Health Assessment and Pathophysiology
Mock Exam
Course Introduction
Health Assessment and Pathophysiology is a foundational course that introduces students to the systematic approach of assessing the health status of individuals across the lifespan, while integrating principles of pathophysiology. Students will develop skills in history-taking, physical examination, and the use of diagnostic tools to identify normal and abnormal findings. Emphasis is placed on understanding the physiological mechanisms underlying disease processes, enabling students to link symptoms and clinical signs with alterations in body systems. Through case studies and practical activities, learners will enhance their clinical reasoning skills required for identifying and interpreting deviations from health, thus preparing them for advanced practice and effective patient care.
Recommended Textbook
Pathophysiology 6th Edition by Jacquelyn L. Banasik
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Chapter 1: Introduction to Pathophysiology
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Sample Questions
Q1) In general,with aging,organ size and function
A) increase.
B) decrease.
C) remain the same.
D) are unknown.
Answer: B
Q2) The nurse is swabbing a patient's throat to test for streptococcal pharyngitis.The nurse must understand that tests such as this differ in the probability that they will be positive for a condition when applied to a person with the condition; this probability is termed sensitivity.
A)True
B)False
Answer: True
Q3) When the cause is unknown,a condition is said to be idiopathic
A)True
B)False
Answer: True
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Page 3
Chapter 2: Homeostasis, Allostasis, and Adaptive
Responses to Stressors
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Sample Questions
Q1) Events which occur during the alarm stage of the stress response include secretion of (Select all that apply.)
A) catecholamines.
B) ACTH.
C) glucocorticoids.
D) immune cytokines.
E) TSH.
Answer: A,B,C,D
Q2) Which is not normally secreted in response to stress?
A) Norepinephrine
B) Cortisol
C) Epinephrine
D) Insulin
Answer: D
Q3) The effect of stress on the immune system
A) is unknown.
B) has been demonstrated to be non-existent in studies.
C) most often involves enhancement of the immune system.
D) may involve enhancement or impairment the immune system.
Answer: D
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Chapter 3: Cell Structure and Function
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Sample Questions
Q1) Some individuals inherit a gene that results in dangerously high blood cholesterol caused by impaired endocytosis of low-density lipoproteins (LDLs).
A)True
B)False
Answer: True
Q2) Ribosomes are very important organelles within the cell that have the function of
A) detoxifying substances.
B) synthesizing proteins.
C) converting energy to forms that can be used.
D) coding for protein synthesis.
Answer: B
Q3) Phospholipids spontaneously form lipid bilayers,because they are A) polar.
B) charged.
C) insoluble.
D) amphipathic.
Answer: D
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Chapter 4: Cell Injury, Aging, and Death
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Sample Questions
Q1) The primary effect of aging on all body systems is
A) decreased functional reserve.
B) diseased function.
C) programmed senescence.
D) senility.
Q2) All these cellular responses are potentially reversible except A) necrosis.
B) metaplasia.
C) atrophy.
D) hyperplasia.
Q3) Necrotic death of brain tissue usually produces _____ necrosis.
A) coagulative
B) caseous
C) liquefactive
D) fat
Q4) Apoptosis is a process that results in cellular A) atrophy.
B) death.
C) proliferation.
D) mutation.
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Chapter 5: Genome Structure, Regulation, and Tissue
Differentiation
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Sample Questions
Q1) Characteristics of cellular differentiation include which of the following? (Select all that apply.)
A) Specialization for different functions
B) Enhanced ability to replicate
C) Influenced by memory of developmental events
D) Dependent on cell-to-cell coordination
E) Generally not reversible
Q2) The primary role of genes is to
A) code for reproduction.
B) direct the synthesis of proteins.
C) determine differentiation.
D) determine cellular apoptosis.
Q3) Characteristics of smooth muscle include
A) being under voluntary control.
B) having striations.
C) contraction being short-lived.
D) being found in blood vessels.
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Page 7
Chapter 6: Genetic and Developmental Disorders
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Sample Questions
Q1) The risk period for maternal rubella infection leading to congenital problems begins A) prior to conception.
B) during the last trimester.
C) at birth.
D) all through pregnancy.
Q2) Information parents should be given about the consequences of PKU includes
A) high dietary phenylalanine may help induce enzyme production.
B) PKU is commonly associated with other congenital anomalies.
C) failure to avoid phenylalanine results in progressive mental retardation.
D) mental retardation is inevitable.
Q3) A point mutation
A) results from the addition or loss of one or more bases.
B) is because of the translocation of a chromosomal segment.
C) always produces significant dysfunction.
D) involves the substitution of a single base pair.
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8
Chapter 7: Neoplasia
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Sample Questions
Q1) Cancer grading is based on
A) tumor size.
B) local invasion.
C) cell differentiation.
D) metastasis.
Q2) Familial retinoblastoma involves the transmission of what from parent to offspring?
A) Mutant tumor-suppressor gene
B) Cancer-causing virus
C) Oncogene
D) Extra chromosome
Q3) The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of
A) tumor necrosis factor.
B) angiogenesis.
C) loss of ATP production.
D) pain medications.
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Chapter 8: Infectious Processes
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Sample Questions
Q1) Drug resistance of microbes occurs secondary to
A) patient allergy to a drug.
B) mutation of the microbe.
C) enhance pathogenicity of the microbe.
D) using high doses of drugs.
Q2) Dietary zinc is an important defense against infection,because it maintains (Select all that apply.)
A) natural killer cell function.
B) lymphocyte activity.
C) antioxidant activity.
D) neutrophil activity.
E) complement activity.
Q3) A characteristic of some bacteria
A) is intracellular parasite.
B) is composed of RNA or DNA.
C) contains cell wall endotoxin.
D) cannot replicate extracellularly.
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10
Chapter 9: Inflammation and Immunity
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Sample Questions
Q1) Functions of B cells include
A) synthesizing antibodies.
B) secreting cytokines.
C) killing antigen-presenting cells.
D) stimulating B cells.
E) killing virally infected cells.
Q2) The membrane attack complex formed by complement is similar in function to A) CD4 .
B) granzymes.
C) CD8.
D) perforin.
Q3) The primary function of kinins is
A) phagocytosis of antigens.
B) production of antibodies.
C) to limit immune reactions.
D) vasodilation to enhance inflammation.
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Chapter 10: Alterations in Immune Function
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Sample Questions
Q1) Seasonal allergic rhinitis is most involved in type II hypersensitivity reactions.
A)True
B)False
Q2) The principle Ig mediator of type I hypersensitivity reactions is
A) IgA.
B) IgG.
C) IgM.
D) IgE.
Q3) Secondary immune deficiency problems may be caused by (Select all that apply.)
A) surgery.
B) high blood sugar.
C) corticosteroids.
D) genetic disorders.
E) low protein level.
Q4) A primary effector cell of the type I hypersensitivity response is A) monocytes.
B) mast cells.
C) neutrophils.
D) cytotoxic cells.
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Chapter 11: Malignant Disorders of White Blood Cells
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Sample Questions
Q1) A 5-year-old patient's parents report loss of appetite and fatigue in their child.The parents also state that the child refuses to walk as a result of pain.The child's most likely diagnosis is
A) ALL (acute lymphoid leukemia)
B) CLL (chronic lymphoid leukemia)
C) AML (acute myeloid leukemia)
D) CML (chronic myeloid leukemia)
Q2) The patient is a 12-year-old boy with acute lymphoblastic leukemia (ALL).Manifestations of the patient's leukemia prior to treatment may include (Select all that apply.)
A) anemia.
B) leukocytosis.
C) leukopenia.
D) thrombocytopenia.
E) anuria.
Q3) In general,the best prognosis for long-term disease-free survival occurs with
A) ALL (acute lymphoid leukemia).
B) CLL (chronic lymphoid leukemia).
C) AML (acute myeloid leukemia).
D) CML (chronic myeloid leukemia).
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Chapter 12: HIV Disease and Aids
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Sample Questions
Q1) As of 2014,_____ individuals worldwide have been infected with HIV infection.
A) 100,000
B) 1 million
C) slightly less than 16 million
D) nearly 35 million
Q2) Which drugs are used for the management of HIV? (Select all that apply.)
A) Nucleoside reverse transcriptase inhibitors
B) DNA polymerase inhibitors
C) Protease inhibitors
D) Nonnucleoside reverse transcriptase inhibitors
E) CD4 analogs
Q3) Which statement best describes the etiologic development and transmission of AIDS?
A) AIDS is caused by a retrovirus and transmitted through body fluids.
B) The mechanism of AIDS transmission is unknown; therefore, AIDS is considered to be highly contagious.
C) AIDS is an autoimmune disease triggered by a homosexual lifestyle.
D) AIDS is caused by a virus that can be transmitted only by sexual contact.
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14
Chapter 13: Alterations in Oxygen Transport
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Sample Questions
Q1) The primary source of erythropoietin is provided by the A) bone marrow.
B) kidney.
C) lung.
D) liver.
Q2) Pernicious anemia is caused by a lack of A) iron.
B) intrinsic factor.
C) folate.
D) erythropoietin.
Q3) The strength of the bond between oxygen and hemoglobin is known as the A) Bohr effect.
B) oxygen-hemoglobin affinity.
C) dissociation curve.
D) hemoglobin synthesis.
Q4) The cause of the most common form of anemia is A) acute bleeding.
B) iron deficiency.
C) protein malnutrition.
D) chronic disease.
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Chapter 14: Alterations in Homeostasis and Blood Coagulation
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Sample Questions
Q1) A patient is diagnosed with a tortuous blood vessel of the right hand that bleeds spontaneously.This patient presents with A) petechiae.
B) purpura.
C) telangiectasia.
D) thrombocytosis.
Q2) The megakaryocyte is a precursor to A) factor IX.
B) white blood cells.
C) red blood cells.
D) platelets.
Q3) The conversion of plasminogen to plasmin results in A) clot retraction.
B) fibrinolysis.
C) platelet aggregation.
D) activation of thrombin.
Q4) The liver is responsible for the synthesis of coagulation factors,with the exception of part of VIII.
A)True B)False
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Chapter 15: Alterations in Blood Flow
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Sample Questions
Q1) The relationship of blood flow (Q),resistance (R),and pressure (P)in a vessel can be expressed by which equation?
A) Q = P/R
B) Q = R/P
C) R = PQ
D) P = Q/R
Q2) When a patient is struck in the eye by a baseball,the result is redness and swelling.This increase in blood flow to a localized area is called A) autoregulation.
B) edema.
C) hyperemia.
D) hypoxia.
Q3) Clinical manifestations of chronic arterial obstruction include A) edema.
B) intermittent claudication.
C) decreased pressure proximal to the obstruction.
D) distal hyperemia.
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Chapter 16: Alterations in Blood Pressure
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Sample Questions
Q1) Which finding is indicative of orthostatic hypotension in a person with a supine blood pressure (BP)of 110/70 and a heart rate (HR)of 100?
A) Sitting BP 88/60, HR 118
B) Sitting BP 108/68, HR 102
C) Sitting BP 110/78, HR 98
D) Sitting BP 120/80, HR 100
Q2) Orthostatic hypotension is a risk factor for (Select all that apply.)
A) stroke.
B) cognitive impairment.
C) death.
D) myocardial infarction.
E) urinary retention.
Q3) Angiotensin-converting enzyme (ACE)inhibitors block the A) release of rennin.
B) conversion of angiotensin I to angiotensin II.
C) conversion of angiotensinogen to angiotensin I.
D) effect of aldosterone on the kidney.
Q4) The most commonly recognized outcome of hypertension is pulmonary disease.
A)True
B)False
Page 18
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Chapter 17: Cardiac Function
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Sample Questions
Q1) Echocardiograms are used to help diagnose (Select all that apply.)
A) heart enlargement.
B) valvular disorders.
C) cardiac tumors.
D) left ventricular motion abnormalities.
E) collection of fluid in lung bases.
Q2) An increase in intracellular calcium ion results in myocardial contraction,because calcium
A) activates membrane calcium pumps.
B) binds troponin, causing actin-binding sites to be exposed.
C) increases affinity of myosin for actin cross-bridge sites.
D) promotes ATP synthesis.
Q3) While caring for a geriatric patient,the changes in the heart that may be expected include
A) increased oxygen consumption.
B) increased coronary artery blood flow.
C) decreased response to an elevated heart rate.
D) cardiomyopathy.
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19
Chapter 18: Alterations in Cardiac Function
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Sample Questions
Q1) Inflammatory disorders that may alter endothelial cell function include (Select all that apply.)
A) multiple sclerosis.
B) lupus erythematosus.
C) Kawasaki syndrome.
D) rheumatoid arthritis.
E) polyarteritis nodosa.
Q2) Rheumatic heart disease is most often a consequence of A) chronic intravenous drug abuse.
B) viral infection with herpesvirus.
C) b-hemolytic streptococcal infection.
D) cardiomyopathy.
Q3) Primary treatment for myocardial infarction (MI)is directed at
A) protecting the heart from further ischemia.
B) decreasing myocardial oxygen demands.
C) reducing heart rate and blood pressure.
D) activating the parasympathetic system.
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Chapter 19: Heart Failure and Dysrhythmias: Common
Sequelae of Cardiac Diseases
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Q1) A patient's ECG lacks recognizable waveforms and is deemed to be in sinus arrest.The patient's sinus arrest may be a result of (Select all that apply.)
A) MI.
B) electrical shock.
C) electrolyte disturbance.
D) acidosis.
E) alkalosis.
Q2) An abnormally wide (more than 0.10 second)QRS complex is characteristic of A) paroxysmal atrial tachycardia.
B) supraventricular tachycardia.
C) junctional escape rhythm.
D) premature ventricular complexes.
Q3) A patient with pure left-sided heart failure is likely to exhibit A) jugular vein distention.
B) pulmonary congestion with dyspnea.
C) peripheral edema.
D) hepatomegaly.
Q4) Chronic elevation of myocardial wall tension results in atrophy.
A)True
B)False
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Chapter 20: Shock
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Sample Questions
Q1) Which causes of shock are considered to be obstructive? (Select all that apply.)
A) Ventricular rupture
B) Pulmonary embolus
C) Cardiac tamponade
D) Tension pneumothorax
E) Acute hemorrhage
Q2) Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.
A)True
B)False
Q3) Sepsis has been recently redefined as
A) a systemic infection with viable organisms in the bloodstream.
B) a systemic inflammatory response to ischemia.
C) a systemic inflammatory response to infection.
D) severe hypotension in an infected patient.
Q4) Tachycardia is an early sign of low cardiac output that occurs because of A) tissue hypoxia.
B) anxiety.
C) baroreceptor activity.
D) acidosis.
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Chapter 21: Respiratory Function and Alterations in Gas Exchange
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Sample Questions
Q1) The peripheral chemoreceptors
A) are located in the medulla oblongata.
B) lead to hypoventilation when stimulated.
C) respond to the arterial oxygen level.
D) are unresponsive to pH and CO levels.
Q2) An increase in filtration of fluid from the pulmonary capillaries into the interstitium occurs with ________ pressure.
A) increased capillary colloid
B) increased capillary hydrostatic
C) decreased capillary hydrostatic
D) decreased interstitial colloid
Q3) Right-sided heart failure secondary to pulmonary hypertension is also called
A) diastolic heart failure.
B) high output failure.
C) coronary disease.
D) cor pulmonale.
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Chapter 22: Obstructive Pulmonary Disorders
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Sample Questions
Q1) Emphysema results from destruction of alveolar walls and capillaries,which is because of
A) release of proteolytic enzymes from immune cells.
B) air trapping with resultant excessive alveolar pressure.
C) excessive a -antitrypsin.
D) autoantibodies against pulmonary basement membrane.
Q2) Which is true about epiglottitis? (Select all that apply.)
A) Is usually caused by H. influenzae type B
B) Can be caused by bacterial infection
C) Usually occurs in children
D) Is characterized by pain with swallowing
E) Generally resolves without intervention
Q3) Cystic fibrosis is associated with A) asthma.
B) chronic bronchitis.
C) bronchiectasis.
D) emphysema.
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Chapter 23: Restrictive Pulmonary Disorders
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Sample Questions
Q1) Restrictive respiratory disorders include (Select all that apply.)
A) pneumothorax.
B) emphysema.
C) chronic asthma.
D) type B COPD.
E) ARDS.
Q2) Neuromuscular disorders impair lung function primarily because of A) inflammatory events in the lung.
B) secondary pneumonia.
C) weak muscles of respiration.
D) inactivity secondary to the disorder.
Q3) The most definitive diagnostic method for active tuberculosis is acquired via A) sputum culture.
B) Mantoux skin test.
C) chest x-ray.
D) blood culture.
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Page 25
Chapter 24: Fluid and Electrolyte Homeostasis and Imbalances
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Sample Questions
Q1) Decreased neuromuscular excitability is often the result of A) hypercalcemia and hypermagnesemia.
B) hypomagnesemia and hyperkalemia.
C) hypocalcemia and hypokalemia.
D) hypernatremia and hypomagnesemia.
Q2) The person at highest risk for developing hypernatremia is a person who A) self-administers a daily tap water enema to manage a partial bowel obstruction.
B) receives tube feedings because he or she is comatose after a stroke.
C) has ectopic production of ADH from small cell carcinoma of the lung.
D) is receiving IV 0.9% NaCl at a fast rate.
Q3) The process responsible for distribution of fluid between the interstitial and intracellular compartments is A) filtration.
B) osmosis.
C) active transport.
D) diffusion.
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Chapter 25: Acid-Base Homeostasis and Imbalances
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Q1) Two primary acid-base disorders that are present independently are referred to as A) metabolic acidosis.
B) metabolic alkalosis.
C) respiratory alkalosis.
D) mixed acid-base imbalance.
Q2) Respiratory acidosis is associated with A) increased carbonic acid.
B) hypokalemia.
C) increased neuromuscular excitability.
D) increased pH.
Q3) The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who
A) is in the diuretic phase of acute renal failure.
B) has had hypokalemia for over a week.
C) has had diarrhea for over a week.
D) has newly diagnosed Cushing syndrome.
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Chapter 26: Renal Function
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Q1) Factors that increase the glomerular filtration rate include
A) fluid volume excess.
B) increased hydrostatic pressure in the Bowman's capsule.
C) high oncotic pressure in glomerular capillary blood.
D) obstruction in the renal tubules.
Q2) The main driving force for glomerular filtration is
A) oncotic pressure in the Bowman's capsule.
B) hydrostatic pressure in glomerular capillaries.
C) permeability of the glomerular membrane.
D) solute content of the blood in the glomerular capillaries.
Q3) The glucose transporter in the proximal tubule
A) has no transport maximum.
B) does not depend on sodium reabsorption.
C) is ATP-dependent.
D) may be saturated at high filtered glucose loads.
Q4) Serum creatinine may be increased by
A) carbohydrate intake.
B) fat intake.
C) muscle breakdown.
D) fluid intake.
Page 28
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Chapter 27: Intrarenal Disorders
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Q1) The manifestations of acute pyelonephritis (Select all that apply.)
A) are mild and insidious.
B) can result in dehydration.
C) often include symptoms of lower urinary tract infection.
D) include fever, chills, and costovertebral angle tenderness.
E) may include urosepsis.
Q2) The organism most commonly associated with acute pyelonephritis is A) Streptococcus.
B) Escherichia coli.
C) Klebsiella.
D) Enterobacter.
Q3) Nephrotic syndrome involves loss of large amounts of ________ in the urine.
A) blood
B) sodium
C) glucose
D) protein
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Chapter 28: Acute Kidney Injury and Chronic Kidney Disease
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Q1) Appropriate management of end-stage renal disease includes A) potassium supplementation.
B) a high-protein diet.
C) erythropoietin administration.
D) a high-phosphate diet.
Q2) One of the most frequent causes of chronic kidney disease is A) hypertension.
B) glomerulonephritis.
C) chronic pyelonephritis.
D) polycystic kidney disease.
Q3) The effect on the renal tubules during the postoliguric phase of acute tubular necrosis involves
A) reconstruction of the basement membrane.
B) blocking the tubule lumens by dead cells.
C) making the glomeruli patent again.
D) regeneration of the renal tubular epithelium.
Q4) Hypotension is both a cause of chronic kidney disease and a result of chronic kidney disease.
A)True B)False
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Chapter 29: Disorders of the Lower Urinary Tract
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Q1) Pelvic floor muscle training is appropriate for A) overflow incontinence.
B) reflux prevention.
C) urge incontinence.
D) functional incontinence.
Q2) A person is unaware that his bladder is full of urine,but complains that he is leaking urine almost constantly.The most accurate term for this type of incontinence is A) overflow.
B) stress.
C) urge.
D) mixed.
Q3) A patient has ureteral colic.The manifestation that requires immediate notification of the physician is A) severe flank pain.
B) vomiting.
C) pink-tinged urine.
D) chills and fever.
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31
Chapter 30: Male Genital and Reproductive Function
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Q1) An important function of the scrotum is to
A) regulate the temperature of the testes.
B) provide support to the prostate gland.
C) regulate blood supply to the penis.
D) supply antibacterial secretions.
Q2) The primary function of the epididymis is to
A) house developing sperm.
B) produce seminal fluid.
C) produce sperm.
D) secrete male hormones.
Q3) The parasympathetic nervous system mediates the process of ejaculation.
A)True
B)False
Q4) The male penis is innervated by the ________ nerve.
A) sciatic
B) sacral
C) pudendal
D) caudal
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Chapter 31: Alterations in Male Genital and Reproductive Function
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Q1) The majority of penile cancer cases are classified as basal cell carcinoma. A)True
B)False
Q2) Sudden,severe testicular pain is indicative of A) prostatitis.
B) testicular cancer.
C) testicular torsion.
D) epididymitis.
Q3) A progressive decrease in the force of the urinary stream,dribbling of urine,and difficulty initiating the urinary stream are characteristic of A) prostatitis.
B) urinary calculi.
C) bladder carcinoma.
D) prostatic enlargement.
Q4) A patient diagnosed with a micropenis must be evaluated for A) endocrine disorders.
B) vascular abnormalities. C) female sex assignment.
D) epispadias.
33
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Chapter 32: Female Genital and Reproductive Function
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Q1) Ovulation occurs approximately how many days prior to the first day of menstruation?
A) 7
B) 10
C) 14
D) 21
Q2) From the time of fertilization until the end of the eighth week,the developing organism is referred to as the A) zygote.
B) fetus.
C) infant.
D) embryo.
Q3) The heartbeat becomes audible through a stethoscope during which phase of fetal development?
A) First trimester
B) Second trimester
C) Third trimester
D) Parturition
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34
Chapter 33: Alterations in Female Genital and Reproductive Function
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Q1) Uterine prolapse is caused by a relaxation of the A) cardinal ligaments.
B) abdominal organs.
C) cervix.
D) vaginal musculature.
Q2) The expected treatment of a pregnant woman with hyperemesis gravidarum is
A) immediate cesarean section.
B) seizure prophylaxis.
C) surgical removal of uterine contents.
D) intravenous therapy.
Q3) It is true that fibrocystic breast disease
A) commonly progresses to breast cancer.
B) may be exacerbated by methylxanthines.
C) is characterized by painless breast lumps.
D) is a contraindication for progesterone birth control pills.
Q4) Excessive vomiting in pregnant women is known as A) placenta previa.
B) hyperemesis gravidarum.
C) abruptio placentae.
D) spontaneous abortion.
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Chapter 34: Sexually Transmitted Infections
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Sample Questions
Q1) Herpes lesions are fluid-filled vesicles that appear __________days after infection.
A) 1 to 2
B) 3 to 7
C) 7 to 10
D) 10 to 14
Q2) A painless ulceration called a chancre is a lesion associated with infection by
A) human papillomavirus.
B) N. gonorrhoeae.
C) C. trachomatis.
D) T. pallidum.
Q3) A 23-year-old male presents with urethritis,dysuria,and purulent urethral discharge.The suspected diagnosis would be A) gonorrhea.
B) urinary tract infection.
C) Chlamydia.
D) syphilis.
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Chapter 35: Gastrointestinal Function
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Sample Questions
Q1) Which enzyme assists with protein digestion?
A) Amylase
B) Chymotrypsin
C) Lactase
D) Lipase
Q2) Which is associated with contraction of the gallbladder?
A) Cholecystokinin
B) Morphine
C) Norepinephrine
D) Gastrin
Q3) Which statement regarding pepsin is true?
A) It is secreted by parietal cells in gastric pits.
B) It is secreted as an inactive proenzyme.
C) It accomplishes most of the digestion of dietary protein.
D) It is permanently denatured by a pH less than 4.0.
Q4) The primary stimulus for pancreatic secretion is
A) gastrin.
B) histamine.
C) acetylcholine.
D) secretin.
Page 37
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Chapter 36: Gastrointestinal Disorders
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Sample Questions
Q1) The most common cause of mechanical bowel obstruction is A) volvulus.
B) intussusception.
C) adhesions.
D) fecal impaction.
Q2) Fecal leukocyte screening would be indicated in a patient with suspected A) lactose intolerance.
B) enterocolitis.
C) laxative abuse.
D) giardiasis.
Q3) Which symptom suggests the presence of a hiatal hernia?
A) Nausea
B) Heartburn
C) Diarrhea
D) Abdominal cramps
Q4) Premature infants are at greater risk for developing
A) necrotizing enterocolitis.
B) pseudomembranous colitis.
C) appendicitis.
D) diverticular disease.
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Chapter 37: Alterations in Function of the Gallbladder and Exocrine Pancreas
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Q1) The finding of hypotension,rigid abdomen,and absent bowel sounds in a patient with pancreatitis
A) is an expected finding and requires no specific intervention.
B) indicates peritonitis with substantial risk for sepsis and shock.
C) requires immediate surgical intervention.
D) is an unusual finding in pancreatitis and indicates misdiagnosis.
Q2) A patient with pancreatitis may experience muscle cramps secondary to A) alkalosis.
B) hyperglycemia.
C) hypocalcemia.
D) hypermagnesemia.
Q3) The pain associated with chronic pancreatitis is generally described as ________ in nature.
A) sharp and constant
B) steady and boring
C) intermittent and burning
D) intermittent and stabbing
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Page 39
Chapter 38: Liver Diseases
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Q1) Hepatitis with the presence of autoantibodies and positive antinuclear antibodies (ANA)is
A) hepatitis D.
B) autoimmune hepatitis.
C) hepatitis A.
D) hepatitis B.
Q2) The most common causes of prehepatic jaundice are ________ and ineffective erythropoiesis.
A) hemolysis
B) metabolism
C) fibrosis
D) canalicular bilirubin transport
Q3) An increased urine bilirubin is associated with A) an increased indirect serum bilirubin.
B) hemolytic reactions.
C) Gilbert syndrome.
D) hepatitis.
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Page 40
Chapter 39: Endocrine Physiology and Mechanisms of
Hypothalamic-Pituitary Regulation
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Sample Questions
Q1) An increase in serum osmolality would be expected to ________ secretion.
A) increase vasopressin
B) decrease vasopressin
C) decrease ADH
D) decrease aldosterone
Q2) An example of a secondary endocrine disorder is
A) pituitary hyposecretion of TSH.
B) adrenal insufficiency following adrenalectomy.
C) congenital adrenal hyperplasia.
D) pheochromocytoma.
Q3) The tightness of the hormone-receptor bond is known as A) specificity.
B) affinity.
C) half-life.
D) set-point.
Q4) Which hormone is highly bound to carrier proteins in the bloodstream?
A) Thyroid hormones
B) Insulin
C) Glucagon
D) Parathyroid hormone
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Chapter 40: Disorders of Endocrine Function
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Sample Questions
Q1) A patient presenting with muscle cramps,fatigue,anxiety,depression,and prolonged
Q-T intervals on EKG may be showing symptoms of A) hyperparathyroidism.
B) hypoparathyroidism.
C) diabetes insipidus.
D) SIADH.
Q2) A thyroid gland that grows larger than normal is known as A) cretinism.
B) myxedema.
C) goiter.
D) colloidosis.
Q3) Surgical removal of a gland may result in A) hypersecretion.
B) hyposecretion.
C) hyporesponsiveness.
D) tissue resistance.
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42
Chapter 41: Diabetes Mellitus
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Sample Questions
Q1) Which are hormones that increase serum glucose level? (Select all that apply.)
A) Vasopressin
B) Glucagon
C) Growth hormone
D) Catecholamine
E) Corticosteroid
Q2) The therapies that would be appropriate for a patient with type 1 diabetes mellitus include (Select all that apply.)
A) carbohydrate counting.
B) high-protein diet.
C) daily exercise.
D) insulin.
E) oral hypoglycemic agents.
Q3) The underlying pathogenic mechanism for type 1 diabetes is A) pancreatic b-cell destruction.
B) lack of insulin receptors.
C) lack of exercise and chronic overeating.
D) impaired glucose transport into cells.
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Chapter 42: Alterations in Metabolism and Nutrition
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Q1) Which patient is at highest risk for severe negative nitrogen balance? (Select all that apply.)
A) Postsurgical patient
B) Postburn patient
C) Posttrauma patient
D) Postsepsis patient
Q2) Which condition is associated with an increase in basal metabolic rate?
A) Aging
B) Fever
C) Obesity
D) Starvation
Q3) The metabolic response to fever is
A) anabolic.
B) catabolic.
C) both anabolic and catabolic.
D) related to gluconeogenesis.
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Chapter 43: Structure and Function of the Nervous System
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Q1) A patient who is experiencing swings in heart rate and irregular breathing during sleep is most likely in the stage of ________ sleep.
A) deep
B) REM
C) alpha wave
D) delta wave
Q2) Voluntary fine-motor movements are produced by activation of the _____ tract(s).
A) dorsal horn-lemniscal
B) lateral corticospinal
C) spinothalamic
D) medial brainstem
Q3) When nerve impulses travel up the ________ side of the cord,the sensations of touch,pressure,and vibration are affected.
A) anterolateral
B) ipsilateral
C) contralateral
D) bilateral
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45
Chapter 44: Acute Disorders of Brain Function
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Sample Questions
Q1) Which brain disorders are a cause of acute brain injury? (Select all that apply.)
A) Seizure disorders
B) Brain trauma
C) Dementias
D) Brain hemorrhage
E) Central nervous system infections
Q2) The most important preventive measure for hemorrhagic stroke is
A) anticoagulation.
B) blood pressure control.
C) thrombolytics.
D) management of dysrhythmias.
Q3) The first indication of brain compression from increasing intracranial pressure (ICP)may be
A) decorticate posturing.
B) absence of verbalization.
C) sluggish pupil response to light.
D) Glasgow Coma Scale score of 13.
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Chapter 45: Chronic Disorders of Neurologic Function
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Sample Questions
Q1) A patient who experiences early symptoms of muscle twitching,cramping,and stiffness of the hands may be demonstrating signs of
A) Guillain-Barré syndrome.
B) amyotrophic lateral sclerosis.
C) Parkinson disease.
D) hydrocephalus.
Q2) _________ is a form of spina bifida in which a saclike cyst filled with CSF protrudes through the spinal defect but does not involve the spinal cord.
A) Spina bifida occulta
B) Meningocele
C) Myelomeningocele
D) Meningomyelocele
Q3) The classic manifestations of Parkinson disease include
A) intention tremor and akinesia.
B) rest tremor and skeletal muscle rigidity.
C) ataxia and intention tremor.
D) skeletal muscle rigidity and intention tremor.
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Chapter 46: Alterations in Special Sensory Function
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Sample Questions
Q1) Nerve fibers of the ________ system have their cell bodies in the mucous membrane of the upper and posterior parts of the nasal cavity.
A) visual
B) auditory
C) gustatory
D) olfactory
Q2) _________ is one of the most common complications of diabetes.
A) Cataract
B) Diabetic retinopathy
C) Macular degeneration
D) Glaucoma
Q3) Ménière disease is characterized by
A) bilateral hearing impairment.
B) vertigo in association with hearing loss.
C) middle ear infection.
D) ossification of bones in the middle ear.
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Chapter 47: Pain
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Sample Questions
Q1) The physiologic mechanisms involved in the pain phenomenon are termed A) nociception.
B) sensitization.
C) neurotransmission.
D) proprioception.
Q2) Pain that waxes and wanes and is exacerbated by physical exertion is likely related to
A) neuralgia.
B) intermittent claudication.
C) fibromyalgia syndrome.
D) neuropathy.
Q3) Pain is thought of as
A) a subjective experience that is difficult to measure objectively.
B) associated with changes in vital signs reflecting its intensity.
C) experienced in the same way by all individuals.
D) always the result of tissue damage that activates nociceptors.
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49
Chapter 48: Neurobiology of Psychotic Illnesses
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Sample Questions
Q1) The assessment of a client recently diagnosed with schizophrenia confirms good cognitive function and reveals affect that is animated.The client is open about describing the voices and the content of their comments,but demonstrates a disorganized thought process.These findings suggest that
A) "negative" psychotic symptoms predominate.
B) there is a high risk for suicidal behaviors.
C) drug therapy is likely to be ineffective.
D) "positive" psychotic symptoms predominate.
Q2) Mania and depression are both characterized by
A) high energy and hyperactivity.
B) poor appetite.
C) hopelessness.
D) altered decision making ability.
Q3) ________ is a term used to describe a serious and debilitating mental state.
A) Psychosis
B) Schizophrenia
C) Major depressive disorder
D) Dysthymia
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Chapter 49: Neurobiology of Nonpsychotic Illnesses
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Q1) PET scans performed on the brains of individuals diagnosed with obsessive-compulsive disorder (OCD)have shown
A) decreases in glucose metabolism.
B) increases in glucose metabolism.
C) increases in serotonin activity.
D) decreases in serotonin activity.
Q2) Repetitive or ritualistic acts that a person performs with urgency are referred to as A) obsessions.
B) delusions.
C) hallucinations.
D) compulsions.
Q3) A person who frequently spends hours each day attending to hand hygiene is referred to as a A) hoarder.
B) washer.
C) checker. D) counter.
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Chapter 50: Structure and Function of the Musculoskeletal System
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Sample Questions
Q1) The neurotransmitter released from the a-motor neuron at the motor end-plate is A) norepinephrine.
B) epinephrine.
C) serotonin.
D) acetylcholine.
Q2) Diarthroses are joints that
A) hold the skull bones together.
B) allow little or no joint movement.
C) contain synovial fluid.
D) connect bony segments by a fibrocartilaginous plate.
Q3) Radicular pain is pain caused by a A) tissue injury.
B) compressed nerve.
C) fracture of long bones.
D) meniscal tear.
Q4) Troponin is a muscle protein that
A) binds the myosin protein to form cross-bridges.
B) forms the noncontractile Z lines.
C) binds calcium and regulates tropomyosin.
D) hydrolyzes ATP to provide energy for contraction.
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Chapter 51: Alterations in Musculoskeletal Function:
Trauma, Infection, and Disease
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Q1) The most common type of osteomyelitis is A) hematogenous.
B) contiguous focus.
C) Brodie abscess.
D) direct invasion.
Q2) The displacement of two bones in which the articular surfaces partially lose contact with each other is called
A) subluxation.
B) subjugation
C) sublimation.
D) dislocation.
Q3) A compound,transverse fracture is best described as a bone that is A) broken in two or more pieces.
B) cracked but not completely separated.
C) broken along the long axis.
D) broken and protruding through the skin.
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Chapter 52: Alterations in Musculoskeletal Function: Rheumatic Disorders
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Sample Questions
Q1) The most common presenting sign/symptom with rheumatic fever is A) cardiac murmur.
B) polyarthritis.
C) rash.
D) painless nodules.
Q2) "Please explain the pathophysiology of osteoarthritis to me," says another nurse."Is it just wear and tear so that the cartilage wears out?" Your best response is
A) "Yes; repeated use just wears out the cartilage, until it becomes thin and denuded. That causes pain and will eventually cause joint inflammation."
B) "Yes; with increasing age, the inflammation from repeated joint use accumulates and causes the cartilage to get thin and ragged until it disappears."
C) "No; cells in bone, cartilage, and the synovial membrane all get activated and secrete inflammatory mediators that destroy cartilage and damage bone."
D) "No; autoimmune cells infiltrate the joint and collect on the cartilage in a mass called 'pannus' that eventually thins and destroys the cartilage."
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Chapter 53: Alterations in the Integumentary System
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Sample Questions
Q1) A major difference between a vesicle and a wheal is that vesicles
A) contain fluid, but wheals are edematous tissue.
B) are palpable, but a wheal is not.
C) are larger than wheals.
D) are smaller than wheals.
Q2) Which type of dermatitis is associated with cradle cap in newborns?
A) Irritant
B) Seborrheic
C) Atopic
D) Stasis
Q3) Onycholysis is characterized by
A) silvery plaques on the skin.
B) itching, oozing rash.
C) destruction of the nails.
D) whitish coating on the tongue.
Q4) Scleroderma is characterized by
A) large, weeping, open sores.
B) thickening and decreased elasticity of the skin.
C) butterfly rash on the face.
D) hair loss and ulcer formation on the extremities.
Page 55
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Chapter 54: Burn Injuries
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Sample Questions
Q1) The immediate management of a thermal burn victim once the fire has been extinguished is to
A) cover with blankets to prevent shock.
B) monitor for signs of respiratory impairment.
C) apply lubricant to the burn area.
D) start an IV line.
Q2) Electrical injury may cause extensive damage to low-resistance tissues,particularly A) bone and muscle.
B) nerves and blood vessels.
C) epidermis.
D) dermis and subcutaneous tissue.
Q3) It is true that covering a burn with cool wet sheets
A) promotes comfort.
B) facilitates healing.
C) prevents fluid loss.
D) promotes hypothermia.
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