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Pathophysiology Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q 
A 14-year-old male has been admitted to the emergency room suffering with a Q onset abdominal pain in lower right quadrant. Abdominal rebound tenderness is intense and he has a fever and leukocytosis. This individual most likely is suffering from:
A. Acute appendicitis
B. Diverticulitis 
C. Ulcerative colitis
D. Cholelithiasis
E. Cholecystitis
A

A.

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2
Q 
A 20-year-old man presents with periumbilical pain fever and loss of appetite. Which of the following is the most likely cause of his abdominal discomfort?
A. Diverticulosis
B. Diverticulitis 
C. Appendicitis
D. Mesenteric venous thrombosis
A

C.
Appendicitis is an inflammation of the very form appendix and commonly occurs between the ages of 20 and 30. There is often. Petiumbilical pain that can be fake. Diverticulosis is asymptomatic diverticular disease, which is herniation or Sakely outpatient pouching of mucosa through the muscle layers of the colon wall. Diverticulitis is inflammation of the diverticuli in the colon. Patients are usually older and have a crappy pain, often in the lower left quadrant. Mesenteric Venus thrombosis usually occurs in older individuals with malignancies, right sided heart failure, and deep vein thrombosis.

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3
Q 
A 23-year-old patient is hit in the temporal portion of his goal during an altercation. Although he initially loses consciousness, he soon awakens and is conversant. Three hours later he is experiencing vomiting, drowsiness, and confusion. These symptoms are most likely related to which type of brain injury?
A. Diffuse axonal 
B. Intracerebral 
C. Subdural
D. Epidural
A

D.
The classic presentation of a epidural hematoma is a person hit in the temporal area with damage to the middle meningeal artery. Patient would lose consciousness at the time of injury, but there may be a period for consciousness is regained. The patient will then become more confused and drowsy. This scenario is not typical with the other types of brain injury.

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4
Q 
A 55-year-old obese male presents to sleep clinic complaining of difficulty sleeping. He reports that he wakes gasping for air and his wife is ready to divorce him because his snoring and keeps her up at night. Which is the most likely diagnosis for this patient?
A. Primary hypersomnia 
B. Parasomnia
C. Somnambulism
D. Obstructive sleep apnea
A

D.
Obstructive sleep apnea is due to upper airway obstruction and is accompanied by excessive snoring and episodic apnea. Primary hypersomnia is excessive daytime sleepiness. Parasomnia is unusual behavior during sleep. Somnambulism is sleepwalking.

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5
Q 
Abnormal findings in which of the following evaluations would indicate possible neurological dysfunction? Select all that apply.
A. Level of consciousness 
B. Pattern of breathing
C. Heart rate
D. Eye position
E. Skeletal muscle motor response
A

All except c

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6
Q

Acute Otis media (AOM):
A. Has no genetic determinants
B. Displays a tympanic membrane progression from erythema to opaqueness with bulging
C. Has breast-feeding as a risk factor
D. Is commonly caused by staphylococcus aureus

A

B.

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7
Q

Age related macular degeneration(AMD):
A. Has a higher incidence in hypotension individuals
B. Occurs in individuals before the age of 60 years
C. Exhibits retinal detachment and loss of photo receptors
D. Exhibits loss of accommodation

A

C.

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8
Q

Although non-rem and rem sleep are defined by electrical recordings, they are characterized by physiologic events. Which does not occur?
A. During non-REM sleep, muscle tone decreases
B. Non-REM sleep is initiated by withdrawal of neurotransmitters from the reticular formation
C. During non-rem, cerebral blood flow to the cortex decreases
D. During non-rem? levels of cortical steroids increase

A

D.

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9
Q

Alzheimer’s disease:
A. Can be caused by increased cerebral levels of acetylcholine
B. Is most prevalent as a late onset dementia
C. Manifest as nerve cell tangles
D. Manifest as neuron senile plaques
E. All above

A

B.

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10
Q

The appropriate definition of perceptual dominance is:
A. The duration of time or intensity of pain before overt pain responses are initiated
B. Pain at one location that may cause an increase in threshold at another location
C. Repeated exposure to a pain stimulus
D. The point at which pain is perceived

A

B.
Perceptual dominance is pain at one location that may cause an increase in threshold at another location. For example, when a patient has severe pain in his leg he may not feel neck pain. Pain tolerance is the duration of time or intensity of pain before overt pain responses are initiated. Repeated exposure to pain usually decrease his pain tolerance. Pain threshold is the point at which pain is perceived.

