Chapters 15 16 17 18 19 20 21 22 And 23 Flashcards
1
Q
Which pathway carries sensory information toward the central nervous system (CNS)?
A
a. Ascending ***
b. Descending
c. Somatic
d. Efferent
2
Q
Which type of axon transmits a nerve impulse at the highest rate?
A
a. Large nonmyelinated
b. Large myelinated *******
c. Small nonmyelinated
d. Small myelinated
3
Q
Which nerves are capable of regeneration?
A
a. Nerves within the brain and spinal cord
b. Peripheral nerves that are cut or severed
c. Myelinated nerves in the peripheral nervous system *************
d. Unmyelinated nerves of the peripheral nervous system
4
Q
Where is the neurotransmitter, norepinephrine, secreted?
A
a. Somatic nervous system
b. Parasympathetic preganglion
c. Sympathetic postganglion*******
d. Parasympathetic postganglion
5
Q
Both oligodendroglia and Schwann cells share the ability to do what?
A
a. Form a myelin sheath **
b. Remove cellular debris
c. Transport nutrients
d. Line the ventricles
6
Q
During a synapse, what change occurs after the neurotransmitter binds to the receptor?
A
a. The permeability of the presynaptic neuron changes; consequently, its membrane potential is changed as well.
b. The permeability of the postsynaptic neuron changes; consequently, its membrane potential is changed as well. **************
c. The postsynaptic cell prevents any change in permeability and destroys the action potential.
d. The presynaptic cell synthesizes and secretes additional neurotransmitters.
7
Q
What name is given to a large network of neurons within the brainstem that is essential for maintaining wakefulness?
A
a. Midbrain
b. Reticular activating system ***
c. Medulla oblongata
d. Pons
8
Q
Thought and goal-oriented behaviors are functions of which area of the brain?
A
a. Cerebellum
b. Limbic system
c. Prefrontal lobe**
d. Occipital lobe
9
Q
- Where is the region responsible for the motor aspects of speech located?
A
a. Wernicke area in the temporal lobe
b. Broca speech area in the frontal lobe*******
c. Wronka area in the parietal lobe
d. Barlow area in the occipital lobe
10
Q
Parkinson disease is associated with defects in which area of the brain?
A
a. Thalamus
b. Medulla oblongata
c. Cerebellum
d. Substantia nigra****
11
Q
Maintenance of a constant internal environment and the implementation of behavioral patterns are main functions of which area of the brain?
A
a. Thalamus
b. Epithalamus
c. Subthalamus
d. Hypothalamus*******
12
Q
The ability of the eyes to track moving objects through a visual field is primarily a function of which colliculi?
A
a. Inferior
b. Superior *******
c. Mid
d. Posterior
13
Q
What part of the brain mediates the physical expression of emotions?
A
a. Hypothalamus ****
b. Basal ganglia
c. Medulla oblongata
d. Subthalamus
14
Q
Reflex activities concerned with heart rate, blood pressure, respirations, sneezing, swallowing, and coughing are controlled by which area of the brain?
A
a. Pons
b. Midbrain
c. Cerebellum
d. Medulla oblongata **
15
Q
A healthcare professional is assessing a patient who suffered a head trauma. The patient is not able to sense touch of a sharp pin and cannot distinguish a hot object from a cold one. What part of the patient’s brain does the professional suspect is damaged?
A
a. Midbrain
b. Pons **
c. Medulla oblongata
d. Lateral colliculi
16
Q
A healthcare professional is assessing a patient for dysfunction of cranial nerve VII. What assessment finding would confirm the professional’s suspicion?
A
a. Patient is unable to open mouth against resistance.
b. Patient does not display intact gag reflex.
c. Patient is able to smile only on one side of the face.***
d. Patient’s tongue deviates to the right when sticking out.
17
Q
Which area of the brain assumes the responsibility for involuntary muscle control and for maintaining balance and posture?
A
a. Cerebrum
b. Cerebellum*******
c. Diencephalon
d. Brainstem
18
Q
A patient has a spinal cord injury that included damage to the upper motor neurons. What assessment finding would the healthcare provider associate with this injury?
A
a. Permanent paralysis below the level of the injury
b. Initial paralysis, but gradual partial recovery later*******
c. Hemiplegia on the contralateral side of the body
d. Notable increase in the amount of cerebral spinal fluid (CSF)
19
Q
What is the membrane that separates the brain’s cerebellum from its cerebrum?
A
a. Tentorium cerebelli **
b. Falx cerebri
c. Arachnoid membrane
d. Falx cerebelli
20
Q
A patient has a defect in the arachnoid villi. What finding would the healthcare professional expect to note?
A
a. Production of excess cerebrospinal fluid (CSF)
b. Ischemia in the choroid plexuses
c. Cloudy cerebral spinal fluid on analysis
d. Absorption of too little cerebrospinal fluid***
21
Q
Where is the cerebrospinal fluid (CSF) produced?
A
a. Arachnoid villi
b. Choroid plexuses **
c. Ependymal cells
d. Pia mater
22
Q
Which of the meninges closely adheres to the surface of the brain and spinal cord and follows the sulci and fissures?
A
a. Dura mater
b. Arachnoid
c. Pia mater***
d. Inner dura
23
Q
Norepinephrine produces what primary response?
A
a. Increased contractility of the heart
b. Release of renin from the kidney
c. Vasoconstriction ***
d. Sleep cycle disturbance
24
Q
A patient is brought to the Emergency Department after being in an explosion. The patient was not seriously injured. Laboratory testing shows an elevated blood glucose (sugar) level, but the patient does not have diabetes. What does the healthcare professional tell the patient about this condition?
A
a. “You should have a physical by your primary care provider.”
b. “Your blood sugar may be high because of the stress of the situation.”******
c. “You actually may have undiagnosed diabetes mellitus.”
d. “You should be tested for underlying neurological problems.”
25
The brain receives approximately what percentage of the cardiac output?
a. 80%
b. 40%
c. 20%per minute ***********
d. 10%
26
What is the collateral blood flow to the brain provided by?
a. Carotid arteries
b. Basilar artery
c. Circle of Willis*******
d. Vertebral arteries
27
The nurse recognizes that a patient’s diagnosis of a bacterial infection of the brain’s meningeal layer is supported by which diagnostic laboratory result?
a. Chloride 125 mEq/L
b. Leukocytes 110/mm3 ********
c. Protein 32 mg/dL
d. Glucose 63 mg/dL
28
1. Pricking one’s finger with a needle would cause minimal pain, whereas experiencing abdominal surgery would produce more pain. This distinction is an example of which pain theory?
a. Gate control theory
b. Intensity theory
c. Specificity theory *********
d. Pattern theory
29
Which pain theory proposes that a balance of impulses conducted from the spinal cord to the higher centers in the central nervous system (CNS) modulates the transmission of pain?
a. Gate control theory (GCT) *********
b. Pattern theory
c. Specificity theory
d. Neuromatrix theory
30
Which type of nerve fibers transmits pain impulses?
a. A-alpha (Aa) fibers
b. A-beta (AB) fibers
c. A-delta (Ab) fibers*********
d. B fibers
31
Where are the primary-order pain-transmitting neurons located within the spinal cord?
a. Lateral root ganglia
b. Dorsal root ganglia*******
c. Anterior root ganglia
d. Medial root ganglia
32
Where is the gate in the gate control theory (GCT) of pain located?
a. Substantia gelatinosa**********
b. Marginal layer
c. Nucleus proprius
d. Dorsolateral tract of Lissauer
33
Which spinal tract carries the most nociceptive information?
