NR507 - all discussions , midterm and final exam

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Week 1: Altered Immune System and Altered Inflammatory Response

- Discussion Part One

This week's graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

6 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic

and disease states. (PO 1, 4)

Discussion

Discussion Part One (graded)

John is a 19-year-old college football player who presents with sneezing, itchy eyes, and nasal congestion that worsens at night. He states that he has a history of asthma, eczema and allergies

to pollen. There is also one other person on the football team that has similar symptoms. His vitals are BP 110/70, P 84, R 18, T 100 F. Write a differential of at least five (5) possible items from the most likely to less likely. For each disease include information about the epidemiology, pathophysiology and briefly argue why this disease fits the presentation and why it might not fit the presentation

Week 1: Altered Immune System and Altered Inflammatory Response - Discussion

Part Two

A patient has been admitted into the emergency room that was in the passenger side of a car that collided with another car head on. The patient is pale, barely conscious and has a weak and thready pulse. An IV is started. The vitals are BP 80/50, P 140, T 96.0 and R 26. As the team fights to keep the patient alive they have to remove the spleen. Blood is given but it has been mistyped. A transfusion reaction occurs. Describe the type of hypersensitivity reaction that has occurred and discuss the molecular pathophysiology of the specific type of hypersensitive reaction you have chosen.

In the event that this patient survived the car accident and the transfusion reaction which organs are most likely to be damaged and why?

Week 1: Altered Immune System and Altered Inflammatory

Response - Discussion Part Three

This week's graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1,

4 Distinguish risk factors associated with selected disease states.(PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Discussion

A 44-year-old patient presents with lump in the chest of approximately 2 cm in diameter. There is a slight dimple over the location of the lump and when the lump is manipulated it seems to be attached to the surrounding tissue. A lumpectomy is performed and the mass is sent to pathology. The pathology report comes back and the mass is confirmed to be an estrogen receptor negative, a progesterone receptor negative and a her2/neu receptor positive breast cancer.

What are some of the risk factors for breast cancer?

What tumor suppressor genes are associated with breast cancer?

What tumor oncogenes are associated with breast cancer?

Compare and contrast tumor suppressor genes from oncogenes?

Week2

Week 2: Respiratory Disorders and Alterations in Acid/Base Balance,

Fluid and Electrolytes - Discussion Part One

This week's graded topics relate to the following Course Outcomes (COs).

Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

Distinguish risk factors associated with selected disease states. (PO1)

Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

Distinguish risk factors associated with selected disease states. (PO1)

Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Discussion Part One (graded)

A five-month-old Caucasian female is brought into the clinic as the parent complain that she has been having ongoing foul-smelling , greasy diarrhea. She seems to be small for her age and a

bit sickly but, her parent’s state that she has a huge appetite. Upon examination you find that

the patient is wheezing and you observe her coughing.

Write a differential diagnosis of at least five (5) disorders and explain why each might be

a possibility and any potential weaknesses of each differential.

Why is it that the later in age this disease manifest itself, the less severe the disease is?

What tests would you run to clarify your differential and potentially come to a definitive

diagnosis?

If the same child was African in ancestry would this change your initial differential? Why

or why not?

Week 2: Respiratory Disorders and Alterations in Acid/Base Balance, Fluid and Electrolytes - Discussion Part Two

This week's graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

4 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Tammy is a 33-year-old who presents for evaluation of a cough. She reports that about 3 weeks ago she developed a “really bad cold” with rhinorrhea. The cold seemed to go away but then she developed a profound, deep, mucus-producing cough. Now, there is no rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Tammy has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves.

Write a differential of at least five (5) possible diagnosis’s and explain how each may be a possible answer to the clinical presentation above.

Remember, to list the differential in the order of most likely to less likely.

Based upon what you have at the top of the differential how would you treat this patient?

Suppose now, the patient has a fever of 100.4 and complains of foul smelling mucous and breath. Indeed, she complains of producing cups of mucous some days. She has some trouble breathing on moderate exertion but this is only a minor complaint to her. How does this change your differential and why?

Week 2: Respiratory Disorders and Alterations in Acid/Base Balance,

Fluid and Electrolytes - Discussion Part Three

This week's graded topics relate to the following Course Outcomes (COs).

Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

Distinguish risk factors associated with selected disease states.

Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

Distinguish risk factors associated with selected disease states. (PO

Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

A nursing student comes into your office because they are struggling with the concept of pulmonary function. They know you as an experienced FNP and so they are comfortable asking if you could clarify the terms residual volume (RV), functional reserve capacity (FRC), total lung capacity (TLC) inspiratory reserve volume (IRV), and expiratory reserve volume (ERV).

Give her a definition of each?

List three (3) disorders that can alter the residual volume and explain how they do so?

Week 3: Cardiovascular, Cellular, and Hematologic Disorders - Discussion

Week 3

Part One

This week's graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

4 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states

A 17-year-old African American from the inner city complains of severe chest and abdominal pain. Upon examination the attending physician performs and EKG, chest x-ray, and an abdominal and chest clinical examination and finds nothing. Assuming, she is drug seeking he sends her home. She comes back to the ER 4 hours later and now you see the patient. She explains that she was running track this past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts feeling extensive pain in her chest and abdomen. She has jaundiced eyes, her blood pressure is 98/50, pulse is 112, T = 99.9 F, R = 28. The pain seems out of proportion to the physical findings.

What is your list of differential diagnoses in this case and explain how each of these fits with the case patient as described above. Be sure to list at least four (4) pertinent differential diagnoses. Indicate which of these you would select as the most likely diagnosis and explain why.

Now, as she is in the ER she begins to exhibit stroke like features. ? Does this change your differential? How do you treat this patient now? Are they any preventative actions that could have been taken?

Week 3: Cardiovascular, Cellular, and Hematologic Disorders –

Discussion Part Two

This week's graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

4 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Jesse is a 57-year-old male who presents with gradual onset of dyspnea on exertion and fatigue. He also complains of frequent dyspepsia with nausea and occasional epigastric pain. He states that at night he has trouble breathing especially while lying on his back. This is relieved by him sitting up. His vitals are 180/110, P = 88, T = 98.0 C, R = 20.

Write a differential in this case and explain how each item in your differential fits and how it might not fit.

What tests would you order? What immediate treatment would you consider giving this patient and what treatment when he went home? Assume your first differential is definitive.

Now, he comes back to your clinic 3 months later and both his ankles are slightly swollen. What possible explanations are there for this observation?

Week 3: Cardiovascular, Cellular, and Hematologic Disorders -

Discussion Part Three

A new patient is brought into the office for their annual evaluation. The child is a 6-year-old and appears a bit small for their age but not so small that any alarm bells are set off. The vitals are: P = 116, R = 22, T = 98.6 F, BP = 110/50. (The normal vitals in a 6-year-old are P = 75 – 120, R = 16 – 22, T = 98.6 , BP = (85-115)/(48-64). Examination of the lungs is normal, HEENT is normal, as is the abdominal exam. The heart however, seems laterally displaced and there appears to be only a continuous murmur which can be described as crescendo/decrescendo systolic murmur that extends into diastole. Because, you were trained at Chamberlain College of Nursing you immediately know that this is probably a patent ductus arteriosus

Week 5

Week 5: Alterations in Endocrine Function - Discussion Part One

Week 5: Discussion Part One


Ms. Blake is an older adult with diabetes and has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. She has a history of Type I diabetes. On admission her laboratory values show:

Sodium (Na+)

156 mEq/L

Potassium (K+)

4.0 mEq/L

Chloride (Cl–)

115 mEq/L

Arterial blood gases (ABGs)

pH- 7.30; Pco2-40; Po2-70; HCO3-20

Normal values

Sodium (Na+)

136-146 mEq/L

Potassium (K+)

3.5-5.1 mEq/L

Chloride (Cl–)

98-106 mEq/L

Arterial blood gases (ABGs)

pH- 7.35-7.45

Pco2- 35-45 mmHg

Po2-80-100 mmHg

HCO3–22-28 mEq/L

  • List three (3) reasons on why she may have become bed ridden?
  • Based on these reasons what tests would you order?
  • Describe the molecular mechanism of the development of ketoacidosis.


Week 5: Discussion Part Two

13 13 unread replies. 39 39 replies.

A three-month-old baby boy comes into your clinic with the main complaint that he frequently vomits after eating. He often has a swollen upper belly after feeding and acts fussy all the time. The vomiting has become more frequent this past week and he is beginning to lose weight.

