Multiple Choice Questions in Clinical Medicine, Exams of Animal Anatomy and Physiology

Download Multiple Choice Questions in Clinical Medicine and more Exams Animal Anatomy and Physiology in PDF only on Docsity! MN551 Final Exam (120 Questions with Verified Answers) Graded A+ A 32-year-old man is complaining of burning, itching, photophobia, and severe pain in his right eye after swimming in the ocean. To determine that the eye condition is corneal rather than a conjunctiva disease, which of the following would be the distinguishing symptom? A.) Burning B.) Itching c.) photophobia D.) Severe pain - Correct answer severe pain A woman with a diagnosis of type 2 diabetes has been ordered by her primary care provider to have a hemoglobin A1C test for the first time. The woman states, "I don't see why you want to test my blood cells when it's sugar that's the problem." What aspect of physiology will underlie the care provider's response to the patient? A.)The amount of glucose attached to A1C cells reflects the average blood glucose levels over the life of the cell. B) Hemoglobin synthesis by the bone marrow is inversely proportionate to blood glucose levels, with low A1C indicating hyperglycemia. C) The high metabolic needs of red cells and their affinity for free glucose indicate the amount of glucose that has been available over 6 to 12 weeks. D) Insulin is a glucose receptor agonist on the hemoglobin molecule, and high glucose suggests low insulin levels. - Correct answer the amount of glucose attached to A1C cells reflects the average blood glucose levels over the life of the cell. A 30 year old man with a diagnosis of type 1 diabetes is aware of the multiple effects that insulin has on his metabolism. Which of the following physiological processes are actions of insulin? - Correct answer facilitating triglycerides from glucose in fat cells A three-year-old girl has just been diagnosed with type 1A diabetes and her parents are currently receiving education from the diabetes education nurse at the hospital where their daughter is receiving treatment. How can the nurse best explain the etiology of their daughter's health problem to her parents? A.) Environmental and lifestyle factors are known to play a part in the fact that her pancreas secretes and withholds insulin at the wrong times." B.) "This tendency to produce insufficient amounts of insulin is likely something that she inherited." C.) "It's not known exactly why your daughter has completely stopped making insulin, and treatment will consist of your rigidly controlling her diet." D.) "The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin - Correct answer "The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin." Which of the following statements best captures an aspect of the role of hormones in the body? A.) Some chemical substances can function as hormones or be integrated with the central and peripheral nervous systems. B) Hormones directly initiate many of the processes that contribute to homeostasis. C) Control of body processes is ensured by the fact that a single hormone can only exert one effect on one specific system or tissue. D) Each hormone that exists in the body is produced by only one specific endocrine gland. - Correct answer some chemical substances can function as either hormones or neurotransmitters. What does a high level of thyroid-stimulating hormone indicate? A.) Thyroid nodule B.) Hyperthyroidism C.) Myxedema D.) Hypothyroidism - Correct answer Hypothyroidism Which of the following statements best captures the role of the adrenal cortex in maintaining homeostasis? Question 1 options: A. Normal sexual function is dependent on adequate adrenal cortical function. B. Redundant, secondary production of adrenal cortical hormones can compensate for the loss of the adrenal glands. C. The adrenal cortical hormones are primarily steroids and sex hormones. Increased white cell count and audible crackles on chest auscultation Coarse, dry skin and hair with decreased sweat production Recent weight gain despite a loss of appetite and chronic fatigue The presence of myxedema in the woman's face and extremities - Correct answer Increased white cell count and audible crackles on chest auscultation A patient with a new diagnosis of an endocrine disorder is unclear about how the body can control the levels of different hormones over time. Which of the following statements most accurately underlies the dominant regulation process of hormone levels in the body? Question 8 options: The pituitary gland is genetically programmed to stimulate and inhibit hormone production and/or release based on needs at different points in the life cycle. The hypothalamus ensures that hormone levels correspond accurately to the diurnal cycle. With input from various sensors, hormone production and release are adjusted based on existing hormone levels. A positive feedback cycle ensures that stable levels of hormones exist in the body over time. - Correct answer with input from various sensors, hormone production and release are adjusted based on existing hormone levels. A care aide at a long-term care facility has informed a resident's nurse practitioner that the 80-year-old woman's eyes appear to be inflamed and her eyelids are caked with sticky secretions. The woman subsequently has been diagnosed with posterior blepharitis. Which of the following treatments is the nurse practitioner likely to