NURS 548 Final Exam Questions & Answers With Rationales
Question
0 out of 2 points
Which of the following IS NOT a characteristic of acute
... [Show More] rhinosinusitis?
RIGHT ANSWER: HOARSENESS
• Characteristics of Acute Rhinosinusitis:
• facial pain, headache, purulent nasal discharge, decreased sense of smell, fever
Question
2 out of 2 points
Which of the following IS NOT a characteristic of Mycobacterium tuberculosis hominis?
BACTERIA DIE WHEN EXPOSED TO AIR
• Characteristics of Mycobacterium tuberculosis hominis
– Aerobic
– Protective waxy capsule
– Can stay alive in “suspended animation” for years
Question 5
2 out of 2 points
Progressive primary TB:
Question 6
2 out of 2 points
Which of the following statements concerning neonatal respiratory distress syndrome is INCORRECT?
UNKNOWN ANSWER???
Neonatal Respiratory Distress Syndrome
• Lack of surfactant; infants are not strong enough to inflate their alveoli
• Protein-rich fluid leaks into the alveoli and further blocks oxygen uptake
• Treatment with mechanical ventilation may lead to bronchopulmonary dysplasia and chronic respiratory insufficiency
Question 7
2 out of 2 points
An incomplete expansion of the lung or portion of the lung is known as:
ATELECTASIS
Atelectasis = the incomplete expansion of the lung or a portion of the lung
Question 8
2 out of 2 points
Which of the following statements concerning pneumothorax is INCORRECT?
AN OPEN PNEUMOTHORAX AIR ENTERS PLEURAL CAVITY THROUGH THE WOUND ON INHALATION BUT CANNOT LEAVE ON EXHALATION
Pneumothorax
• Air enters the pleural cavity
• Air takes up space, restricting lung expansion
• Partial or complete collapse of the affected lung
– Spontaneous: an air-filled blister on the lung ruptures
– Traumatic: air enters through chest injuries
• Open: air enters pleural cavity through the wound on inhalation and leaves on exhalation
• Tension: air enters pleural cavity through the wound on inhalation but cannot leave on exhalation
Question 9
2 out of 2 points
Which of the following IS NOT a cause of intrinsic (non-atopic) asthma?
TYPE 1 HYPERSENSITIVITY
Intrinsic (non-atopic) asthma Episodes are triggered by:
Respiratory infections - Epithelial damage, IgE production
Exercise, hyperventilation, cold air - Loss of heat and water may cause bronchospasm Inhaled irritants - Inflammation, vagal reflex
Aspirin and other NSAIDs - Abnormal arachidonic acid metabolism
Question 10
0 out of 2 points
Bronchiectasis is characterized by:
RIGHT ANSWER: Infection and inflammation destroy smooth muscle in airways, causing permanent dilation
• Bronchiectasis
– Infection and inflammation destroy smooth muscle in airways, causing permanent dilation
Question 11
2 out of 2 points
Which of the following IS NOT typically seen in the patient with chronic bronchitis?
PURSED LIP BREATHING
Blue bloaters (usually bronchitis)
– Cannot increase respiration enough to maintain oxygen levels
– Cyanosis and polycythemia
– Cor pulmonale
Question 12
2 out of 2 points
Which of the following IS NOT typically seen with hypercapnia?
DECREASED RESPIRATIONS HYPERCAPNIA
• PCO2 >50 mm Hg
• Respiratory acidosis
– Increased respiration
– Decreased nerve firing
º Carbon dioxide narcosis
º Disorientation, somnolence, coma
– Decreased muscle contraction
º Vasodilation
▪ Headache, conjunctival hyperemia, warm flushed skin
Question 13
2 out of 2 points
Which of the following statements concerning urinary tract infections (UTIs) is INCORRECT?
OCCURS MORE IN MEN THAN WOMEN
Urinary Tract Infections in Special Populations
• Women
– UTIs are more common in women than in men, with peak incidence in the 15- to 24-year-old age group
– Pregnant women are at increased risk for UTIs
• Children
– UTIs are common in young children
– UTIs in children often involve pyelonephritis
• Elderly
– UTIs are relatively common in the elderly
– 2nd most common form of infection, after respiratory infections, among healthy community-dwelling elderly
Question 14
0 out of 2 points
Which of the following IS NOT associated with nephrotic syndrome?
RIGHT ANSWER: GLOMERULAR DAMAGE
Nephrotic syndrome
– Increased permeability of glomerulus
Question 15
2 out of 2 points
Which of the following IS NOT a cause of pre-renal failure?
