MID TERM Flashcards
1
Q
The cellular uptake of the nutrient cholesterol depends on which process?
A
c. Receptor-mediated endocytosis
2
Q
With a mucous glands so creates a new substance from previously observed material, this process is known ass which specialized cellular function?
A
D . Secretion
3
Q
What is the most abundant class of plasma protein?
A
b. Albumin
4
Q
What is the effect of low plasma albumin?
A
d. Osmotic pressure decreases; thus water moves from the capillaries to the interstitium.
5
Q
- What is the life span of an erythrocyte (in days)?
A
c. 100 to 120
6
Q
What does the student learn about erythrocytes?
A
C.. Erythrocytes have the ability to change shape to squeeze through microcirculation.
7
Q
- What are granulocytes that contain granules of vasoactive amines, such as histamine, called?
A
d. Basophils
8
Q
- Which of these are formed elements of the blood that are not cells but are disk-shaped cytoplasmic fragments essential for blood clotting?
A
b. Platelets
9
Q
What are blood cells that differentiate into macrophages known as?
A
a. Monocytes
10
Q
Without prior exposure to an antigen, which cells are able to destroy some types of tumor cells and some virus-infected cells?
A
D.. Natural killer (NK) cells
11
Q
What is the life span of platelets (in days)?
A
A.10
12
Q
Fetal hematopoiesis occurs primarily in which structure?
A
b. Spleen
13
Q
What is the consequence of a splenectomy?
A
c. The number of defective cells in circulation increases
14
Q
A professor explains to a class that the reason lymph nodes enlarge and become tender during infection is because of what reason?
A
a. B lymphocytes proliferate.
15
Q
Which hemoglobin is made from oxidized ferric iron (Fe3+) and lacks the ability to bind oxygen?
A
c. Methemoglobin
16
Q
A patient has pernicious anemia and asks the healthcare professional to explain the disease. Which statement by the professional is most accurate?
A
b. Your body cannot absorb vitamin B12.
17
Q
By which structure are mature erythrocytes removed from the bloodstream?
A
. D.Spleen
18
Q
A patient has chronic anemia associated with chronic renal failure. What substance does the healthcare professional tell the patient is needed to treat this anemia?
A
b. Erythropoietin
19
Q
What is the role of thromboxane A (TXA2) in the secretion stage of hemostasis?
A
c. Stimulates platelet aggregation.
20
Q
Which of these is the role of nitric oxide (NO) in hemostasis?
A
d. Controls platelet activation through in concert with prostacyclin.
21
Q
The drug heparin acts in hemostasis by which processes?
A
a. Inhibiting thrombin and antithrombin III (AT-III)
22
Q
What is plasmin’s role in the clotting process?
A
d. Degrades the fibrin within blood clots.
23
Q
Soon after birth, a newborn has cord blood drawn which shows hemoglobin of 28.2 mg/dL. What does the healthcare professional understand about this finding?
A
a. The baby suffered from hypoxia in utero.
24
Q
Where are Kupffer cells located?
A
b. Liver
25
The student learns that Langerhans cells are only found in which organ?
a. Skin
26
What does the student learn about the role of collagen in the clotting process?
b. Activates platelets
27
Which form of iron (Fe) can be used in the formation of normal hemoglobin
b. Fe2+
28
What change to the hematologic system is related to age?
b. Lymphocyte function decreases
29
What is the function of erythrocytes?
a. Tissue oxygenation
30
What term is used to describe the capacity of some erythrocytes to vary in size, especially in relationship to some anemias?
c. Anisocytosis
31
What is the fundamental physiologic manifestation of anemia?
c. Hypoxia
32
The paresthesia that occurs in vitamin B12 deficiency anemia is a result of which of these?
b. Myelin degeneration in the spinal cord
33
4. Which of these describes how the body compensates for anemia?
a. Increasing rate and depth of breathing
34
Which of these classified as a megaloblastic anemia?
b. Pernicious
35
The students learn that deficiencies in folate and vitamin B12 alter the synthesis of which of these?
c. DNA
36
A patient has defective secretion of the intrinsic factor leading to anemia. What treatment option does the healthcare professional discuss with the patient?
b. Vitamin B12 injections initially given once a week
37
After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result?
d. Pernicious
38
Which condition resulting from untreated pernicious anemia (PA) is fatal?
c. Heart failure
39
How is the effectiveness of vitamin B12 therapy measured?
a. Reticulocyte count
40
A healthcare professional has educated a student on folic acid. Which statement by the student indicates that more teaching is needed?
a. Folic acid absorption is dependent on the enzyme folacin
41
Which anemia produces small, pale erythrocytes?
c. Iron deficiency
42
A patient in the healthcare clinic reports fatigue, weakness, and dyspnea, as well as pale conjunctiva of the eyes and brittle, concave nails. What assessment by the healthcare professional is most appropriate for the suspected anemia?
b. Oral mucus membranes and tongue
43
A healthcare professional in an urban clinic is seeing a patient who has iron deficiency anemia (IDA). What question by the professional is most appropriate to assess for the cause of IDA?
b. “Have you ever noticed any blood in your stool?”
44
A healthcare professional works with recent refugees. A mother brings in her children who have been diagnosed with iron deficiency anemia. What action by the professional is most appropriate?
b. Arrange to test for parasitic infections.
45
A patient has hepatomegaly, bronze-colored skin, and cardiac dysrhythmias. What condition does the healthcare professional prepare to teach the patient about?
c. Hereditary hemochromatosis
46
A healthcare professional is reviewing a patient’s laboratory results and sees that the patient has a low reticulocyte count and a high iron level. Which type of anemia does the professional associate these findings with?
a. Folate deficiency anemia
47
In aplastic anemia (AA), pancytopenia develops as a result of what?
b. Suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes
48
A student asks the professor what the most common pathophysiologic process is that triggers aplastic anemia (AA). What response by the professor is most accurate?
a. Autoimmune disease against hematopoiesis by activated cytotoxic T (Tc) cells
49
An allogenic bone marrow transplantation remains the preferred method for treating which anemia?
b. Aplastic
50
What does the student learn about warm autoimmune hemolytic anemia?
c. Erythrocytes are bound to macrophages and sequestered in the spleen.
51
A student asks the professor to explain the jaundice that accompanies hemolytic anemia. Which statement is by the professor is most accurate?
b. Heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin.
52
Shortened erythrocyte life span, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiologic characteristics of which type of anemia?
c. Anemia of chronic disease
53
A patient has polycythemia vera and presents to the Emergency Department with plethora and neurological changes. The student asks the healthcare professional to explain the primary cause of these symptoms. What response by the professional is best?
c. Increased blood viscosity
54
What does treatment for polycythemia vera involve?
a. Therapeutic phlebotomy and radioactive phosphorus
55
An adult patient has been hospitalized with thrombocytopenia with a platelet count of 8000/mm3. What action by the healthcare professional is most appropriate?
a. Tell the patient not to get out of bed without assistance.
56
A patient in the hospital has been receiving heparin injections. The platelet count on admission was 222,000/mm3 and four days later is 113,000/mm3. What action by the healthcare professional is best?
c. Switch the heparin to lepirudin
57
A patient is 8 hours postoperative after a long orthopedic procedure. The student asks why this patient is at particular risk of developing a thromboembolism. What response by the healthcare professional is best?
a. Patients tend to have venous stasis from orthopedic operations.
58
A patient has been hospitalized for a large deep vein thrombosis and states he is the third person in his family to have this condition in the last 2 years. What response by the healthcare professional is most appropriate?
b. “We can test your blood for factor V Leiden.”
59
In infectious mononucleosis (IM), what does the Monospot test detect?
b. Immunoglobulin M (IgM)
60
A patient has been diagnosed with acute lymphocytic leukemia (ALL) and asks the healthcare professional to describe it. What description by the professional is most accurate?
a. ALL is a progressive neoplasm defined by the presence of greater than 30% lymphoblasts in the bone marrow or blood.
61
Which description is consistent with chronic myelogenous leukemia (CML)?
d. The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL1.
62
A patient is admitted to the hospital with multiple myeloma (MM). Which diagnostic test should the healthcare professional assess as the priority?
b. Serum calcium level
63
Local signs and symptoms of Hodgkin disease-related lymphadenopathy are a result of what?
b. Pressure and obstruction
64
Which virus is associated with Burkitt lymphoma in African children?
d. Epstein-Barr virus
65
A hospitalized patient’s lab work is as follows: WBC 2000, bands 14.8%, and segmented neutrophils 5. The healthcare professional calculates the patient’s absolute neutrophil count ANC). What action does the professional take next?
a. Implements protocols to prevent life-threatening infections
66
. A person has been diagnosed with acute lymphocytic leukemia (ALL) that is positive for the Philadelphia chromosome. What statement by the healthcare professional is most appropriate?
c. “We are planning to get your disease in remission, but it will be hard.
67
A person comes to the healthcare clinic and reports night sweats and fever. The healthcare professional obtains a chest x-ray which shows a mediastinal mass. What other assessment or diagnostic test does the professional provide as a priority?
a. Listen to heart sounds.
68
1. What is the cause of polycythemia in the fetus?
c. Increased erythropoiesis occurs in response to the hypoxic intrauterine environment.
69
Why does fetal hemoglobin have a greater affinity for oxygen than adult hemoglobin?
c. Fetal hemoglobin interacts less readily with diphosphoglycerate (DPG), which inhibits hemoglobin-oxygen binding.
70
Which blood cell type is elevated at birth and through the preschool years, but decreases to adult levels afterward?
a. Monocytes
71
In a full-term infant, the normal erythrocyte life span is _____ days.
b. 60 to 80
72
What is the most common cause of insufficient erythropoiesis in children?
b. Iron deficiency
73
How does hemolytic disease of the fetus and newborn (HDFN) cause acquired congenital hemolytic anemia?
b. HDFN is an alloimmune disease in which the mother’s immune system produces antibodies against fetal erythrocytes, which are recognized as foreign and removed from circulation.
