Deck 15: Cellular Exchange, Genetics, Immunity, and Cardiovascular System

Question 1

Which of the following cellular exchange mechanisms requires adenosine triphosphate (ATP) and the use of a carrier protein?

A) Facilitated diffusion
B) Osmosis
C) Active transport
D) Simple diffusion

Answer 1

C

Question 2

What is a key determinant of osmotic pressure?

A) Water
B) Sodium
C) Albumin
D) Glucose

Answer 2

B

Question 3

A 58-year-old man was gardening and mowing his lawn for a few hours in the heat. He started developing cramps and feeling dizzy. He has no significant past medical history and is in generally good health. He was transported to the emergency room. His serum osmolality is high. What is the likely explanation for this finding?

A) Hyperglycemia
B) Excess fluid intake
C) Diabetes Insipidus
D) Dehydration

Answer 3

D

Question 4

A routine ultrasound of a 38-year-old woman of 26 weeks' gestation reveals that the fetus has trisomy 21 (Down syndrome). Most cases of Down syndrome are due to:

A) translocation.
B) inversion.
C) nondisjunction.
D) duplication.

Question 5

While discussing treatment options with a parent of a newly diagnosed monosomy X (Turner syndrome) child, the nurse practitioner should state which of the following?

A) There is no treatment or cure.
B) Symptoms of the condition are treated with estrogen.
C) Symptoms of the condition are treated with testosterone.
D) Institutionalization is the preferred method of managing care.

Question 6

Tay-Sachs is caused by a(n):

A) deficiency or absence of hexosaminidase A.
B) defect on chromosome 17 or 22.
C) mutation on chromosome 15.
D) error in converting phenylalanine to tyrosine.

Question 7

Which of the following assessment findings is most concerning and would require immediate action?

A) Speech delays in a 10-year-old with Fragile X syndrome
B) A palpable lump in the left breast of an 18-year-old with Klinefelter syndrome
C) Vision issues in a 14-year-old with Turner syndrome
D) Bruise in a cancer patient receiving chemotherapy

Question 8

Which of the following human immunodeficiency virus positive patients has AIDS (acquired immunodeficiency syndrome)?

A) A 28-year-old woman with advanced cervical cancer
B) A 30-year-old man with the common cold
C) A 35-year-old woman with trichomoniasis vaginal infection
D) A 40-year-old man with a CD4+ cell count of 400 cells/mm³

Question 9

Which of the following situations represents a break in the "first line of defense" against infection?

A) An abnormally low total white blood cell (WBC) count
B) A "shift to the left" on the WBC differential
C) Use of an indwelling bladder catheter
D) Poor nutritional status

Question 10

Education pertaining to prevention of human immunodeficiency virus (HIV) includes:

A) proper use of mosquito repellant in areas with high rate of HIV.
B) use of pre-exposure prophylaxis if engaging in high-risk sexual behavior.
C) use of gloves by healthcare workers with every patient encounter.
D) avoidance of kissing HIV-positive persons.

Question 11

Which of the following is an example of the chemical barriers that are part of the innate immune system?

A) Hydrochloric acid production in the stomach
B) Production of immunoglobulins
C) Release of interferon
D) Killer cells releasing lymphokines

Question 12

Which of the following describes the microbiome?

A) The flora remains consistent throughout a lifetime.
B) It consists of normal flora such as E. Coli in the intestines.
C) It mainly consists of pathogenic flora such as Clostridium difficile.
D) Increase in diversity is associated with disease development.

Question 13

The effects of histamine 1 release during mast cell degranulation includes:

A) increased gastric secretion.
B) decreased vascular permeability.
C) bronchial dilation.
D) edema.

Question 14

Which of the following blood cells have a lifespan of approximately 10 days?

A) Platelets
B) Red blood cells
C) Monocytes
D) Lymphocytes

Question 15

Lymphoid progenitor stem cell lines differentiate into:

A) basophils and mast cells.
B) bands and neutrophils.
C) B and T cells.
D) platelets and white blood cells.

Question 16

A patient who has chronic kidney disease and a hemoglobin of 9 g/dL will be receiving synthetic erythropoietin injections. The therapeutic effect of this medication is:

A) prevention of red blood cell apoptosis.
B) stimulation of red blood cell production.
C) improvement of tissue oxygenation.
D) improvement in blood circulation.