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11
Q 
The appropriate term for pain that is present in an area distant from its point of origin is:
A. Acute pain
B. Chronic pain 
C. Referred pain
D. Somatic pain
A

C.
Referred pain is pain that is present in an area removed or distant from its point of origin. Chronic pain is usually prolonged, lasting at least three months. Somatic pain arises from connective tissue, muscle, balance, and skin. It maybe sharp and well organized or dull, aching, and poorly localized. Acute pain arises from cutaneous, deep somatic, or visceral structures and is a protective mechanism.

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12
Q

Autonomic hyperreflexia is characterized by all of the following except:
A. Hypotension
B. Slower heart rate
C. Stimulation of sensory receptors below the level of the cord lesion
D. Precipitation because of a distended bladder or rectum

A

A.

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13
Q 
A basic Neural system to cognitive function would include: select all that apply.
A. Attentional systems
B. Memory systems
C. Affective or emotive systems
D. Sensory systems
E. Language systems
A

All except d

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14
Q 
A benefit a fever to human blood includes:
A. Decreased lymphocytic transformation
B. Diminished phagocytosis
C. Increased iron concentration
D. A switch to lipolysis and proteolysis
A

D.
Fever has benefits. The higher body temperature decreases serum levels of iron, zinc, and copper, all of which are needed for bacterial replication. It switches from burning glucose to Lipo lysis and proteolysis, that’s depriving bacteria of a food source. There is increased lymphocytic transformation, increasing the immune response. Increase phagocytosis also occurs.

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15
Q 
A cause of a cerebral aneurysm includes: select all that apply
A. Atherosclerosis
B. Heroin abuse
C. Congenital anomaly
D. Trauma
E. Cocaine abuse
A

All except b

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16
Q

Causes of acute renal failure include:
A. Cholecystitis
B. Stones and structures in kidneys or ureters
C. Heart failure leading to poor renal perfusion
D. B and c
E. A, b, and c

A

D

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17
Q 
Cerebral death:
A. Is death of the cerebellum
B. Permits normal internal homeostasis
C. No longer maintains respiratory and cardiovascular functions
D. Is death of the brain stem
A

B.

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18
Q 
The characteristic lesion of Crohn disease is:
A. Found in the ileum
B. Pre-cancerous
C. Granulomatous
D. Malignant
E. A and C
A

E.

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19
Q

A characteristic of Alzheimer disease include: select all that apply
A. Rapid onset of symptomology
B. Short term memory loss
C. Increased irritability and agitation
D. Anxiety and depression
E. Remissions resulting in cognitive clarity

A

B, c, and d

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20
Q 
Chronic constipation may be a result of: select all that apply
A. Low residue diet
B. Sedentary lifestyle
C. Hyperthyroidism
D. Opiate use
E. Aging
A

All except c

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21
Q

Chronic renal failure
A. May result from hypertension
B. Is usually the result of chronic inflammation of the kidney
C. May be treated with dialysis or transplant‘s
D. All above
E. A and C

A

D.

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22
Q 
The classification of acute pain includes: select all that apply
A. Acute visceral 
B. Pleuritic
C. Referred
D. Acute somatic
E. Cutaneous
A

All except b

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23
Q

A client is diagnosed with a Cushing ulcer. What assessment information related to this clients current medical condition supports this diagnosis?
A. Third-degree burns over 20% of the body
B. Profound septicemia with high fever
C. Severe head trauma resulting from auto accident
D. Massive internal trauma as a result of a fall

A

C.
Cushing ulcer is a stress ulcer related to severe head trauma or brain surgery and is caused by overstimulation of the Vegas nerve and decreased mucosal blood flow. Ischemic ulcers develop within hours of an event such as septicemia, hemorrhage, multi system trauma, severe burns, or CHF.

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24
Q 
A client is diagnosed with hematochezia. Which assessment finding confirms this diagnosis?
A. Bloody vomitus
B. Bright red rectal bleeding
C. Presence of tarry stools
D. Positive test for occult blood
A

B.
Hematemesis is blood in the vomitus. Hematochezia is bright red or burgundy colored blood from the rectum. Marina is a description for a dark or tarry stool‘s. Occult bleeding is usually caused by slow, chronic bleeding, and it is not obvious.

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25
Q 
A client presents with epigastric pain and vomiting. He is hypoglycemic and tachycardic. Client reports he is “a heavy drinker but never had problems like this before. “ which disease process is supported by this clients symptoms?
A. Cholelithiasis
B. Cholecystitis 
C. Acute pancreatitis
D. Appendicitis
A

C.
The classic presenting symptoms of pancreatitis is mid epigastric pain and vomiting. This patient admits to heavy alcohol consumption, which can lead to pancreatitis. The history and assessment do not support the other options.

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26
Q

A common cause of both pyelonephritis and cystitis:
A. Urinary calculi
B. Invading, ascending micro organisms, such as E. coli
C. Allergy reactions
D. Heavy metals

A

B.

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27
Q 
Common manifestation of hiatal hernia is:
A. Gastroesophageal reflux
B. Diarrhea
C. Belching
D. Post prandial substernal pain
E. A, c, and d
A

E.

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28
Q 
Criteria for determining brain death include: select all that apply
A. Unresponsive coma
B. No spontaneous respiration
C. Isoelectric EEG
D. Pupils are reactive but unequal
E. Ocular response to head turning
A

A, b, and c

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29
Q 
Depressed T cell function is associated with
A. Follicular cyst
B. Endometrial polyps
C. Leiomyomas
D. Adenomyosis
E. Endometriosis
A

E.

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30
Q

A diabetic child with 4.0 g of protein in her urine each day is experiencing Adema and vitamin D deficiency. Which is the most likely diagnosis?
A. Nephritic syndrome
B. Nephrotic syndrome
C. Acute renal failure
D. Rapidly progressive glomerular nephritis

A

B.
Nephrotic syndrome is characterized by excretion of 3.5 g or more of protein in the urine per day due to glomerular injury. Nephritic syndrome is characterized by blood in the urine with red and white cell cast and varying degrees of protein. Acute renal failure presents with oligoria and a reduction in GFR and BUN. Rapidly progressive call Miller and afraid is usually affects adults in their 50s and 60s and presents with he matures

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31
Q

Duodenal ulcers
A. Occur four times more often in females than males
B. Maybe complicated By hemorrhage
C. Are associated with sepsis
D. May cause inflammation and scar tissue formation around the sphincter of Oddi

A

B.

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32
Q

During vomiting, there is:
A. Forceful diaphragm and abdominal muscle contractions, airway closure, esophageal sphincter relaxation, and deep inspiration
B. Deep inspiration, airway closure, forceful diaphragm and abdominal muscle contractions, and esophageal sphincter relaxation
C. Airwayclosure, forceful diaphragm and abdominal muscle contractions, deep inspiration, and esophageal sphincter relaxation
D. Esophageal sphincter relaxation, forceful diaphragm and abdominal muscle contractions, deep inspiration, and airway closure

A

B

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33
Q 
Dystonia is:
A. Abnormal posture maintained by muscular contractions
B. Flexed posture
C. Stooped, hyper flexed posture
D. A spastic gate
A

A.

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34
Q 
The earliest symptoms of chronic renal failure is
A. Pruritus 
B. Oliguria
C. Polyuria
D. Decreased BUN
A

C.

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35
Q 
An elderly alcoholic man falls and experiences a hematoma that is on top of his brain. The hematoma is most likely:
A. Subdural
B. Epidural
C. Extradural
D. Intracerebral
A

A.
Sub dural hematoma‘s are commonly found in the elderly and persons who abuse alcohol. The remaining options are injuries not generally observed in this population after experiencing an alcohol induced fall.

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36
Q 
Endogenous opioids include: select all that apply.
A. Enkephalins 
B. Endorphins
C. Dynorphins
D. EndoMorphins
E. Denkephalins
A

All except E

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37
Q

Endometriosis
A. Has the ectopic endometrium responding to hormonal fluctuations of the menstrual cycle
B. Occurs primarily in the plural cavity
C. Causes infertility and most women having a disorder
D. Does not reoccur after treatment

A

A.

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38
Q 
Endorphins
A. Increase pain sensations
B. Decrease pain sensations
C. May increase or decrease pain sensations
D. Have no effect on pain sensations
A

B

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39
Q 
Gastric ulcers
A. May lead to malignancy
B. Occur at a younger age then duodenal ulcers
C. Always have increased acid production
D. Exhibit nocturnal pain
E. Both a and C
A

A.

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40
Q

Gastroesophageal reflux is:
A. Caused by rapid gastric emptying
B. Excessive lower esophageal sphincter functioning
C. Associated with abdominal surgery
D. Caused by spontaneously relaxing lower esophageal sphincter

A

D.

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41
Q 
H. Pylori is discovered in the G.I. tract of a client experiencing an inflammation of the gastric mucosal. These findings support which diagnosis?
A. Chronic diarrhea
B. Paralytic ileus
C. Chronic gastritis
D. Pyloric obstruction
A

Helicobacter pylori infection is associated with gastritis. The other options are not related to this organism.

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42
Q 
Hepatic and cephalopathy is manifested by:
A. Ascites
B. Spleno megaly
C. Dark urine
D. Oliguria
E. Cerebral dysfunction
A

E.

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43
Q 
In an automobile accident, an individual’s forehead struck the windshield. The coop counter coop injury would be in the:
A. Frontal/parietal region
B. Frontal/occipital region
C. Parietal/occipital region
D. Occipital/frontal region
A

B

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44
Q 
In bacterial meningitis the CSF has
A. Normal glucose levels
B. An elevated number of lymphocytes
C. Neutrophilic infiltration
D. None of the above
E. A, b, and c
A

C

45
Q

In benign prosthetic hyperplasia, enlargement of periurethral tissue of the prostate causes:
A. Obstruction of the ureter
B. Inflammation of the testes
C. Decreased urinary outflow from the bladder
D. Abnormal dilation of a vein within the spermatic cord
E. Tension of the spermatic cord and testes

A

A

46
Q 
In blunt head trauma
A. Brain tissues are exposed
B. Only focal injury occurs
C. The Dura is severed
D. The Dura remains intact
A

D.

47
Q

In cerebral vasogenic edema
A. Active transport fails
B. There is auto digestion
C. Plasma proteins leak into extracellular spaces
D. Cerebral spinal fluid leaves the ventricles

A

C

48
Q

In chronic renal failure, tubulointerstitial disease leads to
A. Sodium retention
B. Sodium wasting
C. No significant changes in sodium levels.
D. Increased phosphate excretion

A

D.

49
Q

And heat stroke
A. Core temperature usually doesn’t exceed 101 Fahrenheit
B. Sodium loss follow sweating
C. Core temperatures increases as the regulatory center fails
D. Both B and c

A

C

50
Q 
In hypo thermia
A. The viscosity of blood is decreased
B. Acidosis can develop
C. Hypothalamus center prevents shivering
D. All above
A

B

51
Q

In malabsorption syndrome, flatulence and abdominal distention are likely caused by:
A. Protein deficiency and electrolyte imbalance
B. Undigested lactose fermentation by bacteria
C. Fat irritating the bowel
D. Impaired absorption of amino acids and accompanying Edema

A

B

52
Q

In moderate diffuse axonal injury
A. Coma Lasts more than 24 hours
B. Coma Lasts less than 24 hours
C. Disruption of axons occurs in cerebral spheres and those extending into the diencephalon and the brain stem
D. Tearing of axons in the cerebral hemisphere
E. A and D

A

E.

53
Q

In pancreatitis
A. The tissue damage likely results from release of pancreatic enzymes
B. High cholesterol intake is causative
C. Diabetes is uncommon and chronic pancreatitis
D. Bacterial infection is the etiologic cause

A

A.

54
Q

In the gate control theory of pain
A. A closed gate increases pain perception
B. Stimulation of large a fibers closes the gate
C. Both a and B
D. Neither a nor b

A

B.

55
Q 
Increased serum levels of epinephrine increase body temperature by
A. Increasing shivering
B. Increasing muscle tone
C. Increasing heat production
D. Decreasing basal metabolic rate
A

C.

56
Q 
An individual has an elevated blood level of urea and creatinine because of complete calculate blockage of one ureter. This is referred to as
A. Pre-renal disease
B. Intra-renal disease
C. Post renal disease
D. Preeclampsiae. 
E. Hypercalcemia
A

C.

57
Q 
An individual shows flexion and upper extremities and extension and lower extremities. This is
A. Decorticate posturing
B. Decerebrate posturing
C. Excitation posturing
D. Caloric posturing
A

A.

58
Q 
An individual with increased intracranial pressure from a head injury show small and reactive pupils, widen pulse pressure, and slowed breathing. Which stage of ICP exists?
A. Stage one
B. Stage two
C. Stage three
D. Stage four
A

C.

59
Q 
Individuals affected by sleep apnea makes Experience
A. Polycythemia
B. Cyanosis
C. Pulmonary hypertension
D. All above
A

D.

60
Q 
Injury of the cervical cord may be life-threatening because of
A. Increased intracranial pressure
B. Disrupted reflexes
C. Spinal shock
D. Loss of bladder and rectal control
E. Diaphragmatic impairment
A

E.

61
Q 
Intellectual function is impaired in the demented process. Which intellectual function is not impaired?
A. Anterograde memory
B. Retrograde memory
C. Abstraction
D. Language deficits
E. All above impaired
A

E.

62
Q 
Interleukin one
A. Raises hypothalamic set point
B. Endogenous pyrogen
C. Stimulated by EXOgenous pyrogens
D. None above
E. A, B, and C
A

E.

63
Q

Intervertebral disc herniation
A. Usually occurs at the thoracic level
B. In the lumbosacral area causes pain over the gluteal region and into the calf or ankle
C. Is in frequent in the lumbar sacral discs
D. Both B and C are correct
E.A, B, and C

A

B

64
Q 
Intestinal obstruction causes
A. Decreased intraluminal tension
B. Hyperkalemia
C. Decrease nutrient absorption
D. A and B
E. A, B, and C
A

C.

65
Q 
Involuntary unilateral or bilateral rhythmic movement of the eyes is referred to as
A. Nystagmus
B. Amblyopia 
C. Glaucoma
D. Strabismus
A

A.
Nystagmus may be present at rest or when eyes move. Amblyopia is reduced vision in the eye secondary to uncorrected strabismus. Strabismus is when one eye deviates from the other one a person is looking at an object. Glaucoma is increased intraocular pressure.

66
Q

It is correct to assume that a saccular aneurysm
A. Occurs commonly in childhood
B. Grows rapidly
C. Can be due to a combination of congenital and degenerative changes
d. Occurs in about 10% of the general population

A 
C
Saccular (berry) aneurysm can be due to a combination of congenital and degenerative changes. They affect approximately 2% of the general population. They grow slowly over time and are rare in childhood.
67
Q

It is correct to assume that a subarachnoid hemorrhage is
A. A risk for individuals with intracranial aneurysms
B. Seldom experienced in individuals with hypertension
C. Not caused by trauma to the head
D.Rarely fatal

A

A.
Individuals with intracranial aneurysms are at risk for subarachnoid hemorrhage. Hypertension and trauma are also risk factors. The mortality is over 50%

68
Q

It is correct to assume that Cheyne-Stokes respirations (CSR):
A. Involve a pathologically increased ventilatory response
B.Result in hypocapnia and increased ventilatory stimulus
C. Cause changes in PaO2 that produced irregular breathing
D.Increase PaCO2 level when overbreathing occurs

A

A.
The pathophysiology of CSR includes an increased ventilatory response to carbon dioxide stimulation. This causes hypercapnia and diminished ventilatory stimulus. Changes in PaCO2 produce irregular breathing, not changes in PaO2. The PACOto level decreases to below normal went over breathing occurs.

69
Q

It is correct to assume that grade 3 and grade for astrocytomas are
A. Commonly found in the frontal lobe and cerebral hemisphere
B. Generally seen more in women than men
C.Usually neurotic as a result of an absence of vascularity
D. Bluish gray in color with a hard purpleish center

A

A.
They are commonly found in the frontal lobe and cerebral hemisphere and are found twice as often in men as in women. They are often large and well circumcised with a variegated pattern. The rim is pinkish gray and solid with a soft, yellow, necrotic center. There’s vascular proliferation.

70
Q 
It is true that a hemorrhagic stroke
A. Is the most common cause of CVA
B. Accounts for 50% of all CVA
C. Is commonly caused by hypertension
D. Is often caused by micro infarct
A

C.
Chronic, untreated hypertension is generally the cause of hemorrhagic stroke. Hemorrhagic stroke is the third most common cause of CVA. It accounts for 10% to 15% of strokes in whites and 30% in blacks and Asians. An infarct is a type of a occlusive stroke.

71
Q

It is true that Alzheimer’s disease is
A. An uncommon neurological disorder
B. Not believed to have a genetic relationship
C. A result of neuronal proteins becoming distorted and tangled
D.The cause of plaques increasing nerve impulse transmission

A

C.
Neurofibrillary tangles occur when the proteins in neurons become tangled and distorted. There is a genetic relationship in late onset familiar Alzheimer’s dementia. It is a common neurological disorder; nearly 6,000,000 Americans had the disease in 2000. With the formation of plaques, there is decreased nerve impulse transmission.

72
Q

It is true that an acute Cerebrovascular accident CVA is
A. The leading cause of disability in the United States
B.The fifth most common cause of death in the
C. Likely to be followed by a second stroke within one year
D.Experienced by 2 million individuals each year

A

A.
CVAs are the leading cause of disability and the third leading cause of death. There are 500,000 stroke victims a year, and 5% to 14% have a second stroke within one year.

73
Q 
It is true that an oligodendroglioma
A. Accounts for 20% of all brain tumors
B. Is fast growing
C.Usually is undifferentiated
d.Rarely include cysts or calcifications
A

D.
They often have cysts and calcifications that are slow growing, well differentiated tumors that comprise 2% of all brain tumors.

74
Q 
It is true that encephalitis is
A. And a febrile illness
B. Caused by bacteria
C. A result of arthropod borne viruses
D. Caused exclusively by herpes simplex two
A

C.
It is caused by a virus, often arthropod born (tick/mosquito borne). Herpes simplex one can also cause the illness; type one is more common than type two. Encephalitis is an acute febrile illness.

75
Q

It is true that spinal shock
A.Is characterized by an incomplete loss of reflex function
B. Involves all skeletal muscles
C. Causes increased muscle tone below the lesion
D.Results in no disruption of thermal control

A

B.
Spinal shock does involve function of skeletal muscles resulting in paralysis and flaccidity. Such an injury is characterized by a complete loss of reflux function below the level of the lesion, and impairment of control of thermal regulation is observed.

76
Q

It is true that the specificity theory of pain
A. Focuses on the attention of pain
B. Focuses on previous experience of pain
C. Relates the amount of pain to the amount of soft tissue injury
D.Relates to the emotions exhibited towards pain

A

C.
The specificity theory of pain postulates that the intensity of pain is directly related to the amount of associated tissue injury. It does not take into account previous experience, emotions, or attention to pain.

77
Q 
Kussmaul respirations can be a result of: select all that apply
A. Pulmonary edema
B. Metabolic alkalosis
C. Metabolic acidosis
D. Dehydration
E.Impaired protein metabolism
A

A and C

78
Q 
Leptin
A.Promotes insulin resistance
B. Vines to insulin receptors
C. Suppresses hunger/appetite at the hypothalamus
D. A, B, and C
E.None above
A

C.

79
Q 
Low residue diet and chronic constipation play a role in the pathogenesis of
A.Appendicitis
B. Diverticulitis
C. Ulcerative colitis
D.Crohn’s diseases
E. Cholecystitis
A

B

80
Q 
Manifestations of subarachnoid hemorrhage include (more than one answer may be correct)
A.An explosive headache
B. Muscle flaccidity
C. Neurologic deficits
D.A delayed age of onset
A

A andC

81
Q 
A means of classifying a seizure include: select all that apply
A.Clinical manifestations
B.Site of origin
C.Response to therapy
response to therapy
D.Length of activity
E.EEG correlates
A

All except D

82
Q 
A mechanism that does not result in heat loss is
A. Increased respiration
B.Conduction
C. Convection
D.Vasoconstriction
A

D.
Vasoconstriction is a mechanism of heat conservation. Increased respiration, conduction, and convection or all mechanisms of heat loss.

83
Q 
Melt a is
A. Bloody vomitus
B.Gaseous about distention
C.Blood in the stool
D. Loss of appetite
E.Black, tarry stools
A

E.

84
Q 
The most common cause of TBI is
A. Motor vehicle accidents
B. Falls
C. Sports related events
D.Violence
A

A.
Motor vehicle accidents account for 50%. False account for 21%. Sports related events and violence account for 10% and 12%, respectively.

85
Q

The most common manifestation of portal hypertension is
A.Rectal bleeding
B.Cirrhosis
C. Intestinal bleeding
D. Duodenal bleeding
E.Vomiting of blood from esophageal bleeding

A

E.

86
Q 
Most spinal cord injuries occur in the
A. Cervical and thoracic region’s
B.Cervical and lumbar regions
C. Thoracic and lumbar regions
D.Lumber and sacral regions
A

B

87
Q 
Multiple sclerosis involves
A. Degeneration of Dopaminergic receptors
B.Activation of the Syncytin Gene
C. Depletion of GABA
D.Lower motor neuron muscle wasting
A

B.

88
Q

Nephrotic syndrome is associated with blank to plasma blank
A. Increase glomerular permeability; urea
B. Decreased glomerular permeability; proteins
C. Decreased glomerular permeability; tubular filtrate
D.Increased glomerular permeability; proteins

A

D

89
Q 
Nephrotoxins, such as antibiotics, may be responsible for
A.Acute tubular necrosis
B.Acute glomerular nephritis
C. Pyelonephritis
D.Cystitis
A

A

90
Q 
Osmotic diarrhea is caused by
A.Lactase deficiency
B. Bacterial Enterotoxins
C.Ulcerative colitis
ulcerative colitis
D. Crohn’s disease
E.C and d
A

A

91
Q 
A patient diagnosed with Parkinson’s disease initially experiences
A. Difficulty walking
B. Find tremors
C. Postural instability
D.Rigidity of leg muscles
A

B.
Tremor is often the first symptom to appear. The symptoms are often unilateral and then become bilateral, progressing to affect gait and include postural instability and the inability to walk.

92
Q

A patient experiences a large hematoma from a motor vehicle accident. The patient develops jaundice due to increased breakdown (hemolysis) of red blood cells. Which statement about the pathophysiology of the hemolysis regarding this patient’s condition is true?
A. There is a decrease in conjugated Bilirubin
B. Increased amounts of unconjugated Bilirubin occur
C. Bilirubin is excreted in the urine
D. HemolySis is identical to obstructive jaundice

A

B
Hemolysis is increases the unconjugated Bilirubin , which is not water-soluble so it cannot be excreted in the urine. This does not affect the conjugated Bilirubin,which is increased in obstructive jaundice.

93
Q 
A patient experiences of vertebral fracture in which the C1 vertebrae is fractured into several fragments. This type of fracture can be described as
A. Simple
B. Compressed
C. Comminuted
D.Dislocation
A

C
A comminuted fracture is also called a burst fracture, in which the vertebral body is shattered into several fragments. A simple fracture is a single break usually affecting the transverse or spinous process. A compressed fracture is also called a wedge. This occurs when there is a crash type of injury and the vertebrae lose his height. He dislocation is when two bones and joints are no longer in alignment.

94
Q 
A patient experiences abdominal pain that is very localized and intense. Which type of pain does this describe?
A. Parietal
B. Visceral
C. Referred
D.Phantom
A

A
Parietal pain arises from the parietal peritoneum and is more localized and intense than visceral pain. Visceral pain is often poorly localized and/or and arises from the organs themselves. Referred pain as well localized visceral pain felt at some distance from a disease or an infected organ. Phantom pain does not refer to abdominal pain. It is felt after the loss of a limb.

95
Q 
A patient experiences chronic intermittent pain in the epigastric area when the stomach is empty and in the middle of the night. This history supports a diagnosis of
A. Acute gastritis
B. Chronic gastritis
C. Gastric ulcer
D. Duodenal ulcer
A

D.
These symptoms support a diagnosis of a duodenal ulcer. Acute gastritis often has vague abdominal discomfort, epigastric tenderness, and bleeding. Chronic gastritis has symptoms that include anorexia, fullness, nausea, vomiting, and pain. Gastric ulcers have symptoms of epigastric pain and may occur immediately after eating.

96
Q 
A patient experiences de myelination of the peripheral nerve sparing of the axons this is characteristic of
A. Alzheimer’s disease
B. Guillain barre
C.Myasthenia gravis
D. Amyotrophic lateral sclerosis (ALS)
A

B
Guillain-barre is an idiot pathic polyneuritis with acute inflammatory demyelination characteristics. There is demyelination of the peripheral nerves with relative sparing of the accents. Alzheimer’s disease is a form of dementia caused by tangles. Myasthenia gravis is due to anti-acetylcholine receptor antibodies. ALS is a degenerative disorder diffusely involving lower and upper motor neurons, resulting in progressive muscle weakness.

97
Q 
A patient experience has diarrhea, which her physician contributes to increase mucosal discharge of chloride or bicarbonate rich fluid. Which of the following types of diarrhea is this?
A. Osmotic
B. Secretory
C. Motility
D.Parasitic
A

B
Secretory diarrhea is a form of large volume diarrhea caused by excessive mucosal secretion of chloride or bicarbonate rich fluid or inhibition of net sodium absorption. Osmotic diarrhea is due to a non-absorbable substance in the intestine that draws water into the lumen by osmosis; an example is lactase deficiency. Motility diarrhea is caused by resection of the small intestine. This is often found after bypass surgery (bariatric). Parasitic diarrhea is caused by parasites in the gastrointestinal G.I. tract.

98
Q

A patient experiences no nausea but significant vomiting with a CNS injury when the trauma:
A.Impinges directly on the floor of the third ventricle
B. Causes a decrease in intracranial pressure
C. Involves the vestibular nuclei
D.Also involves the abdominal area

A

C
Vomiting associated with CNS injuries involves the vestibular nuclei. It can also be caused by impingement on the fourth ventricle or an increase in intracranial pressure. Vomiting with no associated nausea indicates direct involvement of the central neural mechanisms regardless of abdominal trauma.

99
Q

Patient patient experiencing the tonic phase of a seizure exhibits:
A. Muscle contraction with increased muscle tone
B. Alternating contraction and relaxation of the muscles
C. Muscle contraction alternating with placidity
D. Complete paralysis

A

A
The face of muscle contraction with increased muscle tone is the tonic face. Alternating contraction and muscle relaxation represents the clonic face. The postictal phase immediately falls the seizure. There’s no face that is characterized with muscle contraction alternating with placidity

100
Q 
A patient has a brain abscess with a decreased chronic center and mature collagen. This is most consistent with which stage?
A.Early cerebritis
B. Late cerebritis
C. Early capsule formation
D. Late capsule formation
A

C
Early capsule formation occurs on days 10 to 13. The necrotic center decreases in size and inflammatory infiltrate changes in character. Mature collagen eval‘s, forming a capsule. Early cerebritis occurs on days 1 to 3 and is a localized inflammatory process. There are marked cerebral edema and essential core of necrosis. Late cerebritis occurs on days 4-9, and there is a necrotic center surrounded by inflammatory infiltrate of macrophages and fibroblasts. There is a rapid new blood vessel formation. Weight capsule formation occurs on day 14 and later. There is a well formed aquatic center surrounded by a dense collagenous capsule

101
Q 
A patient has sustained a traumatic brain injury but is able to follow simple commands and can manipulate objects. The term used to describe this state is
A. Coma
B. Vegetative
C. Minimally conscious
D. Locked in syndrome
A

C
The term minimally conscious refers to severely altered consciousness in which the person demonstrates minimal but defined behavioral evidence of self or environmental awareness. The clinical features include following simple commands, manipulation of objects, gestural or verbal yes no responses, intelligible verbalization, and stereotypical movements. Locked in syndrome describes an individual who has both the content of thought at the level of arousal intact. The efferent pathways are disturbed, which means the individual cannot communicate through speech or body movement., It’s the state of a Neurobehavioral unresponsiveness. Vegetative state is a wakeful unconscious state

102
Q 
A patient has uncontrolled or premature contractions of the detrusor muscle. Which condition is associated with this medical problem?
A. Spinal cord injury
B. Immune system dysfunction
C. Congestive heart failure
D. Renal carcinoma
A

A
This patient’s condition is neurogenic Detrusor activity. Spinal cord injury contributes to uncontrolled or premature contractions of the detrusor muscle associated with a neurological disorder. This can also be from Guillain barre or transfers Myelitis

103
Q 
A patient is brought to the emergency room following a motor vehicle accident in which he sustained a few sprayed injury. Which of the following symptoms would be expected to accompany his injury? Select all that apply
A. Memory deficits
B. Swallowing disorders
C. Agitation
D. Fatigue
E. Short attention span
A

All except D

104
Q 
A patient is diagnosed with a kidney stone that is composed of magnesium, ammonium, and phosphate. What type of urinary calculus is this?
A. Calcium
B. Struvite 
C. Uric acid
D. Indinavir
A

B
Calcium oxalate or calcium phosphatase stones account for 70% to 80% of stones. Struvite Stones account for about 15% and are composed of magnesium, ammonium, and phosphate. Uric acid stones account for 7% of stones. Less common stone elements includ cystine, 2,8- dihydroxyadeninuria, triameterene, indinavir, and ammonium acid urate.

105
Q 
A patient is diagnosed with a meningioma. The most likely side of the tumor is the: select all that apply
A. Sella turcica 
B. Olfactory groove
C. Tuberculum sellae 
D. Sphenoidal wing
E. Cerebellopontine angle
A

All

106
Q 
A patient is diagnosed with a peptic ulcer. Which assessment data confirms this diagnosis? Select all that apply
A. Presence of H pylori in the duodenum
B. Advanced age
C. Follows a strict vegetarian diet
D. History of alcohol abuse
E. Diagnosis of rheumatoid arthritis
A

All except C

107
Q 
A patient is diagnosed with colon rectal cancer and is told that it is limited to the bowel wall. This is characteristic of which stage of cancer
A. Stage a
B. Stage B
C. Stage C
D. Stage D
A

A
Stage a is cancer limited to the Bowel wall. Stage B is cancer extending through the bowel wall. Stage C is nodal metastasis regardless of extension into the Bowel wall. Stage D is distant metastasis

108
Q 
A patient is diagnosed with hepatitis A. Transmission of this form of hepatitis occurs via
A. Fecal oral route
B. Infected blood or body fluids
C. Sexual contact
D. Intravenous drug use
A

A

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