initiate? Question 9 options: Intravenous steroids coupled with topical antibiotic ointment Regularly scheduled cleansing of the woman's eyes with normal saline Warm compresses to be applied regularly to her eyes in addition to oral antibiotics Surgical repair of the woman's blocked meibomian glands - Correct answer Warm compresses to be applied regularly to her eyes in addition to oral antibiotics A 28-year-old male who is 6 feet 11 inches tall has a diagnosis of acromegaly. The man is explaining to a curious but sympathetic coworker exactly what accounts for his extraordinary height. Which of the following explanations demonstrates a sound understanding of his health problem? Question 10 options: "A tumor in my brain threw off my hormone levels after I was finished with adolescence." "My pituitary gland produced a much higher than normal amount of growth hormone when I was a child." Tether high sugar levels that go along with my diabetes made my pituitary gland overproduce the hormones that cause you to grow." "My liver is malfunctioning and produces too many of the hormones that ultimately cause growth." - Correct answer "A tumor in my brain threw off my hormone levels after I was finished with adolescence." Following a long history of fatigue, weakness, and poor appetite, a 39-year-old male has been diagnosed with hypopituitarism. Which of the following clinical findings would most likely cause his care team to suspect that the man has an additional endocrine disorder from a different source? Question options: The man displays the signs and symptoms of hypothyroidism. The patient is 5 feet 2 inches tall and was consistently short for his age as a child. The man has a chronic platelet deficiency and is occasionally anemic. The man has a low sperm count and has been unable to have children. - Correct answer the man has a chronic platelet deficiency and is occasionally anemic. A 51-year-old woman has been experiencing signs and symptoms of per menopause and has sought help from her nurse practitioner. Doctors have confirmed a deficiency in estrogen levels as a contributing factor. Which of the following phenomena could potentially underlie the woman's health problem? Question options: A lack of prohormone precursors needed for estrogen synthesis and release Insufficient estrogen production within the smooth endoplasmic reticulum of the relevant cells Inadequate synthesis in the rough endoplasmic reticulum of her ovarian cells Sufficient synthesis of estrogen but inadequate vesicle-mediated release - Correct answer insufficient estrogen production within the smooth endoplasmic reticulum of the relevant cells A patient with a history of an endocrine disorder exhibits signs and symptoms of hormone deficiency. Which of the following processes would the patient's care team most likely rule out first as a contributing factor? Question options: Up-regulation has increased the sensitivity of the body to particular hormone levels. The process of down-regulation has resulted in decreased hormone sensitivity. Hormone production is sufficient, but affinity on the part of the target cells is lacking. The patient's target cells lack sufficient receptors for the hormone in question. - Correct answer Up-regulation has increased the sensitivity of the body to particular hormone levels. A 30-year-old woman has sought care because of her recurrent photophobia, tearing, and eye irritation. During assessment, her care provider asks about any history of cold sores or genital herpes. What is the rationale for the care provider's line of questioning? Question options: A history of HSV with eye irritation is suggestive of glaucoma. Chronic viral infection of the eyes can result in HSV autoinoculation of the mouth and labia. HSV infection of the cornea is a common cause of corneal ulceration and blindness. Herpes simplex virus (HSV) conjunctivitis indicates a need for antiviral rather than antibacterial treatment. - Correct answer HSV infection of the cornea is a common cause of corneal ulceration and blindness. As part of the diagnostic workup for a patient's long-standing vertigo, a clinician wants to gauge the patient's eye movements. Which of the following tests is the clinician most likely to utilize? Question options: Caloric stimulation Electronystagmography (ENG) Rotational tests Recent strenuous physical activity A sharp decrease in blood glucose concentration - Correct answer a decrease in cellular metabolic needs and an increase in glucose levels Which of the following hormones are derivatives of cholesterol? Eicosanoids and retinoid Aldosterone and testosterone Insulin and glucagon Epinephrine and norepinephrine - Correct answer Aldosterone and testosterone An endocrinologist is providing care for a 30-year-old male who has lived with the effects of increased levels of GH. Which of the following teaching points about the patient's future health risks is most accurate? "When your pituitary gland is enlarged, there's a real risk that you'll develop some sight deficiencies. "The high levels of GH that circulate in your body can result in damage to your liver." "GH excess inhibits your pancreas from producing enough insulin." "It's not unusual for unusually high GH levels to cause damage to your hypothalamus." - Correct answer "When your pituitary gland is enlarged, there's a real risk that you'll develop some sight deficiencies. Which of the following measures would likely be rejected as part of a first-line weight loss plan for a patient with a BMI of 30.2, type 2 diabetes, and hypertension? 