Advanced Pathophysiology
Pre-Test Questions
Course Introduction
Advanced Pathophysiology is an in-depth exploration of the physiological processes that underlie human disease across the lifespan. This course examines alterations in normal body functions, focusing on the mechanisms and progression of diseases at the cellular, tissue, organ, and systemic levels. Emphasis is placed on integrating foundational knowledge of anatomy and physiology with an understanding of how disruptions in homeostasis lead to common and complex pathologic conditions. Through case studies and clinical scenarios, students analyze the etiology, pathogenesis, clinical manifestations, and complications of major disease processes, preparing them for advanced practice and clinical decision-making in healthcare settings.
Recommended Textbook
Pathophysiology The Biologic Basis for Disease in Adults and Children 8th Edition by
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Page 2
Kathryn L. McCance
Chapter 1: Cellular Biology
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Sample Questions
Q1) Understanding the various steps of proteolytic cascades may be useful in designing drug therapy for which human diseases?
A)Cardiac and vascular disorders
B)Autoimmune and malignant disorders
C)Gastrointestinal and renal disorders
D)Endocrine and gastrointestinal disorders
Answer: B
Q2) Which statement is true about eukaryotic cells?
A)They lack distinct nucleus.
B)They contain compartments called organelles.
C)They lack an encasing nuclear membrane.
D)They are smaller than the typical prokaryote cell.
Answer: B
Q3) Under anaerobic conditions, what process provides energy for the cell?
A)Oxidative phosphorylation
B)Glycolysis
C)Lactolysis
D)Passive transport
Answer: B
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Page 3
Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents
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Sample Questions
Q1) Which statement is true regarding the difference between subdural hematoma and epidural hematoma?
A)No difference exists, and these terms may be correctly used interchangeably.
B)A subdural hematoma occurs above the dura, an epidural hematoma occurs under the dura.
C)A subdural hematoma is often the result of shaken baby syndrome, whereas an epidural hematoma rapidly forms as a result of a skull fracture.
D)A subdural hematoma usually forms from bleeding within the skull, an epidural hematoma occurs from trauma outside the skull.
Answer: C
Q2) What is the most common site of lipid accumulation?
A)Coronary arteries
B)Kidneys
C)Liver
D)Subcutaneous tissue
Answer: C
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4
Chapter 3: The Cellular Environment: Fluids and Electrolytes,
Acids and Bases
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Sample Questions
Q1) A patient has a serum sodium level of 165 mEq/L. The healthcare professional explains that the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma are caused by what mechanism?
A)High sodium in the blood vessels pulls water out of the brain cells into the blood vessels, causing brain cells to shrink.
B)High sodium in the brain cells pulls water out of the blood vessels into the brain cells, causing them to swell.
C)Low sodium in the blood vessels pulls potassium out of the brain cells, which slows the synapses in the brain.
D)Low sodium in the blood vessels draws chloride into the brain cells followed by water, causing the brain cells to swell.
Answer: A
Q2) Venous obstruction is a cause of edema because of an increase in which pressure?
A)Capillary hydrostatic
B)Interstitial hydrostatic
C)Capillary oncotic
D)Interstitial oncotic
Answer: A
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Chapter 4: Genes and Genetic Diseases
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Sample Questions
Q1) Which is an important criterion for discerning autosomal recessive inheritance?
A)Consanguinity is sometimes present.
B)Females are affected more than males.
C)The disease is observed in both the parents, as well as in the siblings.
D)On average, one half of the offspring of the carrier will be affected.
Q2) What is the purpose of using a Giemsa staining technique on chromosomes?
A)Permit the mitotic process to be followed and monitored for variations.
B)Allow for the numbering of chromosomes and the identification of variations.
C)Identify new somatic cells formed through mitosis and cytokinesis.
D)Distinguish the sex chromosomes from the homologous chromosomes.
Q3) Males, having only one X chromosome, are said to be what?
A)Homozygous
B)Heterozygous
C)Hemizygous
D)Ambizygous
Q4) Consanguinity refers to the mating of people in what situation?
A)Who are unrelated
B)When one has an autosomal dominant disorder
C)Having common family relations
D)When one has a chromosomal abnormality
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Chapter 5: Genes, Environment-Lifestyle, and Common Diseases
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Sample Questions
Q1) Studies have identified several genes that play a role in the prevention of obesity by affecting what?
A)Regulation of appetite
B)Metabolizing of fat
C)Absorption of fat
D)Altering the sense of satiety
Q2) The BRCA1 and BRCA2 mutations increase the risk of which cancer in women?
A)Ovarian
B)Lung
C)Uterine
D)Pancreatic
Q3) The number of new cases of a disease reported during a specific period divided by the number of individuals in the population is defined as which characteristic of a disease?
A)Prevalence rate
B)Incidence rate
C)Relative risk
D)Frequency
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Chapter 6: Epigenetics and Disease
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Sample Questions
Q1) What genetic process is likely responsible for the occurrence of asthma in only one of a pair of identical twins?
A)Epigenetic modifications
B)Genomic imprinting
C)Transgenerational inheritance
D)Methylation
Q2) What is the belief regarding twins who adopt dramatically different lifestyles?