Question 17

Which of the following serum levels is the best measurement for evaluating the effectiveness of iron therapy and adequacy of iron stores?

A) Ferritin
B) Iron
C) Red blood cell count
D) Apoferritin

Question 18

A patient is receiving a heparin infusion. After the second day of infusion, his platelets decrease to 50,000 cells/mL³. The next best action would be to:

A) decrease the rate of the infusion.
B) stop the infusion and switch to another anticoagulant.
C) continue infusion but monitor the platelet count every 4 hours.
D) transfuse the patient with platelets.

Question 19

A patient receiving chemotherapy has a hemoglobin of 7.0 g/dL. Which of the following complaints would be indicative of tissue hypoxia related to anemia?

A) Apathy
B) Syncope
C) Bradycardia
D) Warm, dry skin

Question 20

Which of the following statements regarding disseminated intravascular coagulation syndrome is not true?

A) It results from rapid release of thromboplastic material into the circulation.
B) It may result from any condition associated with extensive tissue destruction, such as shock or sepsis.
C) Levels of blood platelets and concentration of blood coagulation components are subnormal.
D) It is a frequent complication of pulmonary embolism.

Question 21

The order of impulse conduction in the heart is from the:

A) AV node to SA node to bundle of His to Purkinje system.
B) bundle of His to SA node to AV node to Purkinje system.
C) SA node to AV node to bundle of His to Purkinje system.
D) Purkinje system to SA node to AV node to bundle of His.

Question 22

Which of the following laboratory tests would be indicative of worsening heart failure?

A) Elevated hemoglobin
B) Elevated b-type natriuretic peptide (BNP)
C) Decreased myoglobin
D) Decreased b-type natriuretic peptide (BNP)

Question 23

What causes the aortic valve to open?

A) The aortic pressure becomes higher than the left ventricle pressure.
B) The left ventricle pressure becomes higher than the aortic pressure.
C) The left atrial and left ventricle pressure forces the valve open.
D) The left ventricle and aortic pressure equalizes.

Question 24

What happens at the end of diastole?

A) The atria contract to empty the remaining amount of blood into the ventricle.
B) The ventricle dilates to accommodate the entry of blood.
C) The atrial pressure becomes higher than the ventricular pressure.
D) The inferior vena cava and pulmonary pressure increases.

Question 25

A patient comes to the emergency department complaining of coughing and difficulty breathing. The patient's diagnosis is heart failure. How does heart failure cause shortness of breath?

A) The left side of the heart is weak and pumps blood too quickly.
B) The left side of the heart is weak and pulmonary fluid accumulates.
C) The right side of the heart is enlarged and cannot effectively pump blood.
D) The right side of left heart is weak and blood enters the lungs.

Question 26

Which of the following patients has the greatest risk of developing heart failure?

A) A 50-year-old white female with asthma
B) A 48-year-old black female who smokes
C) A 69-year-old black male with hypertension
D) A 75-year-old white male who smokes

Question 27

Which of the following is the most serious complication of an aortic aneurysm?

A) Dilation of the aorta, which may compress adjacent abdominal organs
B) Formation of the thrombi on the rough intimal surface on the aneurysm wall
C) Rupture of the aneurysm
D) Degeneration and calcification of the aneurysm wall

Question 28

A nurse is providing group education about lipids to patients who have been diagnosed with hyperlipidemia. What does the best instruction include?

A) High-density lipoprotein (HDL) is called good cholesterol because it increases the oxygen content in the arteries and stabilizes plaque buildup.
B) High-density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from your body and gets rid of it in your liver.
C) High-density lipoprotein (HDL) is called good cholesterol because it deceases cardiac workload by decreasing oxygen consumption by your heart.
D) High-density lipoprotein (HDL) decreases low-density lipoprotein (LDL) and prevents it from converting to very low-density lipoprotein (VDRL), which is the worst kind of cholesterol in the body.

Question 29

Tuberculosis is:

A) an airborne disease.
B) a sexually transmitted disease.
C) a disease transmitted through skin-to-skin contact.
D) All of these are correct.

Question 30

Which of the following differentiates chronic obstructive pulmonary disease (COPD) from asthma?