30 minutes or more of moderate-intensity activity at least 3 days per week Calorie reduction by 500 to 1,000 kcal/day Gastric bypass Prescription drug therapy - Correct answer Gastric bypass A nurse practitioner is providing care for a male patient with a long-standing hiatal hernia. Which of the following statements most accurately captures an aspect of the pathophysiology of hiatal hernias? An incompetent pyloric sphincter and high fat diet are commonly implicated in the development of hiatal hernias. If esophageal acid clearance is impaired, esophagitis can result. The root causes of hiatal hernias are normally treatable with medication. Par esophageal hiatal hernias are common and are normally not treated if the patient is asymptomatic. - Correct answer if esophageal acid clearance is impaired, esophagitis can result. Which of the following patients is most clearly displaying the signs and symptoms of IBD? A 24-year-old man who has a stressful job but whose diarrhea and cramping do not worsen during periods of high stress. A 44-year-old man who is under great financial stress and who states that his lower abdominal pain is much worse at night than during the day. A 51-year-old male who states that his stomach pain is in his lower abdomen, "comes and goes," and "feels more like a cramp than a dull ache." A 32-year-old mother who complains of intermittent abdominal pain that persists even after defecation. - Correct answer a 51-year-old male who states that his stomach pain is in his lower abdomen, "comes and goes," and "feels more like a cramp than a dull ache." While on tour, a 32-year-old male musician has presented to the emergency department of a hospital after a concert complaining of severe and sudden abdominal pain. He admits to a history of copious alcohol use in recent years, and his vital signs include a temperature of 38.8°C (101.8°F), blood pressure of 89/48 mm Hg, and heart rate of 116 beats per minute. Blood work indicates that his serum levels of C-reactive protein, amylase, and lipase are all elevated. Which of the following diagnoses would the care team first suspect? Acute pancreatitis Liver cirrhosis Cholecystitis Hepatitis C - Correct answer acute pancreatitis A 55-year-old man has been diagnosed with a hiatal hernia, in which the function of the lower esophageal sphincter is compromised. Which of the following consequences of this condition is most likely? Inappropriate release of gastric enzymes Protrusion of the stomach or regurgitation of stomach contents into the esophagus Impaired control of the gastric emptying rate Decreased absorption of ingested foods and fluids - Correct answer Protrusion of the stomach or regurgitation of stomach contents into the esophagus The mother of a 19-week-old infant has brought her baby to a nurse practitioner for assessment because of the baby's persistent weight loss and diarrhea. An intestinal biopsy has confirmed a diagnosis of celiac disease, and the child's mother is anxious to know what caused the disease. Which of the following aspects of the etiology of celiac disease would underlie the explanation that the nurse practitioner provides? Inability to process or absorb the fat content of breast milk results in malnutrition and deficiency of fat-soluble vitamins. Neurogenic or muscular inhibition of peristalsis results in inappropriate motility of ingested food in the lower small intestine and the colon. An inappropriate T-cell mediated response results in increased levels of antibodies and an inflammatory response. Bacterial or chemical invasion of the peritoneum leads to decreased nutrient absorption and transport. - Correct answer an inappropriate T-cell mediated response results in increased levels of antibodies and an inflammatory response. A female neonate has been in respiratory distress since delivery and is unresponsive to oxygen therapy. Endoscopy has confirmed a diagnosis of esophageal atresia and tracheoesophageal fistula (EA/TEF). Which of the following explanations should the care team provide to the infant's parents? The priority in our immediate treatment prior to her surgery will be pain management, as the contents of her stomach can burn her lungs." "The biggest risk that will face your daughter until this is fixed is the danger of malnutrition and dehydration." "This problem will require respiratory therapy and supplementary feeding, but it will likely resolve itself over time." "We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally." - Correct answer "We will have to perform surgery to correct the hole in her throat to make sure that she is able to swallow and breathe normally." Pathogenic microorganisms are causing dilation of his small intestine, increasing motility. - Correct answer Inflammation is accompanied by an increase in peristaltic movements of his small intestine. Which of the following patients on a hospital medical unit is most clearly demonstrating the signs and symptoms of liver failure? A 55-year-old man with ascites, fever, and recent onset of atrial fibrillation A 68-year-old female patient with sudden onset of confusion, a history of alcohol abuse, and low levels of serum AST and ALT A 50-year-old woman with blood pressure of 189/103, jaundice, and multiple thrombosis A 44-year-old man with low hemoglobin levels, low