PATHO 370 Midterm Exam Questions and Answers/West Coast University, Exams of Nursing

Download PATHO 370 Midterm Exam Questions and Answers/West Coast University and more Exams Nursing in PDF only on Docsity! PATHO 370 Midterm Exam Questions and Answers/West Coast University • Question 1 0 out of 0 points Gas exchange occurs in which of the respiratory system's structures? Selected Answer: Trach e a Correct Answer: Alveoli Respons e Feedbac k: The alveoli allow air to come in indirect contact with the bloodstream through the pulmonary capillary system. This alveolar membrane, which is one cell thick, allows carbon dioxide to diffuse into the alveoli from the bloodstream and oxygen to diffuse to the bloodstream from the alveoli. Sinuses are hollow spaces found in the skull. The trachea is a structure that allows passage of gases to and from the gas exchange units (alveoli). Bronchi are branches of the conducting airways that allow passage of gases to and from the gas exchange units (alveoli). • Question 2 0 out of 0 points A patient with heart failure reports awakening intermittently with shortness of breath. Which terms appropriately describes this clinical manifestation? Selected Answer: Dyspnea Correct Answer: Paroxysm al nocturnal Respons e Feedback: Paro xys mal noct urna l dys pne a refe rs to inte rmit tent atta cks of sev ere dys pne a that occ ur duri ng the nigh t. Dys pne a is a gen eral ter m refe rrin g to diffi cult y brea thin g. Cya nosi s is the appearance of a blue or purple coloration of the skin or mucous membranes due to the Correct Answer: Take all the antibiotics ordered even if feeling well after a few days to prevent antibiotic defiant bacteria Respon se Feedbac k : The patient should take all the antibiotics ordered, even if feeling better, to eradicate the moderately resistant microorganisms. Viruses are not impacted by antibacterial medications. Sharing antibiotics indicates that the full course of the medication isn’t being taken, and so contributing to the development of resistant microorganisms. If medication is stopped prematurely, moderately resistant organisms are selected for and become the predominant species, making it more difficult to eradicate next time. • Question 5 0 out of 0 points Cellular hypoxia results in Selected Answer: Failure of the sodium-potassium pump Correct Answer: Failure of the sodium-potassium pump Respons e Feedbac k: Hypoxia is a loss of oxygen to the cell that causes ATP activity to cease. ATP provides the power required to drive the sodium-potassium pump. pH decreases in hypoxia (respiratory acidosis). Hypoxia is a loss of oxygen to the cell that causes ATP activity to cease. Deposits of calcium salts occur in conditions of altered calcium intake, excretion, or metabolism. • Question 6 0 out of 0 points What is the underlying problem common among all types of shock? Selected Answer: Generalized vasodilation Correct Answer: Inadequate cellular Respons e Feedbac k: oxygenation Although each type of shock has specific characteristics, all are associated with a deficiency of cellular oxygen consumption. Inadequate cellular oxygenation may result from decreased cardiac output, maldistribution of blood flow, or reduced blood oxygen content. The impaired oxygen utilization by cells may lead to cell death, organ dysfunction, and stimulation of inflammatory reactions. Cardiac failure can be an outcome, but is not a common cause in all types of shock. Vasodilation occurs in only selective forms of shock. Faulty compensatory mechanisms may contribute to the seriousness of all shocks but that is not the cause of all forms of shock. • Question 7 0 out of 0 points What is the name for the mRNA sequences that contain only the wanted segments? Selected Answer: Pre- mRN A Correct Answer: Exon Respons e Feedbac k: An exon is the mRNA sequence that contains only the wanted segments. Introns are the unwanted areas that are removed in the nucleus by a complex splicing process, thus leaving exons. Pre- mRNA is the original RNA transcript before removal of bases that are unnecessary. Spliceosomes are the areas of the nucleus that are a specialized RNA protein complex that removes introns. • Question 8 0 out of 0 points Thrombosis in the microcirculation throughout the body is called Selected Answer: Disseminated intravascular coagulation (DIC) Correct Answer: Disseminated intravascular coagulation (DIC) Respon se Feedbac k : Thrombosis may also be initiated by a generalized reduction in flow and release of vasoactive substances that occur in shock states. Systemic derangement in coagulation takes place in disseminated intravascular coagulation (DIC), resulting in thrombosis in the microcirculation throughout the body. A stroke results from the obstruction of blood flow in or to the brain by a clot. Atherosclerosis is a circulatory condition that results in the inability of vessels to regulate blood flow as a result of the stiffening of their walls. An MI is a result of obstructed blood flow in a vessel supplying the heart muscle itself. • Question 9 0 out of 0 points Which term is used to identify hypertension that has a specific disease as its cause? Selected Answer: Primary Correct Answer: Second a ry Respons e Feedbac k: Secondary is the term given to hypertension that is secondary to a specific disease. Idiopathic, primary, and essential hypertension are interchangeable terms