A) COPD is an obstructive disease, and asthma is a restrictive disease.
B) The FEV1/FVC ratio is reduced in asthma but not in COPD.
C) Airflow obstruction caused by chronic obstructive pulmonary disease is irreversible, whereas it is reversible in asthma.
D) COPD is characterized by an immunoglobulin E response, whereas asthma involves other mediators

Question 31

The forced expiratory volume (FEV₁) measures:

A) how much air you can breathe out of your lungs after a deep inspiration.
B) the amount of air left in your lungs after you breathe it all out.
C) the amount of air you can forcibly exhale in one second.
D) how much force you can generate when breathing into a spirometer.

Question 32

Which of the following statements regarding Legionnaires' disease is true?

A) It is a bacterial infection.
B) It is usually spread by direct skin-to-skin contact.
C) It is a viral infection.
D) It is treated with supportive care only.

Question 33

Which of the following individuals has a positive tuberculin skin test reaction?

A) A 25-year-old woman with an induration of 7 mm
B) A 30-year-old man with an induration of 5 mm who just arrived from a country with a high prevalence of tuberculosis
C) A nurse who works on a pulmonary unit with an induration of 4 mm
D) A 2-year-old with an induration of 11 mm

Question 34

Latent tuberculosis infection means the:

A) person is asymptomatic but can spread the infection.
B) person is infected but asymptomatic.
C) person will get tuberculosis later in life.
D) person is immunocompromised and has tuberculosis.

Question 35

A 15-year-old is diagnosed with infectious mononucleosis and is told to avoid contact sports because of the:

A) risk for splenic rupture.
B) risk for contaminating teammates.
C) potential for the virus to spread to other organs.
D) increased likelihood for the need for antivirals.

Question 36

A patient needs an infusion of a hypertonic solution. Which of the following is an appropriate intravenous solution to administer?

A) 5% dextrose lactate Ringer's (D5LR)
B) 1/2 normal saline (0.45% NS)
C) normal saline (0.9% NS)
D) Ringer's lactate (RL)

Question 37

A patient presents to the emergency room with a K level of 6.5. What potentially life-threatening complication would you assess for?

A) Cardiac dysrhythmias
B) Decreased urine output
C) Nausea and vomiting
D) Ataxia

Question 38

A patient presents to the emergency room with nausea, vomiting, and diarrhea for three days. The patient's lab values are as follows: K = 3.8, Na = 149, pH = 7.32, HCO₃^- = 20, and PaCO₂ = 40. Which of the following intravenous fluids should be ordered?

A) 0.45% normal saline with 100 mEq/L of sodium bicarbonate
B) 0.9% normal saline with 40 mEq/L of potassium
C) 0.9% normal saline
D) 2.5% dextrose

Question 39

Which of the following is the major effect produced by an increase in the rate and depth of respiration?

A) Plasma PCO₂ rises.
B) Plasma PCO₂ falls.
C) Plasma PCO₂ stays the same.
D) The pH shifts to the alkaline side of the physiologic range.

Question 40

Which of the following is responsible for most of the osmotic pressure?

A) Urea
B) Water
C) Potassium
D) Sodium

Question 41

Which of the following is the primary regulator of water excretion?

A) Sodium
B) Blood volume
C) Aldosterone
D) Antidiuretic hormone

Question 42

Which of the following is the main buffer in the extracellular fluid?

A) Phosphate buffer system
B) Bicarbonate-carbonic acid system
C) Protein system
D) Potassium-hydrogen exchange system

Question 43

The juxtaglomerular complex is the site of the production of which enzyme and hormone involved in blood pressure and fluid balance?

A) Renin
B) Angiotensin
C) Nitric oxidase
D) Antidiuretic hormone

Question 44

Which of the following is not a function of the kidney?

A) Secretion of hydrogen ions
B) Conversion of vitamin D to its active form
C) Conversion of ammonia into urea
D) Production of uromodulin

Question 45

A man had a radical prostatectomy for prostate cancer. When teaching him about urine function, what would be one of the complications of this surgery that he may develop?

A) Kidney stones
B) Stress incontinence
C) Overactive bladder
D) Urinary obstruction

Question 46

A woman is complaining that she often gets a strong need to urinate and then she sometimes "wets herself" because she cannot make it to the bathroom in time. The type of incontinence she is describing is:

A) transient.
B) mixed.
C) stress.
D) urge.

Question 47

A patient has a serum creatinine level of 2.5 mg/dL, a serum potassium level of 6 mEq/L, an arterial pH of 7.32, and a urine output of 250 mL/day. Which phase of acute kidney injury is the patient experiencing?

