Clinical Medicine
Exam Materials
Course Introduction
Clinical Medicine is the branch of medical science that focuses on the direct observation, diagnosis, and treatment of patients. This course encompasses the practical application of medical knowledge to the care of individuals in various healthcare settings, including hospitals and clinics. Students gain hands-on experience in assessing patient symptoms, performing physical examinations, interpreting diagnostic tests, and developing management plans for a range of acute and chronic conditions. Emphasis is placed on clinical reasoning, patient communication, and ethical decision-making, preparing students for effective, compassionate patient care as future healthcare professionals.
Recommended Textbook
Pathophysiology The Biologic Basis for Disease in Adults And Children 5th Edition by Kathryn L. McCance
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47 Chapters
2350 Verified Questions
2350 Flashcards
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Chapter 1: Cellular Biology
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Sample Questions
Q1) The movement of fluid across the arterial end of capillary membranes into the interstitial fluid surrounding the capillary is an example of which process of fluid movement?
A) Hydrostatic pressure
B) Osmosis
C) Diffusion
D) Active transport
Answer: A
Q2) The function of adenosine triphosphate (ATP)is to store energy in molecules of carbohydrates,proteins and lipids,but not to transfer energy from one molecule to another.
A)True
B)False
Answer: False
Q3) The chief function of ribosomes is to provide sites for lipid synthesis.
A)True
B)False
Answer: False
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Chapter 2: Altered Cellular and Tissue Biology
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Sample Questions
Q1) What is the leading cause of injury to and death of patients?
A) Motor vehicle and airplane accidents
B) Fires and burns
C) Drug or alcohol-related accidents
D) Medical errors
Answer: D
Q2) Noise,illumination,and prolonged vibrations can cause cellular injury.
A)True
B)False
Answer: True
Q3) What type of necrosis is often associated with pulmonary tuberculosis?
A) Bacteriologic necrosis
B) Caseous necrosis
C) Liquefactive necrosis
D) Gangrenous necrosis
Answer: B
Q4) Dysplastic changes may be reversible,but may become malignant.
A)True
B)False
Answer: True
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Chapter 3: The Cellular Environment
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Sample Questions
Q1) How does the body reestablish equilibrium when solute is added to extracellular fluid making it hypertonic?
A) Water is drawn from the extracellular space to the intracellular space.
B) Sodium is drawn from the extracellular space to the intracellular space.
C) Sodium is drawn from the intracellular space to the extracellular space.
D) Water is drawn from the intracellular space to the extracellular space.
Answer: D
Q2) What is the significance of deep,rapid breathing (Kussmaul respirations)in metabolic acidosis?
A) It indicates that anxiety,with rapid breathing,is a cause of respiratory acidosis.
B) It indicates the excessive carbon dioxide is exhaled to compensate for metabolic acidosis.
C) It indicates that diabetic ketoacidosis is the cause of the metabolic acidosis.
D) It indicates that more oxygen is necessary to compensate for respiratory acidosis.
Answer: B
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Chapter 4: Genes and Genetic Diseases
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Sample Questions
Q1) Males are affected more often by X-linked recessive genes than females.
A)True
B)False
Q2) Inserting bone marrow cells into an individual who produces abnormal erythrocytes is an example of what therapy?
A) Somatic cell therapy
B) Germ cell therapy
C) Genetic engineering therapy
D) Recombinant DNA therapy
Q3) Duchenne muscular dystrophy
A)Autosomal dominant
B)Autosomal recessive
C)X-linked dominant
D)X-linked recessive
Q4) RNA polymerase is the most important protein in DNA replication.
A)True
B)False
Q5) DNA formation and protein synthesis occur in the cell nucleus.
A)True
B)False
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Chapter 5: Genes, Environment-Lifestyle, and Common Diseases
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Sample Questions
Q1) Number of persons living with the disease
A)Incidence rate effect of multiple genes
B)Gene-environment interaction
C)Prevalence rate at which some diseases occur
D)Obesity
E)Polygenetic
F)Empiric risk
G)Relative risk
Q2) What is the cause of familial hypercholesterolemia?
A) A diet high in saturated fats
B) An increased production of cholesterol by the liver
C) A reduction in the number of LDL receptors on cell surfaces
D) An abnormal function of lipoprotein receptors circulating in the blood
E) A reduction in the co-enzyme HMG-CoA by the liver
Q3) How does obesity act as an important risk factor for type 2 diabetes mellitus?
A) By reducing the amount of insulin the pancreas produces
B) By increasing the resistance to insulin by cells
C) By obstructing the outflow of insulin from the pancreas
D) By stimulating the liver to increase glucose production
Page 7
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Chapter 6: Innate Immunity Including Inflammation
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Sample Questions
Q1) What occurs during the process of repair after tissue damage?
