WGU D027 Exam Review 2024

Which of the following is not a cellular function? Reproduction Combustion Absorption Excretion - combustion Which if the following can cause edema? Decreased capillary hydrostatic pressure Increased lymphatic pressure Increased plasma pressure Decreased capillary permeability - Increased lymphatic pressure Which of the following best describes the result of cellular reproduction? During anaphase, the centromeres come together. During telophase, a nuclear membrane is formed around 23 chromosomes. Two diploid cells, called daughter cells, are produced. Cellular reproduction has a long interphase. - Two diploid cells, called daughter cells, are produced. What is an example of both hyperplasia and hypertrophy? Liver enlargement after partial removal Uterine enlargement due to pregnancy Cardiac enlargement due to hypertension Muscle enlargement due to work - Uterine enlargement due to pregnancy deifine hyperplasia & hypertrophy - Hyperplasia is the increase in the number of cells of an organ or tissue, while hypertrophy is the enlargement of the cells of a given organ or tissue without a change in the number of cells. Muscle cells grow and enlarge (hypertrophy) in response to increased work or stress from exercise or increased cardiovascular pressures. When a liver is damaged or part of it is removed, it is the one internal solid organ capable of regeneration to repair itself creating more cells (hyperplasia). During pregnancy, the uterus must both grow to create more cells and enlarge those existing cells in preparation for the support of a fetus. Previousquestion What regulates the sodium balance? Chloride Aldosterone Renin Potassium - aldosterone When in excess, what do buffers absorb? Oxygen Hydrogen Potassium Bicarbonate - Hydrogen; Think Chem!. H+ is acid describe translation and transcription - Translation refers to this process. Transcription is another process in which RNA is synthesized What is the recurrence rate for autosomal dominant disease? - 50% for a couple in which one or both partners are affected by the disease, the chance of each child being heterozygous affected is 50%. Which of the following statements is true about autosomal recessive disease? It affects only women. It affects both men and women equally. It affects men and women, but men more often. It affects men only. - men and women equal What is the proportion of the population affected by a disease at the specific point in time? Relative risk Incidence rate At-risk rate Prevalence rate - prevalence Incidence rate refers to how many new cases there are of a disease within a period of time divided by the number of the population's individuals. The prevalence rate is affected by the incidence rate and how long the affected patients survive. Risk factor is anything that could lead to disease. Relative risk is the measure of a risk factor effect. Previousquestion Which action is the purpose of the inflammatory - To destroy foreign, invasive microorganisms What causes edema that occurs during the inflammatory process? - Increased pressure in the vasculature secondary to the vasodilatory effects of inflammation will result in the leakage of fluid into third spaces (i.e., edema). In what structure do B lymphocytes mature and become B cells? - BONE MARROW (B for B) The bone marrow is where immature immune cells, such as B and T lymphocytes, reside to mature into B cells. After this maturation process, these cells migrate to other organ sites such as the thyroid, spleen, and thymus to enter their final stages of differentiation and development. Which type of immunity occurs when antibodies are transferred from donor to recipient? - passive acquired immunity Active immune processes are the self-originating processes of the immune system that occur from (acquired) or without (innate) prior exogenous simulation or exposure to foreign antigens. Passive immunity is stabilized. Existing immune responses that are present with or without simulation can arise or be created from oneself (innate) or acquired from an outside source (e.g. donor antibodies). What does T-cell activity cause in older adults? - Increased susceptibility for infection As the human body ages, the immune system's effectiveness to coordinate responses to pathogens and other foreign antigens wanes and the risk for disease