74
How is erythroblastosis fetalis defined
b. Alloimmune disease in which maternal blood and fetal blood are antigenically incompatible
75
A newborn displays pallor, tachycardia, and has a systolic murmur. What hemoglobin value does the healthcare professional correlate with these manifestations?
d. 5 g/dL
76
A child has iron deficiency anemia. In addition to iron supplements, what else does the healthcare professional educate the parents on giving the child?
c. Vitamin C
77
Which mother does the healthcare professional prepare to administer Rh immune globulin (RhoGAM) to?
b. Is Rh-negative and the fetus is Rh-positive
78
When diagnosed with hemolytic disease of the fetus and newborn (HDFN), why does the newborn develop hyperbilirubinemia after birth but not in utero?
a. Excretion of unconjugated bilirubin through the placenta into the mother’s circulation is no longer possible.
79
The healthcare professional is caring for a woman whose baby died of hydrops fetalis. How does the professional explain this condition to a student?
d. Severe intrauterine anemia that leads to edema of the entire body
80
What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in the brain?
a. Kernicterus
81
An infant was born with hemolytic disease of the fetus and newborn (HDFN). What treatment does the healthcare professional anticipate for this baby?
b. Replacement transfusion of Rh-positive blood not contaminated with anti-Rh antibodies
82
The healthcare professional explains to a student that glucose 6-phosphate dehydrogenase (G6PD) deficiency is what type of inherited disorder?
b. X-linked recessive
83
A healthcare professional is teaching a community group about inherited disorders. What pattern of inheritance does the professional describe for sickle cell disease?
b. Inherited autosomal recessive disorder
84
Hemoglobin S (HbS) is formed in sickle cell disease as a result of which process?
c. Genetic mutation in which one amino acid (glutamate) is replaced by another (valine).
85
A child has sickle cell disease (SCD). What treatment or therapy does the healthcare professional discuss with the parents and child?
a. Hydroxyurea
86
Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in children?
b. Edema of the hands and feet
87
A couple who both carry the sickle cell trait wish to have children. What does the healthcare professional tell them is the chance that each pregnancy will result in a child who has sickle cell disease (SCD)?
b. 25%
88
A patient has microcytic, hypochromic anemia. Which type of treatment or procedure does the healthcare professional discuss as a potential cure with the patient?
a. Cord blood transplantation
89
A patient has thalassemia major. After receiving multiple blood transfusions over the last several months, what complication does the healthcare professional assess the patient for?
a. Hemochromatosis
90
. The alpha- and beta-thalassemias are considered what types of inherited disorder?
a. Autosomal recessive
91
Hemophilia B is caused by a deficiency of which clotting factor?
c. IX
92
A student asks the professor why hemophilia A is seen mostly in men. The professor explains that hemophilia A is considered to be what type of inherited disorder?
c. X-linked recessive
93
Which disease is an autosomal dominant inherited hemorrhagic disease?
b. von Willebrand disease
94
A patient has primary immune thrombocytopenic purpura (ITP) and is hospitalized after a bleeding episode. What treatment does the healthcare provider anticipate being ordered for this patient?
b. Infusion of IVIG
95
When does fetal erythrocyte production shift from the liver to the bone marrow?
b. Fifth month of gestation
96
A healthcare professional educates parents to monitor their child’s dietary intake for sufficient iron during which period of time as the priority
b. Between 6 months and 2 years
97
A patient has leukemia. The healthcare professional explains to a patient about the significance of hyperdiploidy. What statement by the professional is most accurate?
a. It indicates a good prognosis.
98
What pulmonary defense mechanism propels a mucous blanket that entraps particles moving toward the oropharynx?
c. Cilia
99
Which term is used to identify the movement of gas and air into and out of the lungs?
b. Ventilation
100
When an individual aspirates food particles, where would the healthcare professional expect to hear decreased or absent breath sounds?
b. Right lung
101
Air passage among alveoli is collateral and evenly distributed because of the function of which structures?
b. Pores of Kohn
102
Where in the lung does gas exchange occur?
c. Alveolocapillary membrane
103
Surfactant produced by type II alveolar cells facilitates alveolar distention and ventilation by which mechanism?
c. Decreasing surface tension in the alveoli
104
Which part of the brainstem provides basic automatic rhythm of respiration by sending efferent impulses to the diaphragm and intercostal muscles?
b. Ventral respiratory group (VRG)
105
Which structures secrete surfactant?
b. Type II alveolar cells
106
Which describes the pressure in the pleural space?
b. Below atmospheric
107
A healthcare professional wants to determine the adequacy of a person’s alveolar ventilation. What assessment finding is most important for the professional to consider?
d. Arterial blood gas shows a PaCO2 of 44 mmHg.
108
Which normal physiologic change occurs in the aging pulmonary system?
c. Stiffening of the chest wall
109
How is most of the oxygen in the blood transported?
b. Bound to hemoglobin
110
Stretch receptors and peripheral chemoreceptors send afferent impulses regarding ventilation to which location in the brain?
c. Dorsal respiratory group (DRG) in the medulla oblongata
111
If a patient develops acidosis, the nurse would expect the oxyhemoglobin dissociation curve to react in which manner?
a. Shift to the right, causing more oxygen (O2) to be released to the cells
112
The sternocleidomastoid and scalene muscles are referred to as which group?
d. Accessory muscles of inspiration
113
A newborn has alveolar collapse, decreased lung expansion, increased work of breathing, and severe gas-exchange abnormalities and the student asks the healthcare professional for an explanation of what is happening. What response by the professional is best?
D.. Lack of surfactant leading to increased alveolar surface tension and fluid collection
114
The student asks the professor to explain what characteristic is demonstrated by lungs with decreased compliance?
c. Stiffness
115
The lung is innervated by the parasympathetic nervous system via which nerve?
a. Vagus
116
What event is characteristic of the function in Zone 1 of the lung?
c. The capillary bed collapses, and normal blood flow ceases.
117
Hypoventilation that results in the retention of carbon dioxide will stimulate which receptors in an attempt to maintain a normal homeostatic state?
b. Central chemoreceptors
118
What is the most important cause of pulmonary artery constriction?
a. Low alveolar partial pressure of arterial oxygen (PaO2)
119
A healthcare professional tells the student that a properly placed endotracheal tube for mechanical ventilation is 5 to 7 cm above the tracheal bifurcation. Where does this bifurcation occur?
c. Carina
120
How low must the partial pressure of arterial oxygen (PaO2) drop before the peripheral chemoreceptors influence ventilation?
c. Below 70 mmHg
121
Which receptors are located in the smooth muscles of airways?
b. Stretch receptors
122
. Which receptors are located near the respiratory center?
c. Central chemoreceptors
123
. Which receptors are located in the aortic bodies, aortic arch, and carotid bodies?
d. Peripheral chemoreceptors
124
A patient is having a spirometry measurement done and asks the healthcare professional to explain this test. What response by the professional is best?
b. To measure the volume and flow rate during forced expiration
125
Besides dyspnea, what is the most common characteristic associated with pulmonary disease?
c. Cough
126
A patient reports needing to sit up at night in order to breathe. What term does the healthcare professional document about this condition?
b. Orthopnea
127
Kussmaul respirations as a respiratory pattern may be associated with which characteristic(s)?
d. Slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
128
Respirations that are characterized by alternating periods of deep and shallow breathing are a result of which respiratory mechanism?
a. Decreased blood flow to the medulla oblongata
129
A hospitalized patient is complaining of shortness of breath, but the student does not notice cyanosis. The patient’s hemoglobin is 9 g/dL, so the student asks the healthcare professional to explain. The professional tells the student that what amount of hemoglobin must be desaturated before cyanosis occurs?
b. 5
130
What does the student learn about ventilation?
c. Hyperventilation causes hypocapnia.
131
A patient has long-standing pulmonary disease and chronic hypoxia. The student assesses the patient’s fingertips and notices bulbous enlargement of the distal segment of the digits. How does the student document this finding?
b. Clubbing
132
The student asks the healthcare professional to explain how pulmonary edema and pulmonary fibrosis cause hypoxemia. What description by the professional is best?
d. Impairs alveolocapillary membrane diffusion
133
High altitudes may produce hypoxemia through which mechanism?
c. Decreased inspired oxygen
134
Which condition is capable of producing alveolar dead space?
b. Pulmonary emboli
135
A patient has pulmonary edema. For what condition should the healthcare professional assess the patient as the priority?
b. Left-sided heart failure
136
A patient has a pulmonary capillary wedge pressure of 30mmHg. What assessment finding by the healthcare professional would be most consistent with this reading?
b. Pink, frothy sputum
137
A patient has a lung problem caused by dysfunction in the pores of Kohn. What action by the healthcare professional is best?
c. Have the patient do breathing exercises.
138
In what form of bronchiectasis do both constrictions and dilations deform the bronchi?
a. Varicose
139
A patient is brought to the Emergency Department with a gunshot wound to the chest. The healthcare professional assesses an abnormality involving a pleural rupture that acts as a oneway valve, permitting air to enter on inspiration but preventing its escape by closing during expiration. What action by the healthcare professional is the priority?
b. Assist with a chest tube insertion.
140
. A patient has a transudative pleural effusion but has minimal symptoms. What action by the healthcare professional is best?
c. Facilitate a blood draw to check protein stores.
141
Which condition involves an abnormally enlarged gas-exchange system and the destruction of the lung’s alveolar walls?
b. Emphysema
142
A patient has been diagnosed with pneumoconiosis and asks the healthcare professional to explain this disease. What description by the professional is best?
b. Inhalation of inorganic dust particles
143
A patient has been diagnosed with acute respiratory distress syndrome (ARDS). For what other health condition should the healthcare professional assess this patient for as the priority?
b. Pneumonia
144
Which structure(s) in acute respiratory distress syndrome (ARDS) release inflammatory mediators such as proteolytic enzymes, oxygen-free radicals, prostaglandins, leukotrienes, and platelet-activating factor?
d. Neutrophils
145
Pulmonary edema in acute respiratory distress syndrome (ARDS) is the result of an increase in what?
b. Capillary permeability
146
In acute respiratory distress syndrome (ARDS), alveoli and respiratory bronchioles fill with fluid as a result of which mechanism?
c. Inactivation of surfactant and the impairment of type II alveolar cells
147
Which type of pulmonary disease requires more force to expire a volume of air?
b. Obstructive
148
Which immunoglobulin (Ig) may contribute to the pathophysiologic characteristics of asthma?
b. IgE
149
A healthcare professional is educating a patient about asthma. The professional states that good control is necessary due to which pathophysiologic process?
b. Uncontrolled inflammation leads to increased bronchial hyperresponsiveness and eventual scarring.
150
A patient comes to the Emergency Department with inspiratory and expiratory wheezing, dyspnea, nonproductive cough, and tachypnea. What treatment does the healthcare professional anticipate for this patient as the priority?
d. Inhaled bronchodilator
151
A healthcare professional is educating a patient on asthma. The professional tells the patient that the most successful treatment for chronic asthma begins with which action?
a. Avoidance of the causative agent
152
. Which factor contributes to the production of mucus associated with chronic bronchitis?
c. Increased Goblet cell size
153
A patient with emphysema comes to the clinic and reports increased, productive cough. What diagnostic test should the healthcare professional facilitate as the priority?
a. Chest x-ray
154
A patient has been diagnosed with primary emphysema but claims there is no history of smoking. What action by the healthcare professional is most appropriate?
a. Facilitate genetic testing on the patient.
155
Which of these is the most common route of lower respiratory tract infection?
a. Aspiration of oropharyngeal secretions
156
A patient has recently been diagnosed with emphysema. What initial step in management of this disease does the healthcare professional discuss with the patient?
c. Cessation of smoking
157
The student asks a professor to explain how tuberculosis (TB) can remain dormant in some people. What explanation by the professor is best?
b. The bacilli can become isolated within tubercles in the lungs.
158
Pulmonary artery hypertension (PAH) results from which alteration?
a. Narrowed pulmonary capillaries
159
Squamous cell carcinoma of the lung is best described as a tumor that causes which alterations?
b. Pneumonia and atelectasis
160
A patient is diagnosed with a pneumothorax and asks the healthcare professional to explain this condition. What statement by the professional is most accurate?
b. Air in the pleural space
161
A patient has been diagnosed with an empyema. What does the healthcare professional tell the patient about this condition?
a. We will have to drain the pus out of your pleural space.
162
Fluid in the pleural space characterizes which condition?
a. Pleural effusion
163
A patient has silicosis. Which medication classification does the healthcare professional educate the patient about?
a. Corticosteroids
164
What medical term is used for a condition that results from pulmonary hypertension, creating chronic pressure overload in the right ventricle?
d. Cor pulmonale
165
Why is nasal congestion a serious threat to young infants?
a. Infants are obligatory nose breathers
166
The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born between how many weeks of gestation?
d. 30 and 36 weeks
167
A healthcare professional is educating a community parent group and informs them that which type of croup is most common?
b. Viral
168
What is the primary cause of respiratory distress syndrome (RDS) of the newborn?
c. Surfactant deficiency
169
What is the primary problem resulting from respiratory distress syndrome (RDS) of the newborn?
c. Atelectasis
170
Bronchiolitis tends to occur during the first years of life and is most often caused by what type of infection?
a. Respiratory syncytial virus (RSV)
171
Which immunoglobulin (Ig) is present in childhood asthma?
c. IgE
172
Which T-lymphocyte phenotype is the key determinant of childhood allergic asthma?
b. CD4 T-helper Th2 lymphocytes
173
A student asks the healthcare professional why researchers are trying to link specific genes to specific asthma phenotypes. What response by the professional is best?
c. It can lead to personalized approaches to treatment
174
Which statement by the healthcare professional accurately describes childhood asthma?
a. An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
175
A 7 year-old-child presents to the clinic where parents report signs and symptoms consistent with asthma. What does the healthcare professional do in order to confirm this diagnosis?
c. Measure expiratory flow rate with spirometry testing
176
Which statement by the professor best describes acute respiratory distress syndrome (ARDS)?
b. A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and the presence of bilateral infiltrates on chest x-ray imaging
177
When assessing for the signs and symptoms of acute respiratory distress syndrome (ARDS), the absence of which condition is considered characteristic?
d. Heart failure
178
. Parents bring a 5-year-old to the Emergency Department and report sudden onset of high fever, drooling, and they describe a “hot potato voice.” What action by the healthcare professional takes priority?
b. Allow the child to remain in the parent’s lap.
179
Which statement best describes cystic fibrosis?
c. Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferen
180
Parents of a child with cystic fibrosis want to know the chance of their next baby having this disease. What response by the healthcare professional is most accurate?
a. Each child will have a 25% chance of having the disease.
181
What abnormalities lead to the mucus plugging seen in children with cystic fibrosis (CF)?
c. Defective chloride secretion and excess sodium absorption thicken the mucus.
182
Between which months of age does sudden infant death syndrome (SIDS) most often occur?
b. 2 and 4
183
What is the most common predisposing factor to obstructive sleep apnea in children?
b. Adenotonsillar hypertrophy
184
Which statement best describes the cellular function of metabolic absorption?
c. Cells can take in and use nutrients
185
Where is most of a cell’s genetic information, including RNA and DNA, contained?
c. Nucleolus
186
Which component of the cell produces hydrogen peroxide (H2O2) by using oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction?
b. Peroxisomes
187
Which cell component is capable of cellular autodigestion when it is released during cell injury?
d. Lysosomes
188
Which cAMP-mediated response is related to antidiuretic hormone?
c. Increased retention of water
189
During which phase of the cell cycle is DNA synthesized?
b. S
190
What organic compound facilitates transportation across cell membranes by acting as receptors, transport channels for electrolytes, and enzymes to drive active pumps?
c. Proteins
191
Understanding the various steps of proteolytic cascades may be useful in designing drug therapy for which human diseases?
b. Autoimmune and malignant disorders
192
Which structure prevents water-soluble molecules from entering cells across the plasma membrane?
d. Lipid bilayer
193
. A student asks for an explanation of the absolute refractory period of the action potential. What response by the professor is best?
b. No stimulus is able to evoke another response at this time.
194
Which form of cell communication is used to communicate within the cell itself and with other cells in direct physical contact?
b. Plasma membrane-bound signaling molecules
195
Which mode of chemical signaling uses blood to transport communication to cells some distance away?
d. Hormonal
196
Which mode of chemical signaling uses local chemical mediators that are quickly taken up, destroyed, or immobilized?
A. Paracrine
197
Neurotransmitters affect the postsynaptic membrane by binding to which structure?
d. Receptors
198
How do cells receive communication from the extracellular fluid surrounding them
d. Chemical messengers such as ligands
199
Which molecule provides the second messenger necessary for extracellular communication to be activated?
b. Adenosine monophosphate (AMP)
200
Under anaerobic conditions, what process provides energy for the cell?
b. Glycolysis
201
What is the mechanism by which the energy produced from carbohydrates, proteins, and lipids is transferred to adenosine triphosphate (ATP)?
c. Oxidative phosphorylation
202
Passive transport is best described with which statement?
a. Being driven by osmosis, hydrostatic pressure, and diffusion
203
Which is the best example of active transport?
b. Movement requiring the expenditure of metabolic energy
204
Which method of transport uses transmembrane proteins with receptors with a high degree of specificity for the substance being transported?
b. Mediated
205
The movement of fluid across the arterial end of capillary membranes into the interstitial fluid surrounding the capillary is an example of which fluid movement process?
a. Hydrostatic pressure
206
A student asks why osmolality is preferred over osmolarity as the measurement of osmotic activity in the clinical assessment of individuals. What response by the professor is most accurate?
c. More of the weight of plasma is influenced by solutes rather than by water.
207
A patient who has diarrhea receives a 3% saline solution intravenously to replace the sodium and chloride lost in the stool. What effect will this fluid replacement have on cells? a
c. Shrink
208
The transport of glucose from the blood to the cell is accomplished by which process?
d. Mediated transport
209
What transports potassium and sodium across plasma membranes?
c. Adenosine triphosphatase (ATPase) enzyme
210
What occurs during exocytosis?
a. Macromolecules can be secreted across eukaryotic cell membranes
211
The cellular uptake of the nutrient cholesterol depends on which process?
c. Receptor-mediated endocytosis
212
What causes the rapid change in the resting membrane potential to initiate an action potential?
b. Sodium gates open, and sodium rushes into the cell, changing the membrane potential from negative to positive.
213
The action of platelet-derived growth factor is to stimulate the production of which cells?
c. Connective tissue cells
214
What role do cytokines play in cell reproduction?
a. Provide growth factor for tissue growth and development
215
What is the process of cellular reproduction?
c. Two diploid cells, called daughter cells, have been formed.
216
Which statement is true about eukaryotic cells?
b. They contain compartments called organelles.
217
Which statement is true about phagocytosis?
c. Phagocytosis involves the ingestion of bacteria.
218
A muscle cell possesses which specialized function?
a. Movement
219
When a mucous gland cell creates a new substance from previously absorbed material, this process is known as which specialized cellular function?
d. Secretion
220
All cells are capable of what process?
a. Excretion
221
What is the best description of cell cycle arrest?
a. The cell cycle is stopped due to damaged DNA.
222
Which type of cell adaptation occurs when normal columnar ciliated epithelial cells of the bronchial lining have been replaced by stratified squamous epithelial cells?
b. Metaplasia
223
What does the loss of the adenosine triphosphate (ATP) during ischemia cause cells to do?
c. Swell because of the influx of sodium chloride (NaCl)
224
The mammary glands enlarge during pregnancy primarily as a consequence of what hormonal process?
b. Hyperplasia
225
Free radicals play a major role in the initiation and progression of which diseases?
a. Cardiovascular diseases such as hypertension and ischemic heart disease.
226
How do free radicals cause cell damage?
d. Giving up an electron, which causes injury to the chemical bonds of the cell membrane
227
What is a consequence of plasma membrane damage to the mitochondria?
b. Influx of calcium ions halts ATP production.
228
What is a consequence of leakage of lysosomal enzymes during chemical injury?
a. Enzymatic digestion of the nucleus and nucleolus occurs, halting DNA synthesis
229
Lead causes damage within the cell by interfering with the action of what?
c. Calcium
230
A health professions student asks the professor to explain apoptosis. What response is most accurate?
a. Programmed cell death
231
A healthcare professional is assessing a child whose parents report poor grades in school, trouble paying attention, and “naughty” behaviors that have become so frequent the child is always in trouble. For which health condition should the professional facilitate testing?
b. Lead poisoning
232
A student asks why carbon monoxide causes tissue damage. What response by the professor is best?
b. Binds to hemoglobin so that it cannot carry oxygen
233
A healthcare professional is working with a person who drinks several 6-packs of beer a week. What testing does the professional encourage the person to get?
a. Hepatic function
234
During cell injury caused by hypoxia, why does an increase in the osmotic pressure within the cell occur?
c. Sodium chloride enters the cell.
235
Which statement is true regarding the difference between subdural hematoma and epidural hematoma?
c. A subdural hematoma is often the result of shaken baby syndrome, whereas an epidural hematoma rapidly forms as a result of a skull fracture.
236
A healthcare professional is working at the health tent during a marathon. A runner is brought to the tent complaining of nausea and weakness. What is the first thing the professional should do?
b. Have the person lie down.
237
In hypoxic injury, why does sodium enter the cell and cause swelling?
b. ATP is insufficient to maintain the pump that keeps sodium out of the cell.
238
What is the most common site of lipid accumulation?
c. Liver
239
What mechanisms occur in the liver cells as a result of lipid accumulation?
b. Increased synthesis of triglycerides from fatty acids and decreased synthesis of apoproteins
240
Hemoprotein accumulations are a result of the excessive storage of what?
a. Iron, which is transferred from the cells to the bloodstream
241
A patient suffered multiple traumatic injuries and received many blood transfusions within a few days of the injuries. For which medical condition should the healthcare professional monitor the patient for?
c. Hemosiderosis
242
What is the cause of free calcium in the cytosol that damages cell membranes by uncontrolled enzyme activation?
d. Depletion of ATP normally pumps calcium from the cell.
243
What two types of hearing loss are associated with noise?
a. Acoustic trauma and noise-induced
244
What type of necrosis results from ischemia of neurons and glial cells?
b. Liquefactive
245
What type of necrosis is often associated with pulmonary tuberculosis?
b. Caseous
246
What type of necrosis is associated with wet gangrene?
b. Liquefactive
247
After ovulation, the uterine endometrial cells divide under the influence of estrogen. This process is an example of what hormonal process?
a. Hyperplasia
248
What is the abnormal proliferation of cells in response to excessive hormonal stimulation?
d. Pathologic hyperplasia
249
Removal of part of the liver leads to the remaining liver cells undergoing which compensatory process?
c. Hyperplasia
250
What is the single most common cause of cellular injury?
a. Hypoxic injury
251
In decompression sickness, emboli are formed by bubbles of what?
b. Nitrogen
252
. Which is an effect of ionizing radiation exposure?
c. DNA aberrations
253
What is dysplasia?
c. Modification in the shape of a specific cell type
254
Why are infants most susceptible to significant losses in total body water?
c. Kidneys are not mature enough to counter fluid losses
255
Why does obesity create a greater risk for dehydration in people?
a. Adipose cells contain little water because fat is water repelling.
256
A patient’s blood gases reveal the following findings: pH 7.3; bicarbonate (HCO3) 27 mEq/L; carbon dioxide (CO2) 58 mm Hg. What is the interpretation of these gases?
c. Respiratory acidosis
257
Water movement between the intracellular fluid (ICF) compartment and the extracellular fluid (ECF) compartment is primarily a function of what?
a. Osmotic forces
258
In addition to osmosis, what force is involved in the movement of water between the plasma and interstitial fluid spaces?
d. Hydrostatic pressure
259
Venous obstruction is a cause of edema because of an increase in which pressure?
a. Capillary hydrostatic
260
At the arterial end of capillaries, why does fluid move from the intravascular space into the interstitial space?
b. Capillary hydrostatic pressure is higher than the capillary oncotic pressure.
261
Low plasma albumin causes edema as a result of a reduction in which pressure?
c. Plasma oncotic
262
How are secretion of antidiuretic hormone (ADH) and the perception of thirst stimulated?
b. Increase in plasma osmolality
263
Thirst activates osmoreceptors following an increase in which blood plasma component?
d. Osmotic pressure
264
. A student asks about natriuretic peptides. Which statement by the professor is most accurate?
a. Decrease blood pressure and increase sodium and water excretion.
265
When changes in total body water are accompanied by proportional changes in electrolytes, what type of alteration occurs?
a. Isotonic
266
Which enzyme is secreted by the juxtaglomerular cells of the kidney when circulating blood volume is reduced?
d. Renin
267
A patient in the hospital has hypernatremia. What condition should the healthcare professional assess for?
b. Hypersecretion of aldosterone
268
A patient has a serum sodium level of 165 mEq/L. The healthcare professional explains that the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma are caused by what mechanism?
a. High sodium in the blood vessels pulls water out of the brain cells into the blood vessels, causing brain cells to shrink.
269
What does vomiting-induced metabolic alkalosis cause?
c.. Retention of bicarbonate to maintain the anion balance
270
The pathophysiologic process of edema is related to which mechanism?
d. Lymphatic obstruction
271
Why is insulin used to treat hyperkalemia?
c. Transports potassium from the blood into the cell along with glucose
272
A major determinant of the resting membrane potential necessary for the transmission of nerve impulses is the ratio between what?
b. Intracellular and extracellular K+
273
During acidosis, the body compensates for the increase in serum hydrogen ions by shifting hydrogen ions into the cell in exchange for which electrolyte?
c. Potassium
274
A healthcare professional is caring for four patients. Which patient should the professional assess for hyperkalemia?
c. Renal failure
275
In hyperkalemia, what change occurs to the cells’ resting membrane potential?
a. Hypopolarization
276
A patient’s chart indicates Kussmaul respirations. The student asks the healthcare professional what this is caused by. What response by the professional is most accurate?
b. A compensatory measure is needed to correct metabolic acidosis.
277
A healthcare provider notes that tapping the patient’s facial nerve leads to lip twitching. What electrolyte value is correlated with this finding?
c. Ca++: 8.2 mg/dL
278
A patient has a history of excessive use of magnesium-containing antacids and aluminumcontaining antacids. What lab value does the healthcare professional correlate to this behavior?
b. Phosphate 1.9 mg/dL
279
A healthcare professional is caring for four patients. Which patient should the professional assess for hypermagnesemia as a priority?
b. Renal failure
280
. Physiologic pH is maintained at approximately 7.4 because bicarbonate (HCO3) and carbonic acid (H2CO3) exist in what ratio
a. 20:1
281
Where is two thirds of the body’s water found?
c. Intracellular fluid compartments
282
A healthcare professional just administered a large dose of insulin to a patient. Which electrolyte value should the professional monitor as a priority?
b. Potassium
283
Why does increased capillary hydrostatic pressure result in edema?
d. Sodium and water retention
284
A patient’s electrocardiogram (ECG) shows tall, peaked T waves. What lab value or assessment would the healthcare professional correlate with this finding?
b. Serum potassium 6.7 mEq/L
285
In somatic cell gene therapy, what type of vector is most commonly used to alter a specific set of an individual’s somatic cells?
a. Virus
286
In DNA replication, what does the enzyme DNA polymerase do?
a. Travel along the single DNA strand, adding the correct nucleotide to the new strand.
287
How is transcription best defined?
c. RNA is synthesized from a DNA template.
288
What is the purpose of using a Giemsa staining technique on chromosomes?
b. Allow for the numbering of chromosomes and the identification of variations
289
An amniocentesis indicates a neural tube defect when an increase in which protein is evident?
b. Alpha fetoprotein
290
Amniocentesis is recommended for pregnant with what history?
b. Have a family history of genetic disorders
291
What is the technique for prenatal diagnosis of chromosomal abnormalities at 10 to 12 weeks’ gestation?
d. Chorionic villus sampling
292
What is the term for an error in which homologous chromosomes fail to separate during meiosis or mitosis?
b. Nondisjunction
293
A healthcare professional is assessing a child who has complete trisomy of the twenty-first chromosome. What findings does the professional relate to this condition?
b. An IQ of 25 to 70, low nasal bridge, protruding tongue, and flat, low-set ears
294
What is the most common cause of Down syndrome?
c. Maternal nondisjunction
295
What syndrome, characterized by an absent homologous X chromosome with only a single X chromosome, exhibits features that include a short stature, widely spaced nipples, and webbed neck?
c. Turner
296
A person with 47, XXY karyotype has the genetic disorder resulting in which syndrome?
b. Klinefelter
297
What is the second most commonly recognized genetic cause of intellectual disability?
b. Fragile X syndrome
298
What is the blood type of a person who is heterozygous, having A and B alleles as codominant?
d. AB
299
A couple has two children diagnosed with an autosomal dominant genetic disease and asks the healthcare professional what the probability is that their next child will have the same genetic disease. What response by the professional is best?
d. One half
300
When a child inherits a disease that is autosomal recessive, it is inherited from whom?
c. Both parents
301
People diagnosed with neurofibromatosis have varying degrees of the condition because of which genetic principle?
b. Expressivity
302
Which genetic disease has been linked to a mutation of the tumor-suppressor gene?
b. Retinoblastoma
303
Cystic fibrosis is caused by what type of gene?
d. Autosomal recessive
304
Which is an important criterion for discerning autosomal recessive inheritance?
a. Consanguinity is sometimes present.
305
Consanguinity refers to the mating of people in what situation?
c. Having common family relations
306
Males, having only one X chromosome, are said to be what?
c. Hemizygous
307
Males are more often affected by which type of genetic disease?
d. Sex-linked recessive
308
Why an X-linked recessive disease can skip generations?
b. The disease can be transmitted through female carriers.
309
The presence of a zygote having one chromosome with the normal complement of genes and one with a missing gene is characteristic of which genetic disorder?
a. Cri du chat
310
A child with which genetic disorder has a characteristic cry?
d. Cri du chat
311
Which statement is true regarding X-linked recessive conditions?
b. These conditions are passed from affected father to all of his female children.
312
DNA formation occurs in which of the cell’s structures?
a. Nucleus
313
What is the risk for the recurrence of autosomal dominant diseases?
c. 50%
314
What is an individual’s genetic makeup called?
b. Genotype
315
The data reporting that sickle cell disease affects approximately 1 in 600 American blacks is an example of which concept?
b. Prevalence
316
The ratio of the disease among the exposed population to the disease rate in an unexposed population is referred to as what type of risk?
d. Relative
317
What are empirical risks for most multifactorial diseases based on?
b. Direct observation
318
What is the cause of familial hypercholesterolemia (FH)?
c. Reduction in the number of low-density lipoprotein (LDL) receptors on cell surfaces
319
Which risk factor for hypertension is influenced by genetic factors and lifestyle?
d. Obesity
320
A student asks, “What is the percentage of all cases of breast cancer that are identified as an autosomal dominant form?” What response by the professor is best?
b. 5 to 10
321
When a woman has one first-degree relative with breast cancer, her risk of developing breast cancer is how many times greater?
a. 2
322
. Adoption studies have shown that the offspring of an alcoholic parent have what amount of an increased risk of developing alcoholism when raised by a nonalcoholic parent?
c. Fourfold
323
Studies have identified several genes that play a role in the prevention of obesity by affecting what?
a. Regulation of appetite
324
The BRCA1 and BRCA2 mutations increase the risk of which cancer in women?
a. Ovarian
325
What are blood pressure variations associated with?
c. The renin-angiotensin system’s effect on vasoconstriction
326
What are the two most important risk factors for type 2 diabetes?
c. Obesity and positive family history
327
A parent wants to know how to prevent type 1 diabetes in the newborn. The healthcare professional explains that prevention is not possible, because which of these is a major characteristic of type 1 diabetes mellitus?
b. An autoimmune cause factor
328
A patient with several risk factors is concerned about developing type 2 diabetes. The healthcare professional advises the patient to lose weight, explaining that obesity is an important risk factor for type 2 diabetes mellitus because it causes what?
b. Increased resistance to insulin in the cells
329
Traits caused by the combined effects of multiple genes are referred to by which term?
a. Polygenic
330
Regarding type 2 diabetes, obesity is considered to be what type of risk?
d. Modifiable
331
Which disease form is associated with identified empirical risks?
b. Multifactorial
332
The number of persons living with a specific disease at a specific point in time is referred to by which term?
c. Prevalence
333
Which type of cancer is said to aggregate among families?
a. Breast
334
Which dietary lifestyle choice has been associated with a decreased risk for developing colon cancer?
c. Decreased consumption of foods high in fat
335
What is currently believed about the risk for developing Alzheimer disease?
d. It doubles among those with an affected first-degree relative.
336
The number of new cases of a disease reported during a specific period divided by the number of individuals in the population is defined as which characteristic of a disease?
b. Incidence rate
337
What genetic process is likely responsible for the occurrence of asthma in only one of a pair of identical twins?
a. Epigenetic modifications
338
Prader-Willi syndrome causes a chromosomal defect that is what?
b. Inherited from the father
339
What can a malfunction in DNA methylation lead to?
c. Cancer
340
Which statement is true regarding the embryonic development of stem cells?
d. They are said to be totipotent.
341
When microRNA (miRNA) are methylated their messenger RNA (mRNA) targets are overexpressed. What would be the resulting effect on existing cancer?
b. Metastasis
342
What is the difference between DNA sequence mutations and epigenetic modifications?
c. Epigenetic modifications potentially can be reversed
343
Which term refers to the silenced gene of a gene pair?
d. Imprinted
344
What is most likely the shape of the face of a child diagnosed with Russell-Silver syndrome?
c. Triangular
345
What are genes responsible for the maintenance of all cells referred to as?
c. Housekeeping
346
What is the belief regarding twins who adopt dramatically different lifestyles?
a. They may experience very different aging processes.
347
What do hypomethylation and the resulting effect on oncogenes result in?
c. An increase in tumor progression from benign to malignant
348
When a chromosome lacking 4 million base pairs is inherited from the mother, the child is at risk for developing which syndrome?
b. Angelman
349
Which action is a purpose of the inflammatory process?
c. To prevent infection of the injured tissue
350
How do surfactant proteins A through D provide innate resistance?
b. Promote phagocytosis.
351
Which secretion is a first line of defense against pathogen invasion that involves antibacterial and antifungal fatty acids, as well as lactic acid?
d. Sebaceous gland sebum
352
Which bacterium grows in the intestines after prolonged antibiotic therapy?
c. Clostridium difficile
353
What causes the edema that occurs during the inflammatory process?
b. Increased capillary permeability
354
What process causes heat and redness to occur during the inflammatory process?
a. Vasodilation of blood vessels
355
What does activation of the classical pathway begin with?
b. Antigen-antibody complexes
356
What plasma protein system forms a fibrinous meshwork at an inflamed site?
b. Coagulation
357
Which component of the plasma protein system tags pathogenic microorganisms for destruction by neutrophils and macrophages?
a. Complement cascade
358
What is the vascular effect of histamine released from mast cells?
c. Vasodilation
359
What is an outcome of the complement cascade?
d. Lysis of bacterial cell membranes
360
What is the function of opsonization related to the complement cascade?
a. To tag pathogenic microorganisms for destruction by neutrophils and macrophages
361
In the coagulation (clotting) cascade, the intrinsic and the extrinsic pathways converge at which factor?
c. X
362
Which chemical interacts among all plasma protein systems by degrading blood clots, activating complement, and activating the Hageman factor?
d. Plasmin
363
How does the chemotactic factor affect the inflammatory process?
c. By directing leukocytes to the inflamed area
364
What effect does the process of histamine binding to the histamine-2 (H2) receptor have on inflammation?
a. Inhibition
365
Frequently when H1 and H2 receptors are located on the same cells, they act in what fashion?
c. Antagonistically
366
Some older adults have impaired inflammation and wound healing because of which problem?
c. Underlying chronic illness(es) exists.
367
Which chemical mediator derived from mast cells retracts endothelial cells to increase vascular permeability and to cause leukocyte adhesion to endothelial cells?
c. Platelet-activating factor
368
What is the inflammatory effect of nitric oxide (NO)?
d. Decreases mast cell function, and decreases platelet aggregation
369
What is the correct sequence in phagocytosis?
c. Recognition, engulfment, fusion, destruction
370
When considering white blood cell differentials, acute inflammatory reactions are related to elevations of which leukocyte?
c. Neutrophils
371
In the later stages of an inflammatory response, which phagocytic cell is predominant?
b. Monocytes
372
In regulating vascular mediators released from mast cells, the role of eosinophils is to release what?
b. Histaminase, which limits the effects of histamine during acute inflammation
373
What is a role of a natural killer (NK) cells?
b. Elimination of malignant cells
374
Which cytokine is produced and released from virally infected host cells?
d. IFN-
375
Which manifestation of inflammation is systemic?
b. Fever and leukocytosis
376
The acute inflammatory response is characterized by fever that is produced by the hypothalamus being affected by what?
a. Endogenous pyrogens
377
What occurs during the process of repair after tissue damage?
a. Nonfunctioning scar tissue replaces destroyed tissue.
378
What is the role of fibroblasts during the reconstructive phase of wound healing?
c. Synthesize and secrete collagen and the connective tissue proteins.
379
A keloid is the result of which dysfunctional wound healing response?
c. Collagen matrix assembly
380
A student is preparing to irrigate a patient’s wound and gathers supplies, including hydrogen peroxide. What response by the health care professional is best?
c. Tell the student to get some normal saline instead.
381
Many neonates have a transient depressed inflammatory response as a result of which condition?
b. Complement and chemotaxis are deficient.
382
During phagocytosis, what is occurring during the step referred to as opsonization?
a. Phagocytes recognize and adhere to the bacteria.
383
Fusion is the step of phagocytosis during which what happens
c. Lysosomal granules enter the phagocyte.
384
What does the phagosome step result in during the process of endocytosis?
d. An intracellular phagocytic vacuole is formed.
385
When cellular damage occurs and regeneration is minor with no significant complications, what is the process of returning the cells to preinjury function referred to as?
b. Resolution
386
Newborns often have deficiencies in collectin-like proteins, making them more susceptible to what type of infection?
c. Respiratory
387
Which cell is the body’s primary defense against parasite invasion?
a. Eosinophil
388
Which primary characteristic is unique for the immune response?
b. The immune response is specific to the antigen that initiates it.
389
In which structure does B lymphocytes mature and undergo changes that commit them to becoming B cells?
c. Bone marrow
390
What is the term for the process during which lymphoid stem cells migrate and change into either immunocompetent T cells or immunocompetent B cells?
a. Clonal diversity
391
Which type of immunity is produced by an individual after either natural exposure to the antigen or after immunization against the antigen?
b. Active-acquired immunity
392
What type of immunity is produced when an immunoglobulin crosses the placenta?
a. Passive-acquired immunity
393
The portion of the antigen that is configured for recognition and binding is referred to as what type of determinant?
c. Epitope
394
Which characteristic is the most important determinant of immunogenicity when considering the antigen
b. Foreignness
395
A student asks why some vaccinations are given orally and some are given by injection. What response by the professor is best?
d. Each route stimulates a different lymphocyte-containing tissue, resulting in different types of cellular and humoral immunity
396
The functions of the major histocompatibility complex (MHC) and CD1 molecules are alike because both do what?
a. Are antigen-presenting molecules
397
Where are antibodies produced?
c. Plasma cells
398
Which immunoglobulin is present in blood, saliva, breast milk, and respiratory secretions?
a. IgA
399
Which antibody initially indicates a typical primary immune response?
b. IgM
400
An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody?
c. IgA
401
How does the B-cell receptor (BCR) complex function?
d. Communicating information about the antigen to the cell nucleus
402
The generation of clonal diversity occurs primarily during which phase of life?
a. Fetal
403
A student is confused about the process of the generation of clonal diversity. What description by the professor is best?
c. It takes place in the primary (central) lymphoid organs
404
Which is an example of an endogenous antigen?
b. Cancer cells
405
Which cytokine is needed for the maturation of a functional helper T cell?
b. IL-2
406
Th2 cells produce IL-4 and suppress which cells?
c. Th1 cells
407
Which statement is believed to be true concerning Th1 cells?
b. They are induced by antigens derived from cancer cells.
408
Which statement is believed to be true concerning Th2 cells?
a. Th2 cells are induced by antigens derived from allergens.
409
When a person is exposed to most antigens, antibodies can be usually detected in their circulation within what timeframe?
d. 6 days
410
Vaccinations are able to provide protection against certain microorganisms because of what?
b. Level of protection provided by IgG
411
The healthcare professional working with older adults teaches general infection-prevention measures as a priority for this age group due to which change in lymphocyte function?
a. Increased production of antibodies against self-antigen
412
. How do antibodies protect the host from bacterial toxins?
b. Binding to the toxins to neutralize their biologic effects
413
Which T cell controls or limits the immune response to protect the host’s own tissues against an autoimmune response?
d. Regulatory T (Treg) cells
414
Evaluation of umbilical cord blood can confirm that which immunoglobulin level is near adult levels?
b. IgG
415
Which statement is true concerning IgM?
a. IgM is the first antibody produced during the initial response to an antigen
416
Which cell has the ability to recognize antigens presented by the MHC class I molecules?
c. CD 8
417
Which cell has a role in developing cell-mediated immunity?
a. Th1
418
A student asks the healthcare professional how the aging process of the T-cell activity affects older adults. What response by the professional is best?
c. Tendency to develop various infections
419
Which statement is true regarding maternal antibodies provided to the neonate?
a. The antibodies enter into the fetal circulation by means of active transport.
420
Antibodies that are associated with mucosal immune system, such as immunoglobulins, function to prevent which type of infections?
d. Infections that focus on epithelial surfaces of the body
421
Cytokines are vital to a cell’s ability to do which function?
d. Communicate
422
How is hypersensitivity best defined?
c. An altered immunologic response to an antigen that results in disease
423
What is a hypersensitivity reaction that produces an allergic response called?
b. Anaphylaxis
424
The common hay fever allergy is expressed through a reaction that is mediated by which class of immunoglobulins?
a. IgE
425
What are blood transfusion reactions an example of?
b. Alloimmunity
426
During an IgE-mediated hypersensitivity reaction, which leukocyte is activated?
c. Eosinophils
427
During an IgE-mediated hypersensitivity reaction, what causes bronchospasm?
c. Smooth muscle contraction caused by histamine bound to H1 receptors
428
A patient is having an IgE-mediated hypersensitivity reaction. What action by the healthcare professional is best?
a. Give the patient an antihistamine.
429
What characteristic do atopic individuals have that make them genetically predisposed to develop allergies?
c. Greater quantities of IgE
430
A student asks about the mechanism that results in type II hypersensitivity reactions. What description by the professor is best?
d. Antibodies bind to the antigens on the cell surface
431
When mismatched blood is administered causing an ABO incompatibility, how are the erythrocytes destroyed?
a. Complement-mediated cell lysis
432
When antibodies are formed against red blood cell antigens of the Rh system, how are the blood cells destroyed?
c. Phagocytosis in the spleen
433
When soluble antigens from infectious agents enter circulation, what is tissue damage a result of?
d. Neutrophil granules and toxic oxygen products
434
How are target cells destroyed in a type II hypersensitivity reaction?
d. Natural killer cells
435
Graves disease (hyperthyroidism) is an example of which type II hypersensitivity reaction?
a. Modulation
436
Type III hypersensitivity reactions are a result of which of these?
b. Antibodies binding to soluble antigens that were released into body fluids and the immune complexes being deposited in the tissues
437
A type IV hypersensitivity reaction causes which result?
c. Lymphokine-producing Th1 cells directly attacking and destroying cellular targets
438
In a type III hypersensitivity reaction, the harmful effects after the immune complexes that are deposited in tissues are a result of what?
c. Complement activation
439
A healthcare professional is teaching a patient about Raynaud phenomenon and instructs the patient to avoid cold. What is the best explanation of how cold impacts the manifestations of this disease?
a. Immune complexes that are deposited in capillary beds, blocking circulation
440
Deficiencies in which element can produce depression of both B- and T-cell function?
b. Zinc
441
An Rh-negative woman gave birth to an Rh-positive baby. When discussing Rho[D] immunoglobulin with her, what information should the healthcare professional provide?
b. It prevents alloimmunity and hemolytic anemia of the newborn.
442
Tissue damage caused by the deposition of circulating immune complexes containing an antibody against the host DNA is the cause of which disease?
c. Systemic lupus erythematosus
443
A patient asks the healthcare professional why tissue damage occurs in acute rejection after organ transplantation. What response by the professional is best?
a. Th1 cells release cytokines that activate infiltrating macrophages, and cytotoxic T cells directly attack the endothelial cells of the transplanted tissue.
444
Which blood cell carries the carbohydrate antigens for blood type?
d. Erythrocytes
445
A person with type O blood needs a blood transfusion. What blood type does the healthcare professional prepare to administer to the patient?
d. O
446
Which class of immunoglobulins forms isohemagglutinins?
d. IgM
447
Which component of the immune system is deficient in individuals with infections caused by viruses, fungi, or yeast?
d. T cells
448
A child in the clinic has an absence of a parathyroid gland, structural heart defects, and a shortened structure of the upper lip. What immune dysfunction does the healthcare professional suspect?
a. Partial-to-complete absence of T-cell immunity
449
How many months does it take for the newborn to be sufficiently protected by antibodies produced by its own B cells?
c. 6 to 8 months
450
Considering the effects of nutritional deficiencies on the immune system, severe deficits in calories and protein lead to deficiencies in the formation of which immune cells?
b. T cells
451
Urticaria is a manifestation of a which type of hypersensitivity reaction?
d. I
452
What is Graves disease a result of?
c. Autoantibodies binding to thyroid-stimulating hormone (TSH)-receptor sites
453
Raynaud phenomenon is an example of which type of hypersensitivity?
b. III
454
Which statement is true concerning an atopic individual?
b. They tend to produce more Fc receptors.
455
Which statement is true regarding immunodeficiency?
a. Immunodeficiency is generally not present in other family members
456
A person with type O blood is considered to be the universal blood donor because type O blood contains which of these?
a. No antigens
457
Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction?
a. I
458
A pregnant woman has Graves disease. What test/s does the healthcare professional advise the woman about?
b. Blood test for hyperthyroidism
459
What is a significant cause of morbidity and mortality worldwide?
d. Infectious disease
460
What is the first stage in the infectious process?
b. Colonization
461
Which type of microorganism reproduces on the skin?
b. Bacteria and fungi
462
Phagocytosis involves neutrophils actively attacking, engulfing, and destroying which microorganisms?
a. Bacteria
463
Once they have penetrated the first line of defense, which microorganisms do natural killer (NK) cells actively attack?
c. Viruses
464
A student asks the healthcare professional to describe exotoxins. Which statement by the professional is best?
d. Exotoxins are released during bacterial growth.
465
A healthcare professional student is learning about fungal infections. What information should the student use to help another student understand?
b. Phagocytes and T lymphocytes control fungal infections.
466
Cytokines are thought to cause fevers by stimulating the synthesis of which chemical mediator?
c. Prostaglandin
467
Considering the hypothalamus, what is a fever produced by?
a. Endogenous pyrogens acting directly on the hypothalamus
468
A healthcare professional is conducting community education on vaccinations. Which statement about vaccines does the professional include in the presentation?
c. Vaccines require booster injections to maintain life-long protection.
469
What are vaccines against viruses created from?
b. Live organisms weakened to produce antigens
470
What does the student learn about HIV?
b. HIV is a retrovirus.
471
What is the role of reverse transcriptase in HIV infection?
d. It converts RNA into double-stranded DNA.
472
After sexual transmission of HIV, how soon can lab results detect the infection?
b. 4 to 10 days
473
Which cells are primary targets for HIV?
b. CD4+ Th cells, macrophages, and dendritic cells
474
What area in the body may act as a reservoir in which HIV can be relatively protected from antiviral drugs?
a. Central nervous system
475
What is the final stage of the infectious process?
d. Spread
476
How is toxigenicity defined?
b. The pathogen’s ability to produce disease by the production of a soluble toxin.
477
What is the ability of the pathogen to invade and multiply in the host referred to as?
a. Infectivity
478
Some bacterial surface proteins bind with the crystalline fragment (Fc) portion of an antibody to do what?
d. Produce a protective “self” protein
479
Which organism is a common sexually transmitted bacterial infection?
d. Treponema pallidum
480
. Which disease is an example of a rickettsial infection?
d. Rocky Mountain spotted fever
481
Exhaustion occurs if stress continues when which stage of the general adaptation syndrome is not successful?
c. Adaptation
482
Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?
b. Hypothalamus
483
During an anticipatory response to stress, what is the reaction from the limbic system stimulated by
c. The paraventricular nucleus of the hypothalamus
484
Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?
a. Norepinephrine
485
Perceived stress elicits an emotional, anticipatory response that begins where?
c. Limbic system
486
A student asks the healthcare professional how immunity is decreased by stress. The professional responds that during a stress response, the helper T (Th) 1 response is suppressed by which hormone?
b. Cortisol
487
Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of what?
c. Epinephrine and norepinephrine
488
A severely stressed patient has cold, clammy skin. The healthcare professional quizzes the student about this effect. The student correctly answers that this effect is directly from which action?
b. Norepinephrine constricting blood vessels in the skin
489
Released stress-induced cortisol results in the stimulation of gluconeogenesis by affecting which structure?
c. Liver
490
What effect of increased secretions of epinephrine, glucagon, and growth hormone would the healthcare professional assess for?
a. Hyperglycemia
491
A severely stressed patient has hypoglycemia each time the patient’s blood glucose is checked. The healthcare professional should order laboratory tests to measure which hormone in the patient’s blood?
c. Cortisol
492
What effect do androgens have on lymphocytes?
c. Suppression of B- and T-cell responses
493
The action of which hormone helps explain increases in affective anxiety and eating disorders, mood cycles, and vulnerability to autoimmune and inflammatory diseases in women as a result of stimulation of the CRH gene promoter and central norepinephrine system?
c. Estrogen
494
Which statement is true concerning the differences between stress-induced hormonal alterations of men and women?
b. Androgens appear to induce a greater degree of immune cell apoptosis after injury, creating greater immunosuppression in injured men than in injured women.
