NURS 548 Final Exam Questions & Answers With Rationales,100% CORRECT

NURS 548 Final Exam Questions & Answers With Rationales Question 0 out of 2 points Which of the following IS NOT a characteristic of acute rhinosinusitis? RIGHT ANSWER: HOARSENESS • Characteristics of Acute Rhinosinusitis: • facial pain, headache, purulent nasal discharge, decreased sense of smell, fever Question 2 out of 2 points Which of the following IS NOT a characteristic of Mycobacterium tuberculosis hominis? BACTERIA DIE WHEN EXPOSED TO AIR • Characteristics of Mycobacterium tuberculosis hominis – Aerobic – Protective waxy capsule – Can stay alive in “suspended animation” for years Question 5 2 out of 2 points Progressive primary TB: Question 6 2 out of 2 points Which of the following statements concerning neonatal respiratory distress syndrome is INCORRECT? UNKNOWN ANSWER??? Neonatal Respiratory Distress Syndrome • Lack of surfactant; infants are not strong enough to inflate their alveoli • Protein-rich fluid leaks into the alveoli and further blocks oxygen uptake • Treatment with mechanical ventilation may lead to bronchopulmonary dysplasia and chronic respiratory insufficiency Question 7 2 out of 2 points An incomplete expansion of the lung or portion of the lung is known as: ATELECTASIS Atelectasis = the incomplete expansion of the lung or a portion of the lung Question 8 2 out of 2 points Which of the following statements concerning pneumothorax is INCORRECT? AN OPEN PNEUMOTHORAX AIR ENTERS PLEURAL CAVITY THROUGH THE WOUND ON INHALATION BUT CANNOT LEAVE ON EXHALATION Pneumothorax • Air enters the pleural cavity • Air takes up space, restricting lung expansion • Partial or complete collapse of the affected lung – Spontaneous: an air-filled blister on the lung ruptures – Traumatic: air enters through chest injuries • Open: air enters pleural cavity through the wound on inhalation and leaves on exhalation • Tension: air enters pleural cavity through the wound on inhalation but cannot leave on exhalation Question 9 2 out of 2 points Which of the following IS NOT a cause of intrinsic (non-atopic) asthma? TYPE 1 HYPERSENSITIVITY Intrinsic (non-atopic) asthma Episodes are triggered by: Respiratory infections - Epithelial damage, IgE production Exercise, hyperventilation, cold air - Loss of heat and water may cause bronchospasm Inhaled irritants - Inflammation, vagal reflex Aspirin and other NSAIDs - Abnormal arachidonic acid metabolism Question 10 0 out of 2 points Bronchiectasis is characterized by: RIGHT ANSWER: Infection and inflammation destroy smooth muscle in airways, causing permanent dilation • Bronchiectasis – Infection and inflammation destroy smooth muscle in airways, causing permanent dilation Question 11 2 out of 2 points Which of the following IS NOT typically seen in the patient with chronic bronchitis? PURSED LIP BREATHING Blue bloaters (usually bronchitis) – Cannot increase respiration enough to maintain oxygen levels – Cyanosis and polycythemia – Cor pulmonale Question 12 2 out of 2 points Which of the following IS NOT typically seen with hypercapnia? DECREASED RESPIRATIONS HYPERCAPNIA • PCO2 50 mm Hg • Respiratory acidosis – Increased respiration – Decreased nerve firing º Carbon dioxide narcosis º Disorientation, somnolence, coma – Decreased muscle contraction º Vasodilation ▪ Headache, conjunctival hyperemia, warm flushed skin Question 13 2 out of 2 points Which of the following statements concerning urinary tract infections (UTIs) is INCORRECT? OCCURS MORE IN MEN THAN WOMEN Urinary Tract Infections in Special Populations • Women – UTIs are more common in women than in men, with peak incidence in the 15- to 24-year-old age group – Pregnant women are at increased risk for UTIs • Children – UTIs are common in young children – UTIs in children often involve pyelonephritis • Elderly – UTIs are relatively common in the elderly – 2nd most common form of infection, after respiratory infections, among healthy community-dwelling elderly Question 14 0 out of 2 points Which of the following IS NOT associated with nephrotic syndrome? RIGHT ANSWER: GLOMERULAR DAMAGE Nephrotic syndrome – Increased permeability of glomerulus Question 15 2 out of 2 points Which of the following IS NOT a cause of pre-renal failure? URINE FLOW IS BLOCKED Types of Acute Renal Failure • Prerenal – Decreased blood supply • Shock, dehydration, vasoconstriction • Postrenal – Urine flow is blocked • Stones, tumors, enlarged prostate • Intrinsic – Kidney tubule function is decreased Ischemia, toxins, intratubular obstruction Question 16 2 out of 2 points Which of the following IS NOT a manifestation of chronic renal failure? HYPOKALEMIA CLINICAL MANIFESTATIONS OF CRF Question 17 2 out of 2 points Which of the following IS NOT a cardiovascular consequence of chronic renal failure? DECREASED BLOOD PRESSURE Cardiovascular Consequences of CRF • Decreased blood viscosity + • Increased blood pressure + • Decreased oxygen supply Question 18 2 out of 2 points A flaccid bladder resulting in a failure to void urine: INJURY TO THE MICTURITION CENTER OF SACRAL CORD, CAUDA EQUINA, OR SACRAL SPINAL NERVES Neurogenic Bladder Disorders Flaccid Bladder: Failure to Empty Urine – May occur because of injury to the micturition center of sacral cord, cauda equina, or sacral spinal nerves – Peripheral neuropathies (a complication of diabetes mellitus) may lead to flaccid bladder Question 19 2 out of 2 points Overflow incontinence in men is most often caused by: PROSTATE ENLARGEMENT Overflow Incontinence – Occurs when intravesicular pressure exceeds the maximal urethral pressure – In men, one of most common causes is prostate enlargement Question 20 2 out of 2 points Which of the following IS NOT a consequence of inflammation and damage to the bowel? INCREASED MUCOSAL FUNCTION Inflammation and Damage to the Bowel Wall Can Lead To … • Hemorrhage  anemia • Perforation  peritonitis • Decreased mucosal function  malabsorption • Decreased bacterial containment  sepsis Question 21 2 out of 2 points Which of the following IS NOT a characteristic of Crohn's disease? CONTINOUS LESIONS Inflammations of the Small and Large Intestines Inflammatory bowel disease – Crohn disease Question 22 2 out of 2 points Which of the following IS NOT a characteristic of infectious enterocolitis? HYPOMOTILITY Infectious Enterocolitis • The bowel attempts to get rid of the infectious agent – Exudate to dilute toxins – Hypermotility • Vomiting • Decreased intestinal function – Food not absorbed • Osmosis draws water into the bowel º Osmotic (or explosive) diarrhea Question 23 2 out of 2 points Which of the following IS NOT a symptom of mechanical obstruction? SILENT ABDOMEN Intestinal Obstruction • Mechanical Obstruction – Severe, colicky pain – Borborygmus – Audible, high-pitched peristalsis; peristaltic rushes – Awareness of intestinal movements Question 24 2 out of 2 points is an immune mediated disorder that is triggered by ingestion of gluten containing grains. CELIAC SPRUE Alterations in Intestinal Absorption Celiac disease (celiac sprue) – Immune-mediated disorder triggered by ingestion of gluten-containing grains Question 25 0 out of 2 points Which of the following statements concerning intestinal neoplasms is INCORRECT? RIGHT ANSWER: COMMON IN BOTH MEN AND WOMEN Intestinal Neoplasms Adenomatous Polyps Most common neoplasm of the intestine Benign neoplasms arising from the intestinal epithelium Most cases of colorectal cancer begin as adenomatous colonic polyps Question 26 2 out of 2 points Which of the following IS NOT a function of the liver? STORAGE BILIRUBIN Metabolic Functions of the Liver Carbohydrate, protein, and lipid metabolism – Sugars  stored as glycogen, converted to glucose, used to make fats – Proteins  synthesized from amino acids; ammonia made into urea – Fats  oxidized for energy, synthesized, packaged into lipoproteins Drug and hormone metabolism – Biotransformation into water-soluble forms – Detoxification or inactivation Bile production Bilirubin elimination Question 27 2 out of 2 points Excessive hemolysis is a cause of jaundice. PREHEPATIC Question 28 2 out of 2 points Which of the following viral subtypes DOES NOT cause chronic viral hepatitis? HAV Chronic Viral Hepatitis Caused by VIRAL SUBTYPES HBV, HCV, and HDV Question 29 2 out of 2 points When considering alcoholic liver disease, the term steatosis refers to: HEPATOCYTES ARE YELLOW WITH FAT Alcoholic Liver Disease Fatty liver (steatosis) – Liver cells contain fat deposits; liver is enlarged Question 30 2 out of 2 points Which of the following IS NOT a consequence of portal hypertension? UNKNOWN ANSWER??? Portal Hypertension Question 31 0 out of 2 points Which of the following IS NOT a consequence of liver failure? RIGHT ANSWER: BLEEDING Liver Failure Leads To … • Hematologic disorders – Anemia, thrombocytopenia, coagulation defects, leukopenia • Endocrine disorders – Fluid retention, hypokalemia, disordered sexual functions – Which hormones would cause these endocrine disorders? • Skin disorders – Jaundice, red palms, spider nevi • Hepatorenal syndrome – Azotemia, increased plasma creatinine, oliguria • Hepatic encephalopathy – Asterixis, confusion, coma, convulsions Question 32 2 out of 2 points refers to stones found in the common bile duct. CHOLEDOCHOLITHIASIS Disorders of the Gallbladder Choledocholithiasis – Stones in the common bile duct Question 33 2 out of 2 points Which of the following statements concerning pancreatic cancer is INCORRECT? MOST CANCER OF THE PANCREASE HAS REMAINED IN SITU (NON- METASTISIZED) AT TIME OF DIAGNOSIS PANCREATIC CANCER • 4th leading cause of cancer death in US • Smoking is a major risk factor for pancreatic cancer • Most cancer of the pancreas has metastasized at time of diagnosis • Pain management is one of the most important aspects of management Question 34 2 out of 2 points Hypothalamic dysfunction is an example of a endocrine defect. TERTIARY HORMONE DISORDER Hormone Disorders Tertiary: abnormality in stimulation from the hypothalamus Secondary: abnormality in stimulation from the pituitary Primary: abnormality in the gland Question 35 2 out of 2 points Which of the following IS NOT a function of growth hormone? DECREASED BLOOD GLUCOSE FUNCTIONS OF GROWTH HORMONE Question 36 2 out of 2 points Hashimoto's thyroiditis: ACQUIRED HPYOTHYRODISM Thyroid Imbalances – Acquired o Hashimotos thyroiditis Question 37 2 out of 2 points Which of the following IS NOT an action of cortisol? MUSCLE HYPERTROPHY Question 38 2 out of 2 points Beta cells in the endocrine pancreas are responsible for secreting: INSULIN Question 39 2 out of 2 points Which of the following IS NOT linked to the pathogenesis of type 2 diabetes? DECREASED CARBOHYDRATE ABSORPTION BY GI Types of Diabetes Mellitus Type 2: a combination of beta cell dysfunction and insulin resistance Pathogenesis of Type 2 Diabetes Question 40 0 out of 2 points Which of the following IS NOT a chronic complication of type 2 diabetes? RIGHT ANSWER: HB A1C HAS LOWER 02 AFFINITY Chronic Complications of Diabetes Mellitus Increased glucose levels allow glucose to bind to proteins in: – Hemoglobin  Hb A1C has higher O2 affinity – Basement membranes of blood vessels o Nephropathy o Retinopathy o May cause increased risk of atherosclerosis – Lens  cataracts Increased vulnerability to infections Question 41 0 out of 2 points Which of the following IS NOT a characteristic of diabetic autonomic neuropathy? RIGHT ANSWER: INCONTINENCE Diabetic Neuropathy Autonomic neuropathy – Defects in vasomotor and cardiac responses – Impaired motility of the gastrointestinal tract – Inability to empty the bladder – Sexual dysfunction Question 42 2 out of 2 points Which of the following IS NOT a consequence of upper motor neuron damage? MUSCLE HYPERTROPHY Upper Motor Neuron Damage • Weakness and loss of voluntary motion • Spinal reflexes remain intact but cannot be modulated by the brain – Increased muscle tone – Hyperreflexia – Spasticity Question 43 2 out of 2 points Which of the following statements concerning myasthenia gravis is INCORRECT? AUTOIMMUNE DISEASE OF DYEMYLINATING SHEATHS OF MOTOR NEURONS Myasthenia Gravis Autoimmune disease – Gradual destruction of acetylcholine receptors – Associated with thymus tumor or hyperplasia Gradual development of weakness – From proximal to distal portions of body Myasthenia crisis: respiration compromised Question 44 2 out of 2 points Violent "flinging" hyperkinetic movements seen with damage to the basal ganglia are known as movements. BALLISMUS Hyperkinesia Choreiform: jerky movements Athetoid: continuous twisting movements Ballismus: violent flinging movements Dystonia: rigidity Question 45 2 out of 2 points Which of the following IS NOT a sign of Parkinson's disease? HYPERKINESIA (RAPID MOVEMENTS) Parkinson Disease • Tremor • Rigidity • Bradykinesia (slow movement) • Loss of postural reflexes • Autonomic system dysfunction • Dementia Question 46 2 out of 2 points Amyotrophic lateral sclerosis is due to damage to the: BOTH UPPER AND LOWER MOTOR NEURONS Amyotrophic Lateral Sclerosis • Damages both upper and lower motor neurons • UMN damage  weakness, lack of motor control – Loss of control over spinal reflexes  stiffness, spasticity • LMN damage – Irritation  fasciculations – Decreased neuron firing  weakness, denervation atrophy, hyporeflexia Question 47 2 out of 2 points refers to a type of spinal cord lesion where motor function is lost on the same (ipsilateral) side of the lesion and the sensation of pain and temperature is lost on the opposite (contralateral) side of the lesion. BROWN-SEQUARD SYNDROME Partial Spinal Cord Injury • Central cord syndrome: – Damage to axons near the gray matter – Arms more affected than legs • Anterior cord syndrome: – Damage to anterior section of cord – Motor functions affected; touch sensation not affected • Brown-Sequard syndrome: – Damage to one side of cord – Motor function lost on that side; pain/temperature sensation lost from other side Question 48 2 out of 2 points A hematoma is commonly due to traumatic rupture of the meningeal arteries and often results in a rapid hemorrhage and unconsciousness. EPIDURAL HEMATOMA Traumatic Brain Injury • Secondary injuries—due to: – Hemorrhage • Epidural space: meningeal arteries • Rapid bleeding; unconsciousness may be followed by brief lucid period • Dura Mater – Subdural space: bridging veins – Slower bleeding; gradual development over days or weeks Question 49 2 out of 2 points Which of the following IS NOT a direct cause of increased intracranial pressure (ICP)? CEREBRAL VASOCONSTRICTION Intracranial Pressure (ICP) • Compartment syndrome in the skull – Intracranial pressure greater than arterial blood pressure – Arteries collapse; blood flow to brain cut off • Brain swelling – Vasogenic: extracellular fluid – Cytotoxic: intracellular fluid • Hydrocephalus: cerebrospinal fluid • Tumors Question 50 2 out of 2 points Which of the following statements concerning meningitis is INCORRECT? VIRAL MENINGITIS IS USUALLY MORE SEVERE THAN BACTERIAL MENINGITIS Brain Infections • Meningitis – Bacterial Meningitis • Fever and chills, headache, stiff neck and back, abdominal and extremity pains, nausea, and vomiting • Caused by Streptococcus pneumoniae, Haemophilus influenzae, or Neisseria meningitidis – Viral Meningitis • Less severe course than bacterial meningitis • Usually caused by coxsackie B and echovirus Question 51 2 out of 2 points seizures are characterized by muscle contraction and loss of consciousness. Tonic-clonic (grand mal): Kinds of Seizures • Absence (petit mal): disturbances in consciousness • Atonic: loss of muscle tone • Myoclonic: muscles contract • Tonic-clonic (grand mal): muscle contraction and loss of consciousness • Generalized convulsive status epilepticus: seizures continue without recovery between them Question 52 2 out of 2 points disease is a type of dementia that is due to the transmission of protein agents known as prions. Creutzfeldt-Jakob disease Abnormal Inclusions in the Brain • Alzheimer disease: amyloid plaques • Pick disease: Pick bodies • Prion diseases: prion proteins – Creutzfeldt-Jakob disease