increases. What is a dermatitis caused by prolonged exposure to chemicals such as acids or soaps also known as? Stasis dermatitis Stopic dermatitis Irritant contact dermatitis Allergic contact dermatitis - Irritant contact dermatitis Prolonged, superficial skin exposure to foreign irritants (e.g., acids or soaps) is a manifestation of an innate, local inflammatory response. The conditions of allergic, stasis, and atopic dermatitis involve more systemic processes of the immune system and vasculature. Which of the following is a self-limiting disease associated with Herpes type viruses and a herald patch? - Pityriasis rosea What is a furuncle? - n infection of the hair follicle that extends to the surrounding tissue What type of lesion may be malignant in the form of squamous cell carcinoma (SCC)? Keratoacanthoma Seborrhaic keratosis Nevi Actinic keratosis - Actinic keratosis What type of abnormal cell growth does carcinoma refer to? - Carcinoma refers to dysplastic epithelial cells that have penetrated the entire thickness of the epithelium into the basement membrane. What is a characteristic of a malignant tumor? - Absence of normal tissue organization Healthy tissue is made up of non-cancerous cells that are well-differentiated, connected via a well-organized stroma and that stay put. Malignant tumors lack those characteristics as well as normal tissue organization. wilms tumor - malignant tumor of the kidney occurring in childhood through genetic component Where do the cancers treated with glucocorticoids stem from - lymphoid tissue ((lymphocytic leukemias, Hodgkin disease, non-Hodgkin lymphomas, and multiple myeloma). six-month-old female infant with failure to thrive comes in to the office with her parents. It is noticed upon exam that the patient has facial deformities and is jaundiced. A complete blood count (CBC) is ordered, which reveals anemia. When that patient's blood is examined under a microscope, the red blood cells appear small and abnormally shaped. A mutational analysis is ordered, and alpha thalassemia is diagnosed. What is the likelihood of incidence of these parent's future children having alpha thalassemia? - 25% Alpha thalassemia is a hereditary blood disorder characterized by reduction in hemaglobin production. Each individual inherits two copies of the HBA1 gene and two copies of the HBA2 gene from each parent. If at least one copy of the four is missing, a variation of alpha thalassemia can result. That means that future offspring have a one in four chance of the disease. Turner Syndrome - A chromosomal disorder in females in which either an X chromosome is missing, making the person XO instead of XX, or part of one X chromosome is deleted.-- no ovaries, baby edema, wide nipples turners syndrome tx - Human growth hormone (until epiphyseal fusion) & estrogen/progestin replacement Klinefelter syndrome - A chromosomal disorder in which males have an extra X chromosome, making them XXY instead of XY. sx gynacomastia and violence Cri du char syndrome - chromosome 5 deletion. "cry of the cat" . results in decreased birth weight, decreased Iq , heart conditions and microcephaly Fragile X Syndrome - a disorder produced by injury to a gene on the X chromosome, producing mild to moderate mental retardation Phenylketonuria - a genetic disorder in which the essential digestive enzyme phenylalanine hydroxylase is missing can build up phenylalanine and can decrease IQ; How is angiotensin I converted to angiotensin II? - By angiotensin traveling in circulatory system to the lungs and attaching to angiotensin converting enzyme (ACE) what 3 areas does angiotensin II affect - smooth muscle vaso constriction, post. pitutiary -- increase ADH Adrenal cortex -- increase aldosterone (Na+ retention) how do ACE I 's and Arbs work - interferes with angiotensin 1 becoming angiotensin 2 block locations of angiotension 2 from binding ace inhibitors ends in side effects? - pril hyperkalemia, angioedema, dry cough arbs end in - -sartan After a thiazide diuretic, what medication should you start in a hypertensive patient? - ace inhibitors how are varapamil and diltiazem different from other calcium channel blockers? (Pines) - they act on the cardiac pace maker cells by decreasing the amount of Ca that can enter the action potential of the heart . thereby making it take longer to acheive