for hypertension that cannot be related to a specific disease/cause. • Question 10 0 out of 0 points Which statement is true regarding the epithelial system of tissue? Selected Answer: Stratified epithelium is several layers thick. Correct Feedback: sublethal ischemia usually results in cell atrophy. Hypertrophy would result in an increase in cell size in response to increased physiological demand. Hyperplasia would result in an increased number of cells in response to increased physiological demand. Metaplasia is the replacement of one differentiated cell type with another better suited for the situation • Question 13 0 out of 0 points Which diagnostic analysis is used to identify patients with heart failure? (Select all that apply.) Selected Answers: BNP (B-type natriuretic peptide) ANP (atrial natriuretic peptide) Echocardiogram Correct Answers: BNP (B-type natriuretic peptide) Echocardiogram Respons e Feedbac k: Chest x-ray film BNP is a blood test that assists in identifying patients with heart failure. An echocardiogram uses sound waves to create a moving picture of the heart and is used in the diagnosis of heart failure. A chest x-ray is a physical diagnostic test that shows heart structures and is used in the diagnosis of heart failure. Complete blood count (CBC) is a blood analysis used to determine the composition of blood related to amounts of specific cells in a serum sample. The overall effect of ANP on the body is to counter increases in blood pressure and volume caused by the renin-angiotensin system. • Question 14 0 out of 0 points Which statement is true about disseminated intravascular coagulation (DIC)? Selected Answer: It is both a bleeding and clotting disorder. Correct Answer: It is both a bleeding and clotting disorder. Respons e Feedbac k: DIC is both a bleeding and clotting disorder. There are two types, with the chronic type being more prone to thrombotic episodes because the liver and bone marrow are functioning at a higher level and are able to produce more clotting factors and platelets. There is a rise in fibrin split products secondary to the destruction of clots. The fibrinogen level decreases as the body uses it up. • Question 15 0 out of 0 points The role of the circulatory system is to do which of the following? (Select all that apply.) Selected Answers: Transport O2 and nutrients throughout the body Remove waste products found within the body Move blood systemically from the right side of the heart Correct Answers: Transport O2 and nutrients throughout the body Respons e Feedbac k: Remove waste products found within the body The primary functions of the circulatory system include the transportation of O2 and nutrients within the body and the removal of metabolic waste products within the body. Movement of blood through the lungs is via the right side of the heart. Systemic blood flow is supplied by the left side of the heart. Nutrients are absorbed into the blood as it moves through the gastrointestinal tract via splanchnic circulation, and O2 uptake and the release of CO2 occur in the specialized vascular bed of the pulmonary circulation. • Question 16 0 out of 0 points Which statement concerning the location of specific buffers is correct? (Select all that apply.) Selected Answers: Phosphate buffers are found in the intracellular space. Hemoglobin buffers are found inside the erythrocytes. Bicarbonate buffers are found in the extracellular space. Protein buffers are found in the intracellular compartment. Correct Answers: Phosphate buffers are found in the intracellular space. Hemoglobin buffers are found inside the erythrocytes. Bicarbonate buffers are found in the extracellular space. Respons e Feedbac k: Protein buffers are found in the intracellular compartment. Bicarbonate buffers are found in the extracellular space. Phosphate buffers are found in the intracellular space and urine. Hemoglobin buffers are found inside the erythrocytes. Protein buffers are found in the intracellular and vascular compartments. Protein buffers are not found in human urine. • Question 17 the presence of plasma proteins, which result in fluid remaining in the capillary. Most plasma proteins remain in the capillaries because they are such large molecules that they are unable to move easily through the capillary walls. The other options do not correctly define the terms or the processes. • Question 19 0 out of 0 points Which statement(s) are true regarding post-exposure prophylaxis? (Select all that apply.) Selected Answers: All exposed individuals require a protease inhibitor drug regimen. Prophylaxis for a significant exposure should be started immediately. Postexposure medication treatment last at least 4 weeks, or even longer. Correct Answers: Prophylaxis for a significant exposure should be started immediately. Postexposure medication treatment last at least 4 weeks, or even longer. Two or more medications may be included in the medication regimen. Respons e Feedbac k: Exposure, sexual or otherwise, requires similar medication protocols. Significant exposure to HIV- infected blood or body fluids such as a needle stick, require that post- exposure prevention protocol be initiated immediately. The length of administration of the agents depends on multiple factors and may be 4 weeks or longer. Often post- exposure protocols involve the administration of two or three medications. This same protocol has been advocated for use as postsexual exposure prophylaxis. According to the Public Health Service and NIH, the selection of a drug regimen for HIV post-exposure prophylaxis must balance the risk for infection against potential toxicities and side effects of the medication. As such, consultation with an infectious disease provider is often recommended. Treatment usually depends on if the exposure source’s viral status, viral load, or antiretroviral therapy response is known. • Question 20 0 out of 0 points Which condition occurs in the presence of cellular damage? Selected Answer: Sodium and water move into the cell. Correct Answer: Sodium and water move into the cell. Respons e Feedbac k: Cellular injury causes failure of the sodium- potassium pump, resulting in migration of sodium ions into the cell. The accumulation of intracellular sodium creates an osmotic gradient that pulls water into the cell, resulting in hydropic swelling. Cells actually swell, not shrink, as a result of cellular damage. Cellular damage results in the cell’s inability to perform normal metabolic functions owing to insufficient cellular energy in the form of adenosine triphosphate (ATP). Osmotic pressure increases to accommodate for swelling • Question 21 0 out of 0 points A patient has a regular heart rate of 54 beats/min. The nurse would document this rhythm as Selected Answer: Bradycar d ia Correct Answer: Bradycar d ia production Respons e Feedbac k: When the citric acid cycle is inhibited, pyruvate accumulates in the cytoplasm. Pyruvate accumulation would quickly inhibit further glycolysis and shut down ATP production entirely except that it can be converted to a substance called lactate, which diffuses from the cell and into the extracellular fluid. A shift to anaerobic metabolism in shock does not result in metabolic alkalosis, decreased oxygen utilization, or decreased hydrogen ion production. • Question 26 0 out of 0 points What gene is associated with chronic myeloid leukemia (CML)? Selected Answer: bcr - abl Correct Answer: bcr - abl Respons e Feedbac k: The bcr-abl fusion gene is the Philadelphia chromosome and is associated with CML. TP53 is noted to have worse outcomes when associated with acute myeloid leukemia (AML). RB is noted to have worse outcomes when associated with acute myeloid leukemia (AML). BRCA-1 is associated with an increase in breast cancer in women. • Question 27 0 out of 0 points Which term means cause of the disease ? Selected Answer: Etiolo g y Correct Answer: Etiolo g y Respons e Feedbac k: Etiology is the cause or reason for a phenomenon. When the link between an etiologic factor and development of a disease is less than certain, but the probability is lun gs. If a me tab olic aci d beg ins to acc um ulat e in the blo od, the kid ney s incr eas e their acid excretion mechanisms to correct the problem. • Question 31 0 out of 0 points Which electrolyte is essential in ensuring a negative resting membrane potential? Selected Answer: Sodium Correct Answer: Potassi u m Respons e Feedbac k: The major determinant of the resting membrane potential is the difference in potassium ion concentration across the membrane; thus the negative value of the resting membrane potential (RMP) is determined by the ratio of intracellular to extracellular potassium ion concentration. At rest, the membrane is permeable to K+, but not to other positively charged cations, including calcium. At rest, the membrane is permeable to K+, but not to other positively charged cations, including sodium. Magnesium is not involved in the resting membrane potential. • Question 32 0 out of 0 points Anemia of chronic renal failure is caused by the lack of Selected Answer: Erythropoi et in Correct Answer: Erythropoi et in Respons e Feedback: Eryt hro poi etin is secr ete d by the kid ney in res pon se to hyp oxia cau sed by a low he mo glo bin con cen trati on. Eryt hro poie tin stim ulat es the bon e mar row to pro duc e mat ure red blood cells. The tissue of the diseased kidney has difficulty producing this hormone. A lack of adrenaline, thyroid hormone, and parathyroid hormone are not factors in anemia of chronic renal failure. pockets of purulent exudate, called abscesses, must generally be removed or drained for healing to take place. Fibrinous exudate is sticky and thick and may have to be removed to allow healing; otherwise, scar tissue and adhesions may develop. Hemorrhagic exudate has a large component of red blood cells. This type of exudate is usually present with the most severe inflammation. Hemorrhagic exudate occurs with severe leakage from blood vessels or after necrosis or breakdown of blood vessels. • Question 35 0 out of 0 points Which term is used to describe an excess of red blood cells? Selected Answer: Polycyth e mia Correct Answer: Polycyth e mia Respons e Feedbac k: Polycythemia is an excess of red blood cells. Anemia is a deficiency of red blood cells. Pancytopenia is a decrease in red blood cells, white blood cells, and platelets. Granulocytopenia is a decrease in platelets. • Question 36 0 out of 0 points Which statement(s) are true regarding replication of the HIV virus? (Select all that apply.) Selected Answers: HIV viruses that enter the cells must be converted to double-stranded DNA. The DNA is a template copied by the DNA polymerase to make a second DNA strand. The process of HIV replication is responsible for the ineffectiveness of many antiviral drugs. Correct Answers: Accuracy of transcription is poor with multiple mutations. The conversion of the DNA is made by the reverse transcriptase from the viral DNA. The DNA is a template copied by the DNA polymerase to make a second DNA strand. Respons e Feedbac k: The process of HIV replication is responsible for the ineffectiveness of many antiviral drugs. The accuracy of DNA transcription is poor, with mutations occurring frequently. This conversion is made by the reverse transcriptase from the viral RNA. The DNA is a template, and the DNA polymerase copies it to make a second DNA strand and destroys the original RNA strands. Mutations make it difficult for antivirals to work. Once the virus enters the cell, it must be converted to single-, not double-, stranded DNA. The accuracy of DNA transcription is poor, with mutations occurring frequently. • Question 37 0 out of 0 points Bacteria are categorized by which of their following? (Select all that apply.) Selected Answers: Shape Site of infection Reaction to staining Correct Answers: Shape Need for oxygen Reaction to staining • Question 41 0 out of 0 points Tachycardia, decreased or absent breath sounds on the affected side, hyperresonance, and sudden chest pain on the affected side are clinical manifestations of Selected Answer: Sarcoidosis Correct Answer: Pneumoth or ax Respon se Feedbac k : Clinical features of a pneumothorax include tachycardia, decreased or absent breath sounds on the affected side, hyperresonance, and sudden chest pain on the affected side. General symptoms of hypersensitivity pneumonitis may include chills, sweating, shivering, myalgias, nausea, lethargy, headache, and malaise. The patient may or may not have a fever. Respiratory symptoms may include dyspnea at rest, dry cough, tachypnea, and chest discomfort. Physical findings may include cyanosis (a late sign) and crackles (rales) in the lung bases. Sarcoidosis is characterized by malaise, fatigue, weight loss, fever chest discomfort, dyspnea of insidious onset, and a dry, nonproductive cough. The clinical features of ARDS usually include a history of a precipitating event that has led to a low blood volume state ( shock state) 1 or 2 days prior to the onset of respiratory failure. The patient may complain of sudden marked respiratory distress. Early signs and symptoms include a slight increase in pulse rate, dyspnea, and a low PaO2. The initial presenting sign may be shallow, rapid breathing. • Question 42 0 out of 0 points Contraction of vascular smooth muscle (referred to as vasomotor tone) is mostly accomplished via the extrinsic mechanism of the autonomic nervous system, resulting in which receptor response? Selected Answer: α - 1 Correct Answer: α - 1 Respon se Feedbac k : Because arteries have the most smooth muscle, they are most affected by central nervous system stimulation. The release of norepinephrine (the postganglionic neurotransmitter) results in arterial vasoconstriction via the α-1 receptors located on the vascular smooth muscle walls Although β-2 receptors on smooth muscles are affected, they only increase nutrient and oxygen supplies to skeletal muscles via vasodilation, not vasoconstriction, during times of stress. β-1 and α-2 receptor responses are not involved in this scenario. • Question 43 0 out of 0 points For proper pH balance within the human body, what is the ratio of bicarbonate ions to carbonic acid molecules? Selected Answer: 20 bicarbonate ions to 1 carbonic acid molecule Correct Answer: 20 bicarbonate ions to 1 carbonic acid molecule Respons e Feedbac k: The pH of any fluid is determined by the relative amounts of acids and bases contained in it. For the pH of the blood to be within the normal range, the ratio of bicarbonate ions to carbonic acid molecules must be 20:1. The other ratios would not maintain normal pH. • Question 44 0 out of 0 points The laboratory analysis conducted on a child with chronic nasal drainage reveals an elevated number of eosinophils on a white blood cell differential. Based on this finding, which is most likely the cause of the nasal drainage? Forced expiratory volumes decrease. Sp utu m is oft en thi ck, ten aci ou s, sca nt, an d vis cid . Bro nc ho sp as m are ex per ien ce d dur ing ast hm a att ack s. Air be co me s tra pped because of the inflammatory changes that occur so increasing residual lung volume. Forced expiratory volumes decrease during asthma attacks. Tidal does not remain constant during an asthma attack. • Question 46 0 out of 0 points Which condition is an endocrine disorder that causes elevated blood pressure? (Select all that apply.) Selected Answers: Guillain- Barré syndrome Coarctation of the aorta Cushing disease Hyperthyroidism Correct Answers: Cushing disease Respons e Feedbac k: Hyperthyroidism Endocrine disorders that result in hypertension include Cushing disease and hyperthyroidism. While Guillain-Barré syndrome results in hypertension, it is neurologic disorder. While coarctation of the aorta causes high blood pressure, it is a cardiac disorder. While pheochromocytoma causes high blood pressure, it is a tumor of adrenal gland tissue. • Question 47 0 out of 0 points Activation of the renin-angiotensin system in shock causes Selected Answer: Fluid retentio n Correct Answer: Fluid Respons e Feedbac k: retention Renin triggers stimulates kidney nephrons to conserve sodium and water. Renin triggers the formation of angiotensin II, which is a potent vasoconstrictor. Renin triggers stimulates kidney nephrons to conserve not shift sodium. Activation of the renin-angiotensin system does not cause glucogenesis. • Question 48 0 out of 0 points The study of specific characteristics and functions of a living organism and its parts is called Selected Answer: Physiol o gy Correct Answer: Physiol o gy Respons e Feedbac k: Physiology is the study of the mechanical, physical, and biochemical functions of living organisms. Psychiatry is a branch of medicine dealing with mental illness. Homeostasis is a dynamic steady state. Pathophysiology refers to the disorder or breakdown of the human body’s function. • Question 49 0 out of 0 points The normal adult pH in the blood is Selected Answer: Between 7.35 and 7.45 Correct Answer: Between 7.35 and 7.45 Respons e Feedback: : Hypertrophy of mucosal glands and goblet cells leads to increased mucous production; the mucus then combines with purulent exudate to form bronchial plugs. Thickening of bronchial smooth muscle occurs. Hyperventilation is not related to airway obstruction. While infection may be evident, it is not the cause of airway obstruction. • Question 52 0 out of 0 points If the host’s immune system is compromised, resident florae may become pathogenic, resulting in Selected Answer: Opportunist ic infections Correct Answer: Opportunist ic infections Respons e Feedbac k: When normal florae are allowed to overgrow as a result of the compromise of the host’s immune system, infection can result. Salmonella requires the presence of a specific pathogen. Otitis media is not generally considered an opportunistic infection. Myocarditis is not generally considered an opportunistic infection • Question 53 0 out of 0 points Which is true regarding catecholamines? Selected Answer: They include epinephrine and norepinephrine. Correct Answer: They include epinephrine and norepinephrine. Respons e Feedbac k: Catecholamines include epinephrine and norepinephrine. Norepinephrine is secreted from the sympathetic nerves, and epinephrine is secreted from the adrenal medulla. Epinephrine and norepinephrine cannot cross the blood- brain barrier. Epinephrine and norepinephrine cause increased heart rate, blood pressure, and blood flow to skeletal muscles. • Question 54 0 out of 0 points Which lung zone has continuous perfusion throughout the cardiac cycle? Selected Answer: Zon e 1 Correct Answer: Zon e 3 Respons e Feedbac k: Zone 3 has continuous perfusion through the entire cardiac cycle. Pulmonary arterial pressure is greater than pulmonary venous pressure. Zone 1 reflects blood flow through the apices and is minimal. The alveolar pressure is higher than capillary pressure. Zone 2 has pulmonary arterial pressure greater than the pressure inside the alveoli during ventricular systole. Zone 2 has intermittent perfusion. There is no recognized Zone 4. • Question 57 0 out of 0 points Characteristics of allergic purpura lesions include which of the following? (Select all that apply.) Selected Answers: Fever and itching Bleeding from the lesions Lesions located on the face Correct Answers: Fever and itching Respons e Feedbac k: Easily palpated lesions Purpura lesions are itchy and a fever is likely. They are raised and are usually easily felt. Bleeding from the lesions themselves and generalized bleeding are uncommon. The lesions tend to be found on the proximal extremities, especially on the legs and butt ocks . The lesio ns tend to be foun d on the prox imal extr emit ies, esp ecial ly on the legs and butt ocks . • Question 58 0 out of 0 points The vasoactive mediators released in septic shock contribute to increase Selected Answer: Vascular permeabilit y Correct Answer: Vascular permeabilit y Respons e Feedbac k: The kinin system is activated and bradykinin is released, which results in vasodilation and increased capillary permeability. Histamine also increases capillary permeability, which enhances edema formation. Systemic vascular resistance is decreased in septic shock. The complement system is activated with release of C5a and C3a, which can produce microemboli and endothelial cell destruction. The coagulation system is activated and may enhance the development of microemboli. Histamine, a potent vasodilator, is released by mast cells. • Question 59 0 out of 0 points Which statement is true regarding asthma? Selected Answer: It is characterized by airway inflammation. Correct Answer: It is characterized by airway inflammation. Respons e Feedbac k: Asthma is characterized by airway inflammation. There is increased airway responsiveness to stimuli. The resulting airway obstruction is usually reversible. Extrinsic asthma is child-onset asthma. • Question 60 production Decreased platelet survival Hemorrhage Correct Answers: Decreased platelet production Decreased platelet survival Splenic sequestration Respons e Feedbac k: Intravascular dilution In thrombocytopenia, four mechanisms are involved, including the decreased production of platelets, the decreased survival of platelets, the sequestration (pooling) of platelets in the spleen, and intravascular dilution. Hemorrhage is not one of the mechanisms involved in thrombocytopenia. • Question 63 0 out of 0 points Factors released by platelets contribute to hemostasis by enhancing Selected Answer: Intrinsi c pathwa y Correct Answer: Platelet aggregatio n Respons e Feedbac k: Platelets, when activated, release factors that lead to vasoconstriction, platelet clumping, and vessel repair. Vasodilation is not caused by platelet factors. The intrinsic pathway and fibrinolysis are steps in clot formation. • Question 64 0 out of 0 points Which is not one of the recognized components of the general adaptation syndrome? Selected Answer: Allosta s is Correct Answer: Allosta s is Respons e Feedbac k: Allostasis is a dynamic process that supports and helps the body achieve homeostasis. Alarm, resistance, and exhaustion are the three recognized components of Selye’s General Adaptation Syndrome. • Question 65 0 out of 0 points A contributing factor to the formation of an embolus includes which of the following?(Select all that apply.) Selected Answers: Dislodged fat after long-bone surgery Air bolus introduced by IV therapy Foreign object in the blood stream An infected blood vessel Correct Answers: Dislodged fat after long-bone surgery Air bolus introduced by IV therapy Foreign object in the blood stream Respons e Feedbac k: An infected blood vessel Fat emboli can occur after long-bone surgery or trauma. Air introduced into the circulatory system can result in an air embolus. Any foreign body in the circulating in the system can be the cause of an embolus. An infection present in a vessel can trigger an embolus. Chronic blood disorders like anemia are not generally triggers for emboli. • Question 66 0 out of 0 points What is the pathophysiologic phenomenon underlying disseminated intravascular coagulation (DIC)? Selected Answer: Clotting that leads to bleeding Correct Answer: Clotting that leads to bleeding Respons e Feedbac k: DIC is a result of widespread clot formation that consumes platelets and clotting factors, which leaves the patient at risk for serious bleeding. As the result of extensive clotting, platelet and fibrinogen levels are decreased not increased. Inadequate cardiac outcome is the fatal outcome of DIC. Mast cell degranulation is not relevant to DIC. • Question 67 0 out of 0 points Which waves on the ECG is representative of depolarization of the lateral walls? Selected Answer: S wave Correct Answer: S wav e Correct Answer: Prote i n Respons e Feedbac k: Cortisol has an anabolic effect on protein, leading to an increased rate of protein synthesis. Cortisol has a catabolic effect on lymphoid tissue Cortisol has a catabolic effect on muscle tissue. Cortisol has a catabolic effect on skin. • Question 70 0 out of 0 points Which statement is true regarding cancer? (Select all that apply.) Selected Answers: The greater the undifferentiated cell count, the more aggressive the cancer. Malignant tumors have the potential to kill the host. Anaplasia means more differentiated cells. Metastasis means less differentiated cells. Correct Answers: The greater the undifferentiated cell count, the more aggressive the cancer. Respons e Feedbac k: Malignant tumors have the potential to kill the host. The greater the degree of anaplasia, the more aggressive the malignant tumor. Malignant tumors, if left untreated, have the potential to kill. Benign tumors often grow slowly than malignant ones. Anaplasia is a lack of cell differentiation. Metastasis means the invasion of cancer to distant sites. • Question 71 0 out of 0 points Aging adults are more prone to dehydration as a result of lack of thirst triggers resulting from Selected Answer: Decreased osmolality in intracellular fluid Correct Answer: Increased osmolality of extracellular fluid Respons e Feedbac k: As the kidneys age, the tubules become less responsive to antidiuretic hormone (ADH) and tend to lose too much water. The excess water loss is accompanied by a decrease in thirst mechanism. As a result, the elderly person is prone to dehydration. Intracellular fluid status is not related to the thirst triggers. An increase in the osmolality of extracellular fluid would result in a risk for dehydration. • Question 72 0 out of 0 points Which statement about oncogene activation is true? (Select all that apply.) Selected Answers: Oncogenes may be introduced into the host cell by a retrovirus. Proto-oncogenes may undergo a mutation thus becoming overly active. DNA sequences that normally suppress proto- oncogene expression may be inactivated. Correc t An error may occur in the replication of the chromosome such that extra copies are produced. Answers: Oncogenes may be introduced into the host cell by a retrovirus. Proto-oncogenes may undergo a mutation thus becoming overly active. DNA sequences that normally suppress proto- oncogene expression may be inactivated. Respons e Feedbac k: An error may occur in the replication of the chromosome such that extra copies are produced. At least four general ways in which proto- oncogenes can be activated: oncogenes may be introduced into the host cell by a retrovirus, a proto- oncogene within the cell may suffer a mutagenic event that changes its structure and function, a DNA sequence that normally regulates proto- oncogene expression may be damaged or lost, thereby allowing the proto-oncogene to become abnormally active, or an error in chromosome replication may occur and cause extra copies to be produced, which is called amplification. Bacteria do not carry genetic material into the cell genome, but retroviruses may. • Question 73 0 out of 0 points Which is an example of active immunity? (Select all that apply.) Selected Answers: Placental transfer of maternal antibodies Yearly flu vaccination Pneumonia vaccine Breast-feeding Correct Answers: Yearly flu vaccination Respons e Feedbac k: Pneumonia vaccine Vaccinations, such as the yearly flu and pneumonia vaccines, stimulate the host immune system to mount an immune response and produce long-lived memory cells and antibody-secreting cells that provide lasting protection, a process called active immunity. Immunity acquired by the newborn via the placenta or via breast milk and gamma globulin injections are examples of passive immunity in which antibodies produced by one individual are form of carb on dioxi de (CO2 ) and wate r (H2O ). The othe r state ment s do not refle ct effective utilization of carbonic acid (H2CO3) • Question 76 0 out of 0 points The major risk factor for the development of lung cancer is Selected Answer: cigarett e smokin g Correct Answer: cigarett e smokin g Respons e Feedbac k: Tobacco smoking is the major cause (85%) of lung cancer, with approximately 160,000 deaths reported per year. While individuals older than 50 years of age have an increased risk for developing lung cancer; it is not comparable to that of a history of tobacco smoking. A family history that includes non-tobacco use related lung cancer doe have an impact on the risk for developing lung cancer; it is not comparable to that of a history of tobacco smoking. Working under conditions of asbestos exposure increases the risk for developing lung cancer; it is not comparable to that of a history of tobacco smoking. • Question 77 0 out of 0 points In muscle hypertrophy, the hypertrophied cells increase in Selected Answer: Si z e Correct Answer: Si z e Respons e Feedbac k: The cellular response to persistent, sublethal stress reflects the cell’s efforts to adapt. A common adaptive response is hypertrophy resulting in an increase in cell size. Hyperplasia is an increase in cell number. An increase in calcium would be pathological and likely result in tetany. An increase in accumulations would be Respons e Feedbac k: proteins There are two strands of RNA. The gag gene encodes the core antigen proteins. The pol gene encodes reverse transcriptase proteins. The core or nucleocapsid is composed of p24, not p17. The layer between the envelope and core is protein p17, not p24. • Question 80 0 out of 0 points Which terms refers to an increased speed of conduction? Selected Answer: Chronotro p ic Correct Answer: Dromotro pi c Respons e Feedbac k: Dromotropic refers to increased speed of conduction. Inotropic refers to increased contractile force. Chronotropic refers to increased heart rate. Acetylcholine is a neurotransmitter for the nervous system. • Question 81 0 out of 0 points It is true that acute lymphoid leukemia (ALL) is Selected Answer: Primarily diagnosed in children Correct Answer: Primarily diagnosed in children Respons e Feedbac k: ALL is a primarily a disorder occurring in children. All is highly curable in children, less so in adults. Peak incidence is between ages 3 and 7 years of age. A second rise occurs in middle age. • Q u e st io n 8 2 0 out of 0 points What is the marker of choice for detecting a myocardial infarction? Selected Answer: Elevated serum levels of cardiac troponin Correct Answer: Elevated serum levels of cardiac troponin Respons e Feedbac k: Two proteins that make up part of the cardiac cell contractile apparatus, troponins I and T, have become the markers of choice for detecting MI. Cardiac troponin levels become elevated in serum at about the same time as CK-MB, but they remain elevated for a longer period. ST-segment elevation is thought to represent acute cell injury and ischemia. An elevated level of serum CK-MB is a highly specific indicator of MI and considered to be diagnostic. However, CK-MB remains elevated for only 48 to 72 hours after MI. Cardiac myoglobin levels are elevated in serum very quickly after MI and may be helpful in early detection; however, cardiac myoglobin is less specific than the other markers. • Question 83 0 out of 0 points What causes a shift of the oxyhemoglobin curve to the left? (Select all that apply.) Selected Answers: Increased pH Decreased H+ ions Decreased temperatur e Correct Answers: Increased pH Decreased H+ ions Decreased temperatur e Selected Answer: Considered a cause of Burkitt lymphoma Correct Answer: Considered a cause of Burkitt lymphoma Respons e Feedbac k: Research has implicated that the Epstein-Barr virus is a causative factor in both Hodgkin disease and Burkitt lymphoma. Epstein-Barr virus is ubiquitous, with 90% of adults having evidence of previous infection. HIV, not Epstein-Barr, is linked to B-cell lymphoma while B-cell lymphoma, not Epstein-Barr, is linked to HIV. • Question 86 0 out of 0 points Which statement(s) are true regarding hemoglobin? (Select all that apply.) Selected Answers: Oxyhemoglobin is hemoglobin-carrying oxygen. Hemoglobin makes up 90% of dry weight of the red cell. Correc t Polypeptide chains contain iron that makes up a heme molecule. Answers: Oxyhemoglobin is hemoglobin-carrying oxygen. Hemoglobin makes up 90% of dry weight of the red cell. Hemoglobin is composed of 2 pairs of polypeptide chains. Respons e Feedbac k: Polypeptide chains contain iron that makes up a heme molecule. Oxyhemoglobin is hemoglobin that is