platelet levels, and spider animas - Correct answer a 44-year-old man with low hemoglobin levels, low platelet levels, and spider animas As part of the intake protocol at an eating disorders clinic, an interview precedes a physical examination. Which of the following questions would a clinician be justified in excluding from an intake interview for a 16-year-old female referred by her pediatrician for the treatment of anorexia nervosa? "Can you tell me about some of the habits that you have related to food in your daily routine?" "Have you had any episodes of shortness of breath in the recent past?" "Have you noticed any new hair growth on your body in the last several months?" "Do you remember when your last menstrual period was? - Correct answer "Have you had any episodes of shortness of breath in the recent past?" A 29-year-old female has been admitted to the emergency department following a suicide attempt by overdose of acetaminophen. What changes in the patient's liver and diagnostic results would the care team most likely anticipate? Rapid onset of hepatitis and increased GGT, ALT, and bilirubin levels Cholestasis reaction with increased bilirubin count Allergic inflammation accompanied by an increase in serum I.e. and basophils Centrilobular necrosis evidenced by increased ALT and AST levels - Correct answer Centrilobular necrosis evidenced by increased ALT and AST levels After several months of persistent heartburn, a 57-year-old female patient has been diagnosed with gastro esophageal reflux disease (GERD). Which of the following treatment regimens is likely to best address the woman's health problem? Proton pump inhibitors, avoiding large meals, and remaining upright after meals Weight loss and administration of calcium channel blocking medications Antacids, avoiding positions that exacerbate reflux, and a soft-textured diet Surgical correction of the incompetent pylorus - Correct answer Proton pump inhibitors, avoiding large meals, and remaining upright after meals A 51-year-old male professional is in the habit of consuming six to eight rum and cokes each evening after work. He assures the nurse practitioner, who is performing his regular physical exam, that his drinking is under control and does not have negative implications for his work or family life. How could the nurse best respond to the patient's statement? "When your body has to regularly break down that much alcohol, your blood and the functional cells in your liver accumulate a lot of potentially damaging toxic byproducts." "In spite of that, the amount of alcohol you are drinking is likely to result first in cirrhosis and, if you continue, in hepatitis or fatty liver changes." "That may be the case, but you are still creating a high risk of hepatitis A or B or liver cancer." "You are more than likely inflicting damage on your liver, but this damage would cease as soon as you quit drinking. - Correct answer "When your body has to regularly break down that much alcohol, your blood and the functional cells in your liver accumulate a lot of potentially damaging toxic byproducts." A 48-year-old woman has been diagnosed with extra hepatic cholestasis following a thorough history, ultrasound, and blood work. Which of the following symptoms most likely caused her to seek medical treatment, and what consequences of her health problem would the medical team anticipate? Pruritus with consequences of deficient levels of fat-soluble vitamins Skin exanthemas (focal accumulations of cholesterol) with consequences of increased risk of bleeding due to deficient clotting factors Anorexia with consequences of impaired drug metabolism and blood filtration Complaints of lower flank pain with consequences of impaired fat metabolism - Correct answer Pruritus with consequences of deficient levels of fat-soluble vitamins A 43-year-old male patient has presented to the emergency department with vomiting that he claims is of sudden onset. The patient also states that the emesis has often contained frank blood in the hours prior to admission. Which of the following potential contributing factors would the care team first suspect? Effects of Helicobacter pylori Staphylococcal enterotoxins Alcohol consumption Overuse of aspirin - Correct answer Alcohol consumption A 43-year-old male who is 5 feet 10 inches tall and weighs 216 pounds has been informed by his nurse practitioner that his body mass index (BMI) is 31. Which of the following clinical conclusions based on these data would his nurse be most justified in rejecting? The patient is borderline obese but is not yet at the point of significantly increased risks to health. He is classified as being obese, likely as the result of the interplay of genetic and lifestyle factors. The patient faces an increased risk of type 2 diabetes and hyperlipidemia. Further investigation of his nutritional status is needed to supplement the BMI value. - Correct answer the patient is borderline obese but is not yet at the point of significantly increased risks to health. David has an acute exacerbation of Cohn’s disease. Which of the following lab tests would you expect to be decreased? Bilirubin level Vitamins A, B complex and C levels Liver enzyme levels Sedimentation rate - Correct answer Vitamins A, B complex and C levels For several years, a 39-year-old female has been averaging two to three bottles of wine each night after her children go to sleep, and has