a + charge inside the cell in order to make the pacemaker cells fire what triggers renin production - decreased blood flow to JG cell s in the kidney Hypoplastic Left Heart Syndrome can survive if which 2 fetal shunts are open - ductus arteriosis and foramen ovale trunkus arterosis - no septum between ventricles. transposition of great arteries can urvive id what defects are in place - septal defect or potent ductus arteriosis coarctation of aorta can survive if what defect is in place - patent ductus arterosis s/s of coarctation of the aorta? - unequal upper and lower extremity pulses S/S of Ventricular Septal Defect - * loud harsh murmur heard at L sternal border * heart failure Many close spontaneously s/s of aortic septal defect - hole between atria; fixed split second heart sound What is patent ductus arteriosus? - PDA is failure of the fetal ductus arterioles (artery connecting the aorta and the pulmonary artery) to close within the first weeks of life. s/s of patent ductus arteriosus - machine murmus; bounding pulses, wide pulse pressure Tx: patent ductus arteriosus - Indomethacin Tetrology of Fallot - pulm. stenosis, ventricular septal defect, overriding aorta and r. ventricular hypertrophy Tricuspid Atresia - Absence of tricuspid valve and hypoplastic RV; requires both ASD and VSD for viability. Primary HTN - no known cause Secondary HTN - identifiable cause ( htn secondary to ) Stages of HTN - Normal: 120/80 Pre-HTN: 120-140/80-90 Stage 1: 140-160/90-100 Stage 2: 160/100 Which chamber of the heart has the thinnest muscle in the heart? - R atrium During diastole, which part of the heart is filling with blood? - both ventricle Oxygenated blood flows through which vessel? Coronary vein Superior vena cava Pulmonary vein Pulmonary artery - pulm vein What effect does atherosclerosis have on the development of an aneurysm? Obstructs the vessel Increases nitric oxide Causes ischemia of the intima Erodes the vessel wall - erodes vessel wall What is the effect of oxidized low-density lipoproteins (LDLs) in atherosclerosis? LDLs cause smooth muscle proliferation. LDLs decrease levels of inflammatory plagues. LDLs cause regression of atherosclerotic plaques. LDLs direct macrophages away from the endothelium. - LDLs cause smooth muscle proliferation. Within the arterial wall subintima, oxidized LDLs stimulate macrophage foam cell formation and proinflammatory pathways, which lead to smooth muscle proliferation, fatty streak creation, and eventual fibrous plaque overlays Which factor is responsible for the hypertrophy of the myocardium associated with hypertension? Angiotensin II Insulin resistance Adducin Increased norepinephrine - Angiotensin 2 Most cardiovascular developments occur between which weeks of gestation? Fourth and seventh weeks Twelfth and fourteenth weeks Fifteenth and seventeenth weeks Eighth and tenth weeks - 4-7 Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot (TOF) to relieve hypoxic spells? Squatting Lying on their left side Performing the Valsalva maneuver Hyperventilating - squatting Spontaneous squatting helps relieve hypercyanotic events in older children through increasing systemic vascular resistance, decreasing venous blood return. This provides a larger amount of oxygenated blood for the body and leads to the temporary reversal of blood through the ventricular septal defect (VSD), which results in increased pulmonary flow. Squatting is rarely seen clinically because most TOF defects are diagnosed and surgically repaired in infancy Which condition is consistent with the cardiac defect of transposition of the great vessels? An intermittent murmur is present. The right ventricle pumps blood to the lungs. The aorta arises from the right ventricle. The pulmonary trunk arises from the right ventricle. - The aorta arises from the right ventricle. Which term identifies the movement of blood into and out of the capillary beds of the lungs to body organs and tissues? Perfusion Diffusion Respiration Ventilation - perfusion What is the mechanism of defense for the alveolar macrophages? To trap and remove foreign particles from inspired air To ingest and remove bacteria from the alveoli by phagocytosis To propel entrapped particles toward the oropharynx To maintain a constant temperature of gas entering the lungs - To ingest and remove bacteria from the