MIDTERM EXAM

Question 1
0 out of 0 points
Gas exchange occurs in which of the respiratory system's structures?
Selected Answer:
Correct Answer:
Response
Feedback:
Trachea
Alveoli
The alveoli allow air to come in indirect contact with the
bloodstream through the pulmonary capillary system. This alveolar
membrane, which is one cell thick, allows carbon dioxide to diffuse
into the alveoli from the bloodstream and oxygen to diffuse to the
bloodstream from the alveoli. Sinuses are hollow spaces found in
the skull. The trachea is a structure that allows passage of gases to
and from the gas exchange units (alveoli). Bronchi are branches of
the conducting airways that allow passage of gases to and from the
gas exchange units (alveoli).

Question 2
0 out of 0 points
A patient with heart failure reports awakening intermittently with shortness of
breath. Which terms appropriately describes this clinical manifestation?
Selected Answer:
Correct Answer:
Response
Feedback:
Dyspnea
Paroxysmal nocturnal
Paroxysmal nocturnal dyspnea refers to intermittent attacks of
severe dyspnea that occur during the night. Dyspnea is a general
term referring to difficulty breathing. Cyanosis is the appearance of
a blue or purple coloration of the skin or mucous membranes due to
the tissues near the skin surface being low on oxygen. Bradypnea
describes abnormal slowness of breathing.

Question 3
0 out of 0 points
What factor causes a congenital heart disease to produce cyanosis?
Selected Answer:
Correct Answer:
Response
Feedback:
Left-to-right shunting of blood
Right-to-left shunting of blood
Disorders that result in right-to-left shunting cause cyanosis. A leftto-right shunt occurs when oxygenated blood from the left side of
the heart or aorta flows back into the right side to be recirculated
through the lungs. The blood reaching the systemic circulation is
oxygenated and the infant is not cyanotic (acyanotic defect).
However, the right side of the heart has an increased workload
because of the extra shunt blood. In time, the overload of the right
side of the heart can result in right ventricular hypertrophy and
high right-sided heart pressures. Large ventricular septal defects
may be apparent at birth because of rapidly developing right-sided
heart failure and a loud systolic murmur. The majority of atrial
septal defects occur at the location of the foramen ovale. The
abnormal septal opening may be of variable size. Small defects (1
cm) are well tolerated. Even larger atrial septal defects may be
asymptomatic for many years as long as the shunt flow is left to
right and therefore acyanotic.

Question 4
0 out of 0 points
A patient education intervention that will help decrease the emergence of resistant
infections is to instruct the patient to
Selected
Answer:
Correct
Answer:
Response
Feedback:
Take all the antibiotics ordered even if feeling well after a few days
to prevent antibiotic defiant bacteria
Take all the antibiotics ordered even if feeling well after a few days
to prevent antibiotic defiant bacteria
The patient should take all the antibiotics ordered, even if feeling
better, to eradicate the moderately resistant microorganisms.
Viruses are not impacted by antibacterial medications. Sharing
antibiotics indicates that the full course of the medication isn’t being
taken, and so contributing to the development of resistant
microorganisms. If medication is stopped prematurely, moderately
resistant organisms are selected for and become the predominant
species, making it more difficult to eradicate next time.

Question 5
0 out of 0 points
Cellular hypoxia results in
Selected Answer:
Correct Answer:
Response
Feedback:
Failure of the sodium-potassium pump
Failure of the sodium-potassium pump
Hypoxia is a loss of oxygen to the cell that causes ATP activity to
cease. ATP provides the power required to drive the sodiumpotassium pump. pH decreases in hypoxia (respiratory acidosis).
Hypoxia is a loss of oxygen to the cell that causes ATP activity to
cease. Deposits of calcium salts occur in conditions of altered
calcium intake, excretion, or metabolism.

Question 6
0 out of 0 points
What is the underlying problem common among all types of shock?
Selected Answer:
Generalized vasodilation
Correct Answer:
Inadequate cellular oxygenation
Response
Feedback:
Although each type of shock has specific characteristics, all are
associated with a deficiency of cellular oxygen consumption.
Inadequate cellular oxygenation may result from decreased cardiac
output, maldistribution of blood flow, or reduced blood oxygen
content. The impaired oxygen utilization by cells may lead to cell
death, organ dysfunction, and stimulation of inflammatory
reactions. Cardiac failure can be an outcome, but is not a common
cause in all types of shock. Vasodilation occurs in only selective
forms of shock. Faulty compensatory mechanisms may contribute to
the seriousness of all shocks but that is not the cause of all forms of
shock.

Question 7
0 out of 0 points
What is the name for the mRNA sequences that contain only the wanted segments?
Selected Answer:
Correct Answer:
Pre-mRNA
Exon
Response
Feedback:
An exon is the mRNA sequence that contains only the wanted
segments. Introns are the unwanted areas that are removed in the
nucleus by a complex splicing process, thus leaving exons. PremRNA is the original RNA transcript before removal of bases that
are unnecessary. Spliceosomes are the areas of the nucleus that are
a specialized RNA protein complex that removes introns.

Question 8
0 out of 0 points
Thrombosis in the microcirculation throughout the body is called
Selected Answer:
Correct Answer:
Response
Feedback:
Disseminated intravascular coagulation (DIC)
Disseminated intravascular coagulation (DIC)
Thrombosis may also be initiated by a generalized reduction in flow
and release of vasoactive substances that occur in shock states.
Systemic derangement in coagulation takes place in disseminated
intravascular coagulation (DIC), resulting in thrombosis in the
microcirculation throughout the body. A stroke results from the
obstruction of blood flow in or to the brain by a clot. Atherosclerosis
is a circulatory condition that results in the inability of vessels to
regulate blood flow as a result of the stiffening of their walls. An MI
is a result of obstructed blood flow in a vessel supplying the heart
muscle itself.

Question 9
0 out of 0 points
Which term is used to identify hypertension that has a specific disease as its cause?
Selected Answer:
Primary
Correct Answer:
Secondary
Response
Feedback:
Secondary is the term given to hypertension that is secondary to a
specific disease. Idiopathic, primary, and essential hypertension are
interchangeable terms for hypertension that cannot be related to a
specific disease/cause.

Question 10
0 out of 0 points
Which statement is true regarding the epithelial system of tissue?
Selected Answer:
Correct Answer:
Response
Feedback:
Stratified epithelium is several layers thick.
Stratified epithelium is several layers thick.
Stratified epithelium that makes up the epidermis of the skin is
several layers thick. Epithelial cells cover the majority of the
external surfaces of the body and line the glands, blood vessels, and
internal surfaces. Keratin is a tough protective protein that is
present in the outer surface of flattened, dead epithelial cells.
Pseudostratified epithelium is a single layer, but it appears to be
more than one layer because of the mixture of cell shapes.

Question 11
0 out of 0 points
Which term refers to a state of tension that can lead to disruption or threaten
physical stability?
Selected Answer:
Correct Answer:
Response
Feedback:
Stress
Stress
Stress is defined as a state of tension that can lead to disruption or
threaten homeostasis. Adaptive changes occur when a body
function changes to work within its environment. Exhaustion
occurs when there is a negative sequela. Homeostasis is dynamic
change.

Question 12
0 out of 0 points
Which type of cellular adaptation is most likely to occur as the result of chronic
ischemia to a region?
Selected Answer:
Hyperplasia
Correct Answer:
Atrophy
Response
Feedback:
Ischemia is inadequate blood supply to a tissue. Chronic sublethal
ischemia usually results in cell atrophy. Hypertrophy would result
in an increase in cell size in response to increased physiological
demand. Hyperplasia would result in an increased number of cells
in response to increased physiological demand. Metaplasia is the
replacement of one differentiated cell type with another better
suited for the situation

Question 13
0 out of 0 points
Which diagnostic analysis is used to identify patients with heart failure? (Select all
that apply.)
Selected Answers:
BNP (B-type natriuretic peptide)
ANP (atrial natriuretic peptide)
Echocardiogram
Correct Answers:
BNP (B-type natriuretic peptide)
Echocardiogram
Chest x-ray film
Response
Feedback:
BNP is a blood test that assists in identifying patients with heart
failure. An echocardiogram uses sound waves to create a moving
picture of the heart and is used in the diagnosis of heart failure. A
chest x-ray is a physical diagnostic test that shows heart structures
and is used in the diagnosis of heart failure. Complete blood count
(CBC) is a blood analysis used to determine the composition of
blood related to amounts of specific cells in a serum sample. The
overall effect of ANP on the body is to counter increases in blood
pressure and volume caused by the renin-angiotensin system.