  • Write three (3) differential diagnoses at this time?
  • Is there any genetic component to the top of your differentials?
  • What tests would you order?

Week 5: Discussion Part Three

27 27 unread replies. 38 38 replies.

Write a one (1) paragraph case study of your own for a patient with Ulcerative Colitis?

Week 6

    Week 6: Discussion Part One

    19 19 unread replies. 38 38 replies.

    You are contacted by an attorney representing a client who has been charged with child abuse and whom faces loss of her child and 15 years in prison. The record indicated that the child was 4 years old and presented to the ER room with a broken arm and a broken leg. There also appeared to be multiple previous fractures. Now, you examine the child and find blue sclera, a sunken chest wall, severe scoliosis, and you observe a triangular face and prominent forehead. You confirm that there have been multiple previous fractures by evaluating the previous X-rays. This is a genetic disorder.

    • What is the most likely genetic disease that this presents and why?
    • What is the molecular basis of this disease?
    • Before, calling the police what should the initial clinician have done?



    Week 6: Discussion Part Two

    22 22 unread replies. 37 37 replies.

    Johnny is a 5-year-old Asian boy who is brought to a family practice office with a “runny” nose that started about 1 week ago but has not resolved. He has been blowing his nose quite frequently and “sores” have developed around his nose. His mother states, “The sores started as ‘big blisters’ that rupture; sometimes, a scab forms with a crust that looks like “dried maple syrup” but continues to seep and drain.” She is worried because the lesions are now also on his forearm. Johnny’s past medical and family histories are normal. He has been febrile but is otherwise asymptomatic. The physical examination was unremarkable except for moderate, purulent rhinorrhea and 0.5- to 1-cm diameter weeping lesions around the nose and mouth and on the radial surface of the right forearm. There is no regional lymphadenopathy.

    • Write a differential of at least three (3) possible diagnoses and explain how each may be a possible answer to the clinical presentation above. Remember, to list the differential in the order of most likely to less likely.
    • Based upon what you have at the top of the differentials how would you treat this patient?
    • When would you allow the student back to school? Elaborate on your reasoning?

    Week 6: Discussion Part Three

    27 27 unread replies. 32 32 replies.

    Keisha, a 13-year-old female, has come into your urgent care center. She has red conjunctiva, a cough and a fever of about 104 F, She also has a rash on her face a possibly the beginning of a rash on her arms. About 10 days ago she was around another student who had similar symptoms.

    • Write three (3) differential diagnoses?
    • What are some of the complications of this disease, assume that the top of your differential is the definitive?
    • Assume that the second item you place on your differential is the definitive diagnosis. What are some complications of that disease?

    Week 7: Reflection

    17 17 unread replies. 56 56 replies.

    Reflect back over the past eight weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #, MSN Essential VIII, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

    Program Outcome #4: Evaluate the design, implementation, and outcomes of strategies developed to meet healthcare needs (MSN Essentials III, IV, VIII).

    MSN Essential VIII: Clinical Prevention and Population Health for Improving Health

    •Recognizes that the master’s-prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations.

    Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

    1. Critically analyzes data and evidence for improving advanced nursing practice.

    2. Integrates knowledge from the humanities and sciences within the context of nursing science.

    3. Translates research and other forms of knowledge to improve practice processes and outcomes.

    4. Develops new practice approaches based on the integration of research, theory, and practice knowledge.

    Midverm

    Question 1

    2 / 2 pts

    Examination of the throat in a child demonstrating signs and symptoms of acute epiglottitis may contribute to which life-threatening complication?

    Retropharyngeal abscess

    Laryngospasms

    Rupturing of the tonsils

    Gagging induced aspiration

    Question 2

    2 / 2 pts

    Causes of hyperkalemia include:

    Hyperparathyroidism and malnutrition

    Vomiting and diarrhea

    Renal failure and Addison disease

    Hyperaldosteronism and Cushing disease

    Question 3

    2 / 2 pts

    What is the life span of an erythrocyte (in days)?

    20 to 30

    60 to 90

    100 to 120

    200 to 240

    Question 4

    2 / 2 pts

    Which substance has been shown to increase the risk of cancer when used in combination with tobacco smoking?