A)They may experience very different aging processes.
B)They will retain very similar methylation patterns.
C)They will experience identical phenotypes throughout their lifespans.
D)They may never demonstrate similar DNA sequences of their somatic cells.
Q3) When microRNA (miRNA) are methylated their messenger RNA (mRNA) targets are over-expressed. What would be the resulting effect on existing cancer?
A)Cell death
B)Metastasis
C)Remission
D)Relapse
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8
Chapter 7: Innate Immunity: Inflammation and Wound Healing
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Sample Questions
Q1) Which chemical mediators induce pain during an inflammatory response? (Select all that apply.)
A)Prostaglandins
B)Leukotrienes
C)Tryptase
D)Phospholipase
E)Bradykinin
Q2) The acute inflammatory response is characterized by fever that is produced by the hypothalamus being affected by what?
A)Endogenous pyrogens
B)Bacterial endotoxin
C)Antigen-antibody complexes
D)Exogenous pyrogens
Q3) In the later stages of an inflammatory response, which phagocytic cell is predominant?
A)Neutrophils
B)Monocytes
C)Chemokines
D)Eosinophils
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Chapter 8: Adaptive Immunity
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Sample Questions
Q1) Which cell has a role in developing cell-mediated immunity?
A)Th1
B)CD4
C)CD8
D)Th2
Q2) The functions of the major histocompatibility complex (MHC) and CD1 molecules are alike because both do what?
A)Are antigen-presenting molecules
B)Bind antigens to antibodies
C)Secrete interleukins during the immune process
D)Are capable of activating cytotoxic T lymphocytes
Q3) Which statements are true concerning the humoral immune response? (Select all that apply.)
A)The humoral immune response is divided into major and minor phases.
B)The response has IgG and IgM produced during each of its phrases.
C)It has a greater presence of IgG than IgM in one of its phases.
D)The humoral immune response is produced in reaction to the presence of an antigen.
E)Phases differ in their response time as a result of the effect of memory cells.
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Chapter 9: Alterations in Immunity and Inflammation
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Sample Questions
Q1) What is Graves disease a result of?
A)Increased levels of circulating immunoglobulins
B)The infiltration of the thyroid with T lymphocytes
C)Autoantibodies binding to thyroid-stimulating hormone (TSH)-receptor sites
D)Exposure to acetylates in substances such as rubber
Q2) A healthcare professional is teaching a patient about Raynaud phenomenon and instructs the patient to avoid cold. What is the best explanation of how cold impacts the manifestations of this disease?
A)Immune complexes that are deposited in capillary beds, blocking circulation
B)Mast cells that are bound to specific endothelial receptors, causing them to degranulate and creating a localized inflammatory reaction that occludes capillary circulation
C)Cytotoxic T cells that attack and destroy the capillaries so that they are unable to perfuse local tissues
D)Antibodies that detect the capillaries as foreign protein and destroy them using lysosomal enzymes and toxic oxygen species
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Chapter 10: Infection
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Sample Questions
Q1) Cytokines are thought to cause fevers by stimulating the synthesis of which chemical mediator?
A)Leukotriene
B)Histamine
C)Prostaglandin
D)Bradykinin
Q2) Which statements are true regarding the development of HIV symptoms? (Select all that apply.)
A)Symptoms generally appear in the clinical latency stage.
B)Symptoms are generally observable within 5 years of the initial infection.
C)T cells levels, particularly those of memory T cells, progressively decrease.
D)Untreated infected individuals may remain asymptomatic for up to10 years.
E)Secondary lymphoid organs experience damage and resulting malfunction.
Q3) Which infections are fungal? (Select all that apply.)
A)Ringworm
B)Candida
C)Cholera
D)Athlete's foot
E)Aspergillus
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Page 12
Chapter 11: Stress and Disease
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Sample Questions
Q1) During an anticipatory response to stress, what is the reaction from the limbic system stimulated by?
A)The retronucleus of the anterior pituitary
B)The anterior nucleus of the hippocampus
C)The paraventricular nucleus of the hypothalamus
D)The prefrontal nucleus of the amygdala
Q2) Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?
A)Adrenal cortex
B)Hypothalamus
C)Anterior pituitary
D)Limbic system
Q3) What effect do androgens have on lymphocytes?
A)Suppression of B-cell responses and enhancement of T-cell responses
B)Suppression of T-cell responses and enhancement of B-cell responses
C)Suppression of B- and T-cell responses
D)Enhancement of B- and T-cell responses
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13
Chapter 12: Cancer Biology
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Sample Questions
Q1) How do cancer cells use the enzyme telomerase?
A)To repair the telomeres to restore somatic cell growth
B)As an intracellular signaling chemical to stimulate cell division
C)To switch off the telomerase to enable cells to divide indefinitely
D)To switch on the telomerase to enable cells to divide indefinitely
Q2) Autocrine stimulation is the ability of cancer cells to do what?
A)Stimulate angiogenesis to create their own blood supply
B)Encourage secretions that turn off normal growth inhibitors
C)Secrete growth factors that stimulate their own growth
D)Divert nutrients away from normal tissue for their own use
Q3) What cellular characteristics are affected by anaplasia? (Select all that apply.)
