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adv. patho > exam 3 questions > Flashcards

exam 3 questions Flashcards

1
Q

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

A

a. Increased serum calcium levels

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2
Q

Regulation of the release of insulin is an example of which type of regulation?

a. Negative feedback
b. Positive feedback
c. Neural
d. Physiologic

A

c. Neural

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3
Q

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.

A

d. Excessive hormone production results from a failure to turn off the system.

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4
Q

Which substance is a water-soluble protein hormone?

a. Thyroxine
b. Aldosterone
c. Follicle-stimulating hormone
d. Insulin

A

d. Insulin

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5
Q

Which of these is a lipid-soluble hormone?

a. Cortisol
b. Oxytocin
c. Epinephrine
d. Growth hormone

A

a. Cortisol

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6
Q

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

A

b. Free in an unbound, water-soluble form

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7
Q

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

A

d. Direct

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8
Q

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

A

b. Negative feedback

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9
Q

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.”

A

c. “No, many hormones are made from cholesterol.”

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10
Q

Which second messenger is stimulated by epinephrine binding to a E-adrenergic receptor?

a. Calcium
b. Inositol triphosphate (IP3)
c. Diacylglycerol (DAG)
d. Cyclic adenosine monophosphate (cAMP)

A

d. Cyclic adenosine monophosphate (cAMP)

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11
Q

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.

A

c. It acts as a second messenger

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12
Q

What is the portion of the pituitary that secretes oxytocin?

a. Posterior
b. Inferior
c. Anterior
d. Superior

A

a. Posterior

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13
Q

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.”

A

d. “Antidiuretic hormone causes vasoconstriction to help increase blood pressure.”

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14
Q

What is the target tissue for prolactin-releasing factor?

a. Hypothalamus
b. Anterior pituitary
c. Mammary glands
d. Posterior pituitary

A

b. Anterior pituitary

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15
Q

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

A

a. Hypothalamus; renal tubular cells

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16
Q

Where is oxytocin synthesized?

a. Hypothalamus
b. Paraventricular nuclei
c. Anterior pituitary
d. Posterior pituitary

A

a. Hypothalamus

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17
Q

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

A

d. Portal hypophyseal blood vessels

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18
Q

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

A

c. Iodide

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19
Q

Which hormone triggers uterine contractions?

a. Thyroxine
b. Oxytocin
c. Growth hormone
d. Insulin

A

b. Oxytocin

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20
Q

What effect does hyperphosphatemia have on other electrolytes?

a. Increases serum calcium
b. Decreases serum calcium
c. Decreases serum magnesium
d. Increases serum magnesium

A

b. Decreases serum calcium

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21
Q

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

A

a. Potassium

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22
Q

A person who has experienced physiologic stresses will have increased levels of which hormone?

a. Cortisol
b. Thyroid hormone
c. Somatostatin
d. Alpha endorphin

A

a. Cortisol

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23
Q

What is the action of calcitonin?

a. Increases metabolism
b. Decreases metabolism
c. Increases serum calcium
d. Decreases serum calcium

A

d. Decreases serum calcium

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24
Q

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)

A

a. Parathyroid hormone (PTH)

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25
Q

Which hormone inhibits the secretion of growth hormone (GH)?

a. Somatostatin
b. Thyroxine
c. Thyroid-stimulating hormone
d. Calcitonin

A

a. Somatostatin

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26
Q

Where are target cells for parathyroid hormone located?

a. Tubules of nephrons
b. Thyroid gland
c. Glomeruli of nephrons
d. Smooth and skeletal muscles

A

a. Tubules of nephrons

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27
Q

Which compound or hormone is secreted by the adrenal medulla?

a. Cortisol
b. Epinephrine
c. Androgens
d. Aldosterone

A

b. Epinephrine

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28
Q

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.

A

c. Beta cell function decreases.

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29
Q

What does aldosterone directly increase the reabsorption of?

a. Magnesium
b. Calcium
c. Sodium
d. Water

A

c. Sodium

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30
Q

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

A

a. Thyroid-stimulating hormone secretion below normal

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31
Q

What are actions of glucocorticoids? (Select all that apply.)

a. Decreasing muscle cell reuptake of glucose
b. Fat storage
c. Decreased blood glucose
d. Carbohydrate metabolism
e. Liver gluconeogenesis

A

a. Decreasing muscle cell reuptake of glucose
d. Carbohydrate metabolism
e. Liver gluconeogenesis

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32
Q

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

A

c. Sodium dilution and water retention

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33
Q

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

A

a. Being treated for small cell carcinoma of the stomach

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34
Q

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

A

c. Serum sodium (Na+) level of 120 mEq/L and serum osmolality 260 mOsm/kg

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35
Q

What is diabetes insipidus a result of?

a. Antidiuretic hormone hyposecretion
b. Antidiuretic hormone hypersecretion
c. Insulin hyposecretion
d. Insulin hypersecretion

A

a. Antidiuretic hormone hyposecretion

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36
Q

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

A

a. Administration of desmopressin

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37
Q

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.

A

a. Stop the water deprivation test.

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38
Q

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

A

c. Posterior pituitary trauma

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39
Q

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

A

b. Nephrogenic

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40
Q

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

A

a. Low urine-specific gravity

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41
Q

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

A

a. Exogenous ADH replacement

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42
Q

Which condition may result from pressure exerted by a pituitary tumor?

a. Hypothyroidism
b. Hypercortisolism
c. Diabetes insipidus
d. Insulin hyposecretion

A

a. Hypothyroidism

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43
Q

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

A

a. The patient has a lack of all hormones associated with the anterior pituitary gland.

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44
Q

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

A

c. Pressure of the tumor on the optic chiasm

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45
Q

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

A

b. Increased growth hormone

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46
Q

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

A

b. Sleep patterns

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47
Q

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.

A

b. Their epiphyseal plates have not yet closed

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48
Q

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

A

c. CT scan of the head

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49
Q

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

A

c. A thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones

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50
Q

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

A

c. Hyperthermia and tachycardia

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51
Q

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

A

a. High levels of circulating thyroid-stimulating immunoglobulins

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52
Q

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

A

d. Thyroid diffusely enlarged

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53
Q

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

A

b. Iodine

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54
Q

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

A

d. Fine-needle aspiration biopsy

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55
Q

Renal failure is the most common cause of which type of hyperparathyroidism?

a. Primary
b. Secondary
c. Exogenous
d. Inflammatory

A

b. Secondary

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56
Q

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

A

c. Serum calcium

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57
Q

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.

A

b. Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis

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58
Q

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

A

c. Elevation in serum glucose

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59
Q

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

A

a. Resistance to insulin by insulin-sensitive tissues

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60
Q

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

A

c. Hypoglycemia caused by increased exercise

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61
Q

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

A

a. 28 mg/dL

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62
Q

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

A

d. Kussmaul respirations

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63
Q

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

A

a. The Somogyi effect

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64
Q

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

A

c. Treatment with an ACE inhibitor

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65
Q

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. -Glycosidase inhibitor (miglitol)

A

a. Biguanide (metformin)

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66
Q

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

A

c. The capillary basement membranes thicken, and cell hyperplasia develops.

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67
Q

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.

A

d. Retinal ischemia and red blood cell aggregation occur.

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68
Q

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

A

d. Use of glucocorticoids

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69
Q
  1. A person may experience which complications as a result of a reduction in parathyroid hormone (PTH)? (Select all that apply.)

a. Muscle spasms
b. Tonic-clonic seizures
c. Laryngeal spasms
d. Hyporeflexia
e. Asphyxiation

A

a. Muscle spasms
b. Tonic-clonic seizures
d. Hyporeflexia
e. Asphyxiation

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70
Q

A chronic complication of diabetes mellitus is likely to result in microvascular complications in which areas? (Select all that apply.)

a. Eyes
b. Coronary arteries
c. Renal system
d. Peripheral vascular system
e. Nerves

A

a. Eyes
c. Renal system
e. Nerves

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71
Q

What are clinical manifestations of hypothyroidism? (Select all that apply.)

a. Intolerance to heat
b. Restlessness
c. Constipation
d. Bradycardia
e. Lethargy

A

c. Constipation
d. Bradycardia
e. Lethargy

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72
Q

Which pathway carries sensory information toward the central nervous system (CNS)?

a. Ascending
b. Descending
c. Somatic
d. Efferent

A

a. Ascending

73
Q

Which type of axon transmits a nerve impulse at the highest rate?

a. Large nonmyelinated
b. Large myelinated
c. Small nonmyelinated
d. Small myelinated

A

b. Large myelinated

74
Q

Which nerves are capable of regeneration?

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

A

c. Myelinated nerves in the peripheral nervous system

75
Q

Where is the neurotransmitter, norepinephrine, secreted?

a. Somatic nervous system
b. Parasympathetic preganglion
c. Sympathetic postganglion
d. Parasympathetic postganglion

A

c. Sympathetic postganglion

76
Q

Both oligodendroglia and Schwann cells share the ability to do what?

a. Form a myelin sheath
b. Remove cellular debris
c. Transport nutrients
d. Line the ventricles

A

a. Form a myelin sheath

77
Q

During a synapse, what change occurs after the neurotransmitter binds to the receptor?

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.

A

b. The permeability of the postsynaptic neuron changes; consequently, its membrane potential is changed as well.

78
Q

What name is given to a large network of neurons within the brainstem that is essential for maintaining wakefulness?

a. Midbrain
b. Reticular activating system
c. Medulla oblongata
d. Pons

A

b. Reticular activating system

79
Q

Thought and goal-oriented behaviors are functions of which area of the brain?

a. Cerebellum
b. Limbic system
c. Prefrontal lobe
d. Occipital lobe

A

c. Prefrontal lobe

80
Q

Where is the region responsible for the motor aspects of speech located?

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

A

b. Broca speech area in the frontal lobe

81
Q

Parkinson disease is associated with defects in which area of the brain?

a. Thalamus
b. Medulla oblongata
c. Cerebellum
d. Substantia nigra

A

d. Substantia nigra

82
Q

Maintenance of a constant internal environment and the implementation of behavioral patterns are main functions of which area of the brain?

a. Thalamus
b. Epithalamus
c. Subthalamus
d. Hypothalamus

A

d. Hypothalamus

83
Q

The ability of the eyes to track moving objects through a visual field is primarily a function of which colliculi?

a. Inferior
b. Superior
c. Mid
d. Posterior

A

b. Superior

84
Q

What part of the brain mediates the physical expression of emotions?

a. Hypothalamus
b. Basal ganglia
c. Medulla oblongata
d. Subthalamus

A

a. Hypothalamus

85
Q

Reflex activities concerned with heart rate, blood pressure, respirations, sneezing, swallowing,
and coughing are controlled by which area of the brain?

a. Pons
b. Midbrain
c. Cerebellum
d. Medulla oblongata

A

d. Medulla oblongata

86
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. Midbrain
b. Pons
c. Medulla oblongata
d. Lateral colliculi

A

b. Pons

87
Q

A healthcare professional is assessing a patient for dysfunction of cranial nerve VII. What assessment finding would confirm the professional’s suspicion?

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.

A

c. Patient is able to smile only on one side of the face.

88
Q

Which area of the brain assumes the responsibility for involuntary muscle control and for maintaining balance and posture?

a. Cerebrum
b. Cerebellum
c. Diencephalon
d. Brainstem

A

b. Cerebellum

89
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. 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)

A

b. Initial paralysis, but gradual partial recovery later

90
Q

What is the membrane that separates the brain’s cerebellum from its cerebrum?

a. Tentorium cerebelli
b. Falx cerebri
c. Arachnoid membrane
d. Falx cerebelli

A

a. Tentorium cerebelli

91
Q

A patient has a defect in the arachnoid villi. What finding would the healthcare professional expect to note?

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

A

d. Absorption of too little cerebrospinal fluid

92
Q

Where is the cerebrospinal fluid (CSF) produced?

a. Arachnoid villi
b. Choroid plexuses
c. Ependymal cells
d. Pia mater

A

b. Choroid plexuses

93
Q

Which of the meninges closely adheres to the surface of the brain and spinal cord and follows the sulci and fissures?

a. Dura mater
b. Arachnoid
c. Pia mater
d. Inner dura

A

c. Pia mater

94
Q

Norepinephrine produces what primary response?

a. Increased contractility of the heart
b. Release of renin from the kidney
c. Vasoconstriction
d. Sleep cycle disturbance

A

c. Vasoconstriction

95
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. “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.”

A

b. “Your blood sugar may be high because of the stress of the situation.”

96
Q

The brain receives approximately what percentage of the cardiac output?

a. 80%
b. 40%
c. 20%
d. 10%

A

c. 20%

97
Q

What is the collateral blood flow to the brain provided by?

a. Carotid arteries
b. Basilar artery
c. Circle of Willis
d. Vertebral arteries

A

c. Circle of Willis

98
Q

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

A

b. Leukocytes 110/mm3

99
Q

Which cranial nerves contain parasympathetic nerves? (Select all that apply.)

a. I (olfactory)
b. III (oculomotor)
c. VII (facial)
d. IX (glossopharyngeal)
e. X (vagus)

A

b. III (oculomotor)
c. VII (facial)
d. IX (glossopharyngeal)
e. X (vagus)

100
Q

The sympathetic nervous system primarily serves to protect an individual by doing which of these? (Select all that apply.)

a. Decreasing mucous production
b. Increasing blood sugar levels
c. Increasing body temperature
d. Decreasing sweat excretion
e. Increasing blood pressure

A

b. Increasing blood sugar levels
c. Increasing body temperature
e. Increasing blood pressure

101
Q

The aging process brings about what changes to human cells? (Select all that apply.)

a. Increased neurofibrillary tangles
b. Imbalance of neurotransmitters
c. Increased neuron production
d. Decreased myelin presence
e. Altered dendrite structure

A

a. Increased neurofibrillary tangles
b. Imbalance of neurotransmitters
d. Decreased myelin presence
e. Altered dendrite structure

102
Q

Which statements are true regarding the blood-brain barrier (BBB)? (Select all that apply.)

a. The BBB is dependent on astrocytes.
b. It uses the meningeal layers of the brain.
c. It restricts the flow of large molecules, such as plasma proteins.
d. Naturally occurring inflammatory mediators affect the BBB.
e. Becomes increasingly permeable with aging

A

a. The BBB is dependent on astrocytes.
c. It restricts the flow of large molecules, such as plasma proteins.
d. Naturally occurring inflammatory mediators affect the BBB.
e. Becomes increasingly permeable with aging

103
Q

What evidence does the nurse expect to see when a patient experiences trauma to the hypothalamus? (Select all that apply.)

a. Uneven expression of mood
b. Unstable blood glucose levels
c. Poor regulation of body temperature
d. Visual disturbances such as blurred vision
e. Nausea, vomiting, and symptoms of gastroesophageal reflux disease

A

a. Uneven expression of mood
b. Unstable blood glucose levels
c. Poor regulation of body temperature

104
Q

What is a Schwann cell? (Select all that apply.)

a. Can form the myelin sheath
b. Is also referred to as a neurolemma
c. Affects the function of the nodes of Ranvier
d. Is located in the peripheral nervous system
e. Is responsible of decreasing conduction velocity

A

a. Can form the myelin sheath
b. Is also referred to as a neurolemma
c. Affects the function of the nodes of Ranvier
d. Is located in the peripheral nervous system

105
Q

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

A

a. Reduced levels of consciousness

106
Q

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

A

a. Brief period of vital sign instability

107
Q

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

A

d. Teaching older adults how to prevent trip-and-fall events

108
Q

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

A

b. Respirations

109
Q

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

A

b. Reflex emptying of the bladder

110
Q

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

A

c. Autonomic hyperreflexia

111
Q

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

A

a. The hypothalamus is unable to regulate body heat as a result of damage to the sympathetic nervous system.

112
Q

Autonomic hyperreflexia-induced bradycardia is a result of stimulation of what?

a. Sympathetic nervous system to -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

A

b. Carotid sinus to the vagus nerve to the sinoatrial node

113
Q

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

A

c. L5 to S1

114
Q

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

A

b. Hypertension

115
Q

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

A

d. Anterior cerebral

116
Q

Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?

a. Hemorrhagic
b. Thrombotic
c. Embolic
d. Lacunar

A

c. Embolic

117
Q

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

A

c. Lacunar

118
Q

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

A

d. Arteriovenous malformation

119
Q

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

A

a. Systolic bruit over the carotid artery

120
Q

Which cerebral vascular hemorrhage causes meningeal irritation, photophobia, and positive
Kernig and Brudzinski signs?

a. Intracranial
b. Subarachnoid
c. Epidural
d. Subdural

A

b. Subarachnoid

121
Q

In adults, how are most intracranial tumors located?

a. Infratentorially
b. Supratentorially
c. Laterally
d. Posterolaterally

A

b. Supratentorially

122
Q

In children, how are most intracranial tumors located?

a. Infratentorially
b. Supratentorially
c. Laterally
d. Posterolaterally

A

a. Infratentorially

123
Q

What is the most common primary central nervous system (CNS) tumor?

a. Microglioma
b. Neuroblastoma
c. Astrocytoma
d. Neuroma

A

c. Astrocytoma

124
Q

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

A

b. Demyelination of nerve fibers in the CNS

125
Q

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

A

a. Frontal

126
Q

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

A

d. Occipital

127
Q

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

A

d. Cervical and thoracic lumbar

128
Q

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.

A

c. Take the patient’s blood pressure and pulse.

129
Q

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

A

d. Arteriovenous malformation

130
Q

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

A

c. At branches of arteries

131
Q

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

A

c. Oral pyrimethamine

132
Q

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

A

a. It is often preceded by a viral illness.

133
Q

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.

A

d. It causes muscle weakness.

134
Q

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

A

c. Myasthenia gravis

135
Q

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.

A

a. Result from demyelination by an immune reaction.

136
Q

Which clinical manifestations are characteristic of cluster headaches? (Select all that apply.)

a. Preheadache aura
b. Severe unilateral tearing
c. Gradual onset of a tight band around the head
d. Can be associated with vomiting
e. Pain lasting from 20 to 120 min

A

b. Severe unilateral tearing

e. Pain lasting from 20 to 120 min

137
Q

What are the initial clinical manifestations immediately noted after a spinal cord injury? (Select all that apply.)

a. Headache
b. Bladder incontinence
c. Loss of deep tendon reflexes
d. Hypertension
e. Flaccid paralysis

A

b. Bladder incontinence
c. Loss of deep tendon reflexes
e. Flaccid paralysis

138
Q

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.

A

b. Ensure the patient has a safe environment.

139
Q

6 stages of water soluble hormones

A

bind to membrane receptor

activation of G protein from binding

G protein activates adenylyl cyclase

adenylyl cyctase catalyzes the conversion of ATP to cAMP

cAMP activates protein kinasses

Protein kinases phosphorylate protein in cytoplasm

140
Q

cranial nerve that

sense of smell

A

olfactory nerve

141
Q

cranial nerve that

vision

A

optic nerve

142
Q

cranial nerve that

motor to eye and eyelid (movement) and pupil constriction

A

oculomotor nerve

143
Q

cranial nerve that

motor to eye (moves eyelid down laterally)

A

trochlear nerve

144
Q

cranial nerve that

motor for chewing muscles, sensory to face and head

A

trigeminal nerve

145
Q

cranial nerve that

eye movement (laterally)

A

abducens nerve

146
Q

cranial nerve that

taste, facial expression

A

facial nerve

147
Q

cranial nerve that

hearing, balance and equilibrium

A

vestibulocochlear nerve

148
Q

cranial nerve that

taste, swallowing

A

glossopharyngeal nerve

149
Q

cranial nerve that

sensory, motor and autonomic functions of the viscera

A

vagus nerve

150
Q

cranial nerve that

motor control of head movement and swallowing

A

accessory nerve

151
Q

cranial nerve that

motor control of the tongue

A

hypoglossal nerve

152
Q

Hormone that:

Stimulates secretion of TSH and prolactin

A

Thyrotropin-releasing hormone

153
Q

Hormone that:

Stimulates secretion of ACTH

A

Corticotropin-releasing hormone

154
Q

2 Hormones that:

Stimulates secretion of growth hormone

A

Gonadotropin-releasing hormone

Growth hormone-releasing hormone

155
Q

Hormone that:

Inhibits secretion of growth hormone

A

Somatotropin release-inhibiting hormone (somatostatin)

156
Q

Hormone that:

Inhibits secretion of prolactin

A

Prolactin-inhibiting factor (dopamine)

157
Q

Hormone that:

Stimulates synthesis and secretion of thyroid hormones

A

Thyroid-stimulating hormone

158
Q

Hormone that:

Stimulates growth of ovarian follicles and estrogen secretion. Promotes sperm maturation (testes

A

Follicle-stimulating hormone

159
Q

Hormone that:

Stimulates ovulation, formation of corpus luteum and synthesis of estrogen and progesterone (ovary)
Stimulates synthesis and secretion of testosterone (testes)

A

Luteinizing hormone

160
Q

Hormone that:

Stimulates protein synthesis and overall growth

A

Growth hormone

161
Q

Hormone that:

Stimulates milk production and breast development

A

Prolactin

162
Q

Hormone that:

Stimulates synthesis and secretion of adrenal cortical hormones

A

Adrenocorticotropic hormone

163
Q

Hormone that:

Stimulates melanin synthesis

A

Melanocyte-stimulating hormone

164
Q

Hormone that:

Milk ejection, uterine contraction

A

Oxytocin

165
Q

Hormone that:

Stimulates H2O reabsorption by renal collecting duct and contraction of arterioles

A

Antidiuretic hormone (vasopressin)

166
Q

Hormone that:

Skeletal growth; Increase O2 consumption; heat production; Increase protein, fat and carbohydrate use; maturation of nervous system (perinatal)

A

L-thyroxine Triiodothyronine

167
Q

Hormone that:

Stimulates gluconeogenesis; anti-inflammatory; immunosuppression

A

Glucocorticoids (cortisol

168
Q

Hormone that:

Growth and development of female reproduction organs; follicular phase of menstrual cycle

A

Estradiol

169
Q

Hormone that:

Luteal phase of menstrual cycle

A

Progesterone

170
Q

Hormone that:

Spermatogenesis; male secondary sex characteristics

A

Testosterone

171
Q

Hormone that:

Increase serum Ca2+; decrease serum phosphate

A

Parathyroid hormone

172
Q

Hormone that:

Decrease serum Ca2+

A

Calcitonin

173
Q

Hormone that:

Increase renal Na+ reabsorption; increase renal K+ secretion; increase renal H+ secretion

A

Aldosterone

174
Q

Hormone that:

Increase intestinal Ca2+ absorption; increase bone mineralization

A

1,25-Dihydroxycholealciferol

175
Q

Hormone that:

Decrease blood glucose, amino acids and fatty acids

A

Insulin

176
Q

Hormone that:

Increase blood glucose and fatty acids

A

Glucagon

177
Q

Hormone that:

Decrease estrogen and progesterone synthesis in corpus luteum of pregnancy

A

Human Chorionic Gonadotropin

178
Q

Hormone that:

Same actions as growth hormone and prolactin during pregnancy

A

Human placental lactogen

179
Q

Hormone that:

Stimulates secretion of TSH and prolactin

A

Thyrotropin-releasing hormone

adv. patho (10 decks)

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