a. Archeospinothalamic
b. Paleospinothalamic
c. Dorsal spinothalamic
d. Lateral spinothalamic*********
34
Where is the major relay station of sensory information located?
a. Basal ganglia
b. Midbrain
c. Thalamus*******
d. Hypothalamus
35
Where in the CNS does a person’s learned pain response occur?
a. Cerebral cortex *********
b. Frontal lobe
c. Thalamus
d. Limbic system
36
Massage therapy relieves pain by closing the pain gate with the stimulation which fibers?
a. AB***********
b. A8
c. B
d. C
37
What part of the brain provides the emotional response to pain?
a. Limbic system ************
b. Parietal lobe
c. Thalamus
d. Hypothalamus
38
Which endogenous opioid is located in the hypothalamus and pituitary and is a strong -receptor agonist?
a. Enkephalins
b. Endorphins*******
c. Dynorphins
d. Endomorphins
39
The healthcare professor states that a patient has reached pain tolerance. What further information from the professor is most accurate?
a. “The patient cannot endure a higher level of pain intensity at this point.” *******************
b. “The patient’s pain tolerance is much lower because of consuming too much alcohol.”
c. “The patient’s pain in one place is higher because pain in multiple other sites.”
d. “The patient now recognizes what is being felt is actually pain.”
40
Pain that warns of actual or impending tissue injury is referred to as what?
a. Chronic
b. Psychogenic
c. Acute************
d. Phantom
41
A patient’s chart describes visceral pain. What does the healthcare professional understand about this term?
a. Is sharp and well-defined when transmitted by A-delta (A8) fibers
b. Is perceived as poorly localized and is transmitted by the sympathetic nervous system***************
c. Arises from connective tissue, muscle, bone, or skin
d. Is perceived as dull, aching, and poorly localized when transmitted by C fibers
42
A healthcare professional is caring for a person who has experienced pain for 3 days. What signs would the professional note if the patient has anxiety in addition to the pain
a. Fever and muscle weakness or reports of fatigue
b. Irritability and depression or reports of constipation
c. Decreased blood pressure or reports of fatigue
d. Increased heart rate and respiratory rate with diaphoresis************************************
43
Enkephalins and endorphins act to relieve pain by which process?
a. Inhibiting cells in the substantia gelatinosa
b. Stimulating the descending efferent nerve fibers
c. Attaching to opiate receptor sites *********
d. Blocking transduction of nociceptors
44
A healthcare professional is caring for a patient who was rewarmed after suffering from hypothermia. What possible long-term complication will the professional continue to assess the patient for?
a. Acidosis
b. Dysrhythmias
c. Shock
d. Renal failure*******
45
How does the release (increase) of epinephrine raise body temperature?
a. The release of epinephrine causes shivering.
b. It affects muscle tone.
c. It raises the metabolic rate. **********
d. It increases and strengthens the heart rate.
46
A healthcare professional is trying to lower a patient’s body temperature by convection. What action by the professional will accomplish this?
a. Lower the temperature in the patient’s room.
b. Place the patient in a cooling blanket.
c. Obtain a fan and set it to blow over the patient. ********
d. Place cold moist towels over the patient.
47
A healthcare professional is working in a health tent at a marathon. A person enters the tent and reports profuse sweating for the last hour. How much fluid does the healthcare professional advise the person to drink to replace this fluid loss?
a. 2 L*********
b. 4 cups
c. 6 L
d. 8 cups
48
The healthcare professional working in a summer camp provides cooling to campers by radiation. What is the most appropriate action by the professional to accomplish this?
a. Have the campers sit inside the air-conditioned camp cafeteria.*********
b. Have the campers sit in front of a large fan.
c. Tell the campers to take cool showers.
d. Instruct the campers to lie still for an hour.
49
A patient has been exposed to prolonged high environmental temperatures and now shows signs of dehydration, decreased plasma volumes, hypotension, decreased cardiac output, and tachycardia. What treatment does the healthcare professional prepare to administer to this patient?
a. Administer salty beverages to the patient.
b. Aggressive cooling methods to rapidly lower temperature
c. Encourage the patient to have genetic testing after recovery.
d. Give the patient plenty of cool fluids to drink.*********
50
In acute hypothermia, what physiologic change shunts blood away from the colder skin to the body core in an effort to decrease heat loss?
a. Hypotension
b. Peripheral vasoconstriction*********
c. Voluntary muscle movements
d. Shivering
51
A patient is in the Emergency Department with heat stroke. What finding does the healthcare provider associate with this condition?
a. Core temperatures usually reaching approximately 39.5C (103.1F)
b. Absence of sweating despite a high core temperature******
c. A rapidly decreasing core temperature as heat loss from the evaporation of sweat ceases
d. Symptoms caused by the loss of sodium and prolonged sweating
52
The major sleep center is located in which section of the brain?
a. Thalamus
b. Cerebellum
c. Frontal lobe
d. Hypothalamus ********
53
Which neuropeptide dysfunction is linked to narcolepsy?
a. Prostaglandin D2
b. L-tryptophan
c. Hypocretins ********
d. Growth factors
54
Which term is also used to refer to paradoxical sleep?
a. Non-REM
b. Light
c. REM *********
d. Delta wave
55
Parents of a child report that the child wakes up from sleep expressing intense anxiety. What disorder does the healthcare professional educate the parents about?
a. Night terrors********
b. Insomnia
c. Somnambulism
d. Enuresis
56
Rapid eye movement (REM) sleep occurs in cycles approximately how often?
a. 45 minutes
b. 90 minutes*********
c. 120 minutes
d. 150 minutes
57
A patient reports loud snoring, fragmented sleep, chronic daytime sleepiness, and fatigue. What treatment does the healthcare professional anticipate teaching this patient about?
a. Continuous positive airway pressure while sleeping ********
b. Eventual adenotonsillectomy
c. Occupational assessment for safety
d. Administration of nightly gabapentin
58
What are the expected changes in sleep patterns of older adults?
a. Older adults experience difficulty falling asleep with less time spent in REM sleep. ************
b. They experience sound sleep during the night with approximately 50% of the time spent in REM sleep and dreaming.
c. Older men commonly experience interrupted sleep patterns later in life than do older women.
d. Older adults awaken often but with a rapid return to sleep; they awaken refreshed but often later in the morning.
59
A parent reports that her child has reddened eyes with purulent drainage. What instruction by the healthcare professional is most appropriate?
a. Give the child soothing saline eyedrops.
b. Tell the child not to go outside during recess.
c. Have the child wear well-fitting sunglasses.
d. Use a separate towel for this child only.*********
60
Why does open-angle glaucoma occur?
a. Decreased production of aqueous humor
b. Increased production of vitreous humor
c. Obstructed outflow of aqueous humor *********
d. Excessive destruction of vitreous humor
61
How can glaucoma cause blindness?
a. Infection of the cornea
b. Pressure on the optic nerve*********
c. Opacity of the lens
d. Obstruction of the venous return from the retina
62
When comparing the effects of acute and chronic pain on an individual, chronic pain is more often what?
a. The external event that results in a sense of fear
b. Viewed as being meaningful but undesirable
c. A factor that contributes to depression********
d. A sense of internal unease
63
When considering the risk factors for the development of phantom limb pain, the nurse recognizes which as a primary contributing factor?
a. Age, with adolescent patients being at a higher risk than adults
b. Presence of pain in the limb before amputation*********
c. Patient’s previous experience with managing pain
d. Cultural views regarding the acceptance of pain
64
A healthcare professional is caring for four postsurgical patients. Based on an understanding of the physiologic process of nociceptors, the nurse expects to give more pain medication to which patient?
a. Repair of several crushed fingers ************
b. Dislocated shoulder replacement
c. Cyst removal on the internal surface of an ovary
d. Repair of a ruptured spleen
65
What is the basis of the specificity theory of pain?
a. Injury to specific organs results in specific types of pain.
b. Chronic pain is generally less intense than acute pain. c. The greater the tissue injury, the greater the pain. *******
d. Acute pain is specific only to certain injuries.