URINE FLOW IS BLOCKED
Types of Acute Renal Failure
• Prerenal
– Decreased blood supply
• Shock, dehydration, vasoconstriction
• Postrenal
– Urine flow is blocked
• Stones, tumors, enlarged prostate
• Intrinsic
– Kidney tubule function is decreased
Ischemia, toxins, intratubular obstruction
Question 16
2 out of 2 points
Which of the following IS NOT a manifestation of chronic renal failure?
HYPOKALEMIA
CLINICAL MANIFESTATIONS OF CRF
Question 17
2 out of 2 points
Which of the following IS NOT a cardiovascular consequence of chronic renal failure?
DECREASED BLOOD PRESSURE
Cardiovascular Consequences of CRF
• Decreased blood viscosity
+
• Increased blood pressure
+
• Decreased oxygen supply
Question 18
2 out of 2 points
A flaccid bladder resulting in a failure to void urine:
INJURY TO THE MICTURITION CENTER OF SACRAL CORD, CAUDA EQUINA, OR SACRAL SPINAL NERVES
Neurogenic Bladder Disorders
Flaccid Bladder: Failure to Empty Urine
– May occur because of injury to the micturition center of sacral cord, cauda equina, or sacral spinal nerves
– Peripheral neuropathies (a complication of diabetes mellitus) may lead to flaccid bladder Question 19
2 out of 2 points
Overflow incontinence in men is most often caused by:
PROSTATE ENLARGEMENT
Overflow Incontinence
– Occurs when intravesicular pressure exceeds the maximal urethral pressure
– In men, one of most common causes is prostate enlargement
Question 20
2 out of 2 points
Which of the following IS NOT a consequence of inflammation and damage to the bowel?
INCREASED MUCOSAL FUNCTION
Inflammation and Damage to the Bowel Wall Can Lead To …
• Hemorrhage anemia
• Perforation peritonitis
• Decreased mucosal function malabsorption
• Decreased bacterial containment sepsis
Question 21
2 out of 2 points
Which of the following IS NOT a characteristic of Crohn's disease?
CONTINOUS LESIONS
Inflammations of the Small and Large Intestines
Inflammatory bowel disease
– Crohn disease
Question 22
2 out of 2 points
Which of the following IS NOT a characteristic of infectious enterocolitis?
HYPOMOTILITY
Infectious Enterocolitis
• The bowel attempts to get rid of the infectious agent
– Exudate to dilute toxins
– Hypermotility
• Vomiting
• Decreased intestinal function
– Food not absorbed
• Osmosis draws water into the bowel
º Osmotic (or explosive) diarrhea
Question 23
2 out of 2 points
Which of the following IS NOT a symptom of mechanical obstruction?
SILENT ABDOMEN
Intestinal Obstruction
• Mechanical Obstruction
– Severe, colicky pain
– Borborygmus
– Audible, high-pitched peristalsis; peristaltic rushes
– Awareness of intestinal movements
Question 24
2 out of 2 points
is an immune mediated disorder that is triggered by ingestion of gluten containing grains.
CELIAC SPRUE
Alterations in Intestinal Absorption
Celiac disease (celiac sprue)
– Immune-mediated disorder triggered by ingestion of gluten-containing grains
Question 25
0 out of 2 points
Which of the following statements concerning intestinal neoplasms is INCORRECT?
RIGHT ANSWER: COMMON IN BOTH MEN AND WOMEN
Intestinal Neoplasms Adenomatous Polyps
Most common neoplasm of the intestine
Benign neoplasms arising from the intestinal epithelium
Most cases of colorectal cancer begin as adenomatous colonic polyps
Question 26
2 out of 2 points
Which of the following IS NOT a function of the liver?
STORAGE BILIRUBIN
Metabolic Functions of the Liver
Carbohydrate, protein, and lipid metabolism
– Sugars stored as glycogen, converted to glucose, used to make fats
– Proteins synthesized from amino acids; ammonia made into urea
– Fats oxidized for energy, synthesized, packaged into lipoproteins
Drug and hormone metabolism
– Biotransformation into water-soluble forms
– Detoxification or inactivation Bile production
Bilirubin elimination
Question 27
2 out of 2 points
Excessive hemolysis is a cause of jaundice.
PREHEPATIC
Question 28
2 out of 2 points
Which of the following viral subtypes DOES NOT cause chronic viral hepatitis?