Question 14
0 out of 0 points
Which statement is true about disseminated intravascular coagulation (DIC)?
Selected Answer:
Correct Answer:
It is both a bleeding and clotting disorder.
It is both a bleeding and clotting disorder.
Response
Feedback:
DIC is both a bleeding and clotting disorder. There are two types,
with the chronic type being more prone to thrombotic episodes
because the liver and bone marrow are functioning at a higher level
and are able to produce more clotting factors and platelets. There is
a rise in fibrin split products secondary to the destruction of clots.
The fibrinogen level decreases as the body uses it up.

Question 15
0 out of 0 points
The role of the circulatory system is to do which of the following? (Select all that
apply.)
Selected Answers:
Transport O2 and nutrients throughout the body
Remove waste products found within the body
Move blood systemically from the right side of the heart
Correct Answers:
Transport O2 and nutrients throughout the body
Remove waste products found within the body
Response
Feedback:
The primary functions of the circulatory system include the
transportation of O2 and nutrients within the body and the removal
of metabolic waste products within the body. Movement of blood
through the lungs is via the right side of the heart. Systemic blood
flow is supplied by the left side of the heart. Nutrients are absorbed
into the blood as it moves through the gastrointestinal tract via
splanchnic circulation, and O2 uptake and the release of CO2 occur in
the specialized vascular bed of the pulmonary circulation.

Question 16
0 out of 0 points
Which statement concerning the location of specific buffers is correct? (Select all
that apply.)
Selected Answers:
Phosphate buffers are found in the intracellular space.
Hemoglobin buffers are found inside the erythrocytes.
Bicarbonate buffers are found in the extracellular space.
Protein buffers are found in the intracellular compartment.
Correct Answers:
Phosphate buffers are found in the intracellular space.
Hemoglobin buffers are found inside the erythrocytes.
Bicarbonate buffers are found in the extracellular space.
Protein buffers are found in the intracellular compartment.
Response
Feedback:
Bicarbonate buffers are found in the extracellular space. Phosphate
buffers are found in the intracellular space and urine. Hemoglobin
buffers are found inside the erythrocytes. Protein buffers are found
in the intracellular and vascular compartments. Protein buffers are
not found in human urine.

Question 17
0 out of 0 points
Restoration of effective function is the goal of which level of prevention?
Selected Answer:
Tertiary
Correct Answer:
Tertiary
Response
Feedback:
Tertiary prevention (appropriate in the stage of advanced disease or
disability) includes rehabilitative and supportive care and attempts
to alleviate disability and restore effective functioning. Primary
prevention is prevention of disease by altering susceptibility or
reducing exposure for susceptible individuals. Clinical is a stage
referred to in early disease prevention (secondary). Secondary
prevention is the early detection, screening, and management of the
disease.

Question 18
0 out of 0 points
What is the difference between capillary fluid pressure and plasma colloid osmotic
pressure?
Selected
Answer:
Capillary fluid pressure is the fluid pressure outside the capillary and
is the force pushing fluid from the interstitium from the capillary;
plasma colloid osmotic pressure is the primary force because of the
presence of anions, which result in fluid remaining in the capillary.
Correct
Answer:
Response
Feedback:
Capillary fluid pressure is the fluid pressure inside the capillary and is
the force pushing fluid from the capillary into the interstitium; plasma
colloid osmotic pressure is the primary force because of the presence
of plasma proteins, which results in fluid remaining in the capillary.
Capillary fluid pressure is the fluid pressure inside the capillary and
is the force pushing fluid from the capillary into the interstitium
(called hydrostatic pressure). Plasma colloid osmotic pressure is the
primary force because of the presence of plasma proteins, which
result in fluid remaining in the capillary. Most plasma proteins
remain in the capillaries because they are such large molecules that
they are unable to move easily through the capillary walls. The
other options do not correctly define the terms or the processes.

Question 19
0 out of 0 points
Which statement(s) are true regarding post-exposure prophylaxis? (Select all that
apply.)
Selected
Answers:
All exposed individuals require a protease inhibitor drug
regimen.
Prophylaxis for a significant exposure should be started
immediately.
Postexposure medication treatment last at least 4 weeks, or even
longer.
Correct
Answers:
Prophylaxis for a significant exposure should be started
immediately.
Postexposure medication treatment last at least 4 weeks, or even
longer.
Two or more medications may be included in the medication
regimen.
Exposure, sexual or otherwise, requires similar medication
protocols.
Response
Feedback:
Significant exposure to HIV- infected blood or body fluids such as a
needle stick, require that post-exposure prevention protocol be
initiated immediately. The length of administration of the agents
depends on multiple factors and may be 4 weeks or longer. Often
post-exposure protocols involve the administration of two or three
medications. This same protocol has been advocated for use as
postsexual exposure prophylaxis. According to the Public Health
Service and NIH, the selection of a drug regimen for HIV postexposure prophylaxis must balance the risk for infection against
potential toxicities and side effects of the medication. As such,
consultation with an infectious disease provider is often
recommended. Treatment usually depends on if the exposure
source’s viral status, viral load, or antiretroviral therapy response is
known.

Question 20
0 out of 0 points
Which condition occurs in the presence of cellular damage?
Selected Answer:
Correct Answer:
Response
Feedback:
Sodium and water move into the cell.
Sodium and water move into the cell.
Cellular injury causes failure of the sodium-potassium pump,
resulting in migration of sodium ions into the cell. The accumulation
of intracellular sodium creates an osmotic gradient that pulls water
into the cell, resulting in hydropic swelling. Cells actually swell, not
shrink, as a result of cellular damage. Cellular damage results in the
cell’s inability to perform normal metabolic functions owing to
insufficient cellular energy in the form of adenosine triphosphate
(ATP). Osmotic pressure increases to accommodate for swelling

Question 21
0 out of 0 points
A patient has a regular heart rate of 54 beats/min. The nurse would document this
rhythm as
Selected Answer:
Bradycardia
Correct Answer:
Bradycardia
Response
Feedback:
Sinus bradycardia is defined as a heart rate of less than 60
beats/min. Normal sinus rhythm is defined as an impulse rate
between 60 and 100 per minute. Sinus arrhythmia is a normal
finding associated with fluctuations in autonomic influences and
respiratory dynamics. Sinus tachycardia is an abnormally fast heart
rate of greater than 100 beats/min.

Question 22
0 out of 0 points
Von Willebrand disease may present itself by which of the following? (Select all
that apply.)
Selected Answers:
Epistaxis
Ecchymoses
Decreased von Willebrand factor
Correct Answers:
Epistaxis
Ecchymoses
Decreased von Willebrand factor
Response
Feedback:
Epistaxis and ecchymoses are common clinical manifestations of
von Willebrand disease, and the level of von Willebrand factor is
decreased or absent. In von Willebrand disease, the platelet count
and PT are normal, but aPTT is prolonged.

Question 23
0 out of 0 points
Which statement is true about the normal biological variations related to age?
Selected Answer:
There is less thirst perception in the elderly.
Correct Answer:
There is less thirst perception in the elderly.
Response
Feedback:
Aging does usually result in diminished thirst perception. Adults
have slower heart rates than infants. The elderly have fewer sweat
glands. The elderly have diminished temperature sensations.

