Question 1.
1. A nurse practitioner student is familiarizing herself with the overnight admissions to an acute medical unit of a
university hospital. Which of the following patients would the student recognize as being least likely to have a
diagnosis of antiphospholipid syndrome in his or her medical history? (Points : 0.4)
A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident
A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic
attacks
A 30-year-old female with a diagnosis of left leg DVT and a pulmonary embolism
A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug
use
Question 2.
2. Which of the following statements most accurately conveys an aspect of lymphatic system activity? (Points : 0.4)
B and T lymphocyte development begins in the bone marrow and ends in the peripheral lymphoid structures.
B cells and macrophages are released from the bone marrow in their completed state.
Stem cells in the lymph nodes initiate and regulate the process of white cell synthesis.
Leukocytes bypass vascular circulation and are distributed instead by the lymphatic system.
Question 3.
3. A 30-year-old man has spent 5 hours on a cross-country flight seated next to a passenger who has been sneezing
and coughing, and the man has been inhaling viral particles periodically. Which of the following situations would most
likely result in the stimulation of the man's T lymphocytes and adaptive immune system? (Points : 0.4)
Presentation of a foreign antigen by a familiar immunoglobulin
Recognition of a foreign MHC molecule
Recognition of a foreign peptide bound to a self MHC molecule
Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell mediation
Question 4.
4. Following a course of measles, a 5-year-old girl developed scattered bruising over numerous body surfaces and
was diagnosed with immune thrombocytopenic purpura (ITP). As part of her diagnostic workup, blood work was
performed. Which of the following results is most likely to be considered unexpected by the health care team? (Points
: 0.4)
Increased thrombopoietin levels
Decreased platelet count
Normal vitamin K levels
Normal leukocyte levels
Question 5.
5. A 24-year-old woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates
neutrophilia with a shift to the left. She most likely has: (Points : 0.4)
A mild parasitic infection
A severe bacterial infection
A mild viral infection
A severe fungal infection
Question 6.
6. A nurse practitioner is providing prenatal care and education for a first-time expectant mother, 22 weeks' gestation,
who has a diagnosis of a sexually transmitted infection. Which of the following statements by the expectant mother
demonstrates an adequate understanding of vertical disease transmission and congenital infections? (Points : 0.4)
“Gonorrhea and chlamydia pose the greatest risks of transmission from mother to child.”
“I know that my baby will need observation for HIV signs and symptoms in the weeks following my delivery.”
“My baby could become infected either across the placenta or during the birth itself.”
“Prophylactic immunization will reduce my baby's chance of being born with an illness.”
,Question 7.
7. A 16-year-old female has been brought to her primary care nurse practitioner by her mother due to the girl's
persistent sore throat and malaise. Which of the following facts revealed in the girl's history and examination would
lead the nurse practitioner to rule out infectious mononucleosis? (Points : 0.4)
The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes.
Her liver and spleen are both enlarged.
Blood work reveals an increased white blood cell count.
Chest auscultation reveals crackles in her lower lung fields bilaterally.
Question 8.
8. Which of the following phenomena would be least likely to result in activation of the complement system? (Points :
0.4)
Recognition of an antibody bound to the surface of a microbe
The binding of mannose residues on microbial glycoproteins
Activation of Toll-like receptors (TLRs) on complement proteins
Direct recognition of microbial proteins
Question 9.
9. Which of the following patients is most likely to benefit from transplantation of thymic tissue or major
histocompatibility complex (MHC)-compatible bone marrow? (Points : 0.4)
A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use
A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM
A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells
A 9-year-old girl who has a diagnosis of IgA deficiency
Question 10.
10. A 29-year-old construction worker got a sliver under his fingernail four days ago. The affected finger is now
reddened, painful, swollen, and warm to the touch. Which of the following hematological processes is most likely
occurring in response to the infection? (Points : 0.4)
Proliferation of immature neutrophils
High circulatory levels of myeloblasts
Increased segmented neutrophil production
Phagocytosis by myelocytes
Question 11.
11. The blood work of a 44-year-old male patient with a diagnosis of liver disease secondary to alcohol abuse
indicates low levels of albumin. Which of the following phenomena would a clinician be most justified in anticipating?