    Alcohol

    Steroids

    Antihistamines

    Antidepressants

    Question 5

    0 / 2 pts

    Which hepatitis virus is known to be sexually transmitted?

    A

    B

    C

    D

    Question 6

    2 / 2 pts

    What is the purpose of the spirometry measurement?

    To evaluate the cause of hypoxia

    To measure the volume and flow rate during forced expiration

    To measures the gas diffusion rate at the alveolocapillary membrane

    To determine pH and oxygen and carbon dioxide concentrations

    Question 7

    2 / 2 pts

    What is the direct action of atrial natriuretic hormone?

    Sodium retention

    Sodium excretion

    Water retention

    Water excretion

    Question 8

    2 / 2 pts

    What is the most important negative inotropic agent?

    Norepinephrine

    Epinephrine

    Acetylcholine

    Dopamine

    Question 9

    2 / 2 pts

    What is the primary cause of respiratory distress syndrome (RDS) of the newborn?

    Immature immune system

    Small alveoli

    Surfactant deficiency

    Anemia

    Question 10

    2 / 2 pts

    An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody?

    IgG

    IgM

    IgA

    IgE

    Question 11

    2 / 2 pts

    Low plasma albumin causes edema as a result of a reduction in which pressure?

    Capillary hydrostatic

    Interstitial hydrostatic

    Plasma oncotic

    Interstitial oncotic

    Question 12

    2 / 2 pts

    Erythrocyte life span of less than 120 days, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiologic characteristics of which type of anemia?

    Aplastic

    Sideroblastic

    Anemia of chronic disease

    Iron deficiency

    Question 13

    2 / 2 pts

    An infant’s hemoglobin must fall below ___ g/dl before signs of pallor, tachycardia, and systolic murmurs occur.

    11

    9

    7

    5

    Question 14

    2 / 2 pts

    What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?

    Macula densa

    Visceral epithelium

    Juxtaglomerular apparatus (JGA)

    Filtration slits

    Question 15

    2 / 2 pts

    The lung is innervated by the parasympathetic nervous system via which nerve?

    Vagus

    Phrenic

    Brachial

    Pectoral

    Question 16

    2 / 2 pts

    Which statement best describes a Schilling test?

    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.

    Question 17

    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)

    Acute lymphocytic leukemia (ALL)

    Non-Hodgkin lymphoma (NHL)

    Iron deficiency anemia (IDA)

    Question 18

    2 / 2 pts

    Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot to relieve hypoxic spells?

    Lying on their left side

    Performing the Valsalva maneuver

    Squatting

    Hyperventilating

    Question 19

    2 / 2 pts

    Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct?

    Antidiuretic hormone

    Aldosterone

    Cortisol

    Adrenocorticotropin hormone

    Question 20

    2 / 2 pts

    What is the fundamental physiologic manifestation of anemia?

    Hypotension

    Hyperesthesia

    Hypoxia

    Ischemia

    Question 21

    2 / 2 pts

    Continuous increases in left ventricular filing pressures result in which disorder?

    Mitral regurgitation

    Mitral stenosis

    Pulmonary edema

    Jugular vein distention

    Question 22

    2 / 2 pts

    Which T-lymphocyte phenotype is the key determinant of childhood asthma?

    Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes

    CD4 T-helper Th2 lymphocytes

    CD8 cytotoxic T lymphocytes

    Memory T lymphocytes

    Question 23

    2 / 2 pts

    Innervation of the bladder and internal urethral sphincter is supplied by which nerves?

    Peripheral nerves

    Parasympathetic fibers

    Sympathetic nervous system

    Tenth thoracic nerve roots

    Question 24

    2 / 2 pts

    Which of the following is classified as a megaloblastic anemia?

    Iron deficiency

    Pernicious

    Sideroblastic

    Hemolytic

    Question 25

    2 / 2 pts

    When an individual aspirates food particles, where would the nurse expect to hear decreased or absent breath sounds?

    Left lung

    Right lung

    Trachea

    Carina

    Question 26

    0 / 2 pts

    The most common site of metastasis for a patient diagnosed with prostate cancer is which location?

    Bones

    Brain

    Bladder

    Kidney

    Question 27

    2 / 2 pts

    Perceived stress elicits an emotional, anticipatory response that begins where?

    Prefrontal cortex

    Anterior pituitary

    Limbic system

    Hypothalamus

    Question 28

    2 / 2 pts

    Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in infants?