66
Which statement is true regarding the gate control theory (GCT) of pain?
a. The pain gate is located in the brain.
b. A closed gate increases pain perception.
c. The brain primarily controls the pain gate.
d. An open gate facilitates the brain in processing the pain. ************
67
Cognitive operations cannot occur without the effective functioning of what part of the brain?
a. Pons
b. Medulla oblongata
c. Reticular activating system*********
d. Cingulate gyrus
68
Which intracerebral disease process is capable of producing diffuse dysfunction?
a. Closed-head trauma with bleeding
b. Subdural pus collections
c. Neoplasm
d. Embolic infarct*********
69
What is the most common infratentorial brain disease process that results in the direct destruction of the reticulating activation system (RAS)?
a. Cerebrovascular disease********
b. Demyelinating disease
c. Neoplasms
d. Abscesses
70
What stimulus causes posthyperventilation apnea (PHVA)?
a. Changes in PaO2 levels
b. Changes in PaCO2 levels********
c. Damage to the forebrain
d. Any arrhythmic breathing pattern
71
A healthcare professional reads in the patient’s chart and notes the patient has Cheyne-Stokes respirations. What clinical finding would the professional correlate with this condition?
a. Sustained deep rapid but regular pattern of breathing b. Crescendo-decrescendo pattern of breathing, followed by a period of apnea*************
c. Prolonged pause after the inspiratory period with occasional end-expiratory pause
d. Completely random, irregular breathing pattern with pauses
72
Vomiting is associated with central nervous system (CNS) injuries that compress which of the brain’s anatomic locations?
a. Vestibular nuclei in the lower brainstem********
b. Floor of the third ventricle
c. Any area in the midbrain
d. Diencephalon
73
Which midbrain dysfunction causes pupils to be pinpoint size and fixed in position?
a. Diencephalon dysfunction
b. Oculomotor cranial nerve dysfunction
c. Dysfunction of the tectum
d. Pontine dysfunction**********
74
A healthcare professional suspects a patient is brain dead. How would the professional assess for brain death?
a. Determine if the patient can make voluntary movements.
b. Perform tests to assess if the patient is in a coma.
c. Remove the patient’s ventilator to see if spontaneous breathing occurs. *************
d. Monitor the patient for eye movements that seem purposeful.
75
A patient has damage to the lower pons and medulla. What finding does the healthcare professional associate with this injury?
a. Flexion with or without extensor response of the lower extremities
b. Extension response of the upper and lower extremities
c. Extension response of the upper extremities and flexion response of the lower extremities
d. Flaccid response in the upper and lower extremities *******************************************************************
76
Which hospitalized patient does the healthcare professional assess as a priority for the development of delirium?
a. An individual with diabetes celebrating a 70th birthday
b. A depressed Hispanic woman
c. An elderly male on the second day after hip replacement ************
d. A man diagnosed with schizophrenia
77
A patient suffered a seizure for the first time. The spouse asks the healthcare professional to explain what a seizure is. What response by the professional is best?
a. Actions that occur without conscious thought because of a stimulus
b. A sudden, explosive, disorderly discharge of brain cells *************
c. A disease where a person has frequent seizures like this one
d. A series of excessive, purposeless movements.
78
A patient had a seizure that consisted of impaired consciousness and the appearance of a dreamlike state. How does the healthcare professional chart this episode?
a. Focal seizure
b. Complex focal seizure********
c. Tonic-clonic seizure
d. Atonic seizure
79
A patient is in status epilepticus. In addition to giving medication to stop the seizures, what would the healthcare professional place highest priority on?
a. Facilitating a CT scan of the head
b. Providing oxygen *********
c. Assessing for brain death
d. Assessing for drug overdose
80
What is the most critical aspect in correctly diagnosing a seizure disorder and establishing its cause?
a. Computed tomographic (CT) scan
b. Cerebrospinal fluid analysis
c. Skull x-ray studies
d. Health history *********
81
What area of the brain mediates the executive attention functions?
a. Limbic
b. Prefrontal *********
c. Parietal
d. Occipital
82
A healthcare professional is caring for a patient diagnosed with aphasia. What action by the professional would be best in working with this patient?
a. Provide physical therapy.
b. Provide speech therapy. *********
c. Provide special thickened foods.
d. Provide balance activities.
83
A patient’s chart notes receptive aphasia. What does the healthcare professional understand about this patient’s abilities related to speech?
a. Speak in made up words.
b. Produce verbal speech, but not comprehend language.***************
c. Comprehend speech, but not verbally respond.
d. Neither respond verbally nor comprehend speech.
84
The healthcare professional notes that the patient’s intracranial pressure is 12 mmHg. What action should the professional take?
a. Do nothing; this is a normal finding.***********
b. Give medications to immediately lower the pressure.
c. Give medication to immediately raise the pressure.
d. Repeat the reading because the first one was inaccurate.
85
Cerebral edema is an increase in the fluid content of what part of the brain?
a. Ventricles
b. Tissue *********
c. Neurons
d. Meninges
86
What type of cerebral edema occurs when permeability of the capillary endothelium increases after injury to the vascular structure?
a. Cytotoxic
b. Interstitial
c. Vasogenic ********
d. Ischemic
87
What is a communicating hydrocephalus caused by an impairment of?
a. Cerebrospinal fluid flow between the ventricles
b. Cerebrospinal fluid flow into the subarachnoid space c. Blood flow to the arachnoid villi
d. Absorption of cerebrospinal fluid ************
88
Which dyskinesia involves involuntary movements of the face, trunk, and extremities?
a. Paroxysmal
b. Tardive ************
c. Hyperkinesia
d. Cardive
89
Antipsychotic drugs cause tardive dyskinesia by mimicking the effects of an increase of what?
a. Dopamine*******
b. Gamma-aminobutyric acid
c. Norepinephrine
d. Acetylcholine
90
The existence of regular, deep, and rapid respirations after a severe closed head injury is indicative of neurologic injury to what?
a. Lower midbrain********
b. Pontine area
c. Supratentorial
d. Cerebral area
91
What type of posturing exists when a person with a severe closed head injury has all four extremities in rigid extension with the forearms in hyperpronation and the legs in plantar extension
a. Decorticate
b. Decerebrate********
c. Spastic
d. Cerebellar
92
After a cerebrovascular accident, a patient has been diagnosed with anosognosia. What action by the healthcare professional would be most helpful?
a. Provide a white board for the patient to write on.
b. Ensure the patient has a safe environment.********
c. Provide physical therapy for strengthening exercises. d. Practice naming colors using flash cards.
93
After a cerebrovascular accident, a man is unable to either feel or identify a comb with his eyes closed. What is this an example of?
a. Agraphia
b. Tactile agnosia**********
c. Anosognosia
d. Prosopagnosia
94
Most aphasias are associated with cerebrovascular accidents involving which artery?
a. Anterior communicating
b. Posterior communicating
c. Circle of Willis
d. Middle cerebral**************
95
A healthcare professional reads in a patient’s chart that the patient shows behaviors suggestive of neurofibrillary tangles. What information does the healthcare professional plan to provide the spouse?
a. The patient will probably develop seizures.
b. The patient will lose all motor function.
c. The patient will have a gradual decline in function. *********
d. The patient’s intracranial pressure will rise.
