensin system.
3. decreased activation of the complement system.
4. lowered production of catecholamine system.
stimulation of the renin-angiotensin system.
51
Which laboratory result should the nurse check for a person with suspected septic shock?
1. Hetastarches
2. Immunoglobulin E (IgE)
3. Lactate
4. Antigen titer
lactate
52
A person arrives at the emergency department with a burn injury. The burn area is covered with thin-walled, fluid-filled blisters and is very painful. The nurse suspects this is a
1. first-degree injury.
2. superficial partial-thickness injury.
3. deep partial-thickness injury.
4. full-thickness injury.
superficial partial-thickness injury.
53
```
A nurse is assigned to care for a person with a 40% deep partial-thickness injury. Which parameter will the nurse closely monitor to best assess adequate fluid resuscitation?
1. Hematocrit level
2. Urine output
3. Heart rate
4Blood pressure
```
urine output
54
Iron deficiency anemia
1. is caused by reduced hemosiderin after birth.
2. may be associated with the ingestion of cow’s milk.
3. produces detectable lethargy and fatigue.
4. is commonly associated with reduced dietary iron in school-age children.
may be associated with the ingestion of cow’s milk.
55
Hemoglobin structural alterations observed with sickle cell disease
1. are irreversible.
2. increase the flexibility of erythrocytes.
3. are stimulated by deoxygenation.
4. are stimulated by alkalosis.
are stimulated by deoxygenation.
56
A child has classic hemophilia (hemophilia A). Which factor will the nurse be prepared to administer?
1. XI
2. IX
3. VIII
4. XV
VIII
57
Which information should the nurse remember while planning care for a child with primary immune thrombocytopenia (ITP)?
Primary immune thrombocytopenia
1. is an autoimmune disease.
2. typically follows a bacterial infection.
3. causes symmetrical bleeding.
is fatal without treatment
is an autoimmune disease.
58
A person diagnosed with acute lymphocytic leukemia (ALL)
1. is usually 26 years of age.
2. typically has defects in C and S proteins.
3. frequently develops disseminated intravascular coagulation (DIC) after diagnosis.
4commonly has fever associated with hypermetabolism
commonly has fever associated with hypermetabolism
59
The parents of a 5-year-old child note that the child has been irritable and weak for the past month. The child no longer plays outside with friends because he “feels tired.” The parents take the child to the primary care provider who performs an assessment and lab studies. The healthcare provider notes that the child is very pale and has a heart rate of 130 bpm. The lab studies reveal a hemoglobin level of 4 g/dL.
Which condition does the child most likely have?
A. Anemia
B. Hemophilia A
C. Hemophilia B
D. Hydrops fetalis
Anemia
60
```
The nurse teaches the child’s parents that iron deficiency anemia may result from ingestion of
A. spinach.
B. red meat.
C. cow’s milk.
D. raisins.
```
cows milk
61
An individual has leukocytosis. What would the nurse expect to find while taking the individual’s history?
1. Stressful work environment
2. History of autoimmune disease
3. History of radiation treatments
4. Immune deficiency disorder
Stressful work environment
62
Which information is correct regarding infectious mononucleosis?
Infectious mononucleosis in children is
1. an acute viral infection of lymphocytes.
2. caused by the Ehrlichia chaffeensis virus.
3. treated with aspirin.
4. transmitted through coughing and sneezing.
an acute viral infection of lymphocytes.
63
A nurse recalls that acute lymphocytic leukemia (ALL)
1. is most common in adults.
2. has a higher mortality rate in children when compared with adults.
3. is defined as greater than 30% lymphoblasts in the bone marrow.
is caused by an abnormal proliferation of myeloid precursor cells
is defined as greater than 30% lymphoblasts in the bone marrow.
64
```
A nurse observes Reed-Sternberg cells on the laboratory results. The nurse is caring for an individual with
1. Hodgkin lymphoma.
2. non-Hodgkin lymphoma.
3. Burkitt lymphoma.
lymphoblastic lymphoma.
```
Hodgkin lymphoma.
65
A nurse recalls that the most common childhood cancers are
1. sarcomas.
2. colon tumors.
3. leukemias.
4. thyroid cancers.
leukemias
66
A nurse knows that most childhood cancers primarily arise from the
1. mesodermal germ layer.