    Atelectasis and pneumonia

    Edema of the hands and feet

    Stasis ulcers of the hands, ankles, and feet

    Splenomegaly and hepatomegaly

    Question 29

    2 / 2 pts

    Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?

    IL–1 and IL-6

    IL-2 and TNF-?

    IFN and IL-12

    TNF-ß and IL-4

    Question 30

    2 / 2 pts

    The generation of clonal diversity occurs primarily during which phase of life?

    Fetal

    Neonatal

    Infancy

    Puberty

    Question 31

    2 / 2 pts

    Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge?

    Trachea

    Left lung

    Bronchus

    Bronchioles

    Question 32

    2 / 2 pts

    Which immunoglobulin (Ig) is present in childhood asthma?

    IgM

    IgG

    IgE

    IgA

    Question 33

    2 / 2 pts

    Between which months of age does sudden infant death syndrome (SIDS) most often occur?

    0 and 1

    2 and 4

    5 and 6

    6 and 7

    Question 34

    2 / 2 pts

    Which complex (wave) represents the sum of all ventricular muscle cell depolarizations?

    PRS

    QRS

    QT interval

    P

    Question 35

    2 / 2 pts

    When a patient has small, vesicular lesions that last between 10 and 20 days, which sexually transmitted infection is suspected?

    Genital herpes

    Chancroid

    Syphilis

    Chlamydia

    Question 36

    2 / 2 pts

    What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn?

    Low birth weight

    Alcohol consumption during pregnancy

    Premature birth

    Smoking during pregnancy

    Question 37

    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.

    Exotoxins are released during bacterial growth.

    Question 38

    2 / 2 pts

    Deficiencies in which element can produce depression of both B- and T-cell function?

    Iron

    Zinc

    Iodine

    Magnesium

    Question 39

    0 / 2 pts

    The function of the foramen ovale in a fetus allows what to occur?

    Right-to-left blood shunting

    Left-to-right blood shunting

    Blood flow from the umbilical cord

    Blood flow to the lungs

    Question 40

    2 / 2 pts

    Decreased lung compliance means that the lungs are demonstrating which characteristic?

    Difficult deflation

    Easy inflation

    Stiffness

    Inability to diffuse oxygen

    Question 41

    2 / 2 pts

    60 to 70

    40 to 60

    30 to 40

    10 to 20

    Question 42

    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.

    The cells are well-differentiated.

    Question 43

    2 / 2 pts

    How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness?

    75 to 100 ml

    100 to 150 ml

    250 to 300 ml

    350 to 400 ml

    Question 44

    2 / 2 pts

    How high does the plasma glucose have to be before the threshold for glucose is achieved?

    126 mg/dl

    150 mg/dl

    180 mg/dl

    200 mg/dl

    Question 45

    0 / 2 pts

    Apoptosis is a(an):

    Normal mechanism for cells to self-destruct when growth is excessive

    Antigrowth signal activated by the tumor-suppressor gene Rb

    Mutation of cell growth stimulated by the TP53 gene

    Transformation of cells from dysplasia to anaplasia

    Question 46

    0 / 2 pts

    What is the role of collagen in the clotting process?

    Initiates the clotting cascade.

    Activates platelets.

    Stimulates fibrin.

    Deactivates fibrinogen.

    Question 47

    0 / 2 pts

    Infants are most susceptible to significant losses in total body water because of an infant’s:

    High body surface–to–body size ratio

    Slow metabolic rate

    Kidneys are not mature enough to counter fluid losses

    Inability to communicate adequately when he or she is thirsty

    Question 48

    0 / 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.

    It inhibits salt and water reabsorption.

    Question 49

    0 / 2 pts

    Which cardiac chamber has the thinnest wall and why?

    The right and left atria; they are low-pressure chambers that serve as storage units and conduits for blood.

    The right and left atria; they are not directly involved in the preload, contractility, or afterload of the heart.

    The left ventricle; the mean pressure of blood coming into this ventricle is from the lung, which has a low pressure.

    The right ventricle; it pumps blood into the pulmonary capillaries, which have a lower pressure compared with the systemic circulation.

    Question 50

    0 / 2 pts

    Research supports the premise that exercise has a probable impact on reducing the risk of which cancer?