A) Destroyed tissue is replaced by non-functioning scar tissue.
B) Regeneration occurs in which original tissue is replaced.
C) Resolution occurs when tissue is regenerated.
D) Destroyed tissue is replaced by epithelialization.
Q2) Many neonates have a transient depressed inflammatory response because:
A) their circulatory system is too immature to adequately perfuse tissues.
B) they are deficient in complement and chemotaxis.
C) they have an insufficient number of mast cells.
D) their lungs are too immature to deliver oxygen to tissues.
Q3) Which chemical mediators induce pain during an inflammatory response?
A) Prostaglandins and bradykinin
B) Leukotrienes and serotonin
C) Tryptase and histamine
D) Phospholipase and prostacyclin
Q4) When histamine binds the histamine 2 (H2)receptor,inflammation is:
A) inhibited.
B) activated.
C) accelerated.
D) not changed.
Page 8
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Chapter 7: Adaptive Immunity
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Sample Questions
Q1) T lymphocytes are primarily responsible for protection against bacteria and a variety of viruses.
A)True
B)False
Q2) At birth,samples of blood from the umbilical cord indicate which immunoglobulin levels,if any,are near adult levels?
A) None of the immunoglobulins are near adult level.
B) Immunoglobulin G (IgG)
C) Immunoglobulin M (IgM)
D) Immunoglobulin E (IgE)
Q3) What are primary characteristics that differentiate the immune response from other protective mechanisms such as inflammation?
A) The immune system responds in the same way each time it is activated.
B) The immune response is specific to the antigen that initiates it.
C) The immune response is a short-term response to a specific pathogen.
D) The immune response is an innate response,rather than acquired.
Q4) Are induced by antigens derived from allergens
A)Helper T1 lymphocytes (Th1)
B)Helper T2 lymphocytes (Th2)
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Chapter 8: Alterations in Immunity and Inflammation
Including Hypersensitivies
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Sample Questions
Q1) In a Type II hypersensitivity reaction,when soluble antigens from infectious agents enter circulation,what causes tissue damage?
A) Complement-mediated cell lysis
B) Phagocytosis by macrophages
C) Phagocytosis in the spleen
D) Neutrophil granules and toxic oxygen products
Q2) HIV antibodies appear within ______ weeks after infection through blood products.
A) 1 to 2
B) 4 to 7
C) 10 to 12
D) 20 to 24
Q3) Atopic individuals tend to produce higher levels of IgM.
A)True
B)False
Q4) Through which lymphocyte is the common allergy hay fever expressed?
A) IgE-mediated reactions
B) IgG-mediated reactions
C) IgM-mediated reactions
D) T cell-mediated reactions
10
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Chapter 9: Infection Including Hivaids
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Sample Questions
Q1) What is colonization?
A) The ability of a pathogen to invade and multiply in the host
B) The presence of pathogens on or in the body without tissue invasion
C) An important factor in determining a pathogen's degree of virulence
D) Direct damage to cells rendering them dysfunctional
Q2) Use metabolism of hosts cells to proliferate
A)Bacteria
B)Viruses
C)Mycoses
D)Dermatophytes
Q3) Colonization is the first stage of infection.
A)True
B)False
Q4) Endotoxins from gram negative bacteria can activate the coagulation cascade.
A)True
B)False
Q5) Diseases caused by fungi are called mycoses.
A)True
B)False
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Chapter 10: Stress and Disease
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Sample Questions
Q1) Cortisol circulates in the plasma free (unbound)and bound to protein.
A)True
B)False
Q2) Decreases glucose uptake in muscles
A)Epinephrine
B)Norepinephrine
C)Cortisol
Q3) The action of which hormone helps explain increases in affective anxiety and eating disorders,mood cycles and vulnerability to autoimmune and inflammatory diseases in women as a result of stimulation of the corticotropin-releasing hormone (CRH)gene promoter and central norepinephrine system?
A) Progesterone
B) Cortisol
C) Estrogen
D) Prolactin
Q4) What changes are expected in the stress-age syndrome?
A) Decreased catecholamines
B) Decreased adrenocorticotropic hormone (ACTH)
C) Decreased cortisol
D) Immunodepression
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Chapter 11: Biology of Cancer
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Sample Questions
Q1) Caretaker gene
A)Loss of differentiation
B)Cancer cells secrete growth factor for their own growth
C)Cells that vary in size and shape
D)Unaltered normal allele
E)Responsible for maintenance of genomic integrity
Q2) Cells from a muscle tumor show a reduced ability to form new muscle and appear highly disorganized.This is an example of:
A) dysplasiA.
B) hyperplasia.
C) myoplasia.
D) anaplasia.
Q3) The term "neoplasm" can refer to a benign tumor.
A)True
B)False
Q4) Which cancers are associated with chronic inflammation?
A) Skin,lung,and pancreatic
B) Colon,liver,and lung
C) Bone,blood cells,and pancreatic
D) Bladder,skin,and kidney
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Chapter 12: Tumor Invasion and Metastasis
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Sample Questions
Q1) What protects tumor cells within an emboli from the host defenses and facilitates attachment to vascular epithelium?
A) Macrophages
B) Fibrin-platelet complex
C) Vascular endothelial growth factor
D) Proteolytic enzymes
Q2) Brain
A)Pressure
B)Compression
C)Stretching
D)Obstruction
E)Tissue destruction
Q3) Cells of the gut,hair follicles,and bone marrow are affected by chemotherapy and radiation because they have high rates of cell division.
A)True
B)False
Q4) Cells with mutant p53 genes escape apoptosis.
A)True
B)False
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Chapter 13: Cancer in Children
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Sample Questions
Q1) Cancers in children are slow growing and usually have not metastasized at time of diagnosis.
A)True
B)False
Q2) Most childhood cancers arise from the:
A) epithelium.
B) mesodermal germ layer.
C) embryologic ectodermal layer.
D) viscera.
Q3) Childhood cancer has a longer latency period than cancer in adults.
A)True
B)False
Q4) Chronic myelogenous leukemia,retinoblastoma and osteosarcoma are associated with which genetic factors in childhood cancers?
A) Chromosome aberrations or single gene defects
B) Mutation of proto-oncogenes to oncogenes
C) Tumor suppressor genes that have lost their suppressor function
D) Congenital malformations
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Chapter 14: Structure and Function of the Neurologic System
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Sample Questions
Q1) The parasympathetic nervous system functions to conserve and restore energy.
A)True
B)False
Q2) The _____ has two main functions: maintenance of a constant internal environment and implementation of behavioral patterns.
A) thalamus
B) epithalamus
C) subthalamus
D) hypothalamus
Q3) The _____ controls reflex activities concerned with heart rate,blood pressure,respirations,sneezing,swallowing,and coughing.
A) pons
B) midbrain
C) cerebellum
D) medulla oblongata
Q4) The fight or flight response is primarily mediated by the parasympathetic nervous system.
A)True
B)False
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Chapter 15: Pain, Temperature Regulation, Sleep, and Sensory Function
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Sample Questions
Q1) Parageusia
A)Loss of ability to smell
B)Perversion of sense of taste
C)Smelling nonexistent odors
D)Defective vision in half of a visual field
E)Defect in central field of vision
F)Involuntary movement of eyeballs
Q2) Older adults have difficulty regulating body heat because they have a decreased shivering response and diminished or absent sweating.
A)True
B)False
Q3) Which disorder of temperature regulation is caused by prolonged high environmental temperatures that produce dehydration,decreased plasma volumes,hypotension,decreased cardiac output,and tachycardia?
A) Heat cramps
B) Heat stroke
C) Malignant hyperthermia
D) Heat exhaustion
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Chapter 16: Concepts of Neurologic Dysfunction
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Sample Questions
Q1) Cognitive operations cannot occur without the _____ functioning.
A) pons
B) medulla oblongata
C) reticular activating system
D) cingulate gyrus
Q2) What are clinical manifestations of Parkinson disease?
A) Muscle tremor;slow,rigid movements;and postural abnormalities
B) Muscle weakness,difficulty chewing,and drooping eye lids
C) Decreased memory,depression,and indifference
D) Paralysis and absent sensation below the level of the lesion
Q3) What causes stage 1 of intracranial hypertension?
A) Loss of autoregulation that normally maintains constant blood flow during changes in cerebral perfusion pressure (CPP)
B) Displacement of cerebrospinal fluid followed by compression of the cerebral venous system
C) Vasoconstriction of the cerebral arterial system with reciprocal increase in systemic blood pressure
D) Compression of the medulla oblongata in the brain stem by herniation of the cerebral cortex
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Page 18
Chapter 17: Disorders of Neurologic Function
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Sample Questions
Q1) After a cervical spinal cord injury,the patient's body temperature fluctuates markedly.What is the most accurate explanation of this phenomenon?
A) The patient probably has developed bilateral pneumonia or a urinary tract infection.
B) The patient's sympathetic nervous system has been damaged disturbing thermal control.
C) The patient also sustained a head injury that damaged the hypothalamus that regulated temperature.
D) The patient has septicemia from an unknown source.
Q2) Rebleeding after a subarachnoid hemorrhage is a significant risk and occurs most often 4 weeks after the initial hemorrhage.
A)True
B)False
Q3) _____ are most at risk of spinal cord injury from minor trauma.
A) Children
B) Adolescents
C) Adults
D) Older adults
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Chapter 18: Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders
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Sample Questions
Q1) General anxiety disorder is diagnosed when a person spends _____ months worrying excessively.
A) 3
B) 6
C) 9
D) 12
Q2) Persistent beliefs are contrary to educational and cultural background
A)Delusions
B)Formal thought disorder
C)Anhedonia
D)Hallucinations
E)Alogia
F)Avolition
Q3) Individuals who eat cheese,sour cream,liver,and avocado when taking MAOIs may experience:
A) kidney damage.
B) hypertensive crisis.
C) orthostatic hypotension.
D) weight gain.
Page 20
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Chapter 19: Alterations of Neurologic Function in Children
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Sample Questions
Q1) Seizures,loss of deep tendon reflexes,respiratory arrest
A)Reye syndrome,stage I
B)Reye syndrome,stage II
C)Reye syndrome,stage III
D)Reye syndrome,stage IV
E)Reye syndrome,stage V
Q2) Bacterial meningitis in children with otitis media generally follows bacteremia.
A)True
B)False
Q3) Which is a characteristic of benign febrile seizures?
A) Seizures occur with a temperature less than 39°C.
B) Respiratory or ear infections usually are present at the time of seizure.
C) Seizures occur after the fifth year of life.
D) Seizures last 30 minutes or more.
Q4) What are the clinical manifestations of dyskinetic cerebral palsy?
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 movements
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Chapter 20: Mechanisms of Hormonal Regulation
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Sample Questions
Q1) The pituitary gland is located in the bony sella turcica.
A)True
B)False
Q2) Cell surface receptors include all of the following except:
A) G-protein-linked.
B) ion channel.
C) second messenger.
D) tyrosine-kinase linked.
Q3) Norepinephrine stimulates the release of which hormone?
A) Thyroxine
B) Adrenocorticotropic hormone
C) Growth hormone
D) Insulin
Q4) Which of the following is a lipid-soluble hormone?
A) Cortisol
B) Thyroxine (T<sub>4</sub>)
C) Epinephrine
D) Growth hormone (GH)
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Chapter 21: Alterations of Hormonal Regulation
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Sample Questions
Q1) A deficiency of _____ may result in hypothyroidism.
A) iron
B) iodine
C) zinc
D) magnesium
Q2) Hypersecretion of thyroid hormone (TH)
A)Acromegaly
B)Cushing disease
C)Addison disease
D)Graves' disease
E)Myxedema
F)Pheochromocytoma
Q3) If the target cells for ADH do not have receptors,the result is _____ diabetes insipidus (DI).
A) neurogenic
B) nephrogenic
C) psychogenic
D) ischemic
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Chapter 22: Structure and Function of the Reproductive Systems
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Sample Questions
Q1) Testosterone causes all of the following except:
A) baldness.
B) increased libido.
C) acne.
D) decreased cholesterol.
Q2) Which anatomic structure secretes follicle-stimulating hormone (FSH),luteinizing hormone (LH),and gonadotropin-releasing hormone (GnRH)?
A) Hypothalamus
B) Ovaries
C) Anterior pituitary
D) Adrenal cortex
Q3) The major difference between male and female sex hormone production is:
A) LH has no apparent action in the male.
B) in the male,sex hormone production is relatively constant.
C) estradiol is not produced in the male.
D) in the male,GnRH does not cause the release of FSH.
Q4) Small amounts of progesterone are steadily secreted by the adrenal cortex.
A)True
B)False
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Chapter 23: Alterations of the Reproductive Systems
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Q1) Which infection has clinical manifestations of sudden onset of malaise,low back pain,and perineal pain with high fever and chills,dysuria,nocturia,and urinary retention?
A) Orchitis
B) Balanitis
C) Epididymitis
D) Bacterial prostatitis
Q2) What are typical findings on breast palpation of a client with fibroadenoma?
A) Painful,round,movable,and fluid-filled mass
B) Painless,movable,hard,and irregular mass
C) Painless,firm,elastic,and well-circumscribed mass
D) Painful,non-movable,irregular,and soft mass
Q3) _____ is the most common infectious cause of orchitis and usually affects postpubertal males.
A) Herpes
B) Escherichia coli
C) Mumps
D) Cytomegalovirus
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25
Chapter 24: Sexually Transmitted Infections
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Q1) A major concern in the treatment of gonococci infections is:
A) development of antibiotic resistance.
B) changes in virulence.
C) changes in pathogenicity.
D) mutations into different strains.
Q2) Sexually transmitted infections are seen in all socioeconomic classes.
A)True
B)False
Q3) Which statement is false about the factors that facilitate the ascent of gonococci into the uterus and fallopian tubes?
A) Ascent of gonococci is facilitated because the cervical plug disintegrates during menstruation.
B) Ascent of gonococci is facilitated because the vaginal pH decreases to 2 or 3.
C) Ascent of gonococci is facilitated because the uterine contractions may cause retrograde menstruation into the fallopian tubes.
D) Ascent of gonococci is facilitated because the bacteria may adhere to sperm and be transported to the fallopian tubes.
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Chapter 25: Structure and Function of the Hematologic System
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Q1) Liver
A)Kupffer's cells
B)Alveolar macrophages
C)Microglial cells
D)Mesangial cells
E)Langerhans cells
Q2) Which nutrients are necessary for the hemoglobin synthesis?
A) Protein and niacin
B) Iron and vitamin B<sub>6</sub> (pyridoxine)
C) Cobalamin (vitamin B<sub>12</sub>)and folate
D) Pantothenic acid and vitamin C
Q3) Two important characteristics allow erythrocytes to function as gas carriers.These are:
A) biconcavity and permanent shape.
B) permanent shape and reversible deformability.
C) reversible deformability and biconcavity.
D) biconcavity and the presence of hyperactive mitochondria.
Q4) Erythropoietin induces the selective proliferation of proerythroblasts.
A)True
B)False
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Chapter 26: Alterations of Erythrocyte Function
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Q1) What causes the paresthesia that occurs in vitamin B<sub>12</sub> deficiency anemia?
A) Reduction in acetylcholine receptors in the post-synaptic nerves
B) Myelin degeneration in the spinal cord
C) Destruction of myelin in peripheral nerves
D) Altered function of neurons in the parietal lobe
Q2) What is the Schilling test?
A) The administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B<sub>12</sub> deficiency
B) The measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia
C) The measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia
D) The administration of folate and measurement in 2 hours of its level in a blood sample to test for folic acid deficiency anemia
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Chapter 27: Alterations in Hematologic Function in Children
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Q1) What is the life span of an erythrocyte in sickle cell anemia?
A) 10 to 20 days
B) 40 to 60 days
C) 80 to 100 days
D) 100 to 120 days
Q2) Using the prepregnancy sickle test,fertilization produces several embryos that are tested for the sickle gene.An embryo without the gene is implanted in the mother and amniocentesis confirms whether the fetus has the sickle cell gene.
A)True
B)False
Q3) Which disorder results in decreased erythrocytes and platelets with changes in leukocytes and has clinical manifestations of pallor,fatigue,petechiae,purpura,bleeding,and fever?
A) Idiopathic thrombocytopenic purpura (ITP)
B) Acute lymphocytic leukemia (ALL)
C) Non-Hodgkin lymphoma (NHL)
D) Iron deficiency anemia (IDA)
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Chapter 28: Structure and Function of the Cardiovascular and Lymphatic Systems
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Q1) Although the heart is innervated by the sympathetic nervous system,neural impulses are not needed to maintain the cardiac cycle.
A)True
B)False
Q2) Myogenic regulation of blood vessel diameter and subsequent blood flow through a vessel is an example of _____ of blood vessels.
A) autonomic regulation
B) somatic regulation
C) autoregulation
D) metabolic regulation
Q3) The _____ complex (wave)represents the sum of all ventricular muscle cell depolarization.
A) PRS
B) QRS
C) QT interval
D) P
Q4) Veins are less compliant than arteries.
A)True
B)False
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Chapter 29: Alterations of Cardiovascular Function
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Q1) Which value may be protective for the development of atherosclerosis?
A) High values of very-low-density lipoproteins (VLDL)
B) High values of low-density lipoproteins (LDL)
C) High values of high-density lipoproteins (HDL)
D) High values of triglycerides (TG)
Q2) What changes in veins occur to create varicose veins?
A) An increase in osmotic pressure
B) Damage to the valves with veins
C) Damage to the venous endothelium
D) An increase in hydrostatic pressure
Q3) What pathologic change occurs in kidneys of people with hypertension that leads to dysfunction of the glomeruli?
A) Compression of the renal tubules
B) Ischemia of the tubule
C) Increased pressure from within the tubule
D) Obstruction of the renal tubule
Q4) An increase in left ventricular end-diastolic volume in diastolic heart failure may lead to pulmonary edema.
A)True
B)False
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Chapter 30: Alterations of Cardiovascular Function in Children
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Sample Questions
Q1) Bulbus cordis
A)Causes atrial separation
B)Gap between the septum primum and the septum secundum
C)Conal portion of the ventricular septum
D)Communication between the aorta and the pulmonary artery
E)Allows right-to-left shunting
Q2) Congenital heart defects that cause acyanotic congestive heart failure usually involve:
A) right-to-left shunts.
B) left-to-right shunts.
C) obstructive lesions.
D) mixed lesions.
Q3) Iron deficiency anemia may result from polycythemia that develops from chronic hypoxia.
A)True
B)False
Q4) Common clinical manifestations of right ventricular failure in children include failure to thrive and periorbital edema.
A)True B)False
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Chapter 31: Structure and Function of the Pulmonary System
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38 Flashcards
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Sample Questions
Q1) The bronchial circulation is part of the systemic circulation and does not participate in gas exchange.
A)True
B)False
Q2) If a patient's hemoglobin concentration (Hb)is 14 g/100 ml and his arterial oxygen saturation (SaO<sub>2</sub>)is 98%,what would be his arterial oxygen content? Remember that 1.34 ml O<sub>2</sub> is the maximum amount of oxygen that can be transported per gram of hemoglobin.(Hint: O<sub>2</sub> content 1 [1.34 × Hb] SaO<sub>2</sub>. )
A) 13.72 ml O<sub>2</sub> per 100 ml blood
B) 18.38 ml O<sub>2</sub> per 100 ml blood
C) 18.76 ml O<sub>2</sub> per 100 ml blood
D) 19.30 ml O<sub>2</sub> per 100 ml blood
Q3) What does decreased compliance within the lung mean?
A) The diaphragm is stiff.
B) The lungs inflate easily.
C) The lungs are stiff.
D) The lungs are unable to diffuse oxygen.
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Chapter 32: Alterations of Pulmonary Function
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63 Flashcards
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Sample Questions
Q1) Aspiration
A)The passage of fluid and solid particles into the lung
B)Inflammatory obstruction of small airways
C)Excessive amount of connective tissue in the lung
D)Alveolar collapse
E)Abnormal dilation of the bronchi
Q2) Clinical manifestations of decreased exercise tolerance,wheezing,shortness of breath,and productive cough are indicative of which pulmonary disease?
A) Chronic bronchitis
B) Emphysema
C) Pneumonia
D) Asthma
Q3) Kussmaul respirations may be characterized as:
A) alternating periods of deep and shallow breathing.
B) a common breathing pattern in pulmonary fibrosis.
C) a common breathing pattern in chronic obstructive pulmonary disease.
D) a slightly increased ventilatory rate;large,tidal volumes;and no expiratory pause.
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34
Chapter 33: Structure and Function of the Renal and Urologic Systems
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Sample Questions
Q1) Which tubule is the only surface inside the nephron where cells are covered with microvilli to increase the reabsorptive surface area?
A) Proximal tubules
B) Distal tubules
C) Ascending loop of Henle
D) Descending loop of Henle
Q2) How high does the serum glucose have to be for the threshold for glucose to be achieved?
A) 126 mg/dl
B) 150 mg/dl
C) 180 mg/dl
D) 200 mg/dl
Q3) Renal blood vessels are innervated by the parasympathetic nervous system.
A)True
B)False
Q4) What stimulates the renal hydroxylation step to produce Vitamin D?
A) Erythropoietin
B) Thyroid hormone
C) Calcitonin
D) Parathyroid hormone
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Chapter 34: Alterations of Renal and Urinary Tract Function
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Sample Questions
Q1) A patient has hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day with albumin as the major protein.These data suggest the presence of which disorder?
A) Cystitis
B) Chronic pyelonephritis
C) Renal carcinoma
D) Nephrotic syndrome
E) Glomerulonephritis
Q2) Impairment to the bladder interferes with normal bladder contraction causing residual urine and ascending infection
A)Kidney stones
B)Vesicoureteral reflux
C)Pregnancy
D)Neurogenic bladder
E)Female sexual trauma
Q3) Complications of urinary obstruction include infection.
A)True
B)False
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Chapter 35: Alterations of Renal and Urinary Tract Function in Children
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Sample Questions
Q1) The total electrolyte concentration in extracellular fluids is greater in the newborn than in the adult.
A)True
B)False
Q2) Epispadias may only be found in males.
A)True
B)False
Q3) Which cells of the inflammatory process are NOT found in acute poststreptococcal glomerulonephritis (PSGN)?
A) Immunoglobulin G (IgG)
B) Immunoglobulin A (IgA)
C) Complement C<sub>3</sub>
D) Immunoglobulin E (IgE)
Q4) Urine formation and excretion do not begin until the eighth month of gestation.
A)True
B)False
Q5) Approximately one third of individuals with horseshoe kidneys are asymptomatic.
A)True
B)False
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Chapter 36: Structure and Function of the Digestive System
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Sample Questions
Q1) Decreases gastric motility and constricts pyloric sphincter
A)Peptide YY
B)Secretin
C)Cholecystokinin
D)Enteroglucagon
E)Pancreatic polypeptide
Q2) Why are water and electrolytes transported in both directions through tight junctions and intercellular spaces rather than across cell membranes?
A) Because the intercellular hydrostatic pressure is inadequate to push the water and electrolytes across the cell membranes
B) Because a balance of cations and ions among the electrolytes on each side of the cell membranes cannot be maintained
C) Because the epithelial cell membranes are formed of lipids that are hydrophobic and,thus,repel water
D) Because receptors on those cell membranes are occupied with a diffusion of amino acids and monosaccharides
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Chapter 37: Alterations of Digestive Function
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60 Verified Questions
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Sample Questions
Q1) What regulates eating behavior,energy metabolism,and body fat mass?
A) Anterior pituitary
B) Hypothalamus
C) Posterior pituitary
D) Parietal lobe
Q2) Which characteristic is consistent with dumping syndrome?
A) Usually responds well to dietary management
B) Occurs 1 to 2 hours after eating,most commonly
C) Is seen following intestinal surgery
D) Can result in alkaline reflux gastritis
Q3) Colonic epithelial immunoglobulin G (IgG)antibodies have been identified in sera of individuals with this disorder.
A)Ulcerative colitis
B)Crohn disease
Q4) Which hormone and/or peptide stimulates eating?
A) Agouti-related protein (AGRP)
B) Alpha-melanocyte stimulating hormone (-MSH)
C) Cocaine-and amphetamine-regulated transcript (CART)
D) Peptide YY (PYY)
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Chapter 38: Alterations of Digestive Function in Children
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Sample Questions
Q1) Increased gastrin secretion by the mother in the last trimester of pregnancy may cause:
A) pyloric stenosis.
B) meconium ileus.
C) esophageal atresia.
D) galactosemia.
Q2) Increased bilirubin production,impaired hepatic uptake and excretion of bilirubin,and reabsorption of bilirubin in the small intestine can each lead to:
A) pathologic jaundice of the newborn.
B) physiologic jaundice of the newborn.
C) hepatitis A.
D) infantile cirrhosis.
Q3) Because lactose intolerance is presumed in children with gluten sensitive enteropathy (celiac sprue),lactose is excluded from their diet.
A)True
B)False
Q4) The primary cause of intrahepatic portal hypertension in children is cirrhosis.
A)True
B)False
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Chapter 39: Structure and Function of the Musculoskeletal System
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Sample Questions
Q1) Which bone cells are responsive to parathyroid hormone,produce osteocalcin when stimulated by 1,25-dihydroxyvitamin D,and synthesize osteoid?
A) Osteoclasts
B) Osteocytes
C) Fibrocytes
D) Osteoblasts
Q2) The balance between receptor activator of nuclear factor <sub>K</sub>B-ligand (RANKL)and osteoprotegerin (OPG)determine overall osteoclast formation.
A)True
B)False
Q3) The outer layer of the periosteum contains blood vessels and nerves,some of which penetrate to the inner structures of the bone by way of:
A) Volkmann canals.
B) canaliculi.
C) Sharpey canals.
D) trabeculae.
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Chapter 40: Alterations of Musculoskeletal Function
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Sample Questions
Q1) Rhabdomyolysis
A)Caused by sedatives and narcotics,particularly street heroin
B)Caused by viruses,bacteria,and parasites
C)Exercise intolerance with normal production of lactic acid
D)Impairs the breakdown of glycogen and production of lactic acid
E)Autoimmune disease
Q2) Myoadenylate deaminase deficiency
A)Caused by sedatives and narcotics,particularly street heroin
B)Caused by viruses,bacteria,and parasites
C)Exercise intolerance with normal production of lactic acid
D)Impairs the breakdown of glycogen and production of lactic acid
E)Autoimmune disease
Q3) In considering osteomyelitis,what is sequestrum?
A) An area of devascularized and devitalized bone
B) An enzyme that phagocytizes necrotic bone
C) A subperiosteal abscess
D) A layer of new bone surrounding the infected bone
Q4) Compartment syndromes are a localized form of crush syndromes.
A)True
B)False
Page 42
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Chapter 41: Alterations of Musculoskeletal Function in Children
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Sample Questions
Q1) Onset at approximately age 3 with rapid progression and frequent mental retardation
A)Duchenne muscular dystrophy
B)Facioscapulohumeral muscular dystrophy
C)Scapuloperoneal muscular dystrophy
D)Myotonic dystrophy
E)Becker muscular dystrophy
Q2) The total mass of muscle in the body can be estimated from which serum laboratory test value?
A) Albumin
B) Blood urea nitrogen
C) Creatinine
D) Creatine
Q3) The normal lordotic curve of the lower spine begins to develop when the infant begins sitting.
A)True
B)False
Q4) Staphylococcus aureus may cause osteomyelitis in newborns and older children.