495
A patient perceives living in a state of chronic stress. What will diagnostic blood work ordered by the healthcare professional likely demonstrate?
c. Decreased Tc cells
496
What are the signs that a patient is in the adaptive stage of the general adaptation syndrome?
c. The patient perceives his or her only options are to run away or fight back.
497
What is the most influential factor in whether a person will experience a stress reaction?
d. Ability to cope
498
A reduction in an individual’s number of natural killer (NK) cells appears to correlate with an increased risk for the development of what?
a. Depression
499
Which cancer originates from connective tissue?
a. Osteogenic sarcoma
500
Carcinoma refers to abnormal cell proliferation originating from which tissue origin?
b. Epithelial cells
501
Carcinoma in situ is characterized by which changes?
c. Cells remain localized in the glandular or squamous cells.
502
4. Which term is used to describe a cell showing a loss of cellular differentiation?
d. Anaplasia
503
What are tumor cell markers?
a. Hormones, enzymes, antigens, and antibodies that are produced by cancer cell
504
What is one function of the tumor cell marker?
d. To screen individuals at high risk for cancer
505
Which statement supports the hypothesis that intestinal polyps are benign neoplasms and the first stage in the development of colon cancer?
b. An accumulation of mutations in specific genes is required to develop cancer.
506
Autocrine stimulation is the ability of cancer cells to do what?
c. Secrete growth factors that stimulate their own growth
507
What is apoptosis?
a. Normal mechanism for cells to self-destruct when growth is excessive
508
A student studying biology asks the professor to describe how the ras gene is involved in cancer proliferation. What explanation by the professor is best?
c. A mutation in this gene allows continuous cell growth.
509
The professor explains to students that oncogenes are genes that are capable of what?
a. Undergoing mutation that directs the synthesis of proteins to accelerate the rate of tissue proliferation
510
Burkitt lymphomas designate a chromosome that has a piece of chromosome 8 fused to a piece of chromosome 14. This is an example of which mutation of normal genes to oncogenes?
b. Chromosome translocation
511
In childhood neuroblastoma, the N-myc oncogene undergoes which type of mutation of normal gene to oncogene?
c. Gene amplification
512
What aberrant change causes the abnormal growth in retinoblastoma?
b. The tumor-suppressor gene is turned off.
513
Why are two “hits” required to inactivate tumor-suppressor genes?
a. Each allele must be altered, and each person has two copies, or alleles, of each gene, one from each parent.
514
How does the ras gene convert from a proto-oncogene to an oncogene?
c. Altering one or more nucleotide base pairs
515
How do cancer cells use the enzyme telomerase?
d. To switch on the telomerase to enable cells to divide indefinitely
516
What are characteristics of benign tumors?
d. Benign tumors include the suffix -oma.
517
What is the major virus involved in the development of cervical cancer?
c. Human papillomavirus
518
The Papanicolaou (Pap) test is used to screen for which cancer?
c. Cervical
519
A healthcare professional is caring for a patient undergoing chemotherapy. What is the skinrelated health risk the professional should assess the patient for and be prepared to treat?
a. Infection
520
Inherited mutations that predispose to cancer are almost invariably what kind of gene?
c. Tumor-suppressor genes
521
What is the consequence for cells when the functioning TP53 gene is lost as a result of mutation?
b. Cells escape apoptosis.
522
Which gastrointestinal tract condition can be an outcome of both chemotherapy and radiation therapy?
c. Stomatitis
523
What is the role of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in cell metastasis?
b. To develop new blood vessels to feed cancer cells
524
It has been determined that a patient’s tumor is in stage 2. How does the healthcare professional describe this finding to the patient?
c. Cancer is locally invasive.
525
A cancer patient has pain at the tumor site and is worried the tumor has metastasized. What does the healthcare provider understand about this patient’s complaint?
d. Pain is generally associated with late-stage cancer.
526
A healthcare professional is caring for four patients with cancer. Which patient does the professional educate about brachytherapy?
c. Cervical
527
A child has been diagnosed with acute lymphoblastic leukemia (ALL). What does the healthcare professional tell the parents about the survival rate at 5 years for this disease?
b. 70%
528
. By what process do cancer cells multiply in the absence of external growth signals?
b. Autocrine stimulation
529
What is the role of caretaker genes?
a. Maintenance of genomic integrity
530
In a normal, nonmutant state, what is an oncogene referred to as?
d. Proto-oncogene
531
What does the student learn about pleomorphic cells?
b. They have different sizes and shapes.
532
What is the most commonly reported symptom of cancer treatment?
b. Fatigue
533
What does the health professions student learn about benign tumors?
d. The cells are well-differentiated.
534
In teaching a women’s community group, which risk factor does the healthcare professional teach is related to high morbidity of cancer of the colon, uterus, and kidney?
c. Women who have a high body mass index
535
Which substance has been shown to increase the risk of cancer when used in combination with tobacco smoking?
a. Alcohol
536
Which cancers pose the highest risk for radiologists?
c. Leukemia
537
Research has shown a link between cancer and which sexually transmitted disease?
c. Human papillomavirus
538
Research has supported that alcohol consumption has a convincing impact on increasing the risk of which cancer?
c. Pharynx
539
A healthcare professional advises patients to exercise because it has a probable impact on reducing which cancer?
d. Colon
540
The World Health Organization (WHO) defines grade 1 (overweight) as which BMI range?
b. 25 to 29.9
541
What congenital malformation is commonly linked to acute leukemia in children?
a. Down syndrome
542
When are childhood cancers most often diagnosed?
b. At peak times of physical growth
543
Prenatal exposure to diethylstilbestrol (DES) can result in which type of cancer?
c. Vaginal cancer
544
. Currently, what percentage of children with cancer can be cured?
d. 85%
545
What do most childhood cancers arise from?
b. Mesodermal germ layer
546
Which form of cancer is linked to congenital malformation syndromes?
a. Wilms tumor
547
Research data support a carcinogenic relationship in children resulting from exposure to which virus?
d. Epstein-Barr virus
548
What does a child diagnosed with acquired immunodeficiency syndrome (AIDS) have an increased risk of developing?
a. Non-Hodgkin lymphoma
549
Which intervention has the greatest effect on a child’s mortality rate when diagnosed with cancer?
b. Participation in clinical trials
550
Which statement is likely true regarding children being treated for cancer with radiation therapy
d. They are at increased risk for developing childhood cancers.
551
How should the healthcare professional reply when parents question why a computed tomographic (CT) scan of the head was not ordered for their 5-year-old child after a minor fall?
d. Research suggests that repeated CT scans can increase the risk of developing brain cancer.
552
Which statement made by a student indicates the healthcare professional needs to describe the pericardium again?
b. It is made up of connective tissue and a surface layer of squamous cells.
553
Which cardiac chambers have the thinnest wall and why?
a. The right and left atria; they are low-pressure chambers that serve as storage units and conduits for blood.
554
Which chamber of the heart endures the highest pressures?
c. Left ventricle
555
What is the process that ensures mitral and tricuspid valve closure after the ventricles are filled with blood?
b. Increased pressure in the ventricles pushes the valves to close.
556
A student asks the healthcare professional to explain the function of the papillary muscles. What response by the professional is best?
b. These muscles prevent backward expulsion of the atrioventricular valves.
557
During the cardiac cycle, why do the aortic and pulmonic valves close after the ventricles relax?
d. Blood fills the cusps of the valves and causes the edges to merge, closing the valves.
558
Oxygenated blood flows through which vessel?
b. Pulmonary veins
559
A healthcare professional tells a student that a patient has lost atrial kick. What would the student expect to see when examining this patient?
c. Signs of decreased cardiac output
560
Occlusion of the left anterior descending artery during a myocardial infarction would interrupt blood supply to which structures?
a. Left and right ventricles and much of the interventricular septum
561
Where are the coronary ostia located?
d. Aorta
562
11. The coronary sinus empties into which cardiac structure?
a. Right atrium
563
During the cardiac cycle, which structure directly delivers action potential to the ventricular myocardium?
c. Purkinje fibers
564
. A patient has a problem with Phase 0 of the cardiac cycle. What electrolyte imbalance would the healthcare professional associate most directly with this problem?
b. Hyponatremia
565
A healthcare professional is caring for a patient who has a delay in electrical activity reaching the ventricle as seen on ECG. What ECG finding would the healthcare professional associate with this problem?
c. PR interval measuring 0.28 sec
566
The cardiac electrical impulse normally begins spontaneously in the sinoatrial (SA) node because of what reason?
d. It depolarizes more rapidly than other automatic cells of the heart.