included several ounces of brandy in recent years as well. Despite negative consequences to her career and the dissolution of her marriage, her drinking continued and now has culminated in a diagnosis of A 24-year-old woman undergoing a premarital screening test is found to have elevated levels of AST, ALT, and Iggy, but no antibody-specific markers for viral hepatitis. A liver biopsy reveals inflammation and cellular damage. Which of the following treatments is most likely to be effective for her? Corticosteroids and immunosuppressant drugs Interferon-alfa-2b Peg interferon and ribavirin Lamivudine - Correct answer Corticosteroids and immunosuppressant drugs A 40-year-old male patient with multiple health problems has been diagnosed with a testosterone deficiency. Which of the following assessment findings would his care provider attribute to an etiology other than this deficiency? Question options: The patient has a low muscle mass as a proportion of total body weight. The patient has a history of susceptibility to upper respiratory infections. The patient has long-standing anemia and low red cell counts. The patient has a voice that is unusually high in pitch. - Correct answer the patient has a history of susceptibility to upper respiratory infections. Which of the following sexually active women most likely faces the highest risk of developing an ectopic pregnancy? Question options: A 22-year-old who has a history of anorexia nervosa and who has a body mass index (BMI) of 12.0 (normal is 18.5 to 24.9). A 27-year-old who stopped using medroxyprogesterone contraceptive injection (Depo- Provera) several months ago A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed A 14-year-old who experienced menarche 2 years prior - Correct answer A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed A 24-year-old woman has presented to an inner-city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginitis. What is the woman's most likely treatment and prognosis? Question options: Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism. Antifungal medications are effective against the anovulation and risk of HIV that accompany the infection. Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease. Abstinence will be required until the infection resolves, since treatments do not yet have proven efficacy. - Correct answer Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease. A 14-year-old boy has been brought to the emergency department by his mother in excruciating pain that is radiating from his scrotum to his inguinal area. The boy's heart rate is 122 beats per minute and he vomited twice before arrival at the hospital. Examination reveals that his scrotum is reddened and slightly swollen and the testes are firm to the touch and tender, with extensive premaster muscle contraction noted. What is the boy's most likely diagnosis? Question options: Varicocele Testicular torsion Hydrocele Epididymitis - Correct answer Testicular torsion Which of the following situations would be considered pathologic in an otherwise healthy 30-year-old female? Question options: The woman's ovaries are not producing progesterone. The epithelium covering the woman's ovaries is broken during the time of ovulation. The woman's ovaries do not synthesize or secrete luteinizing hormone (LH). The woman's ovaries are not producing new ova. - Correct answer the woman's ovaries are not producing progesterone. A 60-year-old woman who is 11 years menopausal has presented to the emergency department stating, "I haven't had my period in years, but lately I've been bleeding again, and quite heavily in the last few days." The care team needs to rule out endometrial cancer. How should they best explain the most accurate plan for confirming or ruling out the diagnosis? Question options: "We can do a Pap smear right now and we will get the results as soon as we can." "We are going to order blood work that will measure your hormone levels." "We're going to have to open your cervix with a speculum and take scrapings from the wall of your uterus." "We're going to book a CT scan for you as soon as possible so that we can see what is inside your uterus." - Correct answer we’re going to have to open your cervix with a speculum and take scrapings from the wall of your uterus." A 66-year-old man has presented to a nurse practitioner to get a refill for his antiplatelet medication. The patient has a history of ischemic heart disease and suffered a myocardial infarction 5 years ago and has unstable angina; he uses a transdermal nitroglycerin patch to control his angina. The patient has a 40-pack-year smoking history and uses nebulized bronchodilators at home for the treatment of transient shortness of breath. He has long-standing hypertension that is treated with a potassium-sparing diuretic and a ß-adrenergic blocking medication. During the nurse's assessment, the man notes that he has been unable to maintain his erection in recent months. Which of the following aspects of the man's health problems and treatments would the nurse identify as NOT being contributing to his erectile dysfunction (ED)? Question options: His age His smoking history His ischemic heart disease His hypertension - Correct answer His use of bronchodilators A 71-year-old man has visited his nurse practitioner for a check-up, during which the nurse practitioner has initiated a discussion about the patient's sexual function. Which