A) Intrarenal
B) Postrenal
C) Oliguric
D) Recovery

Question 48

Progression of chronic kidney disease is thought to occur as a result of:

A) hypofiltration with accumulation of toxic chemicals and decrease urine output.
B) prevention of water and solutes crossing the capillary membrane and large molecules allowed to cross.
C) intraglomerular hypertension and glomerular hypertrophy.
D) tubulointerstitial constriction with decreased blood flow.

Question 49

The definition and criteria used to diagnosis chronic kidney disease is the:

A) serum creatinine.
B) glomerular filtration rate.
C) blood urea nitrogen to creatinine ratio.
D) serum albumin levels.

Question 50

A 65-year-old man is admitted to the intensive care unit from the operating room after a triple coronary artery bypass graft. He is intubated and on a ventilator. Lactic acid levels were normal postoperatively, but now they are rising. The increased level could be an indication of:

A) excessive sedation.
B) bowel ischemia.
C) excessive volume infusion in the operating room.
D) mild hypothermia postoperatively.

Question 51

Which of the following statements describes a cellular membrane exchange process that is active?

A) Sodium moving out of cells and potassium moving into cells
B) The movement of water from an area of low solute concentration to an area of high solute concentration
C) The movement of insulin using a protein to travel across the cell membrane
D) Oxygen moving across the pulmonary capillaries to an area of high carbon dioxide

Question 52

The canola plants genome is altered to produce an herbicide resistant crop. The canola oil produced from this crop is an example of a:

A) pesticide-free food.
B) saturated fat food.
C) genetically modified food.
D) product that is pure.

Question 53

A 30-year-old man has a history of heart transplant and is receiving long-term steroids to prevent rejection. The patient is due for routine vaccines. Attenuated vaccines are contraindicated in this patient because the antigen is:

A) live and can cause infection.
B) mutated and infectious.
C) inactive but still infectious.
D) pathogenic.

Question 54

Plasma protein inflammatory mediator systems include:

A) phagocytic, interferon, and complement systems.
B) complement, fibrinolytic, and clotting systems.
C) complement, clotting, and kinin systems.
D) complement, clotting, and acute phase reactant systems.

Question 55

Which of the following types of vitamin or mineral deficiency can cause megaloblastic anemia and is associated with lower extremity paresthesias?

A) Vitamin B12
B) Folate
C) Iron
D) Vitamin K

Question 56

Anemia of chronic inflammation is generally classified as:

A) hypochromic and microcytic.
B) hypochromic and macrocytic.
C) normochromic and microcytic.
D) normochromic and normocytic.

Question 57

A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person:

A) is normal with no sickle disease.
B) is a sickle cell carrier.
C) has sickle cell anemia.
D) has thalassemia.

Question 58

Primary hypercholesteremia is often a result of:

A) high-density lipoprotein (HDL) defects.
B) monogenic mutations and sedentary lifestyle and high cholesterol in diet.
C) polygenic mutations and environmental factors.
D) low-density lipoprotein (LDL) receptor mutation with defects in the breakdown.

Question 59

The early stages of atheroma development is characterized by:

A) macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima.
B) accumulation of lipids in the intima (i.e., fatty streak).
C) accumulation of proteins such as collagen and elastin (i.e., fibrous cap).
D) development of calcium and a necrotic lipid core.

Question 60

Pain in the lower extremities due to peripheral artery disease usually worsens:

A) with rest because blood flow increases.
B) with elevation of the extremity because blood is diverted away.
C) when the leg is in a dependent position because blood pools.
D) when the leg is touched or massaged because cytokines are released.

Question 61

In chronic obstructive pulmonary disease, the inflammatory response predominantly involves:

A) eosinophils.
B) neutrophils.
C) monocytes.
D) B cells.

Question 62

In which patient is alpha-1 antitrypsin deficiency the likely cause of chronic obstructive pulmonary disease?

A) A 30-year-old who has smoked for 3 years
B) A 65-year-old man who drove a taxi most of his life
C) A 70-year-old woman who smoked for 40 years
D) A 50-year-old with exposure to secondhand smoke

Question 63

Which of the following tests is recommended for lung cancer screening?