A)True
B)False
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Chapter 42: Structure, Function, and Disorders of the Integument
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Sample Questions
Q1) Kaposi sarcoma is a vascular malignancy that occurs only in people with AIDS.
A)True
B)False
Q2) Tinea corporis (ringworm)is a _____ infection of the skin.
A) nematode
B) fungal
C) viral
D) bacterial
Q3) In latex allergies,which immunoglobulin is associated with an immediate reaction?
A) Immunoglobulin A
B) Immunoglobulin E
C) Immunoglobulin G
D) Immunoglobulin M
Q4) What is the first change in the skin to indicate a pressure ulcer?
A) Blanchable erythema of intact skin
B) Nonblanchable erythema of intact skin
C) Blister at the site of pressure
D) Reddish purple discoloration
44
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Chapter 43: Alterations of the Integument in Children
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Sample Questions
Q1) Rubeola and rubella have many of the same clinical manifestations.Which clinical manifestation is present in rubeola,but not rubella?
A) Conjunctivitis
B) Enlarged lymph nodes
C) Presence of a cough
D) Runny nose
Q2) Which contagious disease creates a primary skin lesion that is a pinpointed macule,papule,or wheal with hemorrhagic puncture site?
A) Pediculosis
B) Tinea capitis
C) Scabies
D) Rubeola
Q3) Which skin disorder is characterized by a vesicular eruption after prolonged exposure to perspiration,with subsequent obstruction of the eccrine ducts?
A) Scabies
B) Tinea corporis
C) Pediculosis
D) Miliaria
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Chapter 44: Shock, Multiple Organ Dysfunction Syndrome, and Burns in
Adults
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Sample Questions
Q1) What parameter of stroke volume is affected by cardiogenic shock?
A) Preload is increased.
B) Preload is decreased.
C) Contractility is increased.
D) Afterload is increased.
E) Afterload is decreased.
Q2) In multiple organ dysfunction syndrome (MOSD),the gut hypothesis attempts to explain:
A) paralytic ileus.
B) translocation of bacteria.
C) maldistribution of blood flow.
D) massive diarrhea accompanying septic shock.
Q3) Burn injury induces almost immediate:
A) hypervolemiA.
B) hypermetabolism.
C) hyponatremia.
D) hypotension.
Q4) Second-degree burns can be full-thickness burns.
A)True
B)False
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Chapter 45: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children
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Sample Questions
Q1) Reperfusion injury is stimulated by the generation of highly reactive free oxygen radicals and superoxide.
A)True
B)False
Q2) When circulatory collapse prevents using the intravenous route for burn fluid resuscitation in children,fluids may be given via _____ cannulation.
A) interdermal
B) intraarterial
C) intraosseous
D) gastrointestinal
Q3) To determine a child's response to fluid therapy for shock,the nurse should monitor:
A) hematocrit and hemoglobin levels.
B) urine output and specific gravity.
C) blood pressure and pulse.
D) arterial blood gases and heart rate.
Q4) Hypotension is a late sign of shock in children.
A)True
B)False
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Chapter 46: Alterations of Leukocyte, Lymphoid, and Hemostatic Function
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Sample Questions
Q1) In disseminated intravascular coagulation (DIC),what are indications of microvascular thrombosis?
A) Reduced amplitude in peripheral pulses
B) Symmetric cyanosis of fingers and toes
C) Patient reports of numbness and tingling in fingers and toes
D) Pallor and edema of fingers and toes bilaterally
Q2) In infectious mononucleosis (IM),what does the Monospot test detect?
A) Immunoglobulin E (IgE)
B) Immunoglobulin M (IgM)
C) Immunoglobulin G (IgG)
D) Immunoglobulin A (IgA)
Q3) The two major forms of leukemia,acute and chronic,are classified by a predominant cell type and the rate at which the affected person develops clinical symptoms.
A)True
B)False
Q4) In the leukemias,a single progenitor cell undergoes malignant transformation.
A)True
B)False
Page 48
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Chapter 47: Alterations of Pulmonary Function in Children
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Sample Questions
Q1) Chest wall compliance in infants is __________ in adults.
A) lower than B) higher than C) the same as D) variable,unlike
Q2) Signs of acute respiratory failure remain the same regardless of etiology.
A)True
B)False
Q3) Which description is indicative of acute respiratory distress syndrome (ARDS)?
A) An obstructive airway disease characterized by reversible airflow obstruction,bronchial hyperreactivity,and inflammation.
B) A pulmonary disease characterized by severe hypoxemia,decreased pulmonary compliance,and diffuse densities on chest x-ray.
C) A pulmonary disorder involving an abnormal expression of a protein producing viscous mucus that line the airways,pancreas,sweat ducts,and vas deferens.
D) A pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency.
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