of the following phenomena would the nurse practitioner most likely consider a pathological rather than an age-related change? Question options: A decrease in the force of the man's ejaculation Cessation of FSH production Cryptorchidism - Correct answer Epididymitis Having heard positive reports of the benefits of HT from her sister-in-law and friends, a 49-year-old woman has presented to her nurse practitioner asking to start HT. Her uterus is intact and previous bone scans have indicated low bone density. The patient also has a family history of heart disease. She characterizes her symptoms of menopause as "noticeable, but not debilitating by any means." Based on the most current research, what is her nurse practitioner's best course of action? Question options: Begin low-dose HT but perform regular breast cancer screening and heart health checks Forgo HT but consider alternative therapies and reevaluate if her symptoms significantly affect her quality of life Forgo HT in light of her preexisting low bone density and consequent risk of osteoporosis Begin estrogen-progesterone HT (EPT) to prevent future menopausal symptoms and coronary heart disease (CHD) - Correct answer Forgo HT but consider alternative therapies and reevaluate if her symptoms significantly affect her quality of life Following a visit to her campus medical clinic motivated by persistent abdominal pain and dyspareunia, a 20-year-old female college student has been referred for a diagnostic workup to rule out pelvic inflammatory disease. Her elevated white cell and C-reactive protein levels lead her care provider to suspect pelvic inflammatory disease (PID). What follow-up question is most likely to help with the differential diagnosis? Question options: "Have you ever had a therapeutic abortion in the past?" "How many sexual partners have you had?" "What does your daily hygiene routine usually consist of?" "Are you using tampons during your period, or do you normally use pads?" - Correct answer "How many sexual partners have you had?" After a long and frustrating course of constant vaginal pain, a 38-year-old woman has been diagnosed with generalized vulvodynia by her nurse practitioner. What treatment plan is her nurse practitioner most likely to propose? Question options: Narcotic analgesia and no steroidal anti-inflammatory medications Lifestyle modifications aimed at accommodating and managing neuropathic pain Antidepressant and antiepileptic medications Alternative herbal therapies coupled with antifungal medications - Correct answer Antidepressant and antiepileptic medications A couple that has three daughters would like to add a son to their family, and they have recently learned that the woman is pregnant. Which of the following phenomena would most likely be associated with the woman's eventual delivery of a healthy son? Question options: The production of dihydrotestosterone (DHT) by the embryo and DHT's differentiation into testosterone Development of testes under the influence of the X chromosome Suppression of female reproductive structures by antimüllerian hormone (AMH) Atrophy of the wolfing ducts during embryonic development - Correct answer Suppression of female reproductive structures by antimüllerian hormone (AMH) A 51-year-old woman who has been receiving estrogen and progesterone therapy (EPT) for the last 5 years has visited her care provider because her peers have told her about the risks of heart disease, stroke, and breast cancer that could accompany hormone therapy (HT). How should her care provider respond to her concerns? Question options: "There's in fact a slight protective effect against stroke associated with HT, but this is partially offset by increased rates of heart disease and breast cancer." "HT is actually associated with a decrease in heart disease risk, but there is an increase in stroke risk; the breast cancer connection is still unclear." "All things considered, the benefits of HT outweigh the slightly increased risks of heart disease, stroke, or breast cancer." "There is a demonstrable increase in breast cancer risk with HT, but the risk of stroke or heart disease actually goes down slightly." - Correct answer "HT is actually associated with a decrease in heart disease risk, but there is an increase in stroke risk; the breast cancer connection is still unclear." A 40-year-old woman has been found to have a deficiency in estrogen. Which of the following physiological phenomena is most likely to remain unaffected? Question options: The synthesis and release of adrenal glucocorticoids The maintenance of normal skin and blood vessel structure The regulation of uterine endothelial development Parathyroid hormone antagonism and the rate of bone desorption - Correct answer the synthesis and release of adrenal glucocorticoids A 57-year-old woman who has been diagnosed with atrophic vaginitis has expressed her surprise to her care provider, citing a lifetime largely free of gynecological health problems. She has asked what may have contributed to her problem. How can the care provider best respond? Question options: "The exact cause of this problem isn't known, but it can usually be resolved with a diet high in probiotic bacteria." "This type of vaginitis is most commonly a symptom of a latent sexually transmitted infection that you may have contracted in the distant past." "Vaginitis is not usually the direct result of any single problem, but