alveoli by phagocytosis If an individual aspirates, where would a nurse expect abnormal breath sounds? Left upper lung Trachea Left lower lung Right lung - R lung Besides a cough, the most common symptom of pulmonary disease is . hyperventilation dyspnea sputum nasal congestion - dyspnea A condition caused by postoperative patients' reluctance to change position or breathe deeply is . compression fractures surfactant impairment bronchiectasis pulmonary atelectasis - pulmonary atelectasis What is an abnormal permanent enlargement of gas-exchange airways accompanied by destruction of alveolar wall without obvious fibrosis? Chronic bronchitis Bronchiolitis Asthma Emphysema - emphysema Which type of pneumonia is acquired by infection from inhaling microorganisms in a shopping mall? VAP CAP HAV HCAP - CAP Which type of croup is most common? Laryngotracheobronchopneumonitis Laryngotracheitis Respiratory syncytial virus Laryngotracheobronchitis - Laryngotracheitis How is asthma confirmed in children over the age of six? Pulmonary function testing Serum allergy testing Family history of asthma Frequent upper respiratory infections - Pulmonary function testing What are most cases of acute bronchitis are caused by? TB Fungus Bacteria Viruses - Virus Creutzfeldt-Jakob disease - progressive, incurable, neurologic disease caused by infectious prions Huntington disease - hereditary disorder marked by degenerative changes in the cerebrum leading to abrupt involuntary movements and mental deterioration Acute confusional states - transient disorders of awareness that result from cerebral dysfunction Where is the region responsible for the motor aspects of speech located? The Broca area in the frontal lobe The Wernicke area in the temporal lobe The Brodmann areas in the parietal lobe The occipital lobe - broca Brodmann's areas - vision-motor coordination Wernicke's area - language comprehension Which area of the brain controls reflex activities concerned with heart rate, blood pressure, respirations, sneezing, swallowing, and coughing? Pons Forebrain Midbrain Medulla oblongata - Medulla Pons - Bridge- the part of the brainstem that links the medulla oblongata and the thalamus. Agnosia - the inability to recognize familiar objects. A traumatic brain injury that results in bleeding between the dura mater and the skull is called . a subdural hematoma a concussion an intracerebral hematoma an epidural hematoma - epidural hematome intercerebral hematoma - bleeding within the brain tissue hemodynamic stroke - stroke r/t decreased perfusion to brain Embolitic stroke - stroke from moving clot thrombolytic stroke - clot in brain grows and causes stroke lacunar stroke - a stroke resulting from occlusion of a small penetrating artery with development of a cavity in the place of the infarcted brain tissue sprain vs strain - Sprain: overstretching/damaging ligaments STrain: T for TENDON, overstretching/damaging tendon. The condition when blood flows to an affected area is compromised because of increased venous pressure is called what? Crush syndrome Malignant hyperthermia DIC Compartment syndrome - compartment syndrome Disseminated Intravascular Coagulation (DIC) - abnormal activation of the proteins involved in blood coagulation, causing small blood clots to form in vessels and cutting off the supply of oxygen to distal tissues Malignant hyperthermia - A hereditary condition of uncontrolled heat production that occurs when susceptible people receive certain anesthetic drugs.-- give dantrolene crush syndrome - Significant metabolic derangement that develops when crushed extremities or body parts remain trapped for prolonged periods. This can lead to renal failure and death.