Question 24
0 out of 0 points
The condition associated with hypoxemia as a result of lung disease or living at
high altitudes is called
Selected Answer:
Correct Answer:
Response
Feedback:
secondary polycythemia.
secondary polycythemia.
Secondary polycythemia is the body’s response to hypoxemia from
causes such as lung disease or living at high altitudes. Polycythemia
vera is a high red blood cell count without associated lung disease
or dehydration. It is usually associated with neoplastic disease.
Relative polycythemia is associated with poor intake and
dehydration. Anemia of any type is associated with a low red blood
cell count.

Question 25
0 out of 0 points
The shift to anaerobic metabolism in shock results in
Selected Answer:
Correct Answer:
Response
Feedback:
Decreased oxygen utilization
Increased lactate production
When the citric acid cycle is inhibited, pyruvate accumulates in the
cytoplasm. Pyruvate accumulation would quickly inhibit further
glycolysis and shut down ATP production entirely except that it can
be converted to a substance called lactate, which diffuses from the
cell and into the extracellular fluid. A shift to anaerobic metabolism
in shock does not result in metabolic alkalosis, decreased oxygen
utilization, or decreased hydrogen ion production.

Question 26
0 out of 0 points
What gene is associated with chronic myeloid leukemia (CML)?
Selected Answer:
Correct Answer:
bcr-abl
bcr-abl
Response
Feedback:
The bcr-abl fusion gene is the Philadelphia chromosome and is
associated with CML. TP53 is noted to have worse outcomes when
associated with acute myeloid leukemia (AML). RB is noted to have
worse outcomes when associated with acute myeloid leukemia
(AML). BRCA-1 is associated with an increase in breast cancer in
women.

Question 27
0 out of 0 points
Which term means cause of the disease ?
Selected Answer:
Correct Answer:
Response
Feedback:
Etiology
Etiology
Etiology is the cause or reason for a phenomenon. When the link
between an etiologic factor and development of a disease is less
than certain, but the probability is increased when the factor is
present, it is termed a risk factor. The mechanism of disease
development is called pathogenesis. The functional consequences of
these changes are the clinical manifestations.

Question 28
0 out of 0 points
Which drug is a protease inhibitor? (Select all that apply.)
Selected Answers:
Lamivudine (Epivir)
Nelfinavir (Viracept)
Fosamprenavir (Lexiva)
Correct Answers:
Nelfinavir (Viracept)
Atazanavir (Reyatax)
Fosamprenavir (Lexiva)
Response
Feedback:
Nelfinavir (Viracept), atazanavir (Reyatax), and fosamprenavir
(Lexiva) are protease inhibitors. Lamivudine (Epivir) and
zidovudine (Retrovir) are reverse transcriptase inhibitors.

Question 29
0 out of 0 points
How many liters of blood are circulating in the human body at any one time?
Selected Answer:
4 to 6
Correct Answer:
4 to 6
Response
Feedback:
There are 4 to 6 liters of blood circulating in the body at any one
time. Forty-five percent of the volume is blood cells (red blood cells
and white blood cells), and 55% is plasma volume (which contains
nutrients and plasma proteins). 1 to 2 and 2 to 3 liters are too low a
blood volume. 10 to 20 liters is an exaggerated amount of blood
volume.

Question 30
0 out of 0 points
The kidneys excrete acids that include which of the following? (Select all that
apply.)
Selected Answers:
Lactic
Metabolic
Phosphoric
Hydrochloric
Correct Answers:
Lactic
Metabolic
Phosphoric
Hydrochloric
Response
Feedback:
Lactic acid is a metabolic acid. The kidneys normally excrete
metabolic acids. Acids that are not carbonic acid are called
metabolic acids because cells continuously produce them during
normal metabolism. The kidneys normally excrete metabolic acids.
Phosphoric acid is a metabolic acid. The kidneys normally excrete
metabolic acids. Hydrochloric acid is a metabolic acid. The kidneys
normally excrete metabolic acids. The kidneys can excrete any acid
from the body except carbonic acid, which is excreted solely by the
lungs. If a metabolic acid begins to accumulate in the blood, the
kidneys increase their acid excretion mechanisms to correct the
problem.

Question 31
0 out of 0 points
Which electrolyte is essential in ensuring a negative resting membrane potential?
Selected Answer:
Correct Answer:
Response
Feedback:
Sodium
Potassium
The major determinant of the resting membrane potential is the
difference in potassium ion concentration across the membrane;
thus the negative value of the resting membrane potential (RMP) is
determined by the ratio of intracellular to extracellular potassium
ion concentration. At rest, the membrane is permeable to K+, but not
to other positively charged cations, including calcium. At rest, the
membrane is permeable to K+, but not to other positively charged
cations, including sodium. Magnesium is not involved in the resting
membrane potential.

Question 32
0 out of 0 points
Anemia of chronic renal failure is caused by the lack of
Selected Answer:
Erythropoietin
Correct Answer:
Erythropoietin
Response
Feedback:
Erythropoietin is secreted by the kidney in response to hypoxia
caused by a low hemoglobin concentration. Erythropoietin
stimulates the bone marrow to produce mature red blood cells. The
tissue of the diseased kidney has difficulty producing this hormone.
A lack of adrenaline, thyroid hormone, and parathyroid hormone
are not factors in anemia of chronic renal failure.

Question 33
0 out of 0 points
An increase in which of these characteristics would be present in cells that
demonstrate hypertrophy?
Selected Answer:
Correct Answer:
Response
Feedback:
Size of cells
Size of cells
Hypertrophy is defined as an increase in cell mass (cellular
enlargement). A lipofuscin is a yellow to brown, granular, ironnegative lipid pigment found particularly in muscle, heart, liver, and
nerve cells; it is the product of cellular wear and tear, accumulating
in lysosomes with age. A vacuole is a small cavity in the cytoplasm of
a cell, bound by a single membrane and containing water (hydropic
swelling), food, or metabolic waste. Cells that are capable of mitotic
division generally increase their functional capacity by increasing
the number of cells by hyperplasia

Question 34
0 out of 0 points
A child with ill-fitting shoes developed a vesicle (small blister) that burst, releasing
clear watery fluid. The school nurse would document this drainage as
Selected Answer:
Correct Answer:
Response
Feedback:
Serous
Serous
Serous exudate is watery fluid such as that which collects under a
blister. This type of exudate generally accompanies mild
inflammation. Purulent exudate is called pus. Purulent exudate
generally occurs in severe inflammation accompanied by bacterial
infection. Large pockets of purulent exudate, called abscesses, must
generally be removed or drained for healing to take place. Fibrinous
exudate is sticky and thick and may have to be removed to allow
healing; otherwise, scar tissue and adhesions may develop.
Hemorrhagic exudate has a large component of red blood cells. This
type of exudate is usually present with the most severe
inflammation. Hemorrhagic exudate occurs with severe leakage
from blood vessels or after necrosis or breakdown of blood vessels.

Question 35
0 out of 0 points
Which term is used to describe an excess of red blood cells?
Selected Answer:
Correct Answer:
Response
Feedback:
Polycythemia
Polycythemia
Polycythemia is an excess of red blood cells. Anemia is a deficiency
of red blood cells. Pancytopenia is a decrease in red blood cells,
white blood cells, and platelets. Granulocytopenia is a decrease in
platelets.

Question 36
0 out of 0 points
Which statement(s) are true regarding replication of the HIV virus? (Select all that
apply.)
Selected
Answers:
HIV viruses that enter the cells must be converted to doublestranded DNA.
The DNA is a template copied by the DNA polymerase to make a
second DNA strand.
The process of HIV replication is responsible for the
ineffectiveness of many antiviral drugs.
Correct
Answers:
Accuracy of transcription is poor with multiple mutations.
The conversion of the DNA is made by the reverse transcriptase
from the viral DNA.
The DNA is a template copied by the DNA polymerase to make a
second DNA strand.
The process of HIV replication is responsible for the
ineffectiveness of many antiviral drugs.
Response
Feedback:
The accuracy of DNA transcription is poor, with mutations occurring
frequently. This conversion is made by the reverse transcriptase
from the viral RNA. The DNA is a template, and the DNA polymerase
copies it to make a second DNA strand and destroys the original
RNA strands. Mutations make it difficult for antivirals to work. Once
the virus enters the cell, it must be converted to single-, not double-,
stranded DNA. The accuracy of DNA transcription is poor, with
mutations occurring frequently.