rather an inevitability of the vaginal dryness that accompanies menopause." "The lower levels of estrogen since you've begun menopause make your vagina prone to infection." - Correct answer "The lower levels of estrogen since you've begun menopause make your vagina prone to infection." A newborn male has been diagnosed with hypospadias following his postpartum assessment by a nurse practitioner. Which of the following diagnostics and treatment options is the nurse practitioner most likely to rule out first? Question options: Testosterone supplementation Surgical repair Circumcision Chromosomal studies - Correct answer Circumcision A 20-year-old male has been diagnosed with testicular cancer and is seeking information about his diagnosis from a number of websites. Which of the following statements that he has read is most plausible? Question options: A 13-year-old patient undergoing puberty is alarmed to find small, white bumps surrounding the areolae on her nipples. You reassure her that these are a normal sign of her sexual maturation and tell her that they are which of the following: Question options: Cooper ligaments Montgomery tubercles Bartholdi glands Scene glands - Correct answer Montgomery tubercles Which of the following factors are NOT known to contribute to vaginal yeast infections? Question options: High hormone levels during pregnancy Use of oral contraceptives Recent antibiotic therapy Poorly controlled diabetes' Inflammation of the Scene and Bartholdi glands - Correct answer Inflammation of the Scene and Bartholdi glands Following a spinal cord injury suffered in a motor vehicle accident, a 22-year-old male has lost fine motor function of his finger and thumb, but is still able to perform gross motor movements of his hand and arm. Which of the following components of his white matter has most likely been damaged? Question options: The reticular formation The outer layer (delayer) The middle layer (pale layer) The inner layer (arch layer) - Correct answer the outer layer (delayer) The parents of a 15-year-old boy are frustrated by his persistent inability to fall asleep at a reasonable hour at night, as well as the extreme difficulty that they have in rousing him in the morning. While sleepy after waking, the son claims not to feel drowsy after lunch or in the evening. What is the most likely classification of the boy's sleep disorder? Question options: Chronic insomnia Advanced sleep phase syndrome (ASPS) Non-24-hour sleep-wake syndrome Delayed sleep phase syndrome (DSPS) - Correct answer Delayed sleep phase syndrome (DSPS) A 51-year-old has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which of the following aspects of the patient's history would not be considered to have contributed to his stroke? Question options: History of sickle cell anemia The patient is an African American Male Blood pressure that is normally 120/80 Elevated cholesterol He was diagnosed with type 2 diabetes eight years ago - Correct answer Blood pressure that is normally 120/80 A nurse practitioner is providing care for a 68-year-old female whose anxiety disorder is significantly decreasing her quality of life. Which of the following pharmacologic therapies is most likely to benefit the woman? Question options: An epinephrine and norepinephrine supplement An antipsychotic medication that blocks dopamine receptors A selective serotonin reuptake inhibitor (SSRI) A drug that influences gamma-amino butyric acid (GABA) levels - Correct answer a drug that influences gamma-amino butyric acid (GABA) levels A 17-year-old female is suspected of having narcolepsy. Which of the following aspects of her medical history and sleep analysis would contribute to a confirmation of the diagnosis? Question options: She repeatedly moves her large toe, ankle, and knee during sleep. She complains of a powerful urge to move her legs when in bed at night. She has frequently awakened unable to move or speak. She believes that she experiences auditory hallucinations when she awakens. Her sleep latency is normally around 1 hour. - Correct answer she has frequently awakened unable to move or speak. A patient in the intensive care unit who has a brain tumor has experienced a sharp decline. The care team suspects that water and protein have crossed the blood-brain barrier and been transferred from the vascular space into the patient's interstitial space. Which of the following diagnoses best captures this pathophysiology? Question options: Cacogenic edema Hydrocephalus Cytotoxic edema Focal hypoxia - Correct answer Cacogenic edema The unique clinical presentation of a three-month-old infant in the emergency department leads the care team to suspect botulism. Which of the following assessment questions posed to the parents is likely to be most useful in the differential diagnosis? Question options: "Is there any mold in your home that you know of?" "Has your baby ever been directly exposed to any chemical cleaning products?" "Is there any family history of neuromuscular diseases?" "Have you ever given your child any honey or honey-containing products?" - Correct answer "Have you ever given your child any honey or honey-containing products?" A clinician is conducting an assessment of a male patient suspected of having a disorder of motor function. Which of the following assessment findings would suggest a possible upper motor neuron (UMN) lesion? Question options: The patient displays