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NURS 500 > Exam 1 practice questions > Flashcards

Exam 1 practice questions Flashcards

1
Q

Ribosomes are nucleoproteins:

  1. synthesized in the nucleus and secreted into the cytosol.
  2. attached to the smooth endoplasmic reticulum.
  3. that consist of a network of cisternae.
  4. that synthesize a signal recognition sequence.
A

ANSWER AND RATIONALE: 4. That synthesize a signal recognition sequence. Newly formed ribosomes synthesize a signal recognition sequence recognized by particles in the cytosol.

  1. Ribosomes are synthesized in the nucleolus.
  2. Ribosomes attach to the rough endoplasmic reticulum.
  3. The endoplasmic reticulum is composed of cisternae.
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2
Q

The plasma membrane of a cell is:

  1. vital to the movement of water soluble molecules into the cell.
  2. composed primarily of amphipathic molecules.
  3. dimpled because of peripheral membrane proteins.
  4. impermeable to lipid-soluble molecules.
A

ANSWER AND RATIONALE: 2. Composed primarily of amphipathic molecules. These molecules are polar with a hydrophobic (uncharged, water hating) portion and a hydrophilic (charged, water loving) portion.

  1. The portion of the cell membrane that is water hating or charged prevents the movement of water-soluble molecules into the cell.
  2. The plasma membrane is dimpled because of the presence of caveolae, cave-like indentations.
  3. Lipid-soluble molecules like oxygen diffuse readily through the plasma membrane.
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3
Q

Neurotransmitters:

  1. act on the cells that produce and secrete them.
  2. act on nearby cells that also take them up and destroy them.
  3. are produced by neurosecretory neurons and transmitted via the blood.
  4. diffuse across the synaptic cleft and act on postsynaptic receptors
A

ANSWER AND RATIONALE: 4. Diffuse across the synaptic cleft and act on postsynaptic receptors. Neurotransmitters are produced and released into the synaptic cleft and act on cells or receptors on the postsynaptic cell.

  1. Signaling cells act on the cell that produces and secretes them by autocrine signaling.
  2. In paracrine signaling, cellular mediators act on nearby cells.
  3. Neurohormonal signaling is produced by blood-borne transmission of the products of neurosecretory neurons.
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4
Q

Active transport requires:

  1. receptors capable of recognizing and binding with specific molecules.
  2. a hydrostatic pressure gradient between intra- and extracellular regions.
  3. a molecule bound to a ligand.
  4. the presence of pores in the cell membrane.
A

ANSWER AND RATIONALE: 1. Receptors capable of recognizing and binding with specific molecules. Active transport requires the use of specific receptors matched with molecules and the expenditure of energy.

  1. A hydrostatic pressure gradient moves water by passive transport.
  2. Molecules bound to a ligand may use active transport, but ligand binding is not mandatory.
  3. Passive transport occurs through pores in the cell membrane.
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5
Q

Depolarization occurs when:

  1. potassium permeability increases and potassium rushes out the cell.
  2. the Na+, K+ pump removes sodium from the cell.
  3. voltage-regulated Na+ channels open and Na+ enters the cell.
  4. the cell is depolarized by 25 to 30 millivolts and reaches threshold.
A

ANSWER AND RATIONALE: 3. Voltage-regulated Na+ channels open and Na+ enters the cell. Depolarization occurs when threshold potential is reached due to a slow leak of Na+ into the cell. voltage-dependent sodium channels open and allow rapid entry of Na+ into the cell.

  1. Potassium permeability increases and potassium leaves the cell during repolarization.
  2. The Na+, K+ pump removes Na+ from the cell during repolarization.
  3. Threshold potential is achieved when potential is depolarized by 15 to 20 millivolts.
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6
Q

Aging is associated with:

  1. reduced cross-linking of collagen.
  2. reduced degradation of collagen.
  3. increased cross-linking of collagen.
  4. increased collagen permeability.
A

ANSWER AND RATIONALE: 3. Increased cross-linking of collagen. Aging produces increased cross-linking of collagen that reduces cell permeability, increases rigidity of the extracellular matrix, and decreases solubility.

  1. Aging is associated with increased cross-linking.
  2. Aging is associated with increased degradation of collagen.
  3. Aging is associated with reduced cellular permeability.
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7
Q

A person with chronic heart failure has edema in the lower legs and sacral area. the nurse suspects this is due to a(n):

  1. increase in plasma oncotic pressure.
  2. decrease in capillary hydrostatic pressure.
  3. increase in interstitial hydrostatic pressure.
  4. increase in capillary hydrostatic pressure.
A

ANSWER AND RATIONALE: 4. Increase in capillary hydrostatic pressure. Heart failure produces salt and water retention and subsequent volume overload, which increases capillary hydrostatic pressure.

  1. An increase in plasma oncotic pressure produces movement of fluid from the interstitial space into the vascular space.
  2. A reduction in capillary hydrostatic pressure decreases the force for filtration of fluid from the capillary.
  3. An increase in interstitial hydrostatic pressure would be produced by edema, but would not cause edema.
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8
Q

A person reports severe diarrhea for 2 days. The nurse understands this stimulates a(n):

  1. reduction in aldosterone secretion.
  2. reduction in renin secretion.
  3. increase in antidiuretic hormone secretion.
  4. increase in natriuretic peptide secretion.
A

ANSWER AND RATIONALE: 3. Increase in antidiuretic hormone secretion. Hypovolemia stimulates volume sensitive receptors and baroreceptors and results in secretion of antidiuretic hormone to increase water reabsorption.

  1. Volume depletion produces an increase in aldosterone secretion through the activation of the renin angiotensin aldosterone system.
  2. Volume depletion produces an increase in renin secretion and initiates the renin angiotensin aldosterone system.
  3. Volume depletion results in reduced secretion of natriuretic peptides.
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9
Q

A person arrives in the emergency department after a loss of consciousness and the development of Kussmaul respirations. the individual has a history of diabetes and 2 days of vomiting and diarrhea. the nurse suspects the person has:

  1. respiratory alkalosis.
  2. respiratory acidosis.
  3. metabolic alkalosis.
  4. metabolic acidosis.
A

ANSWER AND RATIONALE: 4. Metabolic acidosis. Diabetic ketoacidosis results in an increase in noncarbonic acids and a decrease in bicarbonate ion which produces metabolic acidosis.

  1. Respiratory alkalosis is produced by alveolar hyperventilation and reduction in carbon dioxide concentration.
  2. Respiratory acidosis is produced by alveolar hypoventilation and increase in carbon dioxide concentration.
  3. Metabolic alkalosis is produced by an excess of bicarbonate ion.
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10
Q

A person with a history of chronic lung disease arrives in the clinic with a 1-week history of a productive cough, a headache, and muscle twitching. the nurse suspects the person is experiencing:

  1. respiratory acidosis.
  2. respiratory alkalosis.
  3. metabolic acidosis.
  4. metabolic alkalosis
A

ANSWER AND RATIONALE: 1. Respiratory acidosis. Respiratory acidosis is produced by alveolar hypoventilation, which is commonly found in individuals with chronic obstructive pulmonary disease. headache and muscle twitching are symptoms of elevated carbon dioxide levels produced by hypoventilation.

  1. Respiratory alkalosis is produced by alveolar hyperventilation and reduction in carbon dioxide concentration. symptoms of respiratory alkalosis include dizziness, confusion, paresthesia, convulsions, and coma.
  2. Metabolic acidosis is produced by an increase in noncarbonic acids and/or a decrease in bicarbonate ion. symptoms of metabolic acidosis include headache, lethargy, Kussmaul respirations, anorexia, nausea and vomiting, dysrhythmias, and coma.
  3. Metabolic alkalosis is produced by an excess of bicarbonate ion. symptoms of metabolic alkalosis include muscle weakness, muscle cramps, hyperreflexia, paresthesias, tetany, and seizures
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11
Q

DNA polymerase functions to:

  1. signal the end of a gene.
  2. pull apart a portion of a DNA strand.
  3. add the correct nucleotides to a DNA strand.
  4. provide a template for the sequence of mRNA nucleotides.
A

ANSWER AND RATIONALE: 3. Add the correct nucleotides to a DNA strand. This enzyme functions to add correct nucleotides to the DNA strand, to edit incorrect nucleotides, and enhance the accuracy of DNA replication.

  1. Termination or nonsense codons signal the end of a gene.
  2. RNA polymerase binds to a promoter site on dna and pulls apart a portion of the DNA strand.
  3. One of the DNA strands exposed by the action of RNA polymerase provides a template for the sequence of mRNA nucleotides
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12
Q

The site of protein synthesis is the:

  1. codon.
  2. intron.
  3. ribosome.
  4. Anticodon.
A

ANSWER AND RATIONALE: 3. The ribosome is the site of actual protein synthesis.
The codon is a set of three adjacent nucleotides or a triplet that constitutes the genetic code for a particular amino acid that is to be added to a polypeptide chain in the synthesis of a protein.

  1. The intron is an rna sequence that has been removed by enzymatic action prior to translation.
  2. The anticodon is a set of three adjacent nucleotides that undergo base pairing with the appropriate codon in the mRNA.
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13
Q

Type 2 diabetes is:

  1. Highly correlated with reduced BMI.
  2. Caused by an absence of insulin production.
  3. Usually more prevalent in individuals less than 40 years of age.
  4. Often treated with lifestyle modification including diet and exercise.
A

ANSWER AND RATIONALE: 4. Often treated with lifestyle modification including diet and exercise. This type of diabetes is highly associated with increased BMI and obesity, thus weight loss is one goal of therapy. Dietary modifications can aid weight loss and reduce total glucose load.

  1. Type 2 diabetes is highly associated with obesity and an increase in BMI.
    Type 2 diabetes produces insulin resistance; cells have difficulty using the insulin that is produced. Type 1 diabetes is characterized by destruction of pancreatic beta cells and reduction/absence of insulin.
  2. Type 2 diabetes is more prevalent in individuals older than 40 years of age.
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14
Q

Recurrence risk in multifactoral diseases is:

  1. Higher if more than one family member is affected.
  2. Lower if the disease is more severe in the proband.
  3. Higher if the proband is the more commonly affected sex.
  4. Increases rapidly in more distant relatives.
A

ANSWER AND RATIONALE: 1. Higher if more than one family member is affected. Families who have one member with the disease have more genetic or environmental risk factors and are more likely to have the disease.

  1. Greater disease severity in the proband produces greater likelihood of disease.
  2. The likelihood of disease is greater if the proband is the less commonly affected sex.
  3. The likelihood of disease decreases rapidly in more distant relatives as the gene environment interactions are likely different.
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15
Q

The relative risk indicates the:

  1. Number of new cases of a disease in a specific time period.
  2. Proportion of a population with a disease at one time point.
  3. Chance of developing a disease relative to an exposure.
  4. Ability of a causative factor to produce a disease.
A

ANSWER AND RATIONALE: 3. Chance of developing a disease relative to an exposure. Relative risk is the ratio of the incidence a disease in those exposed to a risk factor to the incidence of the disease in those not exposed to the risk factor. this is a common indicator of the effects of specific risk factors.

  1. The number of new cases of a disease in a specific time period is the incidence.
  2. The proportion of a population with the disease at one time point is the prevalence.
  3. Pathogenicity describes the ability of a particular disease agent to produce a disease.
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16
Q
  1. The characteristic changes at the site of an injury produce:
  2. Blood vessel constriction.
  3. Dilution of bacterial toxins.
  4. Tightening of the capillary endothelial cell junctions.
  5. Increased microcirculatory flow rate.
A

ANSWER AND RATIONALE: 2. Dilution of bacterial toxins. Biochemical mediators stimulate capillary endothelial cells to retract, which allows plasma and leukocytes to move into the interstitial space and dilute toxins produced by bacteria.

  1. Blood vessels dilate in response to injury to increase blood flow to the area and deliver leukocytes to the area.
  2. Capillary endothelial cell junctions retract to increase permeability.
  3. The microcirculatory flow rate is reduced once plasma moves into the interstitial space
17
Q

. Mast cells:

  1. Can be activated through an intrinsic or extrinsic pathway.
  2. Degranulate in response to chemical agents.
  3. Reduce blood flow after activation.
  4. Can be blocked by the therapeutic use of aspirin.
A

ANSWER AND RATIONALE: 2. Degranulate in response to chemical agents. Mast cells also degranulate or release their granules in response to physical injury, immunologic stimulation, and activation of toll-like receptors by bacteria and viruses.

  1. The coagulation cascade is activated via an intrinsic or extrinsic pathway.
  2. Mast cell activation increases microcirculatory blood flow.
  3. Aspirin blocks the synthesis of prostaglandins and limits inflammation, but does not directly affect mast cells.
18
Q

. Phagocytosis requires:

  1. Digestion of the capillary basement membrane during diapedesis.
  2. A reduction in nitric oxide production.
  3. Formation of a phagosome by a mast cell.
  4. A respiratory burst produced by the release of the primary lysosomal granules.
A

ANSWER AND RATIONALE: 1. Digestion of the capillary basement membrane during diapedesis. Leukocytes digest the capillary basement membrane and migrate into the surrounding tissues through the retracted endothelial junctions.

  1. Inflammation induces an increase in nitric oxide synthesis and vasodilation.
  2. A phagosome is produced once the phagocyte engulfs a microorganism. The walls surrounding the microorganism are composed of the inverted plasma membrane of the phagocyte.
  3. The respiratory burst is produced by a change in cellular metabolism.
19
Q
  1. Natural killer cells:
  2. are formed from megakaryocytes.
  3. regulate mast cell–derived inflammatory mediators.
  4. recognize and eliminate cells infected by viruses.
  5. are the largest normal blood cell.
A

ANSWER AND RATIONALE: 3. Recognize and eliminate cells infected by viruses. This is the primary function of natural killer cells. These cells also eliminate other abnormal host cells like cancer cells.

  1. Platelets are formed from megakaryocytes.
  2. Eosinophils regulate mast cell–derived inflammatory mediators through the actions of enzymes like histaminase.
  3. Monocytes are the largest normal blood cell.
20
Q
  1. A person has a fever of 102o F. the nurse knows:
  2. pyrogens are acting on the thalamus.
  3. exudate is present in the body.
  4. there is a left shift of leukocytes.
  5. cytokines have been released.
A

ANSWER AND RATIONALE: 4. Cytokines have been released. Fever is due in part to the action of these endogenous pyrogens on the hypothalamus after they are release from neutrophils and macrophages.

  1. Pyrogens act on the hypothalamus, the thermostat of the body.
  2. Exudate is the fluid, cells, and cellular debris in the area of inflammation. exudate is not directly related to the presence of fever.
  3. The left shift of leukocytes indicates an increase in immature neutrophils and is not directly related to fever.
21
Q

Passive immunity :

  1. is produced after exposure to an antigen.
  2. is the result of an immunization.
  3. can last for years.
  4. can be conferred by immunotherapy.
A

ANSWER AND RATIONALE: 4. Can be conferred by immunotherapy. Passive immunity is produced when antibodies formed by one individual are transferred to another individual. this could be transfer across the placenta or through infusion.

  1. Exposure to an antigen produces active immunity.
  2. Immunizations produce active acquired immunity.
  3. Passive immunity is short lived as donor antibodies or T lymphocytes are destroyed.
22
Q

The epitope is:

  1. the antigen-binding site.
  2. located on the antigen.
  3. formed in response to an exposure.
  4. a small molecule that functions as an antigen.
A

ANSWER AND RATIONALE: 2. Located on the antigen. The epitope is the portion of the antigen configured for recognition and binding, also known as the antigenic determinant.

  1. The paratope is the antigen-binding site on the antibody.
  2. The epitope is located on the cell surface of the antigen.
  3. Small molecules that function as antigens in combination with larger molecules are haptens.
23
Q

IgA immunoglobulins are:

  1. measureable in the blood in very low concentrations.
  2. the largest immunoglobulin.
  3. found in saliva and other body secretions.
  4. detectable in the fetus and newborn.
A

ANSWER AND RATIONALE: 3. Found in saliva and other body secretions. There are two classes of IgA immunoglobulins, IgA1 and IgA2. IgA2 are found in body secretions including saliva.

  1. IgD immunoglobulins are found in the blood in very low concentrations.
  2. IgM immunoglobulins are the largest immunoglobulin.
  3. IgG immunoglobulins are selectively transported across the placenta to the fetus.
24
Q

Biologic vectors:

  1. passively transfer microorganisms.
  2. transfer microorganisms by direct exposure.
  3. actively transfer microorganisms human to human.
  4. transfer microorganisms through stings or bites.
A

ANSWER AND RATIONALE: 4. Transfer microorganisms through stings or bites. These are typically from insects like mosquitos, fleas, or flies.

  1. Mechanical vectors passively transmit microorganisms from a contaminated site to an individual.
  2. Direct exposure to contaminated materials like food or water can also transmit microorganisms. The use of vectors is an indirect means of transfer.
  3. Human-to-human transmission occurs primarily in aerosolized microorganisms.
25
Q

A person arrives at the clinic and reports mild fatigue and aching following exposure to a family member with the flu. The nurse suspects the person is in the:

  1. convalescence period.
  2. incubation period.
  3. prodromal period.
  4. invasion period.
A

ANSWER AND RATIONALE: 3. Prodromal period. This period is characterized by mild symptoms.

  1. During the convalescent period, the immune system has successfully removed the infectious agent and symptoms are resolving.
  2. During the incubation period, the microorganisms are replicating, but symptoms have not yet developed.
  3. During the invasion period, the microorganisms are multiplying rapidly and the immune system response is maximized.
26
Q

A person is hospitalized with pneumonia caused by pneumocystis jiroveci. the nurse understands this indicates the person is:

  1. serologically negative for HIV.
  2. serologically positive for asymptomatic HIV disease.
  3. in the early stages of HIV disease.
  4. serologically positive for HIV and has AIDS.
A

ANSWER AND RATIONALE: 4. Serologically positive for HIV and has AIDS. The presence of atypical or opportunistic infections is diagnostic for progression of HIV disease to AIDS.

  1. The lack of detectable antibody does not indicate there is no HIV infection. Antibodies may not have been formed and the person is able to transmit the virus.
  2. The presence of antibodies to the HIV virus, but lack of symptoms indicates HIV infection.
  3. Individuals are relatively asymptomatic during the early stages of HIV disease
27
Q

The actions of antibiotics include:

  1. protection of the bacterial cell wall.
  2. prevention of protein synthesis.
  3. support of dna replication.
  4. support for folic acid synthesis.
A

ANSWER AND RATIONALE: 2. Prevention of protein synthesis. Protein synthesis is necessary for microorganism replication.

  1. Integrity of the bacterial cell wall is necessary for survival of the organism.
  2. DNA replication is required for replication of the organism.
  3. Folic acid synthesis is required for replication of the organism.
28
Q

Alloimmunity occurs when:

  1. the immune system produces a response to tissues of another individual.
  2. there is a disturbance in the immunologic tolerance of self-antigens.
  3. antigens are in the environment.
  4. an anaphylactic reaction occurs.
A

ANSWER AND RATIONALE: 1. The immune system produces a response to tissues of another individual. This type of immune response may occur with transfusion, transplantation, or in response to the fetus during pregnancy.

  1. Autoimmunity is a disturbance in the immunologic tolerance of self-antigens.
  2. Allergy is the response to antigens found in the environment.
  3. Anaphylaxis is the rapid, severe, immediate hypersensitivity reaction
29
Q

A nurse suspects a type I allergic reaction when a
person reports:

  1. dermatitis.
  2. rheumatoid arthritis.
  3. Raynaud phenomenon.
  4. conjunctivitis and rhinitis.
A

ANSWER AND RATIONALE: 4. Conjunctivitis and rhinitis. A type I reaction is mediated by antigen-specific ige and histamine. seasonal allergic rhinitis with conjunctivitis is a commonly seen type I reaction.

  1. Contact dermatitis is a type IV allergic response.
  2. Rheumatoid arthritis is an autoimmune disorder.
  3. Raynaud phenomenon is caused by deposition of immune complexes in the capillaries of peripheral vessels.
30
Q

Autoimmunity occurs when:

  1. self-antigents stimulate molecular mimicry.
  2. transplanted tissues are rejected.
  3. the immune system recognizes self-antigens as foreign.
  4. an acute rejection of a transplanted organ or tissue occurs.
A

ANSWER AND RATIONALE: 3. The immune system recognizes self-antigens as foreign. Autoimmune diseases like Graves’ disease, rheumatoid arthritis, and systemic lupus erythematosus may result from immune response to body tissues.

  1. Molecular mimicry is the hypothesized mechanism for the development of autoimmune diseases. Foreign antigens from microorganisms initiate disease through molecular mimicry.
  2. Rejection of transplanted tissues occurs by alloimmune reactions.
  3. Acute rejection is a type of alloimmune reaction to transplanted tissue.
31
Q

Immune suppression may result from:

  1. increased zinc intake.
  2. caring for an older parent with alzheimer disease.
  3. aspirin therapy.
  4. increased protein in the diet.
A

ANSWER AND RATIONALE: 2. Caring for an older parent with alzheimer disease. Stress can produce immune supression through sympathetic nerve activity and hormone secretion.

  1. Inadequate zinc can produce immune suppression.
  2. Aspirin reduces inflammation.
  3. Low protein intake is associated with immune suppression.
32
Q

The stage of resistance in Selye’s general adaptation syndrome includes:

  1. mobilization of the defenses.
  2. homeostasis.
  3. fight or flight response.
  4. breakdown of adaptation.
A

ANSWER AND RATIONALE: 3. Fight or flight response. In this stage of the GAS, mobilization leads to fight or flight and adaptation.

  1. The alarm stage is the period when the defenses are mobilized.
  2. Homeostasis indicates the GAS is not activated or has successfully resolved the stress. This is the optimal steady-state condition.
  3. Exhaustion occurs when the ability to adapt to the stress breaks down.
33
Q

Epinephrine actions include:

  1. vasoconstriction of skeletal muscle blood vessels.
  2. increase of serum glucose concentration.
  3. increase of insulin release from the pancreas.
  4. reduction of venous return to the heart.
A

ANSWER AND RATIONALE: 2. Increase of serum glucose concentration. This occurs because of gluconeogenesis, glycogenolysis, and reduced uptake of glucose by muscle.

  1. Epinephrine produces vasodilation of blood vessels in skeletal muscle.
  2. Insulin release from the pancreas is decreased in response to epinephrine.
  3. Venous return to the heart is increased by epinephrine.
34
Q

Cortisol:

  1. increases the rate of protein synthesis.
  2. reduces gastric secretions.
  3. stimulates immune function.
  4. stimulates fibroblast proliferation at wound sites.
A

ANSWER AND RATIONALE: 1. Increases the rate of protein synthesis. Cortisol stimulates the synthesis of proteins by the liver. This is the anabolic action of cortisol.

  1. Cortisol promotes gastric secretion.
  2. Cortisol suppresses immune function and reduces inflammation.
  3. Cortisol reduces fibroblasts at wound sites and slows wound healing.

NURS 500 (2 decks)

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