Question 37
0 out of 0 points
Bacteria are categorized by which of their following? (Select all that apply.)
Selected Answers:
Shape
Site of infection
Reaction to staining
Correct Answers:
Shape
Need for oxygen
Reaction to staining
Response
Feedback:
Bacteria are named for their shape (cocci, rod, and spirochete),
their need for oxygen (aerobic or anaerobic), and their reaction to
staining (Gram-positive or Gram-negative). Site of infection is
related to parasites. Association with proteins and lipids is related
to viruses.

Question 38
0 out of 0 points
Which statement is false regarding hypophosphatemia?
Selected
Answer:
Correct
Answer:
Response
Feedback:
Hypophosphatemia is caused by factors that increase phosphate
intake.
Hypophosphatemia is caused by factors that increase phosphate
intake.
Hypophosphatemia is caused by factors that decrease phosphate
intake, shift phosphate from extracellular fluid into cells, increase
phosphate excretion, and cause loss of phosphate through abnormal
routes. Anorexia, malaise paresthesias, and impaired cardiac
functioning are classic signs of hypophosphatemia. A serum level
below 2.5 mg/dl is by definition hypophosphatemia. Symptoms are
seldom observable until phosphate levels fall below 1.0 mg/dl.

Question 39
0 out of 0 points
Which statements is true regarding serum potassium (K+) levels? (Select all that
apply.)
Selected Answers:
Hypokalemia is capable of causing elevated diastolic pressure.
Hyperkalemia can result in weakness in the lower extremities.
Hypokalemia can often cause muscle weakness.
Hypokalemia can result in a paralytic ileus.
Correct Answers:
Hyperkalemia can result in weakness in the lower extremities.
Hyperkalemia can be characterized by intestinal cramping.
Hypokalemia can often cause muscle weakness.
Hypokalemia can result in a paralytic ileus.
Response
Feedback:
Both low and high levels of K+ produce skeletal muscle weakness in
an ascending pattern in the lower extremities first, with flaccid
paralysis. Hyperkalemia causes intestinal cramping and diarrhea.
Hypokalemia results in abdominal distention, diminished bowel
sounds, and a paralytic ileus. Hypokalemia results in smooth muscle
relaxation which results in decreased diastolic pressure.

Question 40
0 out of 0 points
Which cell is from myeloid lineage? (Select all that apply.)
Selected Answers:
B cells
Natural killer cells
Granulocytes
Correct Answers:
Platelets
Monocytes
Granulocytes
Response
Feedback:
Platelets, monocytes, and granulocytes are from myeloid lineage.
B cells and natural killer cells are lymphoid.

Question 41
0 out of 0 points
Tachycardia, decreased or absent breath sounds on the affected side,
hyperresonance, and sudden chest pain on the affected side are clinical
manifestations of
Selected Answer:
Correct Answer:
Response
Feedback:
Sarcoidosis
Pneumothorax
Clinical features of a pneumothorax include tachycardia, decreased
or absent breath sounds on the affected side, hyperresonance, and
sudden chest pain on the affected side. General symptoms of
hypersensitivity pneumonitis may include chills, sweating,
shivering, myalgias, nausea, lethargy, headache, and malaise. The
patient may or may not have a fever. Respiratory symptoms may
include dyspnea at rest, dry cough, tachypnea, and chest discomfort.
Physical findings may include cyanosis (a late sign) and crackles
(rales) in the lung bases. Sarcoidosis is characterized by malaise,
fatigue, weight loss, fever chest discomfort, dyspnea of insidious
onset, and a dry, nonproductive cough. The clinical features of ARDS
usually include a history of a precipitating event that has led to a
low blood volume state ( shock state) 1 or 2 days prior to the onset
of respiratory failure. The patient may complain of sudden marked
respiratory distress. Early signs and symptoms include a slight
increase in pulse rate, dyspnea, and a low PaO2. The initial
presenting sign may be shallow, rapid breathing.

Question 42
0 out of 0 points
Contraction of vascular smooth muscle (referred to as vasomotor tone) is mostly
accomplished via the extrinsic mechanism of the autonomic nervous system,
resulting in which receptor response?
Selected Answer:
α-1
Correct Answer:
α-1
Response
Feedback:
Because arteries have the most smooth muscle, they are most
affected by central nervous system stimulation. The release of
norepinephrine (the postganglionic neurotransmitter) results in
arterial vasoconstriction via the α-1 receptors located on the
vascular smooth muscle walls Although β-2 receptors on smooth
muscles are affected, they only increase nutrient and oxygen
supplies to skeletal muscles via vasodilation, not vasoconstriction,
during times of stress. β-1 and α-2 receptor responses are not
involved in this scenario.

Question 43
0 out of 0 points
For proper pH balance within the human body, what is the ratio of bicarbonate
ions to carbonic acid molecules?
Selected Answer:
Correct Answer:
Response
Feedback:
20 bicarbonate ions to 1 carbonic acid molecule
20 bicarbonate ions to 1 carbonic acid molecule
The pH of any fluid is determined by the relative amounts of acids
and bases contained in it. For the pH of the blood to be within the
normal range, the ratio of bicarbonate ions to carbonic acid
molecules must be 20:1. The other ratios would not maintain
normal pH.

Question 44
0 out of 0 points
The laboratory analysis conducted on a child with chronic nasal drainage reveals
an elevated number of eosinophils on a white blood cell differential. Based on this
finding, which is most likely the cause of the nasal drainage?
Selected Answer:
Correct Answer:
Allergies
Allergies
Response
Feedback:
Eosinophils are particularly associated with an increase in number
during allergic reactions, particularly with sinus infections.
Neutrophils, not eosinophils, are seen to increase in numbers
related to bacterial and viral infections. Traditionally, the band
count has been used to differentiate bacterial from viral infections,
and a greater shift to the left is viewed as a more severe infection.
Basophils are also involved in wound healing and chronic
inflammatory conditions.

Question 45
0 out of 0 points
What occurs during an acute asthma attack? (Select all that apply.)
Selected Answers:
Sputum is often thick, tenacious, scant, and viscid.
Bronchoconstriction occurs.
Residual lung volume increases.
Forced expiratory volumes decrease.
Correct Answers:
Sputum is often thick, tenacious, scant, and viscid.
Bronchoconstriction occurs.
Residual lung volume increases.
Forced expiratory volumes decrease.
Response
Feedback:
Sputum is often thick, tenacious, scant, and viscid. Bronchospasm
are experienced during asthma attacks. Air becomes trapped
because of the inflammatory changes that occur so increasing
residual lung volume. Forced expiratory volumes decrease during
asthma attacks. Tidal does not remain constant during an asthma
attack.

Question 46
0 out of 0 points
Which condition is an endocrine disorder that causes elevated blood pressure?
(Select all that apply.)
Selected Answers:
Guillain-Barré syndrome
Coarctation of the aorta
Cushing disease
Hyperthyroidism
Correct Answers:
Cushing disease
Hyperthyroidism
Response
Feedback:
Endocrine disorders that result in hypertension include Cushing
disease and hyperthyroidism.
While Guillain-Barré syndrome results in hypertension, it is
neurologic disorder. While coarctation of the aorta causes high
blood pressure, it is a cardiac disorder. While pheochromocytoma
causes high blood pressure, it is a tumor of adrenal gland tissue.

Question 47
0 out of 0 points
Activation of the renin-angiotensin system in shock causes
Selected Answer:
Correct Answer:
Response
Feedback:
Fluid retention
Fluid retention
Renin triggers stimulates kidney nephrons to conserve sodium and
water. Renin triggers the formation of angiotensin II, which is a
potent vasoconstrictor. Renin triggers stimulates kidney nephrons
to conserve not shift sodium. Activation of the renin-angiotensin
system does not cause glucogenesis.

Question 48
0 out of 0 points
The study of specific characteristics and functions of a living organism and its parts
is called
Selected Answer:
Correct Answer:
Physiology
Physiology
Response
Feedback:
Physiology is the study of the mechanical, physical, and biochemical
functions of living organisms. Psychiatry is a branch of medicine
dealing with mental illness. Homeostasis is a dynamic steady state.
Pathophysiology refers to the disorder or breakdown of the human
body’s function.

Question 49
0 out of 0 points
The normal adult pH in the blood is
Selected Answer:
Correct Answer:
Response
Feedback:
Between 7.35 and 7.45
Between 7.35 and 7.45
An acceptable range is 7.35 to 7.45. 7.30 is slightly below the
normal range. If the blood becomes too acidic (less than 6.9) death
is likely. If the blood becomes too alkaline (greater than 7.8) death
is likely.

Question 50
0 out of 0 points
Systemic vascular resistance (SVR) can be indirectly estimated with the use of
which blood pressure measurement?
Selected Answer:
Correct Answer:
Response
Feedback:
Left ventricular end-diastolic pressure
Diastolic pressure
The systemic diastolic pressure is determined by the narrowing of
blood vessel diameter and therefore the resistance to blood flow,
whether from peripheral vascular constriction or atherosclerosis.
Systolic pressure is not as influenced by the narrowing of blood
vessel diameter. Pulmonary arterial pressure is generated by the
right ventricle ejecting blood into the pulmonary artery. By
definition, the volume of blood within a ventricle immediately
before a contraction is known as the end-diastolic volume.

Question 51
0 out of 0 points
What is the primary cause of airway obstruction in patients with chronic
bronchitis?
Selected Answer:
Correct Answer:
Response
Feedback:
Mucous plugs
Mucous plugs
Hypertrophy of mucosal glands and goblet cells leads to increased
mucous production; the mucus then combines with purulent
exudate to form bronchial plugs. Thickening of bronchial smooth
muscle occurs. Hyperventilation is not related to airway
obstruction. While infection may be evident, it is not the cause of
airway obstruction.

Question 52
0 out of 0 points
If the host’s immune system is compromised, resident florae may become
pathogenic, resulting in
Selected Answer:
Correct Answer:
Response
Feedback:
Opportunistic infections
Opportunistic infections
When normal florae are allowed to overgrow as a result of the
compromise of the host’s immune system, infection can result.
Salmonella requires the presence of a specific pathogen. Otitis
media is not generally considered an opportunistic infection.
Myocarditis is not generally considered an opportunistic infection

Question 53
0 out of 0 points
Which is true regarding catecholamines?
Selected Answer:
Correct Answer:
Response
Feedback:
They include epinephrine and norepinephrine.
They include epinephrine and norepinephrine.
Catecholamines include epinephrine and norepinephrine.
Norepinephrine is secreted from the sympathetic nerves, and
epinephrine is secreted from the adrenal medulla. Epinephrine and
norepinephrine cannot cross the blood-brain barrier. Epinephrine
and norepinephrine cause increased heart rate, blood pressure, and
blood flow to skeletal muscles.

Question 54
0 out of 0 points
Which condition explains the genetic basis for cancer development?
Selected Answer:
Loss of or defect in tumor suppressor genes
Correct Answer:
Loss of or defect in tumor suppressor genes
Response
Feedback:
Tumor suppressor genes inhibit cancer proliferation pathways.
Decreased immune function and exposure to ionizing radiation may
be factors but not the basis of cancer development. Infection by
oncogenic bacteria is not a factor, since bacterial infection is not
relevant.

Question 55
0 out of 0 points
Which chromosomal abnormalities has been linked with Down syndrome?
Selected Answer:
Translocation
Correct Answer:
Translocation
Response
Feedback:
Chromosomal translocations result from the exchange of pieces of
DNA between nonhomologous chromosomes. The exchange of a
long chromatid arm for a short one results in the formation of one
very large chromosome and one very small chromosome This is
called a Robertsonian translocation and is responsible for a rare
hereditary form of Down syndrome. Extra copies of a portion of
DNA is called duplication. Inversion refers to the removal and
upside-down reinsertion of a section of chromosome. Loss of
chromosomal material is called deletion.

Question 56
0 out of 0 points
Which lung zone has continuous perfusion throughout the cardiac cycle?
Selected Answer:
Zone 1
Correct Answer:
Response
Feedback:
Zone 3
Zone 3 has continuous perfusion through the entire cardiac cycle.
Pulmonary arterial pressure is greater than pulmonary venous
pressure. Zone 1 reflects blood flow through the apices and is
minimal. The alveolar pressure is higher than capillary pressure.
Zone 2 has pulmonary arterial pressure greater than the pressure
inside the alveoli during ventricular systole. Zone 2 has intermittent
perfusion. There is no recognized Zone 4.

Question 57
0 out of 0 points
Characteristics of allergic purpura lesions include which of the following? (Select
all that apply.)
Selected Answers:
Fever and itching
Bleeding from the lesions
Lesions located on the face
Correct Answers:
Fever and itching
Easily palpated lesions
Response
Feedback:
Purpura lesions are itchy and a fever is likely. They are raised and
are usually easily felt. Bleeding from the lesions themselves and
generalized bleeding are uncommon. The lesions tend to be found
on the proximal extremities, especially on the legs and buttocks. The
lesions tend to be found on the proximal extremities, especially on
the legs and buttocks.

Question 58
0 out of 0 points
The vasoactive mediators released in septic shock contribute to increase
Selected Answer:
Correct Answer:
Vascular permeability
Vascular permeability
Response
Feedback:
The kinin system is activated and bradykinin is released, which
results in vasodilation and increased capillary permeability.
Histamine also increases capillary permeability, which enhances
edema formation. Systemic vascular resistance is decreased in
septic shock. The complement system is activated with release of
C5a and C3a, which can produce microemboli and endothelial cell
destruction. The coagulation system is activated and may enhance
the development of microemboli. Histamine, a potent vasodilator, is
released by mast cells.

Question 59
0 out of 0 points
Which statement is true regarding asthma?
Selected Answer:
Correct Answer:
Response
Feedback:
It is characterized by airway inflammation.
It is characterized by airway inflammation.
Asthma is characterized by airway inflammation. There is
increased airway responsiveness to stimuli. The resulting airway
obstruction is usually reversible. Extrinsic asthma is child-onset
asthma.

Question 60
0 out of 0 points
Which statement is true regarding hypertension during pregnancy?
Selected
Answer:
Correct
Answer:
Response
Feedback:
More than 50% of pregnancies are complicated by high blood
pressure.
Cardiac output (CO) is reduced by 40% to 60% during
pregnancy.
CO decreases by 40% to 60% during the first two trimesters of
pregnancy. Only 12% to 22% of pregnancies are complicated with
hypertension. Blood pressure normally decreases during the first
two trimesters and gradually returns to normal levels during the
third trimester. Serious side effects of hypertension, including
seizure, fetal death, and maternal death, can occur during
pregnancy.

Question 61
0 out of 0 points
Cardiac output is the product of both
Selected Answer:
Stroke volume and heart rate
Correct Answer:
Stroke volume and heart rate
Response
Feedback:
The product of stroke volume and heart rate provides the amount
of cardiac output. None of the other options (MAP, SVR, or pulse
pressure) are factors in cardiac output.

Question 62
0 out of 0 points
A general mechanism noted in thrombocytopenia is which of the following? (Select
all that apply.)
Selected Answers:
Decreased platelet production
Decreased platelet survival
Hemorrhage
Correct Answers:
Decreased platelet production
Decreased platelet survival
Splenic sequestration
Intravascular dilution
Response
Feedback:
In thrombocytopenia, four mechanisms are involved, including the
decreased production of platelets, the decreased survival of
platelets, the sequestration (pooling) of platelets in the spleen, and
intravascular dilution. Hemorrhage is not one of the mechanisms
involved in thrombocytopenia.

Question 63
0 out of 0 points
Factors released by platelets contribute to hemostasis by enhancing
Selected Answer:
Correct Answer:
Response
Feedback:
Intrinsic pathway
Platelet aggregation
Platelets, when activated, release factors that lead to
vasoconstriction, platelet clumping, and vessel repair. Vasodilation
is not caused by platelet factors. The intrinsic pathway and
fibrinolysis are steps in clot formation.

Question 64
0 out of 0 points
Which is not one of the recognized components of the general adaptation
syndrome?
Selected Answer:
Correct Answer:
Response
Feedback:
Allostasis
Allostasis
Allostasis is a dynamic process that supports and helps the body
achieve homeostasis. Alarm, resistance, and exhaustion are the
three recognized components of Selye’s General Adaptation
Syndrome.

Question 65
0 out of 0 points
A contributing factor to the formation of an embolus includes which of the
following?(Select all that apply.)
Selected Answers:
Dislodged fat after long-bone surgery
Air bolus introduced by IV therapy
Foreign object in the blood stream
An infected blood vessel
Correct Answers:
Dislodged fat after long-bone surgery
Air bolus introduced by IV therapy
Foreign object in the blood stream
An infected blood vessel
Response
Feedback:
Fat emboli can occur after long-bone surgery or trauma. Air
introduced into the circulatory system can result in an air embolus.
Any foreign body in the circulating in the system can be the cause of
an embolus. An infection present in a vessel can trigger an embolus.
Chronic blood disorders like anemia are not generally triggers for
emboli.

Question 66
0 out of 0 points
What is the pathophysiologic phenomenon underlying disseminated intravascular
coagulation (DIC)?
Selected Answer:
Clotting that leads to bleeding
Correct Answer:
Clotting that leads to bleeding
Response
Feedback:
DIC is a result of widespread clot formation that consumes platelets
and clotting factors, which leaves the patient at risk for serious
bleeding. As the result of extensive clotting, platelet and fibrinogen
levels are decreased not increased. Inadequate cardiac outcome is
the fatal outcome of DIC. Mast cell degranulation is not relevant to
DIC.

Question 67
0 out of 0 points
Which waves on the ECG is representative of depolarization of the lateral walls?
Selected Answer:
Correct Answer:
Response
Feedback:
S wave
S wave
The S wave is representative of lateral wall depolarization. The Q
wave represents septal depolarization. The R wave represents
apical depolarization. The T wave represents ventricular
repolarization.

Question 68
0 out of 0 points
Which type of cellular adaptation would create the greatest concern if found on a
biopsy report?
Selected Answer:
Correct Answer:
Response
Feedback:
Dysplasia
Dysplasia
Dysplastic cells have significant potential to transform into
cancerous cells and are usually regarded as preneoplastic lesions.
Metaplasia is the replacement of one differentiated cell type with
another. This most often occurs as an adaptation to persistent
injury, with the replacement cell type better able to tolerate the
injurious stimulation and is fully reversible when the injurious
stimulus is removed. Hyperplasia is an increase in cell number
usually in response to physiologic demands, hormonal stimulation
or chronic cell injury. This is generally a normal adaptation, and not
nearly the concern of the correct option. Hypertrophy is an increase
in cell mass accompanied by an augmented functional capacity. This
is generally a normal adaptation, and of little or no concern.

Question 69
0 out of 0 points
On which area does cortisol have an anabolic effect?
Selected Answer:
Correct Answer:
Response
Feedback:
Protein
Protein
Cortisol has an anabolic effect on protein, leading to an increased
rate of protein synthesis. Cortisol has a catabolic effect on lymphoid
tissue Cortisol has a catabolic effect on muscle tissue. Cortisol has a
catabolic effect on skin.

Question 70
0 out of 0 points
Which statement is true regarding cancer? (Select all that apply.)
Selected
Answers:
The greater the undifferentiated cell count, the more aggressive
the cancer.
Malignant tumors have the potential to kill the host.
Anaplasia means more differentiated cells.
Metastasis means less differentiated cells.
Correct
Answers:
The greater the undifferentiated cell count, the more aggressive
the cancer.
Malignant tumors have the potential to kill the host.
Response
Feedback:
The greater the degree of anaplasia, the more aggressive the
malignant tumor. Malignant tumors, if left untreated, have the
potential to kill. Benign tumors often grow slowly than malignant
ones. Anaplasia is a lack of cell differentiation. Metastasis means the
invasion of cancer to distant sites.

Question 71
0 out of 0 points
Aging adults are more prone to dehydration as a result of lack of thirst triggers
resulting from
Selected Answer:
Correct Answer:
Response
Feedback:
Decreased osmolality in intracellular fluid
Increased osmolality of extracellular fluid
As the kidneys age, the tubules become less responsive to
antidiuretic hormone (ADH) and tend to lose too much water. The
excess water loss is accompanied by a decrease in thirst mechanism.
As a result, the elderly person is prone to dehydration. Intracellular
fluid status is not related to the thirst triggers. An increase in the
osmolality of extracellular fluid would result in a risk for
dehydration.

Question 72
0 out of 0 points
Which statement about oncogene activation is true? (Select all that apply.)
Selected
Answers:
Oncogenes may be introduced into the host cell by a retrovirus.
Proto-oncogenes may undergo a mutation thus becoming overly
active.
DNA sequences that normally suppress proto-oncogene
expression may be inactivated.
An error may occur in the replication of the chromosome such that
extra copies are produced.
Correct
Answers:
Oncogenes may be introduced into the host cell by a retrovirus.
Proto-oncogenes may undergo a mutation thus becoming overly
active.
DNA sequences that normally suppress proto-oncogene
expression may be inactivated.
An error may occur in the replication of the chromosome such that
extra copies are produced.
Response
Feedback:
At least four general ways in which proto-oncogenes can be
activated: oncogenes may be introduced into the host cell by a
retrovirus, a proto-oncogene within the cell may suffer a mutagenic
event that changes its structure and function, a DNA sequence that
normally regulates proto-oncogene expression may be damaged or
lost, thereby allowing the proto-oncogene to become abnormally
active, or an error in chromosome replication may occur and cause
extra copies to be produced, which is called amplification. Bacteria
do not carry genetic material into the cell genome, but retroviruses
may.

Question 73
0 out of 0 points
Which is an example of active immunity? (Select all that apply.)
Selected Answers:
Placental transfer of maternal antibodies
Yearly flu vaccination
Pneumonia vaccine
Breast-feeding
Correct Answers:
Yearly flu vaccination
Pneumonia vaccine
Response
Feedback:
Vaccinations, such as the yearly flu and pneumonia vaccines,
stimulate the host immune system to mount an immune response
and produce long-lived memory cells and antibody-secreting cells
that provide lasting protection, a process called active immunity.
Immunity acquired by the newborn via the placenta or via breast
milk and gamma globulin injections are examples of passive
immunity in which antibodies produced by one individual are
transferred to another. These antibodies provide only short-term
protection, because the host does not produce memory cells or
antibodies.

Question 74
0 out of 0 points
A heart that has to pump harder in order to effectively circulate blood is likely to
undergo which type of cellular adaptation?
Selected Answer:
Atrophy
Correct Answer:
Hypertrophy
Response
Feedback:
Cells hypertrophy in response to increased physiologic or
pathophysiologic demands. If the heart has to pump harder than
normal to meet the body s demand for oxygen and nutrients, the
cardiac cells will become larger, resulting in cardiac hypertrophy.
Atrophy results in cell death that would render the cells nonfunctional. Metaplasia is the replacement of one differentiated cell
type with another. Muscle contraction could possibly be lost rather
than enhanced. Hyperplasia would result in an increased number of
cells rather than an enhanced pumping capacity.