weakness in the distal portions of his limbs. The patient's muscles appear atrophied. Meissen corpuscles Ruffing end organs Parisian corpuscles - Correct answer Meissen corpuscles A student is feeling inside her backpack to find her mobile phone, which has fallen to the bottom, and there are a number of items in the bag in addition to the phone. Which of the following components of somatosensory conduction is most likely to provide the detailed sensory information that will help her distinguish her phone from other items? Question options: A bilateral, multisynaptic, slow-conducting tract The opposite anterolateral pathway that travels to the reticular activating system A slow-conducting pathway that projects into the intraluminal nuclei of the thalamus The primary dorsal root ganglion neuron, the dorsal column neuron, and the thalamic neuron - Correct answer the primary dorsal root ganglion neuron, the dorsal column neuron, and the thalamic neuron Which of the following factors is most responsible for the fact that prefrontal lobotomy is no longer a common treatment for mental illness? Question options: Loss of communication to and from the prefrontal cortex changes, but ultimately exacerbates, symptoms of mental illness. Severing connections between the brain and its prefrontal areas inhibits problem solving and results in a loss of ambition. Lobotomy inhibits the individual's ability to add perception and meaning to sensory information. Individuals treated by lobotomy have difficulty interpreting somatic, visual, and auditory information. - Correct answer severing connections between the brain and its prefrontal areas inhibits problem solving and results in a loss of ambition. A nurse practitioner is providing care for a 40-year-old male who is experiencing chronic insomnia in recent months while going through a divorce and child custody proceedings. The man is requesting a prescription for "sleeping pills" to help him through this time. Which of the following statements forms a valid basis for the nurse practitioner's plan for treatment? Question options: Behavioral therapies, counseling, and education may be of some use to the patient. Melatonin supplements will be the safest and most effective long-term pharmacological treatment. The man is suffering from primary insomnia. Sedative and hypnotic drugs will not provide safe relief of the man's health problem. - Correct answer Behavioral therapies, counseling, and education may be of some use to the patient. A 70-year-old male has been diagnosed with a stroke that resulted in an infarct to his cerebellum. Which of the following clinical findings would be most closely associated with cerebellar insult? Question options: Unsteady gait and difficulty speaking and swallowing Tremor, rigidity, and bradykinesia Difficulty starting movement, stopping movement, and maintaining rhythmic movement Flaccid loss of muscle tone - Correct answer unsteady gait and difficulty speaking and swallowing A 22-year-old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem? Question options: Excess acetyl cholinesterase production; treatment with thymectomy Cerebellar lesions; surgical and immunosuppressive treatment A shortage of acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulin’s Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids - Correct answer a shortage of acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulin’s A male newborn infant has been diagnosed with spine bifida occult. Which of the following pathophysiologic processes has most likely contributed to the infant's health problem? Question options: The infant's soma and viscera are underdeveloped. The child's central and peripheral nervous systems have insufficiently differentiated during embryonic development. The infant's spinal cord and meninges protrude through his skin. The vertebral arches around his neural tube have failed to completely close. - Correct answer the vertebral arches around his neural tube have failed to completely close. A 44-year-old female has been diagnosed with major depression. Which of the following neuroimaging findings is most congruent with the woman's diagnosis? Question 1 options: Enlargement of the lateral and third ventricles and reduction in frontal and temporal volumes Atrophy and decreased blood flow in the amygdala Reduced activity and gray matter volume in the prefrontal cortex Decreased brain activity in the pons and brain stem - Correct answer Reduced activity and gray matter volume in the prefrontal cortex Which of the following statements most accurately characterizes an aspect of the neurobiology of sleep? Question 2 options: Input from the retinas is interpreted by the cerebellum and contributes to maintenance of the circadian rhythm. The reticular formation, thalamus, and cerebral cortex interact to integrate the sleep- wake cycle. The pituitary releases melatonin at predictable points in the circadian rhythm in order to facilitate sleep. The hypothalamus stimulates the anterior and posterior pituitary to modulate sleeping- waking cycles. - Correct answer the reticular formation, thalamus, and cerebral cortex interact to integrate the sleep-wake cycle. Following a motor vehicle accident three months prior, a 20-year-old female who has been in a coma since her accident has now had her condition declared a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her parents? Question 3 options: