NR507 NR 507 Midterm Exam Review Score for this quiz: 118 out of 120
Question 1
2 / 2 pts
The lung is innervated by the parasympathetic nervous
... [Show More] system via which nerve?
Correct!
Vagus
Phrenic
Brachial
Pectoral
Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel
only in the vagus nerve to the lung.
Question 2
2 / 2 pts
What is the action of urodilatin?
Urodilatin causes vasoconstriction of afferent arterioles.
It causes vasodilation of the efferent arterioles.
Urodilatin inhibits antidiuretic hormone secretion.Correct!
It inhibits salt and water reabsorption.
Urodilatin (a natriuretic peptide) inhibits sodium and water reabsorption from the
medullary part of collecting duct, thereby producing diuresis. It is not involved in the
actions described by the other options.
Question 3
2 / 2 pts
What is the direct action of atrial natriuretic hormone?
Sodium retention
Correct!
Sodium excretion
Water retention
Water excretion
Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) inhibit the secretion
of renin, inhibit angiotensin-induced secretion of aldosterone, vasodilate the afferent
and constrict the efferent glomerular arterioles, and inhibit sodium and water absorption
by kidney tubules. The other actions are not a result of the atrial natriuretic hormone.
Question 4
2 / 2 pts
Which statement best describes a Schilling test?
Correct!Administration of radioactive cobalamin and the measurement of its excretion in the
urine to test for vitamin B12 deficiency
Measurement of antigen-antibody immune complexes in the blood to test for hemolytic
anemia
Measurement of serum ferritin and total iron-binding capacity in the blood to test for iron
deficiency anemia
Administration of folate and measurement in 2 hours of its level in a blood sample to
test for folic acid deficiency anemia.
The Schilling test indirectly evaluates vitamin B12 absorption by administering radioactive
B12 and measuring excretion in the urine. This selection is the only option that accurately
describes a Schilling test.
Question 5
2 / 2 pts
Hemolytic disease of the newborn (HDN) can occur if the mother:
Is Rh-positive and the fetus is Rh-negative
Correct!
Is Rh-negative and the fetus is Rh-positive
Has type A blood and the fetus has type O
Has type AB blood and the fetus has type B
HDN can occur only if antigens on fetal erythrocytes differ from antigens on maternal
erythrocytes. Maternal-fetal incompatibility exists only if the mother and fetus differ in
ABO blood type or if the fetus is Rh-positive and the mother is Rh-negative. This
erythrocyte incompatibility does not exist in any of the other options.Question 6
2 / 2 pts
Which T-lymphocyte phenotype is the key determinant of childhood asthma?
Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes
Correct!
CD4 T-helper Th2 lymphocytes
CD8 cytotoxic T lymphocytes
Memory T lymphocytes
Asthma develops because the Th2 response (in which CD4 T-helper cells produce
specific cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and
allergic response in the airways. This selection is the only option that accurately
identifies the appropriate T-lymphocyte phenotype.
Question 7
2 / 2 pts
Perceived stress elicits an emotional, anticipatory response that begins where?
Prefrontal cortex
Anterior pituitary
Correct!
Limbic systemHypothalamus
Perceived stressors elicit an anticipatory response that begins in the limbic system of
the brain, the only option responsible for emotions and cognition.
Question 8
2 / 2 pts
Hypersensitivity is best defined as a(an):
Disturbance in the immunologic tolerance of self-antigens
Immunologic reaction of one person to the tissue of another person
Correct!
Altered immunologic response to an antigen that results in disease
Undetectable immune response in the presence of antigens
Hypersensitivity is an altered immunologic response to an antigen that results in
disease or damage to the host. The other options are not accurate definitions of
hypersensitivity.
Question 9
2 / 2 pts
It has been determined that a tumor is in stage 2. What is the meaning of this finding?
Cancer is confined to the organ of origin.
Cancer has spread to regional structures.Correct!
Cancer is locally invasive.
Cancer has spread to distant sites
Cancer confined to the organ of origin is stage 1; cancer that is locally invasive is stage
2; cancer that has spread to regional structures, such as the lymph nodes, is stage 3;
and cancer that has spread to distant sites, such as a liver cancer spreading to the lung
or a prostate cancer spreading to bone, is stage 4.
Question 10
2 / 2 pts
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?
Atrial septal defect (ASD)
Correct!
Ventricular septal defect (VSD)
Patent ductus arteriosus (PDA)
Atrioventricular canal (AVC) defect
On physical examination, a loud, harsh, holosystolic murmur and systolic thrill can be
detected at the left lower sternal border. The intensity of the murmur reflects the
pressure gradient across the VSD. An apical diastolic rumble may be present with a
moderate-to-large defect, reflecting increased flow across the mitral valve. Thepresentations of the other congenital heart defects are not consistent with the described
symptoms.
Question 11
2 / 2 pts
Which statement concerning exotoxins is true?
Exotoxins are contained in cell walls of gram-negative bacteria.
Exotoxins are released during the lysis of bacteria.
Exotoxins are able to initiate the complement and coagulation cascades.
Correct!
Exotoxins are released during bacterial growth.
Exotoxins are proteins released during bacterial growth. The other options are not true
of exotoxins.
Question 12
2 / 2 pts
The function of the foramen ovale in a fetus allows what to occur?
Correct!
Right-to-left blood shunting
Left-to-right blood shunting
Blood flow from the umbilical cordBlood flow to the lungs
The nonfused septum secundum and ostium secundum result in the formation of a
flapped orifice known as the foramen ovale, which allows the right-to-left shunting
necessary for fetal circulation. The foramen ovale is not involved in the blood flow
described by the other options.
Question 13
2 / 2 pts
Which laboratory test is considered adequate for an accurate and reliable diagnosis of
gonococcal urethritis in a symptomatic man?
Ligase chain reaction (LCR)
Correct!
Gram-stain technique
Polymerase chain reaction (PCR)
DNA testing
Microscopic evaluation of Gram-stained slides of clinical specimens is deemed positive
for Neisseria gonorrhoeae if gram-negative diplococci with the typical “kidney bean”
morphologic appearance are found inside polymorphonuclear leukocytes. Such a
finding is considered adequate for the diagnosis of gonococcal urethritis in a
symptomatic man. The other options are not relevant to the diagnosis of this condition.
Question 14
2 / 2 pts
Which manifestations of vasoocclusive crisis are associated with sickle cell disease
(SCD) in infants?Atelectasis and pneumonia
Correct!
Edema of the hands and feet
Stasis ulcers of the hands, ankles, and feet
Splenomegaly and hepatomegaly
Symmetric, painful swelling of the hands and feet (hand-foot syndrome) caused by
infarction in the small vessels of the extremities is often the initial manifestation of SCD
in infants. This selection is the only option that accurately identifies the manifestations of
a vasoocclusive crisis associated with SCD in infancy.
Question 15
2 / 2 pts
Which statement concerning benign tumors is true?
The resulting pain is severe.
Benign tumors are not encapsulated.
Benign tumors are fast growing.
Correct!
The cells are well-differentiated.A benign tumor is well-differentiated with its tissue appearing similar to the tissue from
which it arose. The other options are characteristic of a malignant tumor.
Question 16
2 / 2 pts
Which primary characteristic is unique for the immune response?
The immune response is similar each time it is activated.
Correct!
The immune response is specific to the antigen that initiates it.
The response to a specific pathogen is short term.
The response is innate, rather than acquired.
Unlike inflammation, which is nonspecifically activated by cellular damage and
pathogenic microorganisms, the immune response is primarily designed to afford longterm specific protection (i.e., immunity) against particular invading microorganisms; that
is, it has a memory function. The other options are not unique characteristics of the
immune response.
Question 17
2 / 2 pts
Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child?
Parental history of asthma
Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels
Correct!Reduced expiratory flow rates confirmed by spirometry testing
Improvement on a trial of asthma medication
Confirmation of the diagnosis of asthma relies on pulmonary function testing using
spirometry, which can be accomplished only after the child is 5 to 6 years of age.
Reduced expiratory flow rates that are reversible in response to an inhaled
bronchodilator would be characteristic abnormalities. For younger children, an empiric
trial of asthma medications is commonly initiated. The remaining options are major
historical and physical factors that contribute but do not confirm the diagnosis of asthma
in children.
Question 18
0 / 2 pts
Where are antibodies produced?
Helper T lymphocytes
Thymus gland
Correct Answer
Plasma cells
You Answered
Bone marrow
An antibody or immunoglobulin is a serum glycoprotein produced only by plasma cells
in response to a challenge by an immunogen.
Question 19
2 / 2 ptsHow much urine accumulates in the bladder before the mechanoreceptors sense
bladder fullness?
75 to 100 ml
100 to 150 ml
Correct!
250 to 300 ml
350 to 400 ml
When the bladder accumulates 250 to 300 ml of urine, it contracts and the internal
urethral sphincter relaxes through activation of the spinal reflex arc (known as
the micturition reflex).
Question 20
2 / 2 pts
Which disorder results in decreased erythrocytes and platelets with changes in
leukocytes and has clinical manifestations of pallor, fatigue, petechiae, purpura,
bleeding, and fever?
Idiopathic thrombocytopenic purpura (ITP)
Correct!
Acute lymphocytic leukemia (ALL)
Non-Hodgkin lymphoma (NHL)Iron deficiency anemia (IDA)
Pallor, fatigue, petechiae, purpura, bleeding, and fever are generally present with the
most common symptoms reflecting the consequence of bone marrow failure, which
results in decreased red blood cells and platelets and changes in white blood cells. This
selection is the only option that correctly identifies the disease with the symptoms
described.
Question 21
2 / 2 pts
Carcinoma in situ is characterized by which changes?
Cells have broken through the local basement membrane.
Cells have invaded immediate surrounding tissue.
Correct!
Cells remain localized in the glandular or squamous cells.
Cellular and tissue alterations indicate dysplasia.
Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or
squamous cell origin. These early stage cancers are localized to the epithelium and
have not broken through the local basement membrane or invaded the surrounding
tissue. Dysplasia refers to changes in mature cell structure.
Question 22
2 / 2 pts
What is the life span of platelets (in days)?
Correct!10
30
90
120
A platelet circulates for approximately 10 days and ages. Macrophages of the
mononuclear phagocyte system, mostly in the spleen, remove platelets.
Question 23
2 / 2 pts
What is the primary cause of respiratory distress syndrome (RDS) of the newborn?
Immature immune system
Small alveoli
Correct!
Surfactant deficiency
Anemia
RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in
alveolar surface area for gas exchange. None of the other options are related to the
cause of RDS.Question 24
2 / 2 pts
What is the life span of an erythrocyte (in days)?
20 to 30
60 to 90
Correct!
100 to 120
200 to 240
Because it cannot undergo mitotic division, the erythrocyte has a limited life span of
approximately 120 days. [Show Less]