2. central nervous system.
3. respiratory tract system.
4. diploblastic germ layer.
mesodermal germ layer.
67
```
A nurse recalls that the most common genetic abnormality linked to the development of acute leukemia is
1. Down syndrome.
2. Tuberous sclerosis.
3. Gorlin syndrome.
4N-myc gene.
```
Down syndrome
68
Studies suggest that physical activity may reduce the risk for several different cancers, independent of weight changes. The protective effects of physical activity includes
A. changing gastric absorption of carcinogenic compounds.
B. increasing the insulin-like growth factor.
C. decreasing free radicals.
D. improving gastric motility.
improving gastric motility.
69
```
The woman begins radiation therapy in an attempt to kill the cancer cells while minimizing damage to normal structures. Effective cell killing by radiation also requires
A. oxygen.
B. follicle-stimulating hormone.
C. cytokines.
D. adhesion molecules.
```
oxygen
70
The nurse understands which statement to be true regarding non-Hodgkin lymphoma in adolescents?
A. It is a type of embryonal tumor.
B. It is the most common solid tumor type.
C. It is slow growing.
D. It is the most common cancer of this age group.
it is the most common cancer of this age group
71
The adolescent’s parents ask the nurse if adolescent boys of color also get lymphoma. Which statement made by the nurse is true?
A. “Lymphoma is more prominent in teen girls of color.”
B. “Lymphoma typically affects only children.”
C. “Lymphoma is more common in white boys.”
“DLymphoma affects Asians more than other groups
“Lymphoma is more common in white boys.”
72
```
A person has an infection with early inflammation. Which agranulocyte is the primary immunogenic WBC?
1. Neutrophil
2. Natural killer cell
3. Lymphocyte
4Eosinophil
```
Lymphocyte
73
Which physiologic process occurs in hematopoiesis?
1. Niches control the differentiation of hematopoietic progenitor cells.
2. The spleen as the primary adult site uses splenic pulp to develop RBCs.
3. Peyer patches in the bone marrow stimulate the growth process.
4. Mesenchymal stem cells differentiate into hematologic cells.
Niches control the differentiation of hematopoietic progenitor cells.
74
A person has an inadequate intake of folic acid (folate). What will happen to this person’s RBCs?
1. Impaired iron metabolism
2. Impaired DNA synthesis
3. Impaired hemoglobin synthesis
4. Impaired heme metabolism
Impaired DNA synthesis
75
von Willebrand factor is
1. essential for platelet activation.
2. necessary for platelet adhesion.
3. needed to stimulate platelet aggregation.
4required for Hageman factor to degrade platelets
necessary for platelet adhesion.
76
Which information is correct regarding an infant or child’s hematologic system?
1. Blood cell counts decrease at birth from the loss of blood and then increase throughout childhood.
2. Immediately after birth of a full-term neonate, the reticulocyte count decreases.
3. Platelets increase at birth and then decrease to adult levels.
4. Polycythemia of the newborn occurs from the hypoxic intrauterine environment.
Polycythemia of the newborn occurs from the hypoxic intrauterine environment.
77
A person with a gastrectomy is seen in the clinic for generalized weakness, fatigue, difficulty walking, and abdominal pain. The nurse suspects this individual has
1. folate deficiency anemia.
2. eryptosis anemia.
3. polycythemia anemia.
4. pernicious anemia.
pernicious anemia.
78
Anemia of chronic disease is caused by
1. immunoglobulin G (IgG) binding to erythrocytes at normal body temperatures.
2. autoantibodies against erythrocyte surface antigens.
3. reduced response to erythropoietin.
4. paroxysmal nocturnal hemoglobinuria.
paroxysmal nocturnal hemoglobinuria.
79
A person is admitted with an autoimmune disease directed against the hematopoietic stem cells. The nurse knows this will produce
1. aplastic anemia.
2. iron deficiency anemia.
3. sideroblastic anemia.
4. fanconi anemia.
aplastic anemia.
80
A person arrives in the clinic reporting 4 days of nausea, vomiting, and diarrhea. The hematocrit is 61%. The nurse suspects
1. primary polycythemia.
2. secondary polycythemia.
3. relative polycythemia.
4. absolute polycythemia.
relative polycythemia.
81
An individual has disseminated intravascular coagulation (DIC). Which pathophysiologic mechanism is occurring?
1. Platelet consumption results in thrombocytosis.
2. Tissue factor is decreased.
3. Clotting is abnormally widespread and ongoing.
4. Natural anticoagulants are greatly increased.
Clotting is abnormally widespread and ongoing.
82
Which statement indicates the nurse has an accurate understanding about the association between tobacco and cancers?
“Tobacco use is associated with cancer of the
1. prostate.”
2. endometrium.”
3. esophagus.”
4breast.”
esophagus.”
83
A nurse recalls that in women, obesity is associated with
1. small intestinal cancer.
2. prostate cancer.
3. lung cancer.
4. endometrial cancer.
endometrial cancer.
84
```
Which information is correct regarding ultraviolet light?
Ultraviolet light causes
1. multiple myeloma.
2. basal cell carcinoma.
3. cervical cancer.
4. glioma.
```
basal cell carcinoma.
85
```
A nurse learns that an individual has benign tumors. What does this mean?
The tumors
1. are poorly differentiated.
2. are encapsulated.
3. may develop anaplasia.
4. may spread to a distant location.
```
are encapsulated.
86
Chromosome instability may result in the overexpression of
1. tumor-suppressor genes.
2. heterozygosity.
3. oncogenes.
4. point mutations.
oncogenes.
87
Epithelial-mesenchymal transition (EMT) produces which result?
1. Increased resistance to apoptosis
2. Adherence to basement membranes
3. Decreased migratory capacity
4. Promotion of angiogenesis
increased resistance to apoptosis
88
A tumor that has advanced to regional structures is in which Stage?
1. Stage 1
2. Stage 2
3. Stage 3
4. Stage 4
Stage 3
89
```
Which factor indicates a recurrence of prostate cancer?
1. Decrease in PSA
2. Increase in PSA
3. False negative
4False positive
```
Increase in PSA
90
A person is admitted to the unit with a diagnosis of lung cancer and SIADH. The nurse expects the person to have
1. dilute urine.
2. a hypoosmolar state.
3. hypernatremia.
4. reduced extracellular volume.
a hypoosmolar state.
91
A nurse knows that Graves disease is caused by a(n)
1. multiple hyperfunctioning nodules.
2. reduced production of the thyroid hormone.
3. autoimmune response.
4. increased myxedema.
autoimmune response.
92
```
Which information is correct regarding hyperparathyroidism?
Hyperparathyroidism is associated with
1. pathologic fractures.
2. increased osteoblast activity.
3. hyperphosphatemia.
4. acidic urine.
```
pathologic fractures.
93
A patient with diabetes arrives at the emergency department after an abrupt decrease in level of consciousness. The person has tachycardia, diaphoresis, irritability, tremors, and confusion. The nurse suspects the person has
1. inadequate insulin level.
2. hyperosmolar hyperglycemia nonketotic syndrome.
3. hypoglycemia.
4diabetic ketoacidosis
hypoglycemia
94
A person has Cushing syndrome. Which pathophysiologic effect is occurring?
1. Overproduction of pituitary ACTH
2. Excessive aldosterone secretion
3. Reduction of serum glucose
4. Chronic exposure to excess cortisol
Chronic exposure to excess cortisol
95
```
Glucagon excess may also be as important as insulin insufficiency of diabetes.
Glucagon
A. stimulates lipolysis.
B. stops the release of amylin.
C. increases somatostatin production.
Ddecreases ghrelin levels
```
stimulates lipolysis.
96
Obesity is present in 60%–80% of patients with type 2 diabetes and is a major contributor to insulin resistance by many mechanisms including:
A. Decreased release of inflammatory cytokines
B. Minimization of free fatty acids
C. Maintenance of oxidative phosphorylation in cellular mitochondria
D. Increased insulin-receptor density
Maintenance of oxidative phosphorylation in cellular mitochondria
97
Where is the largest amount of bone marrow adipose tissue found?
1. Flat bones
2. Short bones
3. Long bones
4. Sesamoid bones
long bone
98
Which of the following is a global concern associated with obesity?
1. Primary cause of death
2. High healthcare costs
3. Improved mood
4. High socioeconomic status
High healthcare costs
99
Which is a risk factor for anorexia of aging?
1. Increased activity
2. Dislike of food
3. Overhydration
4. Social isolation
social isolation
100
Sensitivity of a target cell is down-regulated when the
1. level of hormone that binds with the receptor is high.
2. number of receptors for the hormone is high.
3. direct effects of the hormone are detected.
permissive effects of the hormone are detected
evel of hormone that binds with the receptor is high.
101
A nurse knows that ADH is
1. released by the anterior pituitary.
2. released in response to decreased sodium (Na+).
3. regulated by the osmoreceptors in the hypothalamus.
4. regulated by the chromophils of the anterior pituitary.
regulated by the osmoreceptors in the hypothalamus.
102
A nurse recalls that calcitonin
1. increases serum sodium concentration.
2. activates osteoclasts.
3. suppresses osteoblasts.
4. reduces serum calcium concentration.
reduces serum calcium concentration.
103
Which information is most correct about insulin?
1. Insulin promotes glycogenolysis.
2. Insulin is required by the brain for glucose uptake.
3. Insulin facilitates the uptake of glucose by cells.
4. Insulin release is stimulated by a decreased concentrations of glucose.
Insulin facilitates the uptake of glucose by cells.
104
```
Glucocorticoids act to
1. reduce serum glucose concentrations.
2. stimulate immune response to microorganisms.
3. reduce angiotensin II.
stimulate protein catabolism.
```
stimulate protein catabolism.
105
Which information is correct regarding associational neurons?
Associational neurons
1. carry impulses between two distinct processes arising from the cell body.
2. carry impulses from peripheral receptors to the CNS.
3. transmit impulses to an effector organ.
4. transmit impulses from neuron to neuron.
transmit impulses from neuron to neuron.
106
A nurse knows that the premotor area (Brodmann area 6) is
1. responsible for goal-oriented behavior.
2. involved in eye movements.
3. responsible for the motor aspects of speech.
4. involved in programming motor movements.
involved in programming motor movements.
107
```
Which information is most accurate regarding the subarachnoid space?
The subarachnoid space
1. contains CSF.
2. lies above the dura mater.
3. lies below the pia mater.
4. adheres to the brain and spinal cord.
```
contains csf
108
The neurotransmitter released by preganglionic parasympathetic fibers is
1. dopamine.
2. epinephrine.
3. acetylcholine.
4. norepinephrine.
acetylcholine.
109
A nurse recalls that increased intracranial pressure with hydrocephalus may be the result of
1. excess dopamine.
2. inflammation.
3. reduced production of CSF.
4. reduced reabsorption of CSF.
reduced reabsorption of CSF.
110
```
A child has meningitis. A nurse observes flexion of the knees and hips when the child’s neck is rapidly flexed forward. Which sign did the nurse observe as positive?
1. Homan sign
2. Brudzinski sign
3. Kernig sign
Clarke sign
```
Brudzinski sign
111
Which finding will help the nurse determine whether the febrile seizure is a simple febrile seizure?
1. The seizure lasts 20 minutes.
2. The convulsion is generalized.
3. Two seizures occur within 24 hours.
4. CNS infection is present.
The convulsion is generalized.
112
The most useful treatment for brain tumors in children is
1. radiation therapy.
2. surgical therapy.
3. chemotherapy.
4. brachytherapy.
surgical therapy
113
```
Which vaccine may have prevented the boy’s contraction of bacterial meningitis?
A. MMR
B. H. influenzae
C. Varicella
D. N. meningitidis
```
H. influenzae
114
```
2. Upon physical examination, the child shows resistance to knee extension in the supine position with the knees and hips flexed against the body. Which sign is the child displaying?
A. Kernig
B. Brudzinski
C. Opisthotonic
D. Nuchal rigidity
```
kernig
115
An unconscious person is admitted to the hospital after a motorcycle accident. The person experienced a brief loss of consciousness at the scene followed by an awake, lucid period of 1 hours. The nurse suspects this individual has a(n)
1. subdural hematoma.
2. open penetrating trauma.
3. extradural hematoma.
4. mild concussion.
extradural hematoma.
116
A nurse knows that spinal shock results in
1. bradycardia.