Question 75
0 out of 0 points
Which statement is true regarding carbonic acid (H2CO3)?
Selected
Answer:
If body fluids are too acidic, carbonic acid is excreted through the
respiratory system in the form of carbon dioxide and water.
Correct
Answer:
Response
Feedback:
If body fluids are too acidic, carbonic acid is excreted through the
respiratory system in the form of carbon dioxide and water.
If too much acid is present, bicarbonate (HCO3) picks up a hydrogen
(H+) molecule to form carbonic acid (H2CO3), and with the help of
the enzyme called carbonic anhydrase, the carbonic acid is then
excreted through the respiratory system in the form of carbon
dioxide (CO2) and water (H2O). The other statements do not reflect
effective utilization of carbonic acid (H2CO3)

Question 76
0 out of 0 points
The major risk factor for the development of lung cancer is
Selected Answer:
cigarette smoking
Correct Answer:
cigarette smoking
Response
Feedback:
Tobacco smoking is the major cause (85%) of lung cancer, with
approximately 160,000 deaths reported per year. While individuals
older than 50 years of age have an increased risk for developing
lung cancer; it is not comparable to that of a history of tobacco
smoking. A family history that includes non-tobacco use related lung
cancer doe have an impact on the risk for developing lung cancer; it
is not comparable to that of a history of tobacco smoking. Working
under conditions of asbestos exposure increases the risk for
developing lung cancer; it is not comparable to that of a history of
tobacco smoking.

Question 77
0 out of 0 points
In muscle hypertrophy, the hypertrophied cells increase in
Selected Answer:
Correct Answer:
Response
Feedback:
Size
Size
The cellular response to persistent, sublethal stress reflects the
cell’s efforts to adapt. A common adaptive response is hypertrophy
resulting in an increase in cell size. Hyperplasia is an increase in cell
number. An increase in calcium would be pathological and likely
result in tetany. An increase in accumulations would be pathological
and likely result in cell injury

Question 78
0 out of 0 points
A current diagnosis of tuberculosis requires a
Selected Answer:
Positive sputum culture for acid-fast bacillus
Correct Answer:
Positive sputum culture for acid-fast bacillus
Response
Feedback:
Three consecutive morning sputum specimens are obtained to
identify the slow-growing acid-fast bacillus and confirm a current
diagnosis of tuberculosis. A chest ray is used to confirm nodules
with infiltrates in the lung apex and posterior segments of the upper
lobes; not the definitive diagnostic result. The Mantoux test does not
distinguish between current disease and past infection.
Presentation of symptoms is not considered a definitive indication
of the disease.

Question 79
0 out of 0 points
Which statement(s) are true regarding the HIV virus structure? (Select all that
apply.)
Selected Answers:
There are two strands of RNA.
The nucleocapsid or core is composed of p17.
Between the envelope and core is a protein layer called p24.
Correct Answers:
There are two strands of RNA.
The gag gene encodes the core antigen proteins.
The pol gene encodes reverse transcriptase proteins
Response
Feedback:
There are two strands of RNA. The gag gene encodes the core
antigen proteins. The pol gene encodes reverse transcriptase
proteins. The core or nucleocapsid is composed of p24, not p17. The
layer between the envelope and core is protein p17, not p24.

Question 80
0 out of 0 points
Which terms refers to an increased speed of conduction?
Selected Answer:
Chronotropic
Correct Answer:
Dromotropic
Response
Feedback:
Dromotropic refers to increased speed of conduction. Inotropic
refers to increased contractile force. Chronotropic refers to
increased heart rate. Acetylcholine is a neurotransmitter for the
nervous system.

Question 81
0 out of 0 points
It is true that acute lymphoid leukemia (ALL) is
Selected Answer:
Primarily diagnosed in children
Correct Answer:
Primarily diagnosed in children
Response
Feedback:
ALL is a primarily a disorder occurring in children. All is highly
curable in children, less so in adults. Peak incidence is between
ages 3 and 7 years of age. A second rise occurs in middle age.

Question 82
0 out of 0 points
What is the marker of choice for detecting a myocardial infarction?
Selected Answer:
Elevated serum levels of cardiac troponin
Correct Answer:
Elevated serum levels of cardiac troponin
Response
Feedback:
Two proteins that make up part of the cardiac cell contractile
apparatus, troponins I and T, have become the markers of choice for
detecting MI. Cardiac troponin levels become elevated in serum at
about the same time as CK-MB, but they remain elevated for a
longer period. ST-segment elevation is thought to represent acute
cell injury and ischemia. An elevated level of serum CK-MB is a
highly specific indicator of MI and considered to be diagnostic.
However, CK-MB remains elevated for only 48 to 72 hours after MI.
Cardiac myoglobin levels are elevated in serum very quickly after
MI and may be helpful in early detection; however, cardiac
myoglobin is less specific than the other markers.

Question 83
0 out of 0 points
What causes a shift of the oxyhemoglobin curve to the left? (Select all that apply.)
Selected Answers:
Increased pH
Decreased H+ ions
Decreased temperature
Correct Answers:
Increased pH
Decreased H+ ions
Decreased temperature
Response
Feedback:
The shift of the curve to the left occurs with an increase in pH, a
decrease in H+ concentration, and with a decrease in temperature.
The shift of the oxyhemoglobin curve to the right enhances oxygen
release to the cell. The shift provides the increase in oxygen delivery
that is needed during stress, chronic disease, and exercise. The shift
of the curve to the left occurs with a decrease in 2,3-DPG, in some
congenital hemoglobinopathies, and with carboxyhemoglobin.

Question 84
0 out of 0 points
Which form(s) of anemia will present with macrocytes? (Select all that apply.)
Selected Answers:
Folate deficiency
Iron-deficiency
Thalassemia
B12
Correct Answers:
Folate deficiency
B12
Response
Feedback:
Folate and B12 deficiency causes the production of macrocytes in the
peripheral blood. In renal failure, the red blood cells are decreased
and may have spicules. Iron-deficiency anemia is described by the
presence of hypochromic and microcytic cells. Thalassemia is
caused by destruction or hemolysis of red blood cells

Question 85
0 out of 0 points
It is true that the Epstein-Barr virus is
Selected Answer:
Correct Answer:
Response
Feedback:
Considered a cause of Burkitt lymphoma
Considered a cause of Burkitt lymphoma
Research has implicated that the Epstein-Barr virus is a causative
factor in both Hodgkin disease and Burkitt lymphoma. Epstein-Barr
virus is ubiquitous, with 90% of adults having evidence of previous
infection. HIV, not Epstein-Barr, is linked to B-cell lymphoma while
B-cell lymphoma, not Epstein-Barr, is linked to HIV.

Question 86
0 out of 0 points
Which statement(s) are true regarding hemoglobin? (Select all that apply.)
Selected
Answers:
Oxyhemoglobin is hemoglobin-carrying oxygen.
Hemoglobin makes up 90% of dry weight of the red cell.
Polypeptide chains contain iron that makes up a heme
molecule.
Correct Answers:
Oxyhemoglobin is hemoglobin-carrying oxygen.
Hemoglobin makes up 90% of dry weight of the red cell.
Hemoglobin is composed of 2 pairs of polypeptide chains.
Polypeptide chains contain iron that makes up a heme
molecule.
Response
Feedback:
Oxyhemoglobin is hemoglobin that is carrying oxygen molecules.
Hemoglobin makes up about 90% of the dry weight of the red blood
cell, and is composed of two pairs of polypeptide chains: the globins.
Each globin has an attached heme molecule that is composed of iron
plus a protoporphyrin molecule. There are 300, not 100,
hemoglobin molecules per cell.

Question 87
0 out of 0 points
Which is a transport form for CO2 in the blood? (Select all that apply.)
Selected Answers:
Dissolved gas
As a bicarbonate ion
Association with hemoglobin (Hgb)
Correct Answers:
Dissolved gas
As a bicarbonate ion
Association with hemoglobin (Hgb)
Response
Feedback:
Carbon dioxide, a by-product of cellular metabolism, is transported
in the blood as a dissolved gas, as a bicarbonate ion (HCO 3), and in
association with hemoglobin (Hgb). Bivalent molecules are
molecules formed from two or more atoms bound together as a
single unit molecule. They are not a mechanism for transport of CO2
in the blood. Bone marrow is stimulated by a hormone growth
factor called erythropoietin. It is not a mechanism for transport of
CO2 in the blood.