A)Size
B)Ability to differentiate
C)Life expectancy
D)Tissue structure
E)Shape
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14
Chapter 13: Cancer Epidemiology
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Sample Questions
Q1) The healthcare professional advises clients to make which personal lifestyle choices in order to likely reduce the risk for developing cancer? (Select all that apply.)
A)Avoiding crowds
B)Wearing a hat while golfing
C)Eating a strict vegetarian diet
D)Having regular health screenings
E)Staying indoors during smog alerts
Q2) Research data support the relationship between the exposure of ultraviolet light (UVL) and the development of what? (Select all that apply.)
A)Basal cell carcinoma
B)Squamous cell carcinoma
C)Hodgkin lymphoma
D)Non-Hodgkin lymphoma
E)Soft tissue sarcoma
Q3) Which cancers pose the highest risk for radiologists?
A)Thyroid
B)Breast
C)Leukemia
D)Brain
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Page 15
Chapter 14: Cancer in Children
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Sample Questions
Q1) Which statement is likely true regarding children being treated for cancer with radiation therapy?
A)They will most likely have a successful remission of tumor growth.
B)They seldom require follow-up maintenance treatments.
C)They are prone to experience severe developmental delays.
D)They are at increased risk for developing childhood cancers.
Q2) Which intervention has the greatest effect on a child's mortality rate when diagnosed with cancer?
A)Age at the time of diagnosis
B)Participation in clinical trials
C)Proximity to a major cancer treatment center
D)Parental involvement in the treatment planning
Q3) Which statements are true regarding cancers that develop in children? (Select all that apply.)
A)Childhood cancers tend to be fast growing.
B)Childhood cancers are diagnosed during growth spurts.
C)Childhood cancer generally metastasizes by the time of diagnosis.
D)Childhood cancer is typically at low risk for aggressive metastasis.
E)Childhood cancers respond well to standardized treatment modalities.
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Page 16
Chapter 15: Structure and Function of the Neurologic System
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Sample Questions
Q1) Parkinson disease is associated with defects in which area of the brain?
A)Thalamus
B)Medulla oblongata
C)Cerebellum
D)Substantia nigra
Q2) Which cranial nerves contain parasympathetic nerves? (Select all that apply.)
A)I (olfactory)
B)III (oculomotor)
C)VII (facial)
D)IX (glossopharyngeal)
E)X (vagus)
Q3) Both oligodendroglia and Schwann cells share the ability to do what?
A)Form a myelin sheath
B)Remove cellular debris
C)Transport nutrients
D)Line the ventricles
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17
Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function
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Sample Questions
Q1) What are the expected changes in sleep patterns of older adults?
A)Older adults experience difficulty falling asleep with less time spent in REM sleep.
B)They experience sound sleep during the night with approximately 50% of the time spent in REM sleep and dreaming.
C)Older men commonly experience interrupted sleep patterns later in life than do older women.
D)Older adults awaken often but with a rapid return to sleep; they awaken refreshed but often later in the morning.
Q2) A healthcare professional is caring for four postsurgical patients. Based on an understanding of the physiologic process of nociceptors, the nurse expects to give more pain medication to which patient?
A)Repair of several crushed fingers
B)Dislocated shoulder replacement
C)Cyst removal on the internal surface of an ovary
D)Repair of a ruptured spleen
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18
Chapter 17: Alterations in Cognitive Systems, Cerebral
Hemodynamics, and Motor Function
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Sample Questions
Q1) A healthcare professional suspects a patient is brain dead. How would the professional assess for brain death?
A)Determine if the patient can make voluntary movements.
B)Perform tests to assess if the patient is in a coma.
C)Remove the patient's ventilator to see if spontaneous breathing occurs.
D)Monitor the patient for eye movements that seem purposeful.
Q2) Cerebral edema is an increase in the fluid content of what part of the brain?
A)Ventricles
B)Tissue
C)Neurons
D)Meninges
Q3) What is the most critical aspect in correctly diagnosing a seizure disorder and establishing its cause?
A)Computed tomographic (CT) scan
B)Cerebrospinal fluid analysis
C)Skull x-ray studies
D)Health history
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Page 19
Chapter 18: Disorders of the Central and Peripheral Nervous
Systems and the Neuromuscular Junction
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Sample Questions
Q1) A healthcare professional is planning a community event to reduce risk of cerebrovascular accident (CVA) in high risk groups. Which group would the professional target as the priority?
A)Insulin-resistant diabetes mellitus
B)Hypertension
C)Polycythemia
D)Smoking
Q2) What do diffuse axonal injuries (DAIs) of the brain often result in?
A)Reduced levels of consciousness
B)Mild but permanent dysfunction
C)Fine motor tremors
D)Visual disturbances
Q3) What is the type of vascular malformation that most often results in hemorrhage?
A)Cavernous angioma
B)Venous angioma
C)Capillary telangiectasia
D)Arteriovenous malformation
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Page 20
Chapter 19: Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders
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Sample Questions
Q1) Hypothalamic-pituitary-adrenal (HPA) system abnormalities exist in a large percentage of individuals with what?
A)Schizophrenia
B)Major depression
C)Mania
D)Panic disorder
Q2) A patient has a history of panic disorder. What substances does the healthcare professional teach the patient to avoid? (Select all that apply.)