567
What period follows depolarization of the myocardium and represents a period during which no new cardiac potential can be propagated?
a. Refractory
568
A patient has a disorder affecting ventricular depolarization. What ECG finding would the healthcare professional associate with this condition?
b. Prolonged QRS interval
569
What can shorten the conduction time of action potential through the atrioventricular (AV) node?
b. Catecholamines
570
A patient had a myocardial infarction that damaged the SA node, which is no longer functioning as the pacemaker of the heart. What heart rate would the healthcare provider expect the patient to have?
b. 40 to 60 beats/min
571
What is the effect of epinephrine on 3 receptors on the heart?
d. Prevents overstimulation of the heart by the sympathetic nervous system
572
Where in the heart are the receptors for neurotransmitters located?
c. Myocardium and coronary vessels
573
What enables electrical impulses to travel in a continuous cell-to-cell fashion in myocardial cells?
b. Intercalated disks
574
Within a physiologic range, what does an increase in left ventricular end-diastolic volume (preload) result in?
a. Increase in force of contraction
575
The healthcare professional explains to a student that the amount of volume of blood in the heart is directly related to the _____ of contraction.
b. Strength
576
Pressure in the left ventricle must exceed pressure in which structure before the left ventricle can eject blood?
b. Aorta
577
A healthcare professional is caring for a patient who has continuous increases in left ventricular filing pressures. What disorder would the professional assess the patient for?
c. Pulmonary edema
578
The resting heart rate in a healthy person is primarily under the control of which nervous system?
b. Parasympathetic
579
. The Bainbridge reflex is thought to be initiated by sensory neurons in which cardiac location?
a. Atria
580
A healthcare professional cares for older adults in a skilled nursing facility. What should the professional assess for in these individuals related to cardiovascular functioning?
a. Increased rate of falling and dizzy spells
581
Reflex control of total cardiac output and total peripheral resistance is controlled by what mechanism?
b. Sympathetic stimulation of the heart, arterioles, and veins
582
What is the most important negative inotropic agent?
c. Acetylcholine
583
The right lymphatic duct drains into which structure?
c. Right subclavian vein
584
A patient had a motor vehicle crash and suffered critical injuries to the brainstem. What physiological responses would the healthcare professional expect to see?
c. Pulse and blood pressure changes
585
What is an expected change in the cardiovascular system that occurs with aging?
a. Arterial stiffening
586
What is the major determinant of the resistance that blood encounters as it flows through the systemic circulation?
c. Muscle layer of the arterioles
587
What physical sign does the healthcare professional relate to the result of turbulent blood flow through a vessel?
d. Murmur heard on auscultation
588
What is the major effect of a calcium channel blocker such as verapamil on cardiac contractions?
b. Decreases the strength of cardiac contractions
589
An early diastole peak caused by filling of the atrium from peripheral veins is identified by which intracardiac pressure?
b. V wave
590
What is the initiating event that leads to the development of atherosclerosis?
c. Injury to the endothelial cells that line the artery walls
591
When endothelial cells are injured, what alteration contributes to atherosclerosis?
b. Cells are unable to make the normal amount of vasodilating cytokines.
592
Which factor is responsible for the hypertrophy of the myocardium associated with hypertension?
c. Angiotensin II
593
What pathologic change occurs to the kidney’s glomeruli as a result of hypertension?
b. Ischemia of the tubule
594
What effect does atherosclerosis have on the development of an aneurysm?
c. Atherosclerosis erodes the vessel wall.
595
Regarding the endothelium, what is the difference between healthy vessel walls and those that promote clot formation?
a. Inflammation and roughening of the endothelium of the artery are present.
596
A healthcare professional is caring for four patients. Which patient does the professional assess for pulmonary emboli (PE) as the priority?
a. Deep venous thrombosis
597
Which factor can trigger an immune response in the bloodstream that may result in an embolus?
a. Amniotic fluid
598
Which statement best describes thromboangiitis obliterans (Buerger disease)?
a. Inflammatory disorder of small- and medium-size arteries in the feet and sometimes in the hands
599
A patient has been diagnosed with Raynaud disease and asks for an explanation. What statement by the healthcare professional is best?
c. Vasospastic disorder of the small arteries and arterioles of the fingers and, less commonly, of the toes
600
A patient who has lung cancer calls the clinic reports facial and neck swelling severe enough so that shirts no longer fit. What question by the healthcare professional there would be most appropriate?
c. “Does your voice sound hoarse?”
601
What term is used to identify when a cell is temporarily deprived of blood supply?
b. Ischemia
602
A person wishes to reduce the risk of developing coronary artery disease. This person has a normal lipid panel. What risk factor reduction would the healthcare professional advise for this person?
b. Controlling the blood pressure
603
Nicotine increases atherosclerosis by the release of which neurotransmitter?
d. Epinephrine
604
Which substance primarily contains cholesterol and protein?
b. Low-density lipoproteins (LDLs)
605
Which elevated value may be protective of the development of atherosclerosis?
c. High-density lipoproteins (HDLs
606
Which laboratory test is an indirect measure of atherosclerotic plaque?
d. C-reactive protein (CRP)
607
Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes?
c. 20
608
A patient reports chest pain that occurs most often during sleep. What treatment does the healthcare professional discuss with the patient?
d. Oral calcium channel blockers
609
A patient who had a myocardial infarction is going to cardiac rehabilitation where progressive exercise is monitored by health care professionals. When would this patient be most vulnerable to injury and complications?
b. Between 10 and 14 days
610
What electrocardiogram (ECG) change would the healthcare professional assess for when a patient’s myocardial infarction extends through the myocardium from the endocardium to the epicardium?
b. ST elevation
611
A patient in the Emergency department is suspected of having a myocardial infarction (MI). The initial cardiac troponin 1 level was negative. What action by the healthcare professional is best?
c. Schedule repeat lab within a few hours.
612
How does angiotensin II increase the workload of the heart after a myocardial infarction (MI)?
b. By causing dysrhythmias as a result of hyperkalemia
613
A healthcare provider is assessing a patient who has a pericardial effusion and notes a pulsus paradoxus. A student asks for an explanation of how this occurs. What description by the professional is best?
d. Diastolic filling pressures of the left ventricle and reduction of blood volume in all four heart chambers
614
A patient reports sudden onset of severe chest pain that radiates to the back and worsens with breathing and when lying down. What action by the healthcare professional is most appropriate?
d. Teach the patient about a course of antiinflammatory medications.
615
A disproportionate thickening of the interventricular septum is the hallmark of which form of cardiomyopathy?
b. Hypertrophic
616
Amyloidosis, hemochromatosis, or glycogen storage disease usually causes which form of cardiomyopathy?
b. Restrictive
617
Which condition is a cause of acquired aortic regurgitation?
c. Rheumatic fever
618
A patient in the clinic reports fever, arthralgia, a rash, and nosebleeds. What other information should the healthcare professional elicit from this patient?
b. History of a recent bacterial infection
619
What is the most common cause of infective endocarditis?
c. Bacterium
620
A patient is diagnosed with chronic obstructive pulmonary disease (COPD) and has elevated pulmonary vascular resistance. Which complication would the health care professional assess the patient for?
a. Right heart failure
621
What cardiac pathologic condition contributes to ventricular remodeling?
c. Myocardial ischemia
622
In systolic heart failure, what effect does the renin-angiotensin-aldosterone system (RAAS) have on stroke volume?
b. Increases preload and increases afterload
623
What is the cause of the dyspnea resulting from a thoracic aneurysm?
a. Pressure on surrounding organs
624
Which statement is true concerning the cells’ ability to synthesize cholesterol?
c. Most body cells are capable of producing cholesterol.
625
What is the trigger for angina pectoris?
d. Myocardial ischemia
626
Most cardiovascular developments occur between which weeks of gestation?
a. Fourth and seventh weeks
627
The presence of the foramen ovale in a fetus allows what to occur?
a. Right-to-left blood shunting
628
The student studying pathophysiology learns which fact about circulation at birth?
b. Gas exchange shifts from the placenta to the lung.
629
When does systemic vascular resistance in infants begin to increase?
d. Once the placenta is removed from circulation
630
Which event triggers congenital heart defects that cause acyanotic congestive heart failure?
b. Left-to-right shunts
631
Older children with an unrepaired cardiac septal defect experience cyanosis because of which factor?
a. Right-to-left shunts
632
A baby has been born with Down syndrome. What congenital heart defect does the healthcare professional assess this baby for?
d. Ventricular septal defect (VSD)
633
An infant has a continuous machine-type murmur best heard at the left upper sternal border throughout systole and diastole. The healthcare professional suspects a congenital heart disorder. What other assessment finding is inconsistent with the professional’s knowledge about this disorder?
c. Thrill on palpation
634
An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border. The healthcare professional suspects an atrial septal defect (ASD). For what other manifestation does the healthcare professional assess to confirm the suspicion?
a. Wide, fixed splitting of the second heart sound
635
An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect?
b. Ventricular septal defect (VSD)
636
Where can coarctation of the aorta (COA) be located?
c. Between the origin of the aortic arch and the bifurcation of the aorta in the lower abdomen
637
A parent brings a 10-year-old child to the clinic and reports a mottled appearance to the skin and legs cramps when the child is in physical education class. What diagnostic testing or treatment does the healthcare professional prepare the family for?
d. An echocardiogram
638
What is the initial manifestation of aortic coarctation observed in a neonate?
a. Heart failure (HF)
639
A parent asks the healthcare professional to explain why a child diagnosed with Tetralogy of Fallot squats frequently. What explanation by the professional is best?
c. Relieves hypoxia
640
An infant diagnosed with a small patent ductus arteriosus (PDA) would likely exhibit which symptom?
b. Lack of symptoms
641
A newborn has chronic sustained hypertension but otherwise appears healthy. What diagnostic testing does the healthcare professional facilitate as the priority?
d. Renal function studies
642
Which condition is consistent with the cardiac defect of transposition of the great vessels?
a. The aorta arises from the right ventricle.
643
Which scenario describes total anomalous pulmonary venous return?
b. Pulmonary venous return is to the right atrium.
644
A healthcare professional assesses a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border. What condition does the professional prepare to educate the parents on?
c. Aortic stenosis
645
A healthcare professional is assessing a baby in the neonatal intensive care unit who is very unstable. The professional hears a systolic ejection click at the upper left sternal border with a thrill palpated at the upper left sternal border. What procedure does the professional prepare the parents for the baby to have?
b. Balloon angioplasty
646
Which heart defect results in a single vessel arising from both ventricles, providing blood to both the pulmonary and systemic circulations
d. Truncus arteriosus
647
A 9-year-old child has a blood pressure of 112/72 mmHg in the school nurse’s office. What action by the school nurse is most appropriate?
b. Note the normal finding in the child’s records.