2. moderate hypertension.
3. fever.
4. poor venous circulation.
poor venous circulation.
117
A nurse recalls that fusiform aneurysms are
1. congenital.
2. common in children.
3. due to arteriosclerotic changes.
from arteritis caused by bacterial emboli
due to arteriosclerotic changes.
118
A person arrives at the clinic and reports a unilateral headache for 2 days that worsens with movement and light. No trauma has occurred. The nurse suspects
1. subarachnoid hemorrhage.
2. cerebral tumor.
3. chronic paroxysmal hemicrania.
4. migraine headache
migraine
119
A person is diagnosed with an alteration in arousal. Which clinical manifestation is typical of this diagnosis?
1. Genetic defect on chromosome 4
2. Degeneration of upper and lower neurons
3. Vomiting without nausea
4. Irreversible dementia
Vomiting without nausea
120
```
A nurse knows the onset of an acute confusional state is
1. insidious.
2. 1 week.
3. sudden.
predictable.
```
sudden
121
Seizures are initiated by
1. hyperexcitability of neurons.
2. closure of the voltage-dependent sodium (Na+) channels.
3. long-lasting neuronal repolarization.
4. formation of neuritic plaques.
hyperexcitability of neurons.
122
A nurse recalls that increased intracranial pressure can occur because of
1. loss of cerebrospinal fluid.
2. increased cerebral activity.
3. loss of cerebral function.
4. cerebral edema.
cerebral edema
123
During the morning report, a nurse is assigned to care for a person who is areflexic. The nurse understands this means the person has
1. no tendon reflexes.
2. muscle rigidity.
3. paratonia.
4. cogwheel phenomenon.
no tendon reflexes.
124
A nurse recalls the reflex withdrawal of an affected body part from painful stimuli before the pain is perceived is controlled by
1. myelinated A-beta fibers.
2. unmyelinated C fibers.
3. unmyelinated C-alpha fibers.
4. myelinated A fibers.
myelinated A fibers.
125
```
Which finding would the nurse expect to recognize during the assessment of a person with chronic pain?
The person is
1. experiencing tachycardia.
2. probably malingering (faking).
3. depressed.
hypertensive.
```
depressed
126
Fever is stimulated by
1. arginine vasopressin.
2. endogenous pyrogens (endotoxins).
3. metabolism of brown fat.
4. tumor necrosis factor-α.
tumor necrosis factor-α.
127
A nurse recalls the majority of the sleep cycle is spent in stage
1. N1.
2. N2.
3. N3.
4. REM.
N2
128
A person has glaucoma. Which pathophysiologic process is occurring in this person?
1. Cloudy or opaque area is located in the lens.
2. Circumscribed defect alters the central field of vision.
3. Intraocular pressure is above normal.
4. Drusen accumulates within the deep retinal layers.
Intraocular pressure is above normal.
129
A person is admitted to the hospital after experiencing delusions. The nurse knows that a delusion
1. is a perception experienced without external sensory stimulation.
2. is a persistent belief that is contrary to the background of the individual.
3. is caused by inadequate acetylcholine in the brain.
4. involves auditory, tactile, visual, gustatory, and olfactory characteristics.
is a persistent belief that is contrary to the background of the individual.
130
```
Which food item would be most appropriate for a person taking a monoamine oxidase inhibitor?
1. Liver
2. Avocados
3. Ham
Raisins
```
ham
131
A patient has excessive and persistent worrying. Which diagnosis will the nurse observe documented on the chart?
1. PTSD
2. Generalized anxiety disorder
3. Agoraphobia
4. Panic disorder
generalized anxiety disorder
132
A person with hypertension and heart failure has edema in the lower legs and sacral area. The nurse suspects this condition is due to a(n)
1. increase in plasma oncotic pressure.
2. decrease in capillary hydrostatic pressure.
3. decrease in lymph obstruction pressure.
4. increase in capillary hydrostatic pressure.
increase in capillary hydrostatic pressure.
133
A person reports severe diarrhea for 2 days. The nurse understands this stimulates a(n)
1. reduction in aldosterone secretion.
2. reduction in renin secretion.
3. increase in antidiuretic hormone secretion.
increase in natriuretic peptide secretion
increase in antidiuretic hormone secretion.