A)Carbon dioxide
B)Coffee
C)Diesel fumes
D)Soda pop
E)Asbestos
Q3) A criterion for a diagnosis of generalized anxiety disorder (GAD) is a period of excessive worrying that lasts for at least how many months?
A)3
B)6
C)9
D)12
21
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Chapter 20: Alterations of Neurologic Function in Children
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Sample Questions
Q1) Parents bring their 1-year-old child to the emergency department, reporting that the child has been irritable and pounding on her head, has projectile vomiting, and seems very sleepy for most of the last 3 days. What diagnostic testing does the healthcare professional prepare the child and parents for as the priority?
A)Brain scanning with either CT or MRI
B)Lumbar puncture with CSF cultures
C)Developmental assessment
D)Ophthalmologic assessment
Q2) A 7 months old in the clinic displays an intact tonic neck reflex. What action by the healthcare professional is most appropriate?
A)Chart the finding as normal in the child's chart.
B)Assess the baby for signs of malnutrition.
C)Educate the parents on how to improve mobility.
D)Assess the child's development further.
Q3) The clinical manifestations of dyskinetic cerebral palsy include what?
A)Increased muscle tone and prolonged primitive reflexes
B)Exaggerated deep tendon reflexes, clonus, and rigidity of extremities
C)Scoliosis, contractures, and stiffness of trunk muscles
D)Jerky uncontrolled and abrupt fine musculoskeletal movements
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Page 22
Chapter 21: Mechanisms of Hormonal Regulation
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Sample Questions
Q1) Which is an expected hormonal change in an older patient?
A)Thyroid-stimulating hormone secretion below normal
B)Triiodothyronine level below normal
C)Cortisol level below normal
D)Adrenocorticotropic hormone level above normal
Q2) Regulation of the release of insulin is an example of which type of regulation?
A)Negative feedback
B)Positive feedback
C)Neural
D)Physiologic
Q3) When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an example of what type of effect by a hormone?
A)Pharmacologic
B)Permissive
C)Synergistic
D)Direct
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Chapter 22: Alterations of Hormonal Regulation
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Q1) A healthcare professional reads a chart that notes the patient has panhypopituitarism. What does the professional understand that term to mean?
A)The patient has a lack of all hormones associated with the anterior pituitary gland.
B)The patient has a lack of all hormones associated with the lateral pituitary gland.
C)The patient has total adrenocorticoptropic hormone deficiency.
D)The patient has a dysfunction of the posterior pituitary gland due to a tumor.
Q2) Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake?
A)Biguanide (metformin)
B)Sulfonylureas (glyburide)
C)Meglitinides (glinides)
D)a-Glycosidase inhibitor (miglitol)
Q3) Which condition may result from pressure exerted by a pituitary tumor?
A)Hypothyroidism
B)Hypercortisolism
C)Diabetes insipidus
D)Insulin hyposecretion
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Page 24
Chapter 23: Obesity and Disorders of Nutrition
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Q1) Which individual does the health care professional determine is obese?
A)Body mass index 23 kg/m<sup>2</sup>
B)Body mass index 25 kg/m<sup>2</sup>
C)Body mass index 29 kg/m<sup>2</sup>
D)Body mass index 32 kg/m<sup>2</sup>
Q2) What does the student learn about the effects of long-term starvation? (Select all that apply.)
A)Energy is supplied through glycogenolysis.
B)Gluconeogenesis begins for energy requirements.
C)Increase in inflammatory mediators.
D)Use of ketone bodies for energy needs.
E)Proteolysis begins in adipose tissue.
Q3) The student asks the professor for a definition of "orexigenic neurons." What description by the professor is most accurate?
A)Promote appetite and stimulate eating
B)Suppress appetite and inhibit eating
C)Increase overall metabolism
D)Promote satiety after eating
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25
Chapter 24: Structure and Function of the Reproductive Systems
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Q1) Where is the usual site of fertilization of an ovum?
A)Trumpet end of the fallopian tubes
B)Fimbriae of the fallopian tubes
C)Ampulla of the fallopian tubes
D)Os of the fallopian tubes
Q2) When does the male body begin to produce sperm?
A)Before birth
B)Shortly after birth
C)At puberty
D)When erection is possible
Q3) Where is the usual site of cervical dysplasia or cancer in situ?
A)Squamous epithelium of the cervix meets the cuboidal epithelium of the vagina.
B)Columnar epithelium of the cervix meets the squamous epithelium of the uterus.
C)Squamous epithelium of the cervix meets the columnar epithelium of the uterus.
D)Columnar epithelium of the cervix meets the squamous epithelium of the vagina.
Q4) A surge of which hormone causes the corpus luteum to produce progesterone?
A)Follicle stimulating hormone
B)Luteinizing hormone
C)Gonadotropin-releasing hormone
D)Estrogen
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Chapter 25: Alterations of the Female Reproductive System
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Q1) A woman has been diagnosed with cervical carcinoma in situ and asks the healthcare professional to explain it to her. What description by the professional is best?
A)It involves the full epithelial thickness of the cervix.
B)It involves abnormal cells growing on the cervix.
C)It is when cancer has spread to the peritoneum.
D)It is when only the top layer of the cervix is affected.
Q2) What type of cyst develops when an ovarian follicle is stimulated but no dominant follicle develops and completes the maturity process?
A)Follicular
B)Corpus luteum
C)Corpus albicans
D)Benign ovarian
Q3) Which term is used to identify benign uterine tumors that develop from smooth muscle cells in the myometrium and are commonly called uterine fibroids?
A)Endometrial polyps
B)Myometrial polyps
C)Leiomyomas
D)Myometriomas
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Chapter 26: Alterations of the Male Reproductive System
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Q1) The risk of which cancer is greater if the man has a history of cryptorchidism?
A)Penile
B)Testicular
C)Prostate
D)Epididymal
Q2) What is the first sign of puberty in boys?
A)Thickening of the scrotal skin
B)Growth of pubic hair
C)Enlargement of the testes
D)Change in voice
Q3) A healthcare professional is educating a community men's group on symptoms of benign prostatic hyperplasia (BPH). The professional relates that most symptoms are a result of which pathophysiologic condition?
A)Infection of the prostate
B)Obstruction of the urethra
C)Ischemia of the urethra
D)Compression of the urethra
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Chapter 27: Sexually Transmitted Infections
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Q1) By which method is the organism that causes syphilis best identified?
A)Acid-fast stain
B)Gram-stained slide
C)In vitro culture
D)Dark-field microscopy
Q2) Which sexually transmitted infection frequently coexists with gonorrhea?
A)Syphilis
B)Herpes simplex virus
C)Chlamydia
D)Chancroid
Q3) A patient reports small, vesicular lesions that last between 10 and 20 days. What treatment does the healthcare professional educate the patient about?
A)Acyclovir (Zovirax)
B)Three injections of penicillin
C)One time dose of azithromycin
D)Test of cure
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Chapter 28: Structure and Function of the Hematologic System
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Q1) What are the primary anticoagulant mechanisms? (Select all that apply.)
A)Antithrombin III
B)Tissue factor pathway inhibitor
C)Hematopoiesis
D)Protein C
E)Phagocytosis
Q2) Which nutrients are necessary for the synthesis of DNA and the maturation of erythrocytes? (Select all that apply.)
A)Protein
B)Iron
C)Cobalamin (vitamin B<sub>12</sub>)
D)Folate
E)Pantothenic acid
Q3) A patient has chronic anemia associated with chronic renal failure. What substance does the healthcare professional tell the patient is needed to treat this anemia?
A)Iron
B)Erythropoietin
C)Cobalamin (vitamin B12)
D)Folate
30
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Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function
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Sample Questions
Q1) A healthcare professional is evaluating laboratory results for a patient who has disseminated intravascular coagulation (DIC). What results would the professional consider consistent with this condition? (Select all that apply.)
A)Elevated d-dimer
B)Elevated creatinine
C)Decreased protein C
D)Decreased lactate dehydrogenase
E)Increased pH
Q2) An allogenic bone marrow transplantation remains the preferred method for treating which anemia?
A)Polycythemia vera
B)Aplastic
C)Sideroblastic
D)Anemia of chronic disease (ACD)
Q3) What is the fundamental physiologic manifestation of anemia?
A)Hypotension
B)Hyperesthesia
C)Hypoxia
D)Ischemia
31
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Chapter 30: Alterations of Leukocyte and Lymphoid Function
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Sample Questions
Q1) Which classic clinical manifestations are symptoms of infectious mononucleosis (IM)? (Select all that apply.)
A)Lymph node enlargement
B)Hepatitis
C)Pharyngitis
D)Edema in the area of the eyes
E)Fever
Q2) A person comes to the healthcare clinic and reports night sweats and fever. The healthcare professional obtains a chest x-ray which shows a mediastinal mass. What other assessment or diagnostic test does the professional provide as a priority?
A)Listen to heart sounds.
B)Assess the patient's skin.
C)Arrange for familial DNA testing.
D)Test blood for anemia.
Q3) Which virus is associated with Burkitt lymphoma in African children?
A)Cytomegalovirus
B)Adenovirus
C)Human papillomavirus
D)Epstein-Barr virus
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Chapter 31: Alterations of Hematologic Function in Children
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Sample Questions
Q1) A patient has leukemia. The healthcare professional explains to a patient about the significance of hyperdiploidy. What statement by the professional is most accurate?
A)It indicates a good prognosis.
B)It indicates a poor prognosis.
C)It limits treatment options.
D)Hyperdiploidy demonstrates remission.
Q2) In a full-term infant, the normal erythrocyte life span is _____ days.
A)30 to 50
B)60 to 80
C)90 to 110
D)120 to 130
Q3) A patient has thalassemia major. After receiving multiple blood transfusions over the last several months, what complication does the healthcare professional assess the patient for?
A)Hemochromatosis
B)Iron deficiency anemia
C)Vitamin C depletion
D)Rh autoimmunity
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Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems
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39 Verified Questions
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Sample Questions
Q1) A healthcare professional is caring for a patient who has a delay in electrical activity reaching the ventricle as seen on ECG. What ECG finding would the healthcare professional associate with this problem?
A)A prolonged ST interval
B)Variability in measurement with heart rate
C)PR interval measuring 0.28 sec
D)A QRS complex measuring 0.08 sec
Q2) Occlusion of the left anterior descending artery during a myocardial infarction would interrupt blood supply to which structures?
A)Left and right ventricles and much of the interventricular septum
B)Left atrium and the lateral wall of the left ventricle
C)Upper right ventricle, right marginal branch, and right ventricle to the apex
D)Posterior interventricular sulcus and the smaller branches of both ventricles
Q3) What enables electrical impulses to travel in a continuous cell-to-cell fashion in myocardial cells?
A)Sarcolemma sclerotic plaques
B)Intercalated disks
C)Trabeculae carneae
D)Bachmann bundles
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Chapter 33: Alterations of Cardiovascular Function
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43 Verified Questions
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Sample Questions
Q1) A healthcare provider is assessing a patient who has a pericardial effusion and notes a pulsus paradoxus. A student asks for an explanation of how this occurs. What description by the professional is best?
A)Diastolic filling pressures of the right ventricle and reduction of blood volume in both ventricles
B)Blood ejected from the right atrium and reduction of blood volume in the right ventricle
C)Blood ejected from the left atrium and reduction of blood volume in the left ventricle
D)Diastolic filling pressures of the left ventricle and reduction of blood volume in all four heart chambers
Q2) Which laboratory test is an indirect measure of atherosclerotic plaque?
A)Homocysteine
B)Low-density lipoprotein (LDL)
C)Erythrocyte sedimentation rate (ESR)
D)C-reactive protein (CRP)
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Chapter 34: Alterations of Cardiovascular Function in Children
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Sample Questions
Q1) A healthcare professional assesses a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border. What condition does the professional prepare to educate the parents on?
A)Coarctation of the aorta
B)Pulmonic stenosis
C)Aortic stenosis
D)Hypoplastic left heart syndrome
Q2) What is the initial manifestation of aortic coarctation observed in a neonate?
A)Heart failure (HF)
B)Cor pulmonale
C)Pulmonary hypertension
D)Cerebral hypertension
Q3) What congenital heart defects are associated with intrauterine exposure to rubella? (Select all that apply.)
A)Pulmonary stenosis (PS)
B)Cardiomegaly
C)Patent ductus arteriosus (PDA)
D)Coarctation of aorta (COA)
E)Ventricular septal defect (VSD)
Page 36
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Chapter 35: Structure and Function of the Pulmonary System
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Sample Questions
Q1) Which describes the pressure in the pleural space?
A)Atmospheric
B)Below atmospheric
C)Above atmospheric
D)Variable
Q2) Air passage among alveoli is collateral and evenly distributed because of the function of which structures?
A)Type I alveolar cells
B)Pores of Kohn
C)Acinus pores
D)Alveolar pores
Q3) The lung is innervated by the parasympathetic nervous system via which nerve?
A)Vagus
B)Phrenic
C)Brachial
D)Pectoral
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Chapter 36: Alterations of Pulmonary Function
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Sample Questions
Q1) The student asks the healthcare professional to explain how pulmonary edema and pulmonary fibrosis cause hypoxemia. What description by the professional is best?
A)Creates alveolar dead space
B)Decreases the oxygen in inspired gas
C)Creates a right-to-left shunt
D)Impairs alveolocapillary membrane diffusion
Q2) Respirations that are characterized by alternating periods of deep and shallow breathing are a result of which respiratory mechanism?
A)Decreased blood flow to the medulla oblongata
B)Increased partial pressure of arterial carbon dioxide (PaCO )
C)Stimulation of stretch or J-receptors
D)Fatigue of the intercostal muscles and diaphragm
Q3) A patient has been diagnosed with acute respiratory distress syndrome (ARDS). For what other health condition should the healthcare professional assess this patient for as the priority?
A)Heart failure
B)Pneumonia
C)Pulmonary emboli
D)Acute pulmonary edema
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Chapter 37: Alterations of Pulmonary Function in Children
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24 Verified Questions
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Sample Questions
Q1) What is the most common predisposing factor to obstructive sleep apnea in children?
A)Chronic respiratory infections
B)Adenotonsillar hypertrophy
C)Obligatory mouth breathing
D)Paradoxical breathing
Q2) A student asks the healthcare professional why researchers are trying to link specific genes to specific asthma phenotypes. What response by the professional is best?
A)Some types of asthma are easier to treat than others.
B)Some people could use cheaper medications.
C)It can lead to personalized approaches to treatment.
D)More and more asthma phenotypes are being recognized.
Q3) Parents bring a 5-year-old to the Emergency Department and report sudden onset of high fever, drooling, and they describe a "hot potato voice." What action by the healthcare professional takes priority?
A)Immediate assessment for aspiration of a foreign body
B)Allow the child to remain in the parent's lap.
C)Send the child to radiology for x-rays of the throat and chest.
D)Start the child and all family members on rifampin.
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Page 39
Chapter 38: Structure and Function of the Renal and Urologic Systems
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Sample Questions
Q1) What process allows the kidney to respond to an increase in workload?
A)Glomerular filtration
B)Secretion of 1,25-dihydroxyvitamin D3
C)Increased heart rate
D)Compensatory hypertrophy
Q2) What is the only surface inside the nephron where cells are covered with microvilli to increase the reabsorptive surface area called?
A)Proximal convoluted tubules
B)Distal tubules
C)Ascending loop of Henle
D)Descending loop of Henle
Q3) The glomerular filtration rate is directly related to which factor?
A)Perfusion pressure in the glomerular capillaries
B)Diffusion rate in the renal cortex
C)Diffusion rate in the renal medulla
D)Glomerular active transport
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Chapter 39: Alterations of Renal and Urinary Tract Function
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31 Verified Questions
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Sample Questions
Q1) Creatinine is primarily excreted by glomerular filtration after being constantly released from what type of tissue?
A)Nervous system
B)Kidneys
C)Muscle
D)Liver
Q2) How does progressive nephron injury affect angiotensin II activity?
A)Angiotensin II activity is decreased.
B)Angiotensin II activity is elevated.
C)Angiotensin II activity is totally suppressed.
D)Angiotensin II activity is not affected.
Q3) Pyelonephritis is usually caused by which type of organism?
A)Bacteria
B)Fungi
C)Viruses
D)Parasites
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Chapter 40: Alterations of Renal and Urinary Tract Function in Children
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24 Verified Questions
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Sample Questions
Q1) The excretion of urea is low in infants because of which features? (Select all that apply.)
A)Medullary nephrons with comparatively short loops
B)Immature tubular transport capacity impairing the excretion of urea
C)High anabolic state
D)Dilute urine as a result of the immaturity of an infant's glomeruli
E)Available protein used for physical growth
Q2) When does an individual have their full complement of renal nephrons?
A)At birth
B)At 6 months of age
C)At puberty
D)Between the ages 18 and 21 years
Q3) The functional kidney is associated with which embryonic organ?
A)Metanephros
B)Mesonephros
C)Pronephros
D)Endonephros
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Page 42
Chapter 41: Structure and Function of the Digestive System
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Sample Questions
Q1) Where in the small intestines are lymphocytes, plasma cells, and macrophages produced?
A)Brush border
B)Microvilli
C)Lamina propria
D)Crypts of Lieberkühn
Q2) Which structure synthesizes clotting factors and the vitamin K necessary for hemostasis?
A)Colon
B)Spleen
C)Gallbladder
D)Liver
Q3) Which hormones are involved in regulating gastric motility by lowering the threshold potential of muscle fibers? (Select all that apply.)
A)Estrogen
B)Secretin
C)Somatostatin
D)Gastrin
E)Motilin
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Page 43
Chapter 42: Alterations of Digestive Function
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Sample Questions
Q1) By what mechanism does intussusception cause an intestinal obstruction?
A)Telescoping of part of the intestine into another section of intestine
B)Twisting the intestine on its mesenteric pedicle
C)Loss of peristaltic motor activity in the intestine
D)Fibrin and scar tissue that attaches to the intestinal omentum
Q2) What information does the student learn about parietal pain? (Select all that apply.)
A)Parietal pain arises from the parietal peritoneum.
B)It is generally more localized than visceral pain.
C)Parietal pain is usually less intense than visceral pain.
D)Nerve fibers that travel to the spinal cord are involved in parietal pain.
E)Parietal pain corresponds to dermatomes T6 and L1.
Q3) After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which mechanism?
A)Excessive relaxation of gastric and vascular smooth muscles
B)Postoperative hemorrhage
C)Concentrated food bolus, causing hyperglycemia
D)Rapid gastric emptying
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Chapter 43: Alterations of Digestive Function in Children
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Sample Questions
Q1) Incomplete fusion of the nasomedial and intermaxillary process during the fourth week of embryonic development causes which condition in an infant?
A)Cleft palate
B)Sinus dysfunction
C)Cleft lip
D)Esophageal malformation
Q2) A child has celiac disease. Which foods does the healthcare professional teach the parents to eliminate from their child's diet? (Select all that apply.)
A)Citrus fruits
B)Starchy vegetables
C)Wheat products
D)Barley
E)Fat soluble vitamins
Q3) What does the student learn distinguishes kwashiorkor from marasmus?
A)All nutrients, proteins, fats, and carbohydrates are reduced in kwashiorkor.
B)Physical growth of children is stunted in kwashiorkor but not in marasmus.
C)Muscle wasting, diarrhea, low hemoglobin, and infection characterize kwashiorkor.
D)Subcutaneous fat, hepatomegaly, and fatty liver are present in kwashiorkor.
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Chapter 44: Structure and Function of the Musculoskeletal System
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Sample Questions
Q1) Which four-step process correctly describes muscle contraction?
A)Coupling, contraction, relaxation, excitation
B)Contraction, relaxation, excitation, coupling
C)Relaxation, excitation, coupling, contraction
D)Excitation, coupling, contraction, relaxation
Q2) What information does the student learn about osteocytes? (Select all that apply.)
A)An osteocyte is a transformed osteoblast.
B)An osteocyte obtains nutrients from capillaries in the canaliculi.
C)Osteocytes are the prime target of thyroid hormone action.
D)Osteocytes signal osteoclasts and osteoblasts to form new bone.
E)An osteocyte helps maintain levels of calcium and phosphorus in blood plasma.
Q3) Which bone cells are large and multinucleated and contain lysosomes filled with hydrolytic enzymes?
A)Osteoblasts
B)Osteoclasts
C)Osteocytes
D)Fibrocytes
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Page 46
Chapter 45: Alterations of Musculoskeletal Function
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Q1) A patient has a bone density T score of -2.8. What diagnosis does the health care professional educate the patient on?
A)Osteoplasia
B)Osteoporosis
C)Osteopenia
D)Osteomalacia
Q2) The health care professional teaches a group of seniors that the most common clinical manifestation of osteoporosis is which of these?
A)Bone deformity
B)Bone pain
C)Pathologic fracture
D)Muscle strain
Q3) A patient has a temporary displacement of two bones causing the bone surfaces to partially lose contact with each other. What treatment does the health care professional prepare the patient for?
A)Internal fixation
B)Reduction and immobilization
C)Calcium phosphate cement
D)Low-density ultrasound
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Chapter 46: Alterations of Musculoskeletal Function in Children
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Sample Questions
Q1) A child has Duchenne muscular dystrophy and the parents want to know how this occurred. Which statement by the healthcare professional is most accurate?
A)X-linked recessive inheritance
B)Common SMN1 gene abnormality
C)Autosomal dominant inheritance
D)Inheritance is not well defined
Q2) What does the student learn about bone growth before adulthood? (Select all that apply.)
A)Growth in the length of bone occurs at the physeal plate.
B)Growth occurs through endochondral ossification.
C)Bone growth takes place under hormonal control.
D)Cartilage cells at the epiphyseal side of the physeal plate multiply and enlarge.
E)Cartilage cells at the metaphyseal side of the plate are replaced by bone.
Q3) What is the most common malignant bone tumor diagnosed during childhood?
A)Chondrosarcoma
B)Fibrosarcoma
C)Ewing Sarcoma
D)Osteosarcoma
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Chapter 47: Structure, Function, and Disorders of the Integument
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Sample Questions
Q1) In latex allergies, which immunoglobulin (Ig) is associated with an immediate reaction?
A)IgA
B)IgE
C)IgG
D)IgM
Q2) The healthcare professional educates a community group that chickenpox (varicella) may be followed years later by which disorder?
A)Erysipelas
B)Cytomegalovirus
C)Warts
D)Herpes zoster
Q3) A patient has a furuncle. Where would the healthcare professional assess the patient for this condition?
A)Feet
B)Palms
C)Hair follicles
D)Fingernails
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Chapter 48: Alterations of the Integument in Children
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Q1) The healthcare professional is educating a parenting class on Koplik spots? What information is most appropriate to include? (Select all that apply.)
A)Koplik spots are associated with rubeola.
B)They appear as white spots.
C)The lesions are surrounded by a red ring.
D)The lesions of Koplik spots are large in size.
E)Koplik spots are primarily found on buccal mucosa.
Q2) An infant has a skin disorder that is characterized by a vesicular eruption after prolonged exposure to perspiration, with subsequent obstruction of the eccrine ducts. What care measures does the healthcare provider educate the parents about?
A)Topical antifungals
B)Corticosteroids
C)Oral ivermectin
D)Keeping skin cool and dry
Q3) Which immunoglobulin (Ig) is elevated in atopic dermatitis?
A)IgA
B)IgM
C)IgE
D)IgG
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Page 50
Chapter 49: Shock, Multiple Organ Dysfunction Syndrome, and Burns
in Adults
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Q1) A student learns that a fatal burn injury has what effect on interleukins (ILs)?
A)Decreases levels of IL-2
B)Decreases levels of IL-4 lymphocytes
C)Increases levels of IL-6
D)Increases levels of IL-12
Q2) What assessment finding would indicate to the healthcare professional that the patient is no longer in burn shock?
A)Blood pressure 100/58 mmHg
B)Pulse rate 98 beats/min
C)Respiratory rate 24 breaths/min
D)Urine output 35 mL/hour for 4 hours
Q3) What is the final outcome of impaired cellular metabolism?
A)Cellular alterations in the heart and brain
B)Buildup of cellular waste products
C)Cellular alterations in the vasculature structures and kidneys
D)Impairment of urine excretion
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Chapter 50: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children
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Sample Questions
Q1) Hypotension is likely to occur when an infant or child is greater than _____ % dehydrated.
A)2
B)5
C)7
D)10
Q2) Which information does the student learn regarding multiple organ dysfunction syndrome (MODS)? (Select all that apply.)
A)Diagnosis requires simultaneous failure of at least two organs.
B)Primary MODS occurs immediately after the attributing cause.
C)Secondary MODS occurs within 3 to 7 days of the initial insult.
D)Chronic illness increases a child's risk for MODS.
E)Risk factors for MODS include severe or prolonged shock, sepsis, and trauma.
Q3) Which assessment findings would be recognized as late signs of shock in a child?
(Select all that apply.)
A)Metabolic (lactic) acidosis
B)Cool skin
C)Bradycardia
D)Prolonged capillary refill
E)Hypotension
Page 52
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