96
The body compensates for a rise in intracranial pressure by first displacing what?
a. Cerebrospinal fluid ***********
b. Arterial blood
c. Venous blood
d. Cerebral cells
97
A patient is in the intensive care unit and has intercranial pressure (ICP) monitoring. The patient’s ICP is 17 mmHg. The healthcare professional notes that the chart indicates the patient is now in stage 1 intracranial hypertension. What assessment finding does the professional associate with this condition?
a. Rapid spike in measured ICP
b. No significant change in ICP readings*********
c. Restlessness and subtle breathing and pupil changes
d. A widened pulse pressure and bradycardia
98
Dilation of the ipsilateral pupil following uncal herniation is the result of pressure on which cranial nerve (CN)?
a. Optic (CN I)
b. Abducens (CN VI)
c. Oculomotor (CN III)*********
d. Trochlear (CN IV)
99
To quickly assess a patient’s nervous system for dysfunction, what assessment should the healthcare professional perform as the priority?
a. Size and reactivity of pupils
b. Pattern of breathing
c. Motor response
d. Level of consciousness ************
100
What does diagnostic criteria for a persistent vegetative state include?
a. Absence of eye opening
b. Lack of subcortical responses to pain stimuli
c. Roving eye movements with visual tracking
d. Return of autonomic functions********
101
When does uncal herniation occur?
a. The hippocampal gyrus shifts from the middle fossa through the tentorial notch into the posterior fossa.**********
b. The diencephalon shifts from the middle fossa straight downward through the tentorial notch into the posterior fossa.
c. The cingulate gyrus shifts under the falx cerebri.
d. A cerebellar tonsil shifts through the foramen magnum.
102
Which assessment finding marks the end of spinal shock?
a. Return of blood pressure and heart rate to normal
b. Gradual return of spinal reflexes**********
c. Return of bowel and bladder function
d. Evidence of diminished deep tendon reflexes and flaccid paralysis
103
A patient demonstrates rippling under the skin on the arms. The patient’s spouse asks the healthcare professional to explain why this occurs. What response by the professional is most accurate?
a. Loss of temperature regulation in distal, proximal, or midline muscles
b. Atrophy of primary motor neurons **********
c. Loss of sensation leading to flaccid paralysis
d. Spastic movements due to increased deep tendon reflexes
104
A patient has finally been diagnosed with amyotrophic lateral sclerosis (ALS) after seeing several physicians. The patient expresses frustration that the diagnosis has taken so long. What information can the healthcare professional give to the patient about this situation?
a. Many diseases cause weakness and fatigue.
b. Only upper motor neurons are involved.
c. Several nerves are connected to each muscle. *******
d. Lack of sensation makes it hard to describe.
105
Parkinson disease is a degenerative disorder of which part of the brain?
a. Hypothalamus
b. Anterior pituitary
c. Frontal lobe
d. Basal ganglia*******
106
Clinical manifestations of Parkinson disease are caused by a deficit in which of the brain’s neurotransmitters?
a. Gamma-aminobutyric acid
b. Dopamine *********
c. Norepinephrine
d. Acetylcholine
107
Tremors at rest, rigidity, akinesia, and postural abnormalities are a result of the atrophy of neurons in which part of the brain?
a. Caudate that produces serotonin
b. Putamen that produces gamma-aminobutyric acid
c. Substantia nigra that produces dopamine********
d. Hypothalamus that produces acetylcholine
108
1. What do diffuse axonal injuries (DAIs) of the brain often result in?
a. Reduced levels of consciousness********
b. Mild but permanent dysfunction
c. Fine motor tremors
d. Visual disturbances
109
2. What event is most likely to occur when a person experiences a closed head injury?
a. Brief period of vital sign instability ***********
b. Cerebral edema throughout the cerebral cortex
c. Cerebral edema throughout the diencephalon
d. Disruption of axons extending from the diencephalon and brainstem
110
A healthcare professional wants to volunteer for a community education project to help prevent spinal cord injury. What activity would the professional most likely volunteer for?
a. Teaching school aged children bicycle safety
b. Teaching stretching to high school athletes
c. Teaching adults good body mechanics for lifting
d. Teaching older adults how to prevent trip-and-fall events **********
111
A patient has a spinal cord injury at C4. What should the healthcare professional assess as the priority in this patient?
a. Blood pressure
b. Respirations *********
c. Pulse
d. Temperature
112
What indicates that spinal shock is terminating?
a. Voluntary movement below the level of injury
b. Reflex emptying of the bladder*******
c. Paresthesia below the level of injury
d. Decreased deep tendon reflexes and flaccid paralysis
113
A healthcare professional is caring for a patient who has a spinal cord injury at T5. The patient exhibits severe hypertension, a heart rate of 32 beats/min, and sweating above the spinal cord lesion. How does the professional chart this event?
a. Craniosacral dysreflexia
b. Parasympathetic dysreflexia
c. Autonomic hyperreflexia *******
d. Retrograde hyperreflexia
114
Why does a person who has a spinal cord injury experience faulty control of sweating?
A. The hypothalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system.*********
b. The thalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system.
c. The hypothalamus is unable to regulate body heat as a result of damage to the parasympathetic nervous system.
d. The thalamus is unable to regulate body heat as a result of damage to spinal nerve roots.
115
Autonomic hyperreflexia-induced bradycardia is a result of stimulation of what?
a. Sympathetic nervous system to B.-adrenergic receptors to the sinoatrial node
B. Carotid sinus to the vagus nerve to the sinoatrial node*****
c. Parasympathetic nervous system to the glossopharyngeal nerve to the atrioventricular node
d. Bundle branches to the -adrenergic receptors to the sinoatrial node
116
A herniation of which disk will likely result in motor and sensory changes of the lateral lower legs and soles of the feet?
a. L2 to L3
b. L3 to L5
c. L5 to S1 *******
d. S2 to S3
117
A healthcare professional is planning a community event to reduce risk of cerebrovascular accident (CVA) in high risk groups. Which group would the professional target as the priority?
a. Insulin-resistant diabetes mellitus
b. Hypertension *********
c. Polycythemia
d. Smoking
118
A right hemisphere embolic CVA has resulted in left-sided paralysis and reduced sensation of the left foot and leg. Which cerebral artery is most likely affected by the emboli?
a. Middle cerebral
b. Vertebral
c. Posterior cerebral
d. Anterior cerebral*****
119
Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?
a. Hemorrhagic
b. Thrombotic
c. Embolic ******
d. Lacunar
120
Microinfarcts resulting in pure motor or pure sensory deficits are the result of which type of stroke?
a. Embolic
b. Hemorrhagic
c. Lacunar *******
d. Thrombotic
121
Which vascular malformation is characterized by arteries that feed directly into veins through vascular tangles of abnormal vessels?
a. Cavernous angioma
b. Capillary telangiectasia
c. Arteriovenous angioma
d. Arteriovenous malformation ********
122
Which clinical finding is considered a diagnostic indicator for an arteriovenous malformation (AVM)?
a. Systolic bruit over the carotid artery*******
b. Decreased level of consciousness
c. Hypertension with bradycardia
d. Diastolic bruit over the temporal artery
123
Which cerebral vascular hemorrhage causes meningeal irritation, photophobia, and positive Kernig and Brudzinski signs?
a. Intracranial
b. Subarachnoid*******
c. Epidural
d. Subdural
124
In adults, how are most intracranial tumors located?