HAV
Chronic Viral Hepatitis
Caused by VIRAL SUBTYPES HBV, HCV, and HDV
Question 29
2 out of 2 points
When considering alcoholic liver disease, the term steatosis refers to:
HEPATOCYTES ARE YELLOW WITH FAT
Alcoholic Liver Disease
Fatty liver (steatosis)
– Liver cells contain fat deposits; liver is enlarged
Question 30
2 out of 2 points
Which of the following IS NOT a consequence of portal hypertension?
UNKNOWN ANSWER???
Portal Hypertension
Question 31
0 out of 2 points
Which of the following IS NOT a consequence of liver failure?
RIGHT ANSWER: BLEEDING
Liver Failure Leads To …
• Hematologic disorders
– Anemia, thrombocytopenia, coagulation defects, leukopenia
• Endocrine disorders
– Fluid retention, hypokalemia, disordered sexual functions
– Which hormones would cause these endocrine disorders?
• Skin disorders
– Jaundice, red palms, spider nevi
• Hepatorenal syndrome
– Azotemia, increased plasma creatinine, oliguria
• Hepatic encephalopathy
– Asterixis, confusion, coma, convulsions Question 32
2 out of 2 points
refers to stones found in the common bile duct.
CHOLEDOCHOLITHIASIS
Disorders of the Gallbladder
Choledocholithiasis
– Stones in the common bile duct
Question 33
2 out of 2 points
Which of the following statements concerning pancreatic cancer is INCORRECT? MOST CANCER OF THE PANCREASE HAS REMAINED IN SITU (NON- METASTISIZED) AT TIME OF DIAGNOSIS
PANCREATIC CANCER
• 4th leading cause of cancer death in US
• Smoking is a major risk factor for pancreatic cancer
• Most cancer of the pancreas has metastasized at time of diagnosis
• Pain management is one of the most important aspects of management
Question 34
2 out of 2 points
Hypothalamic dysfunction is an example of a endocrine defect.
TERTIARY HORMONE DISORDER
Hormone Disorders
Tertiary: abnormality in stimulation from the hypothalamus Secondary: abnormality in stimulation from the pituitary Primary: abnormality in the gland
Question 35
2 out of 2 points
Which of the following IS NOT a function of growth hormone?
DECREASED BLOOD GLUCOSE
FUNCTIONS OF GROWTH HORMONE
Question 36
2 out of 2 points Hashimoto's thyroiditis:
ACQUIRED HPYOTHYRODISM
Thyroid Imbalances
– Acquired
o Hashimotos thyroiditis
Question 37
2 out of 2 points
Which of the following IS NOT an action of cortisol?
MUSCLE HYPERTROPHY
Question 38
2 out of 2 points
Beta cells in the endocrine pancreas are responsible for secreting:
INSULIN
Question 39
2 out of 2 points
Which of the following IS NOT linked to the pathogenesis of type 2 diabetes?
DECREASED CARBOHYDRATE ABSORPTION BY GI
Types of Diabetes Mellitus
Type 2: a combination of beta cell dysfunction and insulin resistance
Pathogenesis of Type 2 Diabetes
Question 40
0 out of 2 points
Which of the following IS NOT a chronic complication of type 2 diabetes?
RIGHT ANSWER: HB A1C HAS LOWER 02 AFFINITY
Chronic Complications of Diabetes Mellitus
Increased glucose levels allow glucose to bind to proteins in:
– Hemoglobin Hb A1C has higher O2 affinity
– Basement membranes of blood vessels
o Nephropathy
o Retinopathy
o May cause increased risk of atherosclerosis
– Lens cataracts
Increased vulnerability to infections
Question 41
0 out of 2 points
Which of the following IS NOT a characteristic of diabetic autonomic neuropathy?
RIGHT ANSWER: INCONTINENCE
Diabetic Neuropathy
Autonomic neuropathy
– Defects in vasomotor and cardiac responses
– Impaired motility of the gastrointestinal tract
– Inability to empty the bladder
– Sexual dysfunction Question 42
2 out of 2 points
Which of the following IS NOT a consequence of upper motor neuron damage?
MUSCLE HYPERTROPHY
Upper Motor Neuron Damage
• Weakness and loss of voluntary motion
• Spinal reflexes remain intact but cannot be modulated by the brain
– Increased muscle tone
– Hyperreflexia
– Spasticity Question 43
2 out of 2 points
Which of the following statements concerning myasthenia gravis is INCORRECT?