    Liver

    Endometrial

    Stomach

    Colon

    Question 51

    0 / 2 pts

    What is the trigone?

    A smooth muscle that comprises the orifice of the ureter

    The inner mucosal lining of the kidneys

    A smooth triangular area between the openings of the two ureters and the urethra

    One of the three divisions of the loop of Henle

    Question 52

    2 / 2 pts

    What is the most abundant class of plasma protein?

    Globulin

    Albumin

    Clotting factors

    Complement proteins

    Question 53

    2 / 2 pts

    The glomerular filtration rate is directly related to which factor?

    Perfusion pressure in the glomerular capillaries

    Diffusion rate in the renal cortex

    Diffusion rate in the renal medulla

    Glomerular active transport

    Question 54

    0 / 2 pts

    Which cells have phagocytic properties similar to monocytes and contract like smooth muscles cells, thereby influencing the glomerular filtration rate?

    Principle cells

    Podocin cells

    Mesangial cells

    Intercalated cells

    Question 55

    0 / 2 pts

    Why is nasal congestion a serious threat to young infants?

    Infants are obligatory nose breathers.

    Their noses are small in diameter.

    Infants become dehydrated when mouth breathing.

    Their epiglottis is proportionally greater than the epiglottis of an adult’s.

    Question 56

    2 / 2 pts

    The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born between how many weeks of gestation?

    16 and 20

    20 and 24

    24 and 30

    30 and 36

    Question 57

    2 / 2 pts

    What is the ratio of coronary capillaries to cardiac muscle cells?

    1:1 (one capillary per one muscle cell)

    1:2 (one capillary per two muscle cells)

    1:4 (one capillary per four muscle cells)

    1:10 (one capillary per ten muscle cells)

    Question 58

    2 / 2 pts

    A person with type O blood is considered to be the universal blood donor because type O blood contains which of the following?

    No antigens

    No antibodies

    Both A and B antigens

    Both A and B antibodies

    Question 59

    2 / 2 pts

    The drug heparin acts in hemostasis by which processes?

    Inhibiting thrombin and antithrombin III (AT-III)

    Preventing the conversion of prothrombin to thrombin

    Shortening the fibrin strands to retract the blood clot

    Degrading the fibrin within blood clots

    Question 60

    2 / 2 pts

    What effects do exercise and body position have on renal blood flow?

    Exercise and body position activate renal parasympathetic neurons and cause mild vasoconstriction.

    They activate renal sympathetic neurons and cause mild vasoconstriction.

    Both activate renal parasympathetic neurons and cause mild vasodilation.

    They activate renal sympathetic neurons and cause mild vasodilation.


    Final exam


    Question 1

    2 / 2 pts

    What is the major virus involved in the development of cervical cancer?

    Herpes simplex virus type 6

    Herpes simplex virus type 2

    Human papillomavirus

    Human immunodeficiency virus

    Question 2

    2 / 2 pts

    Which statement accurately describes childhood asthma?

    An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation

    A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging

    A pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens

    An obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency

    Question 3

    0 / 2 pts

    The ability of the pathogen to invade and multiply in the host is referred to as:

    Infectivity

    Toxigenicity

    Pathogenicity

    Virulence

    Question 4

    2 / 2 pts

    Obesity creates a greater risk for dehydration in people because:

    Adipose cells contain little water because fat is water repelling.

    The metabolic rate of obese adults is slower than the rate of lean adults.

    The rate of urine output of obese adults is higher than the rate of output of lean adults.

    The thirst receptors of the hypothalamus do not function effectively.

    Question 5

    2 / 2 pts

    Continued therapy of pernicious anemia (PA) generally lasts how long?

    6 to 8 weeks

    8 to 12 months

    Until the iron level is normal

    The rest of one’s life

    Question 6

    2 / 2 pts

    Which statement best describes cystic fibrosis?

    Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation

    Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging

    Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens

    Pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency

    Question 7

    2 / 2 pts

    What pulmonary defense mechanism propels a mucous blanket that entraps particles moving toward the oropharynx?

    Nasal turbinates

    Alveolar macrophages

    Cilia

    Irritant receptors on the nares

    Question 8

    2 / 2 pts

    As stated in the Frank-Starling law, a direct relationship exists between the _____ of the blood in the heart at the end of diastole and the _____ of contraction during the next systole.