a. Infratentorially
b. Supratentorially*****
c. Laterally
d. Posterolaterally
125
In children, how are most intracranial tumors located?
a. Infratentorially******
b. Supratentorially
c. Laterally
d. Posterolaterally
126
What is the most common primary central nervous system (CNS) tumor?
a. Microglioma
b. Neuroblastoma
c. Astrocytoma *******
d. Neuroma
127
A person has been diagnosed with multiple sclerosis and asks the healthcare professional to explain the disease. What description by the professional is most accurate?
a. Myelination of nerve fibers in the peripheral nervous system (PNS)
B. Demyelination of nerve fibers in the CNS*****
c. Development of neurofibrillary tangles in the CNS
d. Inherited autosomal dominant trait with high penetrance
128
A blunt-force injury to the forehead would result in a coup injury to which region of the brain?
a. Frontal *********
b. Temporal
c. Parietal
d. Occipital
129
A blunt-force injury to the forehead would result in a contrecoup injury to which region of the brain?
a. Frontal
b. Temporal
c. Parietal
d. Occipital *********
130
Spinal cord injuries occur most frequently in which region?
a. Cervical and thoracic
b. Thoracic and lumbar
c. Lumbar and sacral
d. Cervical and thoracic lumbar********
131
A patient who sustained a cervical spinal cord injury 2 days ago suddenly develops severe headache and blurred vision. What should the healthcare professional do?
a. Give the patient a glass of cool water.
b. Give the patient some pain medication.
c. Take the patient’s blood pressure and pulse.******
d. Facilitate the patient having a head CT scan.
132
What is the type of vascular malformation that most often results in hemorrhage?
a. Cavernous angioma
b. Venous angioma
c. Capillary telangiectasia
d. Arteriovenous malformation **********
133
Where are atheromatous plaques most commonly found?
a. In larger veins
b. Near capillary sphincters
c. At branches of arteries ************
d. On the venous sinuses
134
A patient has AIDS and reports fever, clumsiness, difficulty with balance and walking, and trouble speaking. What treatment does the healthcare professional educate the patient about?
a. Radiation therapy
b. Chemotherapy
c. Oral pyrimethamine********
d. Surgery
135
A patient has been hospitalized with Guillain-Barré syndrome (GBS). The patient asks how this could have occurred. What response by the healthcare professional is best?
a. It is often preceded by a viral illness.*********
b. It is due to a genetic defect in acetylcholine.
c. It could be caused by a brain tumor.
d. It is often transmitted by family pets.
136
What does a healthcare professional explain to a student about myasthenia gravis?
a. It is an acute autoimmune disease.
b. It affects the nerve roots.
c. It may result in adrenergic crisis.
d. It causes muscle weakness. *********
137
In which disorder are acetylcholine receptor antibodies (IgG antibodies) produced against acetylcholine receptors?
a. Guillain-Barré syndrome
b. Multiple sclerosis
c. Myasthenia gravis *********
d. Parkinson disease
138
Multiple sclerosis and Guillain-Barré syndrome are similar in that they both do what?
a. Result from demyelination by an immune reaction.*****
b. Cause permanent destruction of peripheral nerves.
c. Result from inadequate production of neurotransmitters. d. Block acetylcholine receptor sites at the myoneuronal junction.
139
1/19/Which would be considered a positive symptom of schizophrenia?
a. Blunted affect
b. Auditory hallucinations********
c. Poverty of speech
d. Lack of social interaction
140
A healthcare professional is seeing a patient with suspected schizophrenia. For which prenatal occurrence should the professional assess?
a. Viral infection******
b. Maternal depression
c. Maternal smoking
d. Exposure to toxic waste
141
Which neurotransmitter is reduced in people with schizophrenia?
a. Dopamine
b. Gamma-aminobutyric acid*********
c. Acetylcholine
d. Serotonin
142
A patient has positive signs of schizophrenia and is scheduled for a brain scan. What part of the brain does the healthcare professional expect the scan will focus on?
a. Parietal lobe
b. Limbic system
c. Temporal lobe ********
d. Hypothalamus
143
A patient has started on clozapine. The healthcare professional educates the patient that this drug blocks which neurotransmitter receptor?
a. Norepinephrine
b. Gamma-aminobutyric acid
c. Serotonin
d. Dopamine *********
144
Hypothalamic-pituitary-adrenal (HPA) system abnormalities exist in a large percentage of individuals with what?
a. Schizophrenia
b. Major depression*********
c. Mania
d. Panic disorder
145
The common property among the three types of medications used to treat depression is that they do what?
a. Increase neurotransmitter levels within the synapse ********************************************
b. Increase neurotransmitter levels in the presynapse
c. Decrease neurotransmitter levels in the postsynapse
d. Decrease neurotransmitter levels within the synapse
146
What is the link between major depression and cortisol secretion?
a. Individuals with depression show suppression of plasma cortisol when given dexamethasone.
b. Individuals with depression have a decreased plasma cortisol level, despite the administration of exogenous corticosteroids.
c. Individuals with depression show that persistently elevated plasma cortisol levels can result in inflammation that is believed to trigger depression.****************
d. Individuals with depression have normal plasma cortisol levels throughout the day when they take antidepressant medication as prescribed.
147
A decrease in receptor binding for which neurotransmitter is found in individuals with depression?
a. Norepinephrine
b. Serotonin*********
c. Dopamine
d. Acetylcholine
148
A severely depressed patient has been taking venlafaxine but is now pregnant and asks the healthcare professional what treatment options are available for her. What therapy does the professional discuss as a first choice?
a. Electroconvulsive therapy (ECT)***********
b. Switch to haloperidol
c. Intensive psychotherapy until the baby is weaned
d. Limit zinc and magnesium in the diet
149
A patient has been diagnosed with lithium toxicity. Which electrolyte imbalance does the healthcare professional correlate with this condition?
a. Hypernatremia
b. Hyponatremia *******
c. Hyperkalemia
d. Hypokalemia
150
A criterion for a diagnosis of generalized anxiety disorder (GAD) is a period of excessive worrying that lasts for at least how many months?
a. 3
b. 6 *********
c. 9
d. 12
151
A patient is taking phenelzine and presents to the clinic complaining of “feeling awful.” The patient reports eating aged cheese and avocados last night. What assessment by the healthcare professional is the priority?
a. Kidney function studies
b. Blood pressure*********
c. Chest x-ray
d. Weight
152
What is a notable complication of panic disorder?
a. Avolition
b. Anhedonia
c. Alogia
d. Agoraphobia **********
153
A patient reports frequent nightmares. For which of these should the healthcare professional assess the patient?
a. A recent major loss
b. Family history of nightmares
c. History of traumatic event ***************
d. Poor nutrition and weight loss
154
1/20/The neural groove closes dorsally during which week of gestational life?
a. Second
b. Fourth*******
c. Eighth
d. Twelfth
155
A healthcare professional advises a pregnant woman to add supplements of which nutrient to her diet to prevent birth defects?
a. Iron
b. Vitamin C
c. Zinc
d. Folate -*********
156
Which defect of neural tube closure is most common?
a. Anterior
b. Posterior*******
c. Lateral
d. Midline
157
What is the anomaly in which the soft bony component of the skull and much of the brain is missing?
a. Anencephaly********
b. Myelodysplasia
c. Cranial meningocele
d. Hydrocephaly
158
What is the most common cause of obstructive hydrocephalus in infants?