AUTOIMMUNE DISEASE OF DYEMYLINATING SHEATHS OF MOTOR NEURONS
Myasthenia Gravis
Autoimmune disease
– Gradual destruction of acetylcholine receptors
– Associated with thymus tumor or hyperplasia Gradual development of weakness
– From proximal to distal portions of body Myasthenia crisis: respiration compromised
Question 44
2 out of 2 points
Violent "flinging" hyperkinetic movements seen with damage to the basal ganglia are known as
movements.
BALLISMUS
Hyperkinesia
Choreiform: jerky movements
Athetoid: continuous twisting movements Ballismus: violent flinging movements Dystonia: rigidity
Question 45
2 out of 2 points
Which of the following IS NOT a sign of Parkinson's disease?
HYPERKINESIA (RAPID MOVEMENTS)
Parkinson Disease
• Tremor
• Rigidity
• Bradykinesia (slow movement)
• Loss of postural reflexes
• Autonomic system dysfunction
• Dementia
Question 46
2 out of 2 points
Amyotrophic lateral sclerosis is due to damage to the:
BOTH UPPER AND LOWER MOTOR NEURONS
Amyotrophic Lateral Sclerosis
• Damages both upper and lower motor neurons
• UMN damage weakness, lack of motor control
– Loss of control over spinal reflexes stiffness, spasticity
• LMN damage
– Irritation fasciculations
– Decreased neuron firing weakness, denervation atrophy, hyporeflexia
Question 47
2 out of 2 points
refers to a type of spinal cord lesion where motor function is lost on the same (ipsilateral) side of the lesion and the sensation of pain and temperature is lost on the opposite (contralateral) side of the lesion.
BROWN-SEQUARD SYNDROME
Partial Spinal Cord Injury
• Central cord syndrome:
– Damage to axons near the gray matter
– Arms more affected than legs
• Anterior cord syndrome:
– Damage to anterior section of cord
– Motor functions affected; touch sensation not affected
• Brown-Sequard syndrome:
– Damage to one side of cord
– Motor function lost on that side; pain/temperature sensation lost from other side
Question 48
2 out of 2 points
A hematoma is commonly due to traumatic rupture of the meningeal arteries and often results in a rapid hemorrhage and unconsciousness.
EPIDURAL HEMATOMA
Traumatic Brain Injury
• Secondary injuries—due to:
– Hemorrhage
• Epidural space: meningeal arteries
• Rapid bleeding; unconsciousness may be followed by brief lucid period
• Dura Mater
– Subdural space: bridging veins
– Slower bleeding; gradual development over days or weeks
Question 49
2 out of 2 points
Which of the following IS NOT a direct cause of increased intracranial pressure (ICP)?
CEREBRAL VASOCONSTRICTION
Intracranial Pressure (ICP)
• Compartment syndrome in the skull
– Intracranial pressure greater than arterial blood pressure
– Arteries collapse; blood flow to brain cut off
• Brain swelling
– Vasogenic: extracellular fluid
– Cytotoxic: intracellular fluid
• Hydrocephalus: cerebrospinal fluid
• Tumors
Question 50
2 out of 2 points
Which of the following statements concerning meningitis is INCORRECT? VIRAL MENINGITIS IS USUALLY MORE SEVERE THAN BACTERIAL MENINGITIS
Brain Infections
• Meningitis
– Bacterial Meningitis
• Fever and chills, headache, stiff neck and back, abdominal and extremity pains, nausea, and vomiting
• Caused by Streptococcus pneumoniae, Haemophilus influenzae, or
Neisseria meningitidis
– Viral Meningitis
• Less severe course than bacterial meningitis
• Usually caused by coxsackie B and echovirus
Question 51
2 out of 2 points
seizures are characterized by muscle contraction and loss of consciousness.
Tonic-clonic (grand mal):
Kinds of Seizures
• Absence (petit mal): disturbances in consciousness
• Atonic: loss of muscle tone
• Myoclonic: muscles contract
• Tonic-clonic (grand mal): muscle contraction and loss of consciousness
• Generalized convulsive status epilepticus: seizures continue without recovery between them
Question 52
2 out of 2 points
disease is a type of dementia that is due to the transmission of protein agents known as prions.
Creutzfeldt-Jakob disease
Abnormal Inclusions in the Brain
• Alzheimer disease: amyloid plaques
• Pick disease: Pick bodies
• Prion diseases: prion proteins
– Creutzfeldt-Jakob disease [Show Less]