carrying oxygen molecules. Hemoglobin makes up about 90% of the dry weight of the red blood cell, and is composed of two pairs of polypeptide chains: the globins. Each globin has an attached heme molecule that is composed of iron plus a protoporphyrin molecule. There are 300, not 100, hemoglobin molecules per cell. • Question 87 0 out of 0 points Which is a transport form for CO2 in the blood? (Select all that apply.) Selected Answers: Dissolved gas As a bicarbonate ion Association with hemoglobin (Hgb) Correct Answers: Dissolved gas As a bicarbonate ion Respons e Feedbac k: Association with hemoglobin (Hgb) Carbon dioxide, a by-product of cellular metabolism, is transported in the blood as a dissolved gas, as a bicarbonate ion (HCO 3), and in association with hemoglobin (Hgb). Bivalent molecules are molecules formed from two or more atoms bound together as a single unit molecule. They are not a mechanism for transport of CO2 in the blood. Bone marrow is stimulated by a hormone growth factor called erythropoietin. It is not a mechanism for transport of CO2 in the blood. • Question 88 0 out of 0 points A series of events occur during acute inflammation resulting from cellular injury. Which event occurs initially? Selected Answer: Phagocytosis results in pus formation Correct Answer: Brief constriction of vessel walls Respons e Feedbac k: Immediately after injury, the precapillary arterioles around the injured area contract briefly. When phagocytosis is incomplete, a collection of dead neutrophils, bacteria, and cellular debris, called pus, may form at the site. After edema formation, blood flows through areas of inflammation, causing neutrophils to move to the sides of the blood vessels and roll along the endothelium of the vessel wall. After vessel constrictions, the increased pressure along with increased permeability pushes fluid out of the blood vessels and into the surrounding tissue contributing to local swelling. • Question 89 0 out of 0 points What stimulates the release of renin? (Select all that apply.) Selected Answers: Renal hypoperfusion Parasympathetic activation Decreased sodium delivery Correct Answers: Renal hypoperfusion Sympathetic activation Respons e Feedbac k: Decreased sodium delivery Renal hypoperfusion, sympathetic activation, and decreased sodium delivery stimulate renin release. Increased heart rate and parasympathetic activation do not stimulate the release of renin. • Question 90 0 out of 0 points • Question 92 0 out of 0 points Which retrovirus is believed to cause cancer? (Select all that apply.) Selected Answers: Human immunodeficiency virus (HIV) Epstein-Barr virus Parvovirus Poxvirus Correct Answers: Human immunodeficiency virus (HIV) Human T-lymphocyte virus type I Respons e Feedbac k: Epstein-Barr virus The HIV virus has been associated with Kaposi sarcoma. The human T-lymphocyte virus type I has been associated with T-cell leukemia- lymphoma. The Epstein- Barr virus has been associated with Burkitt lymphoma. Parvovirus results in fifth disease, a rash generally seen in children. Poxvirus is most commonly associated with diseases such as smallpox • Question 93 0 out of 0 points When emphysema is a result of a α1-Antitrypsin disorder, assessment data is likely to include which of the following? (Select all that apply.) Selected Answers: Client age younger than 50 Elevated levels of α1- Antitrypsin Enzyme levels that are below normal Correct Answers: Client age younger than 50 No history of cigarette smoking Respons e Feedbac k: Enzyme levels that are below normal When emphysema occurs in young to middle-aged adults or before the age of 50 in a smoker, it may be associated with a deficiency of α1-antitrypsin activity in the lung. Cigarette smoking is not always a risk factor when this hereditary disorder is present. α1-Antitrypsin deficiency is a hereditary disorder characterized by low serum levels (25 to 50 mg/dl). Research does not currently support race as being a risk factor. α1- Antitrypsin deficiency is a hereditary disorder characterized by low serum levels (25 to 50 mg/dl). • Question 94 0 out of 0 points Acute bronchitis can be caused by which of the following? (Select all that apply.) Selected Answers: Influenza A Coxsackie virus Pseudomonas aeruginosa Staphylococc us pneumoniae Correct Answers: Influenza A Adenovirus Coxsackie virus Staphylococc us 0 out of 0 points When the cause of a disease is due to unintended or unwanted medical treatment, the term to describe this is Selected Answer: Iatroge n ic Correct Answer: Iatroge n ic Respons e Feedbac k: Iatrogenic means that the cause was medical intervention. Genotype refers to the genetic inheritance for a condition. Idiopathic is when the cause of the condition is unknown. Ecogenetics is a struggle between genetic makeup and environment. • Question 99 0 out of 0 points Which is a characteristic of cancer cells? Selected Answer: Poor differentiatio n Correct Answer: Poor differentiatio n Respons e Feedbac k: Cancer cells lose their differentiated features and contribute poorly or not at all to the function of their tissue. Cancer cells divide in an unpredictable manner. Cellular cohesiveness is lacking among cancer cells. Cancer cells do not reproduce uniformly in either size or shape. • Question 100 0 out of 0 points Which enzyme is responsible for rapidly unwinding and separating the DNA strands? Selected Answer: Polymera