a. Obstructed arachnoid villi
b. Stenosis of the aqueduct of Sylvius*********
c. Excessive production of cerebrospinal fluid
d. Impaired cerebrospinal fluid circulation in the subarachnoid space
159
A student reads in a chart that a baby was born with an encephalocele. The student asks the healthcare professional to explain this condition. What explanation by the healthcare professional is best?
a. A herniation or protrusion of brain and meninges through a defect in the skull *************
b. A protruding saclike cyst of meninges filled with spinal fluid and is a mild form of spina bifida
c. Protrusion of a saclike cyst containing meninges, spinal fluid, and a portion of the spinal cord through a defect in the posterior arch of a vertebra
d. Premature closure of one or more of the cranial sutures during the first 18 to 20 months of an infant’s life
160
What is the result of a Chiari type II malformation associated with a myelomeningocele?
a. Upward displacement of the cerebellum into the diencephalon
b. Motor and sensory lesions below the level of the myelomeningocele
c. Downward displacement of the cerebellum, brainstem, and fourth ventricle *************
d. Generalized cerebral edema and hydrocephalus
161
A baby is born with a myelomeningocele and needs urgent surgery to repair the defect. The parents want to take the baby home instead. What does the healthcare professional tell the parents about the purpose of this surgery?
a. “Surgery is much easier on a tiny infant than on a larger, older baby.”
b. “If your baby has surgery this young, he/she cannot feel pain.”
c. “Additional nervous system damage will occur the longer we wait.”****************
d. “Prompt surgery is needed to prevent total paralysis later on.
162
A baby demonstrates asymmetric pathological reflexes and microcephaly at a 9-month checkup. The baby appeared normal at birth. What action by the healthcare professional is best?
a. Determine the baby’s risk for developing an HIV infection since birth. ************
b. Assess the baby for other signs of child abuse or neglect.
c. Ask the mother if she uses drugs or alcohol in excess. d. Perform spinal cord imaging and other diagnostic studies.
163
An infant is brought to the emergency department by parents who report that the baby’s fontanels seem to be bulging outward. What action by the healthcare provider is most appropriate?
a. Assess the baby for recent trauma to the head.
b. Measure the head circumference and plot it on a growth chart. *************
c. Prepare the baby for a lumbar puncture and blood cultures.
d. Determine how much fluid the baby had in the last 24 hours.
164
Gait disturbances and instability are characteristic of which form of cerebral palsy?
a. Spastic
b. Dystonic
c. Ataxic *******
d. Biochemical
165
. A child has phenylketonuria (PKU). The healthcare professional educates the parents on the special diet needed, telling them that children with PKU are unable to synthesize what?
a. Essential amino acid, phenylalanine, to tyrosine ********
b. Renin, erythropoietin, and antidiuretic hormone
c. Aldosterone, cortisol, and androgens
d. Neurotransmitters gamma-aminobutyric acid (GABA) and acetylcholine
166
A healthcare professional teaches a parenting class that benign febrile seizures are characterized by what?
a. A temperature higher than 38.5C (101.3F)
b. Concurrent respiratory or ear infections-*********
c. Onset after the fifth year of life
d. Episodes lasting 30 min or longer
167
Parents bring their 1-year-old child to the emergency department, reporting that the child has been irritable and pounding on her head, has projectile vomiting, and seems very sleepy for most of the last 3 days. What diagnostic testing does the healthcare professional prepare the child and parents for as the priority?
a. Brain scanning with either CT or MRI*********
b. Lumbar puncture with CSF cultures
c. Developmental assessment
d. Ophthalmologic assessment
168
A 7 months old in the clinic displays an intact tonic neck reflex. What action by the healthcare professional is most appropriate?
a. Chart the finding as normal in the child’s chart.
b. Assess the baby for signs of malnutrition.
c. Educate the parents on how to improve mobility.
d. Assess the child’s development further. **********
169
A pregnant woman is seen for the first time at 6 months’ gestation and has not taken prenatal vitamins. The healthcare professional educates the woman on the need for a blood test specifically to assess what substance?
a. Total protein
b. Culture
c. a-Fetoprotein*********
d. C-reactive protein
170
The clinical manifestations of dyskinetic cerebral palsy include what?
a. Increased muscle tone and prolonged primitive reflexes
b. Exaggerated deep tendon reflexes, clonus, and rigidity of extremities
c. Scoliosis, contractures, and stiffness of trunk muscles
d. Jerky uncontrolled and abrupt fine musculoskeletal movements *************
171
1/21/What imbalance lessens the rate of secretion of parathyroid hormone (PTH)?
a. Increased serum calcium levels ********
b. Decreased serum magnesium levels
c. Decreased levels of thyroid-stimulating hormone
d. Increased levels of thyroid-stimulating hormone
172
Regulation of the release of insulin is an example of which type of regulation?
a. Negative feedback
b. Positive feedback
c. Neural **********
d. Physiologic
173
A student asks the professor how a faulty negative-feedback mechanism results in a hormonal imbalance. What response by the professor is best?
a. Hormones are not synthesized in response to cellular and tissue activities.
b. Decreased hormonal secretion is a response to rising hormone levels.
c. Too little hormone production is initiated.
d. Excessive hormone production results from a failure to turn off the system.*******
174
Which substance is a water-soluble protein hormone?
a. Thyroxine
b. Aldosterone
c. Follicle-stimulating hormone
d. Insulin*******
175
Which of these is a lipid-soluble hormone?
a. Cortisol **********
b. Oxytocin
c. Epinephrine
d. Growth hormone
176
Most protein hormones are transported in the bloodstream and are what?
a. Bound to a lipid-soluble carrier
b. Free in an unbound, water-soluble form**********
c. Bound to a water soluble-binding protein
d. Free because of their lipid-soluble chemistry
177
When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an example of what type of effect by a hormone?
a. Pharmacologic
b. Permissive
c. Synergistic
d. Direct *****
178
Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone (TH) and is inhibited when plasma levels of TH are adequate. What is this an example of?
a. Positive feedback
b. Negative feedback*********
c. Neural regulation
d. Physiologic regulation
179
A person wants to know if eating only plant-based foods is advisable as a way to cut cholesterol to near-zero levels. What response by the health care professional is best?
a. “No, you will become extremely malnourished.”
b. “Yes, that is an effective way to eliminate cholesterol.”
c. “No, many hormones are made from cholesterol.” ************************************
d. “Yes, that will increase the action of insulin.”
180
Which second messenger is stimulated by epinephrine binding to a -adrenergic receptor?
a. Calcium
b. Inositol triphosphate (IP3)
c. Diacylglycerol (DAG)
d. Cyclic adenosine monophosphate (cAMP) ********
181
Why is the control of calcium in cells important?
a. It is controlled by the calcium negative-feedback loop. b. It is continuously synthesized.
c. It acts as a second messenger.**********
d. It carries lipid-soluble hormones in the bloodstream.
182
What is the portion of the pituitary that secretes oxytocin?
a. Posterior *********
b. Inferior
c. Anterior
d. Superior
183
A patient is in severe shock and is receiving vasopressin. A student asks the health care professional to explain the rationale for this treatment. What response by the professional is most accurate?
a. “Antidiuretic hormone conserves fluid when urine output is less than 20 mL/hr.”
b. “Antidiuretic hormone causes serum osmolality to be increased.”
c. “Antidiuretic hormone leads to better insulin utilization.”
d. “Antidiuretic hormone causes vasoconstriction to help increase blood pressure.”**********
184
What is the target tissue for prolactin-releasing factor?
a. Hypothalamus
b. Anterior pituitary********
c. Mammary glands
d. Posterior pituitary
185
Where is antidiuretic hormone (ADH) synthesized, and where does it act?
a. Hypothalamus; renal tubular cells*********
b. Renal tubules; renal collecting ducts
c. Anterior pituitary; posterior pituitary
d. Posterior pituitary; loop of Henle
186
Where is oxytocin synthesized?
a. Hypothalamus***********
b. Paraventricular nuclei
c. Anterior pituitary
d. Posterior pituitary
187
How do the releasing hormones that are made in the hypothalamus travel to the anterior pituitary?
a. Vessels of the zona fasciculata
b. Infundibular process
c. Pituitary stalk
d. Portal hypophyseal blood vessels*********
188
To ensure optimal thyroid health and function, which mineral does the health care professional advise a nutrition class to include in the daily diet?
a. Iron
b. Zinc
c. Iodide ********
d. Copper
189
Which hormone triggers uterine contractions?
a. Thyroxine
b. Oxytocin*********
c. Growth hormone
d. Insulin
190
What effect does hyperphosphatemia have on other electrolytes?
a. Increases serum calcium
b. Decreases serum calcium **********
c. Decreases serum magnesium
d. Increases serum magnesium
191
A diabetic patient has not taken insulin in several days and has an extremely high blood sugar. What electrolyte would the health care professional assess as the priority?
a. Potassium********
b. Calcium
c. Sodium
d. Chloride
192
A person who has experienced physiologic stresses will have increased levels of which hormone?
a. Cortisol ********
b. Thyroid hormone
c. Somatostatin
d. Alpha endorphin
193
What is the action of calcitonin?
a. Increases metabolism
b. Decreases metabolism
c. Increases serum calcium
d. Decreases serum calcium **************
194
Which hormone is involved in the regulation of serum calcium levels?
a. Parathyroid hormone (PTH) ************
b. Thyroxine (T4)
c. Adrenocorticotropic hormone (ACTH)
d. Triiodothyronine (T3)
195
Which hormone inhibits the secretion of growth hormone (GH)?
a. Somatostatin **************
b. Thyroxine
c. Thyroid-stimulating hormone
d. Calcitonin
196
Where are target cells for parathyroid hormone located?
a. Tubules of nephrons**********
b. Thyroid gland
c. Glomeruli of nephrons
d. Smooth and skeletal muscles
197
Which compound or hormone is secreted by the adrenal medulla?
a. Cortisol
b. Epinephrine**********
c. Androgens
d. Aldosterone
198
What are the effects of aging on pancreatic cells?
a. Pancreatic cells are replaced by fibrotic cells.
b. Increased insulin production is typical.
c. Beta cell function decreases. ***********
d. No appreciable change occurs on pancreatic cells.
199
. What does aldosterone directly increase the reabsorption of?
a. Magnesium
b. Calcium
c. Sodium*******
d. Water
200
Which is an expected hormonal change in an older patient?
a. Thyroid-stimulating hormone secretion below normal*********
b. Triiodothyronine level below normal
c. Cortisol level below normal
d. Adrenocorticotropic hormone level above normal
201
1/22/ The effects of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion include which solute?
a. Sodium and water retention
b. Sodium retention and water loss
c. Sodium dilution and water retention *******
d. Sodium dilution and water loss
202
Which patient would the healthcare professional assess for elevated levels of antidiuretic hormone (ADH) secretion?
a. Being treated for small cell carcinoma of the stomach**********
b. Taking high dose acetaminophen (Tylenol) for arthritis c. Had a hip replacement operation 14 days ago
d. Has long-standing kidney disease from diabetes
203
Which laboratory value would the nurse expect to find if a person is experiencing syndrome of inappropriate antidiuretic hormone (SIADH)?
a. Hypernatremia and urine hypoosmolality
b. Serum potassium (K+) level of 5 mEq/L and urine hyperosmolality compared to serum
c. Serum sodium (Na+) level of 120 mEq/L and serum osmolality 260 mOsm/kg ************
d. Serum potassium (K+) of 2.8 mEq/L and serum hyperosmolality
204
What is diabetes insipidus a result of?
a. Antidiuretic hormone hyposecretion*******
b. Antidiuretic hormone hypersecretion
c. Insulin hyposecretion
d. Insulin hypersecretion
205
A patient who is diagnosed with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits, but the antidiuretic hormone (ADH) level is low. Although the patient has had no intake for 4 hours, no change in the polyuria level has occurred. What treatment or diagnostic testing does the healthcare professional prepare the patient for?
a. Administration of desmopressin*********
b. Serum copeptin testing
c. Insulin administration
d. Renal angiogram
206
A patient is having a water deprivation test. The patient’s initial weight was 220 pounds (100 kg). The next weight is 209 pounds (95 kg). What action by the healthcare professional is most appropriate?
a. Stop the water deprivation test. *********
b. Administer salt tablets.
c. Continue with the test as planned.
d. Take the patient’s blood glucose.
207
A healthcare professional is caring for four patients. Which patient does the professional assess for neurogenic diabetes insipidus (DI)?
a. Anterior pituitary tumor
b. Thalamus hypofunction
c. Posterior pituitary trauma **********
d. Renal tubule disease
208
Which form of diabetic insipidus (DI) will result if the target cells for antidiuretic hormone (ADH) in the renal collecting tubules demonstrate insensitivity?
a. Neurogenic
b. Nephrogenic *********
c. Psychogenic
d. Ischemic
209
Which laboratory value is consistent with diabetes insipidus (DI)?
a. Low urine-specific gravity*********
b. Low serum sodium
c. Low urine protein
d. High serum total protein
210
A patient has nephrogenic diabetes insipidus (DI). What treatment does the healthcare professional anticipate for this patient?
a. Exogenous ADH replacement *********
b. Intranasal desmopressin
c. Water and sodium restriction
d. Loop diuretic administration
211
Which condition may result from pressure exerted by a pituitary tumor?
a. Hypothyroidism************
b. Hypercortisolism
c. Diabetes insipidus
d. Insulin hyposecretion
212
A healthcare professional reads a chart that notes the patient has panhypopituitarism. What does the professional understand that term to mean?
a. The patient has a lack of all hormones associated with the anterior pituitary gland.***********
b. The patient has a lack of all hormones associated with the lateral pituitary gland.
c. The patient has total adrenocorticoptropic hormone deficiency.
d. The patient has a dysfunction of the posterior pituitary gland due to a tumor.
213
Visual disturbances are a result of a pituitary adenoma because of what?
a. Liberation of anterior pituitary hormones into the optic chiasm
b. Pituitary hormones clouding the lens of the eyes
c. Pressure of the tumor on the optic chiasm********
d. Pressure of the tumor on the optic and oculomotor cranial nerves
214
A patient has an enlarged tongue, body odor, rough skin, and coarse hair. Which laboratory result does the healthcare professional associate with this presentation?
a. Decreased blood glucose
b. Increased growth hormone**********
c. Decreased ACTH
d. Increased TSH
215
A patient has acromegaly. What assessment by the healthcare professional would be most important?
a. Skin condition
b. Sleep patterns *******
c. Bowel function
d. Range of motion
216
Why does giantism occur only in children and adolescents?
a. Their growth hormones are still diminished.
b. Their epiphyseal plates have not yet closed.*********
c. Their skeletal muscles are not yet fully developed.
d. Their metabolic rates are higher than in adulthood.