    Pressure; force

    Volume; strength

    Viscosity; force

    Viscosity; strength

    Question 9

    2 / 2 pts

    The tonic neck reflex observed in a newborn should no longer be obtainable by:

    2 years

    1 year

    10 months

    5 months

    Question 10

    2 / 2 pts

    Carcinoma refers to abnormal cell proliferation originating from which tissue origin?

    Blood vessels

    Epithelial cells

    Connective tissue

    Glandular tissue

    Question 11

    2 / 2 pts

    Which of the following describes how the body compensates for anemia?

    Increasing rate and depth of breathing

    Decreasing capillary vasoconstriction

    Hemoglobin holding more firmly onto oxygen

    Kidneys releasing more erythropoietin

    Question 12

    2 / 2 pts

    What term is used to describe a hernial protrusion of a saclike cyst that contains meninges, spinal fluid, and a portion of the spinal cord through a defect in a posterior arch of a vertebra?

    Encephalocele

    Meningocele

    Spina bifida occulta

    Myelomeningocele

    Question 13

    2 / 2 pts

    Chvostek and Trousseau signs indicate which electrolyte imbalance?

    Hypokalemia

    Hyperkalemia

    Hypocalcemia

    Hypercalcemia

    Question 14

    2 / 2 pts

    After sexual transmission of HIV, a person can be infected yet seronegative for how many months?

    1 to 2

    6 to 14

    18 to 20

    24 to 36

    Question 15

    2 / 2 pts

    Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?

    Norepinephrine

    Epinephrine

    Cortisol

    Adrenocorticotropic hormone (ACTH)

    Question 16

    2 / 2 pts

    Which blood cells are the chief phagocytes involved in the early inflammation process?

    Neutrophils

    Monocytes

    Eosinophils

    Erythrocytes

    Question 17

    2 / 2 pts

    Where are alveolar macrophages found?

    Skin

    Breasts

    Gastrointestinal tract

    Lungs

    Question 18

    2 / 2 pts

    Which normal physiologic change occurs in the aging pulmonary system?

    Decreased flow resistance

    Fewer alveoli

    Stiffening of the chest wall

    Improved elastic recoil

    Question 19

    0 / 2 pts

    An infant diagnosed with a small patent ductus arteriosus (PDA) would likely exhibit which symptom?

    Intermittent murmur

    Lack of symptoms

    Need for surgical repair

    Triad of congenital defects

    Question 20

    2 / 2 pts

    Hemophilia B is caused by a deficiency of which clotting factor?

    V

    VIII

    IX

    X

    Question 21

    2 / 2 pts

    A hypersensitivity reaction that produces an allergic response is called:

    Hemolytic shock

    Anaphylaxis

    Necrotizing vasculitis

    Systemic erythematosus

    Question 22

    2 / 2 pts

    Which statement is true regarding pain and cancer?

    Pain is primarily a result of pressure caused by the tumor.

    Pain indicates the metastasis of a cancer.

    Pain is usually the initial symptom of cancer.

    Pain is generally associated with late-stage cancer.

    Question 23

    2 / 2 pts

    What is the anomaly in which the soft bony component of the skull and much of the brain is missing?

    Anencephaly

    Myelodysplasia

    Cranial meningocele

    Hydrocephaly

    Question 24

    0 / 2 pts

    At birth, which statement is true?

    Systemic resistance and pulmonary resistance fall.

    Gas exchange shifts from the placenta to the lung.

    Systemic resistance falls and pulmonary resistance rises.

    Systemic resistance and pulmonary resistance rise.

    Question 25

    2 / 2 pts

    What is the most commonly reported symptom of cancer treatment?

    Nausea

    Fatigue

    Hair loss

    Weight loss

    Question 26

    0 / 2 pts

    The common property among the three types of medications used to treat depression is that they:

    Increase neurotransmitter levels within the synapse.

    Increase neurotransmitter levels in the presynapse.

    Decrease neurotransmitter levels in the postsynapse.

    Decrease neurotransmitter levels within the synapse.

    Question 27

    0 / 2 pts

    NR507 all discussions , midterm and final exam
    Answered by sharpie
    Expert Rating: 381 Ratings
    Dated: 15th Apr'18 10:59 AM
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