Question 88
0 out of 0 points
A series of events occur during acute inflammation resulting from cellular injury.
Which event occurs initially?
Selected Answer:
Phagocytosis results in pus formation
Correct Answer:
Response
Feedback:
Brief constriction of vessel walls
Immediately after injury, the precapillary arterioles around the
injured area contract briefly. When phagocytosis is incomplete, a
collection of dead neutrophils, bacteria, and cellular debris, called
pus, may form at the site. After edema formation, blood flows
through areas of inflammation, causing neutrophils to move to the
sides of the blood vessels and roll along the endothelium of the
vessel wall. After vessel constrictions, the increased pressure along
with increased permeability pushes fluid out of the blood vessels
and into the surrounding tissue contributing to local swelling.

Question 89
0 out of 0 points
What stimulates the release of renin? (Select all that apply.)
Selected Answers:
Renal hypoperfusion
Parasympathetic activation
Decreased sodium delivery
Correct Answers:
Renal hypoperfusion
Sympathetic activation
Decreased sodium delivery
Response
Feedback:
Renal hypoperfusion, sympathetic activation, and decreased
sodium delivery stimulate renin release. Increased heart rate and
parasympathetic activation do not stimulate the release of renin.

Question 90
0 out of 0 points
A patient diagnosed with cancer presents with Cushing syndrome secondary to
excessive adrenocorticotropic hormone secretion. This syndrome is described as
Selected Answer:
Correct Answer:
Ionizing
Paraneoplastic syndrome
Response
Feedback:
Paraneoplastic syndromes are symptom complexes that cannot be
explained by obvious tumor properties; they occur in 10% to 15%
of patients with cancer. Many of these syndromes are associated
with excessive hormone production. Ionizing is a form of cancer
treatment (radiation). Hypercalcemia, an elevation of calcium ions,
may occur as a result of this syndrome. Opportunistic infection is
when the immune system is compromised and infections that are
normally eliminated by the immune system cause infection.

Question 91
0 out of 0 points
If a patient has a recessive trait, what is the genotype of this patient?
Selected Answer:
Correct Answer:
Response
Feedback:
aa
aa
aa refers to the genotype that will produce a recessive
characteristic. AA will produce the phenotype of the dominant gene.
It takes only one dominant gene in the genotype to produce a
phenotype that displays this dominant characteristic. Aa will
produce the phenotype of the dominant gene. It takes only one
dominant gene in the genotype to produce a phenotype that
displays this dominant characteristic. aA will produce the
phenotype of the dominant gene. It takes only one dominant gene in
the genotype to produce a phenotype that displays this dominant
characteristic.

Question 92
0 out of 0 points
Which retrovirus is believed to cause cancer? (Select all that apply.)
Selected Answers:
Human immunodeficiency virus (HIV)
Epstein-Barr virus
Parvovirus
Poxvirus
Correct Answers:
Human immunodeficiency virus (HIV)
Human T-lymphocyte virus type I
Epstein-Barr virus
Response
Feedback:
The HIV virus has been associated with Kaposi sarcoma. The human
T-lymphocyte virus type I has been associated with T-cell leukemialymphoma. The Epstein-Barr virus has been associated with Burkitt
lymphoma. Parvovirus results in fifth disease, a rash generally seen
in children. Poxvirus is most commonly associated with diseases
such as smallpox

Question 93
0 out of 0 points
When emphysema is a result of a α1-Antitrypsin disorder, assessment data is likely
to include which of the following? (Select all that apply.)
Selected Answers:
Client age younger than 50
Elevated levels of α1-Antitrypsin
Enzyme levels that are below normal
Correct Answers:
Client age younger than 50
No history of cigarette smoking
Enzyme levels that are below normal
Response
Feedback:
When emphysema occurs in young to middle-aged adults or before
the age of 50 in a smoker, it may be associated with a deficiency of
α1-antitrypsin activity in the lung. Cigarette smoking is not always a
risk factor when this hereditary disorder is present. α1-Antitrypsin
deficiency is a hereditary disorder characterized by low serum
levels (25 to 50 mg/dl). Research does not currently support race as
being a risk factor. α1-Antitrypsin deficiency is a hereditary disorder
characterized by low serum levels (25 to 50 mg/dl).

Question 94
0 out of 0 points
Acute bronchitis can be caused by which of the following? (Select all that apply.)
Selected Answers:
Influenza A
Coxsackie virus
Pseudomonas aeruginosa
Staphylococcus pneumoniae
Correct Answers:
Influenza A
Adenovirus
Coxsackie virus
Staphylococcus pneumoniae
Response
Feedback:
Influenza A, adenovirus, Coxsackie virus, and Staphylococcus
pneumoniae can cause acute bronchitis. Pseudomonas aeruginosa
does not cause acute bronchitis.

Question 95
0 out of 0 points
Chronic myeloid leukemia (CML) is characterized by which of the following?
(Select all that apply.)
Selected Answers:
Enlarged, painless lymph nodes
Elevated granulocyte count
Abdominal discomfort
Weight loss
Correct Answers:
Elevated granulocyte count
Abdominal discomfort
Weight loss
Response
Feedback:
Classic signs of CML include elevated granulocyte count, abdominal
discomfort, and weight loss. Enlarged painless lymph nodes are
seen with chronic lymphoid leukemia (CLL). Symptoms of acute
myeloid leukemia (AML) and acute lymphoid leukemia (ALL) are
similar and cause bone pain.

Question 96
0 out of 0 points
The local warmth that occurs during an inflammatory response is the result of
Selected Answer:
Swelling
Correct Answer:
Increased blood flow
Response
Feedback:
Because of the dilated blood vessels and open capillaries, more
blood is carried to the injured area and contributes to the redness,
pain, heat, and swelling of inflammation. While there may be effects
on the vascular system resulting from cellular injury, it is more
likely to affect vessel permeability. Leukocytosis is the recruitment
and emigration of leukocytes that are focused on destroying
possible pathogens. Swelling is one of the cardinal symptom of
inflammation, but it is not responsible for local warmth at the injury
site.

Question 97
0 out of 0 points
Lipid molecules cross cell membranes by
Selected Answer:
Using channel proteins as a membrane transport system
Correct Answer:
Diffusion
Response
Feedback:
The plasma membrane is composed of a lipid bilayer that is
impermeable to most water-soluble molecules, including ions,
glucose, and amino acids, but permeable to lipid-soluble substances,
such as oxygen and steroid hormones. Lipid-soluble molecules can
directly cross the lipid bilayer of cell membranes by simple
diffusion. Endocytosis is a process of cellular ingestion by which the
plasma membrane folds inward to bring substances into the cell.
Channel proteins are a form of active transport. Voltage-gated ion
channels are activated by changes in electrical potential difference
near the channel; these types of ion channels are especially critical
in neurons, but are common in many types of cells.

Question 98
0 out of 0 points
When the cause of a disease is due to unintended or unwanted medical treatment,
the term to describe this is
Selected Answer:
Correct Answer:
Response
Feedback:
Iatrogenic
Iatrogenic
Iatrogenic means that the cause was medical intervention.
Genotype refers to the genetic inheritance for a condition.
Idiopathic is when the cause of the condition is unknown.
Ecogenetics is a struggle between genetic makeup and
environment.

Question 99
0 out of 0 points
Which is a characteristic of cancer cells?
Selected Answer:
Correct Answer:
Response
Feedback:
Poor differentiation
Poor differentiation
Cancer cells lose their differentiated features and contribute poorly
or not at all to the function of their tissue. Cancer cells divide in an
unpredictable manner. Cellular cohesiveness is lacking among
cancer cells. Cancer cells do not reproduce uniformly in either size
or shape.

Question 100
0 out of 0 points
Which enzyme is responsible for rapidly unwinding and separating the DNA
strands?
Selected Answer:
Correct Answer:
Response
Feedback:
Polymerase
Helicase
Helicase is responsible for unwinding the DNA. Polymerase binds
the single strands of DNA so that they may be replicated.
Telomerase is needed to help replicate the ends of the DNA
fragments. The Okazaki fragments are backstitched in place by DNA
ligase.