217
A patient chart notes the patient has amenorrhea, galactorrhea, hirsutism, and osteoporosis. What diagnostic test would the healthcare professional prepare the patient for?
a. Water deprivation test
b. Hemoglobin A1C
c. CT scan of the head********
d. Ovarian biopsy
218
What does Graves’ disease develop from?
a. A viral infection of the thyroid gland that causes overproduction of thyroid hormone
b. An autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue
c. A thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones ***************
d. An ingestion of goitrogens that inhibits the synthesis of the thyroid hormones, causing a goiter
219
Which patient would the healthcare professional assess for other signs of thyrotoxic crisis?
a. Constipation with gastric distention
b. Bradycardia and bradypnea
c. Hyperthermia and tachycardia **********
d. Constipation and lethargy
220
Which pathologic changes are associated with Graves’ disease?
a. High levels of circulating thyroid-stimulating immunoglobulins***************
b. Diminished levels of thyrotropin-releasing hormone
c. High levels of thyroid-stimulating hormone
d. Diminished levels of thyroid-binding globulin
221
A healthcare professional is palpating the neck of a person diagnosed with Graves’ disease. What finding would the professional associate with this disorder?
a. Parathyroids left of midline
b. Thyroid small with discrete nodules
c. Parathyroids normal in size
d. Thyroid diffusely enlarged ********
222
A person has hypothyroidism. What chemical does the healthcare professional advise the person to include in the diet?
a. Iron
b. Iodine******
c. Zinc
d. Magnesium
223
A patient has a suspected thyroid carcinoma. What diagnostic test does the healthcare professional prepare the patient for?
a. Measurement of serum thyroid levels
b. Radioisotope scanning
c. Ultrasonography
d. Fine-needle aspiration biopsy ************
224
Renal failure is the most common cause of which type of hyperparathyroidism?
a. Primary
b. Secondary *********
c. Exogenous
d. Inflammatory
225
A patient had a thyroidectomy and now reports tingling around the mouth and has a positive Chvostek sign. What laboratory finding would be most helpful to the healthcare professional?
a. TSH and T4
b. Serum sodium
c. Serum calcium ********
d. Urine osmolality
226
A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500 mg/dL; positive urine glucose and ketones; serum potassium (K+) 2 mEq/L; serum sodium (Na+) 130 mEq/L. The patient reports that he has been sick with the “flu” for 1 week. What relationship do these values have to his insulin deficiency?
a. Increased glucose use causes the shift of fluid from the intravascular to the intracellular space.
b. Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis. ****************************************
c. Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis.
d. Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss.
227
Why does polyuria occur with diabetes mellitus?
a. Formation of ketones
b. Chronic insulin resistance
c. Elevation in serum glucose***********
d. Increase in antidiuretic hormone
228
A student asks the professor to differentiate Type 2 diabetes mellitus from Type 1. The professors’ response would be that Type 2 is best described as what?
a. Resistance to insulin by insulin-sensitive tissues *******
b. Need for lifelong insulin injections
c. Increase of glucagon secretion from beta cells of the pancreas
d. Presence of insulin autoantibodies that destroy beta cells in the pancreas
229
A person diagnosed with type 1 diabetes experienced an episode of hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The healthcare professional teaches the person that what is the most probable cause of these symptoms?
a. Hyperglycemia caused by incorrect insulin administration
b. Dawn phenomenon from eating a snack before bedtime
c. Hypoglycemia caused by increased exercise*********
d. Somogyi effect from insulin sensitivity
230
Which serum glucose level would indicate hypoglycemia in a newborn?
a. 28 mg/dL *******
b. 40 mg/dL
c. 60 mg/dL
d. 80 mg/dL
231
When comparing the clinical manifestations of both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS), which condition is associated with only DKA?
a. Fluid loss
b. Weight loss
c. Increased serum glucose
d. Kussmaul respirations*******
232
Hypoglycemia, followed by rebound hyperglycemia, is observed in those with what?
a. The Somogyi effect********
b. The dawn phenomenon
c. Diabetic ketoacidosis
d. Hyperosmolar hyperglycemic nonketotic syndrome
233
A patient has diabetes mellitus. A recent urinalysis showed increased amounts of protein. What therapy does the healthcare provider educate the patient that is specific to this disorder?
a. More frequent blood glucose monitoring
b. Moderate dietary sodium restriction
c. Treatment with an ACE inhibitor********
d. Home blood pressure monitoring
234
Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake?
a. Biguanide (metformin)**********
b. Sulfonylureas (glyburide)
c. Meglitinides (glinides)
d. a-Glycosidase inhibitor (miglitol)
235
What causes the microvascular complications in patients with diabetes mellitus?
a. The capillaries contain plaques of lipids that obstruct blood flow.
b. Pressure in capillaries increases as a result of the elevated glucose attracting water.
c. The capillary basement membranes thicken, and cell hyperplasia develops*********
d. Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries.
236
A healthcare professional advises a person with diabetes mellitus to have an annual eye exam. When the person asks why this is necessary, the professional states that retinopathy develops in patients with diabetes mellitus because of what reason?
a. Plaques of lipids develop in the retinal vessels.
b. Pressure in the retinal vessels increase as a result of increased osmotic pressure.
c. Ketones cause microaneurysms in the retinal vessels. d. Retinal ischemia and red blood cell aggregation occur. **********************************
237
A person has acne, easy bruising, thin extremities, and truncal obesity. The healthcare professional assesses the person for which of these?
a. Previous thyroid surgery
b. Urine osmolality
c. Serum electrolytes
d. Use of glucocorticoids *******
238
1/23/A researcher is moving to an area with a year-round cold climate. The researcher asks the health care professional how people in these areas are able to adjust to the temperature. What response by the professional is most accurate?
a. They have less adipose tissue.
b. They have more beige (bAT) adipose tissue.*********
c. Their bone marrow produces more adipose tissue.
d. They gain weight which insulates them.
239
A health care professional wishes to provide community screening for obesity. Which population should the professional focus on as the priority?
a. Caucasians
b. Non-Hispanic blacks********
c. Hispanics
d. Asians
240
The student asks the professor for a definition of “orexigenic neurons.” What description by the professor is most accurate?
a. Promote appetite and stimulate eating **********
b. Suppress appetite and inhibit eating
c. Increase overall metabolism
d. Promote satiety after eating
241
A student asks the health care professional why obese people are at higher risk for hypertension than non-obese individuals. What response by the professional is best?
a. They produce more ghrelin in the stomach.
b. Their thyroid gland secretes less hormone.
c. They produce more angiotensinogen. *******
d. They secrete fewer endocannabinoids.
242
Which individual does the health care professional determine is obese?
a. Body mass index 23 kg/m2
b. Body mass index 25 kg/m2
c. Body mass index 29 kg/m2
d. Body mass index 32 kg/m2**********
243
A health care professional is caring for a patient admitted to the hospital with severe anorexia. What action by the health care professional would be most important?
a. Ensuring the patient is on a cardiac monitor******
b. Facilitating laboratory testing of electrolytes
c. Arranging a psychiatry consultation
d. Assessing the patient’s favorite foods
244
A person has abnormally severe tooth decay and erosion of the tooth enamel. What problem should the health care professional assess the person for?
a. Anorexia nervosa
b. Binge eating
c. Bulimia ******
d. Refeeding syndrome
245
A patient weighs 82 pounds and is hospitalized for anorexia. In order to prevent refeeding syndrome, how many calories should the person eat in the first two days?
a. 400
b. 745*******
c. 936
d. 1200
246
A severely malnourished patient is in the hospital to improve nutrition. On the second day, the patient reports palpitations and difficulty breathing. After placing the patient on a cardiac monitor, what action does the health care professional take next?
a. Take the patient’s temperature.
b. Have lab drawn for electrolyte levels. *********
c. Cancel the patient’s next meal.
d. Facilitate a chest x-ray.