( rhabdo) A chronic, systemic inflammatory autoimmune disorder that affects the joints is called what? Rheumatoid arthritis Osteoathritis Ankylosing spondylitis Gout - rheumatoid arthritis ankylosing spondylitis - a form of rheumatoid arthritis that primarily causes inflammation of the joints between the vertebrae (RA of the Vertebrae) Osteoarthritis (OA) - progressive, degenerative joint disease with loss of articular cartilage and hypertrophy of bone (formation of osteophytes, or bone spurs) at articular surfaces A type of dystrophy caused by a deletion of one or more exons of the DMD gene on the X chromosome is what? Limb girdle dystrophy Spinal muscular dystrophy Duchenne muscular dystrophy Myotonic dystrophy - Duchenne muscular dystrophy ( death by 20 r/t resp. failure) Myotonic Dystrophy - Autosomal Dominant, CTG trinucleotide repeat enzyme Frontal balding, testicular atrophy, muscle wasting (no fatty deposits) Spinal Muscular Dystrophy - weakness of the voluntary muscles in the shoulders, hips, thighs, and upper back potentially leading to spine curvatures. the earlier the detection the worse the prognosis. Limb Girdle Muscular Dystrophy - - Onset between 1st and 3rd decades of life - Proximal muscles of pelvis and shoulder initially affected - Progresses slowly Oxygenated blood flows through which vessel? - Pulmonary vein Which complex (wave) represents the sum of all ventricular muscle cell depolarizations? - QRS What effect does atherosclerosis have on the development of an aneurysm? Obstructs the vessel Increases nitric oxide Causes ischemia of the intima Erodes the vessel wall - Erodes the vessel wall What is the effect of oxidized low-density lipoproteins (LDLs) in atherosclerosis? LDLs cause smooth muscle proliferation. LDLs decrease levels of inflammatory plagues. LDLs cause regression of atherosclerotic plaques. LDLs direct macrophages away from the endothelium. - LDLs cause smooth muscle proliferation. Which factor is responsible for the hypertrophy of the myocardium associated with hypertension Angiotensin II Insulin resistance Adducin Increased norepinephrine - Angiotensin II Most cardiovascular developments occur between which weeks of gestation? Fourth and seventh weeks Twelfth and fourteenth weeks Fifteenth and seventeenth weeks Eighth and tenth weeks - Fourth and seventh weeks Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot (TOF) to relieve hypoxic spells? Squatting Lying on their left side Performing the Valsalva maneuver Hyperventilating - squatting helps relieve hypercyanotic events in older children through increasing systemic vascular resistance, decreasing venous blood return. This provides a larger amount of oxygenated blood for the body and leads to the temporary reversal of blood through the ventricular septal defect (VSD), which results in increased pulmonary flow. Squatting is rarely seen clinically because most TOF defects are diagnosed and surgically repaired in infancy (McCance, p. 1127). hich condition is consistent with the cardiac defect of transposition of the great vessels? An intermittent murmur is present. The right ventricle pumps blood to the lungs. The aorta arises from the right ventricle. The pulmonary trunk arises from the right ventricle. - The aorta arises from the right ventricle. What produces ADH? Posterior pituitary Hypothalamus Anterior pituitary Hypothalamus pituitary axis - Posterior pituitary The thyroid gland hormones (T3 and T4) are regulated by . - TSH What do the pancreas beta cells produce? - Insulin What do high levels of ADH cause? Diabetes insipidus ACTH deficiency Acromegaly SIADH - SIADH Which condition is indicated by a high level of TSH and low T4? Thyrotoxicosis Hyperthyroidism Hypoparathyroidism Hypothyroidism - Hypothyroidism What diagnosis results if a patient's anterior pituitary produces none of the normal pituitary hormones? Panhypopituitarism Failure of the pituitary cortex Hyperthyroidism Hyperpituitarism - Panhypopituitarism Which of the following symptoms is not indicative of metabolic syndrome? Dyslipidemia Cachexia Hypertension Elevated fasting glucose - Cachexia What is occlusion of the capillaries due to diabetes called? Peripheral artery disease Macrovascular disease Microvascular disease Hyperglycemic hyperosmolar state - Microvascular disease Which of the following is anorexia of aging associated with? Poor dentition, decreased gastric emptying, and the effects of medication An intense fear of gaining weight Increased orexigenic signals Persistent use of laxatives - Poor dentition, decreased gastric emptying, and the effects of medication A BMI greater than what indicates obesity? 24 kg/m2 40 kg/m2 45 kg/m2 30 kg/m2 - 30 kg/m2 How is Crohn disease (CD) different from ulcerative colitis (UC)? CD does not increase cancer risk. CD occurs more in men. CD affects only the rectum and sigmoid colon. CD affects any part of the GI tract and involves skip lesion - CD affects any part of the GI tract and involves skip lesion