A) Chest X-ray
B) Pulmonary function test
C) Computed tomography (CT) scan
D) Magnetic resonance image

Question 64

Most body fluids are located in the:

A) intravascular space.
B) intracellular space.
C) extracellular space.
D) transcellular space.

Question 65

In which of the following cases is dehydration more likely to occur?

A) A 50-year-old woman who is a bodybuilder
B) A 50-year-old man who is morbidly obese
C) A 10-year-old child is thin
D) A 30-year-old with multiple sclerosis

Question 66

Which of the following is a factor that leads to increased risk for dehydration in the elderly?

A) More insensible losses
B) Increase in muscle mass
C) Decline in kidney function
D) Decrease in fat

Question 67

Which of the following is a clinical manifestation in a patient with renal impairment associated with polycystic kidney disease?

A) Suprapubic pain
B) Periorbital edema
C) Low serum creatinine level
D) Palpable kidneys

Question 68

The decreased glomerular filtration rate in a patient with acute glomerulonephritis is due to which pathophysiologic process?

A) Decreased renal-induced constriction of the renal arteries
B) Immune complex deposition, increased capillary permeability, and cellular proliferation
C) Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure
D) Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis

Question 69

With nephritic syndrome in comparison to nephrotic syndrome, there is:

A) higher amounts of albuminuria.
B) negligible hematuria or absence of hematuria.
C) presence of red blood cell casts in the urine.
D) hypoalbuminemia.

Question 70

Which of the following characterizes ductal carcinoma in situ?

A) It is less common than lobular carcinoma in situ.
B) Malignant cells have not invaded the stroma.
C) It is considered a cancer precursor.
D) It has a higher risk for invasive cancer in comparison to lobular carcinoma in situ.
E) Malignant cells have not invaded the stroma, it is considered a cancer precursor, and it has a higher risk for invasive cancer in comparison to lobular carcinoma in situ.

Question 71

Women who have breast cancer due to a BRCA1 gene mutation are usually:

A) positive for human epidermal receptor 1 and 2.
B) negative for receptor to estrogen.
C) positive for receptors to estrogen, progesterone, and human epidermal receptor 2.
D) negative for receptors to estrogen, progesterone, and human epidermal receptor 2.

Question 72

Which of the following women are at highest risks for the development of endometrial cancer?

A) A 50-year-old postmenopausal woman with a history of high-risk human papilloma virus
B) A 45-year-old woman who is obese and whose menstrual pattern consists of periods of amenorrhea and are infrequent.
C) A 40-year-old woman who is overweight and has hypertension.
D) A 55-year-old woman who is smokes.

Question 73

Which of the following is a common cause of mechanical small intestine obstruction?

A) Infection
B) Postoperative adhesions
C) Tumors
D) Foreign body

Question 74

A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following are consistent with this diagnosis?

A) Right lower quadrant cramping
B) Severe bloody diarrhea
C) Nausea and vomiting
D) Mostly affects the rectum

Question 75

Which of the following statements characterize irritable bowel syndrome?

A) Usually causes anemia
B) Generally associated with intestinal E. coli
C) Can be associated with anxiety and/or depression
D) Often associated with bloody diarrhea

Question 76

Which of the following disorders is more likely associated with blood in stool?

A) Gastroesophageal reflux
B) Crohn disease
C) Irritable bowel syndrome
D) Colon cancer

Question 77

Which of the following patients are at higher risk for developing oral cancer?

A) A female who has taken oral contraceptives for the last 4 years
B) An adult male with a history of alcoholism
C) An adult female who eats spicy foods regularly
D) A middle-aged male who smokes a pipe
E) An older adult female who chews gum frequently
F) Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe

Question 78

Manifestations of Cushing syndrome include:

A) truncal obesity with thin extremities.
B) enlargement of face, hands, and feet.
C) cachexia.
D) thick scalp hair.

Question 79

A 51-year-old woman has the following clinical findings: thin hair, exophthalmos, hyperreflexia, and pretibial edema. These findings are consistent with:

A) subacute thyroiditis.
B) autoimmune thyroiditis.
C) Graves disease.
D) Hashimoto's disease.

Question 80

A 30-year-old has poorly controlled asthma and is taking prednisone 10 mg by mouth once a day. He has been on this regimen for 6 weeks. Abrupt withdrawal or discontinuation of this medication can cause:

A) adrenal crisis.
B) hypercortisolism.
C) ACTH stimulation.
D) thyroid crisis.