(Points : 0.4)
Impaired immune function
Acid-base imbalances
Impaired thermoregulation
Fluid imbalances
Question 12.
12. A 2-year-old girl has had repeated ear and upper respiratory tract infections since she was born. A pediatrician
has determined a diagnosis of transient hypogammaglobulinemia of infancy. What is the physiological origin of the
child's recurrent infections? (Points : 0.4)
Antibody production by plasma cells is compromised because of impaired communication between B and T
cells.
The child had a congenital absence of immunoglobulin G (IgG) antibodies and her body is only slowly
beginning to produce them independently.
The child was born with immunoglobulin A (IgA) and immunoglobulin (IgM) antibodies, suggesting
intrauterine infection.
The child lacks the antigen presenting cells integral to normal B-cell antibody production.
, Question 13.
13. A 22-year-old female who adheres to a vegan diet has been diagnosed with iron-deficiency anemia. Which of the
following components of her diagnostic blood work would be most likely to necessitate further investigation? (Points :
0.4)
Decreased mean corpuscular volume (MCV)
Decreased hemoglobin and hematocrit
Microcytic, hypochromic red cells
Decreased erythropoietin levels
Question 14.
14. A 66-year-old female patient has presented to the emergency department because of several months of
intermittently bloody stools that has recently become worse. The woman has since been diagnosed with a
gastrointestinal bleed secondary to overuse of nonsteroidal anti-inflammatory drugs that she takes for her arthritis.
The health care team would realize that which of the following situations is most likely? (Points : 0.4)
The woman has depleted blood volume due to her ongoing blood loss.
She will have iron-deficiency anemia due to depletion of iron stores.
The patient will be at risk for cardiovascular collapse or shock.
She will have delayed reticulocyte release.
Question 15.
15. A 60-year-old woman is suspected of having non-Hodgkin lymphoma (NHL). Which of the following aspects of her
condition would help to rule out Hodgkin lymphoma? (Points : 0.4)
Her neoplasm originates in secondary lymphoid structures.
The lymph nodes involved are located in a large number of locations in the lymphatic system.
The presence of Reed-Sternberg cells has been confirmed.
The woman complains of recent debilitating fatigue.
Question 16.
16. A child has been diagnosed with thalassemia. Which of the following other health problems is the child at risk for?
(Points : 0.4)
Hypocoagulation
Iron and ferritin deficiencies
Splenomegaly and hepatomegaly
Neutropenia
Question 17.
17. A tourist presented to a primary care health clinic complaining of malaise, fever, and headache. She has
subsequently been diagnosed with Rocky Mountain spotted fever, a pathology caused by Rickettsiaceae. Which of
the followed statements best captures a characteristic trait of Rickettsiaceae? (Points : 0.4)
They are eukaryotic.
They have both RNA and DNA.
They have a distinct spiral-shaped morphology.
They are neither gram-negative nor gram-positive.
Question 18.
18. A 60-year-old male patient with an acute viral infection is receiving interferon therapy. The nurse practitioner is
teaching the family of the patient about the diverse actions of the treatment and the ways that it differs from other
anti-infective therapies. Which of the following teaching points should the nurse practitioner exclude? (Points : 0.4)
“Interferon can help your father's unaffected cells adjacent to his infected cells produce antiviral proteins that
limit the spread of the infection.”
“Interferon can help limit the replication of the virus that's affecting your father.”
“Interferon helps your father's body recognize infected cells more effectively.”
“Interferon can bolster your father's immune system by stimulating natural killer cells that attack viruses.”
1. A nurse practitioner student is familiarizing herself with the overnight admissions to an acute medical unit of a
university hospital. Which of the following patients would the student recognize as being least likely to have a
diagnosis of antiphospholipid syndrome in his or her medical history? (Points : 0.4)
A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident
A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic
attacks
A 30-year-old female with a diagnosis of left leg DVT and a pulmonary embolism
A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug
use
Question 2.
2. Which of the following statements most accurately conveys an aspect of lymphatic system activity? (Points : 0.4)
B and T lymphocyte development begins in the bone marrow and ends in the peripheral lymphoid structures.
B cells and macrophages are released from the bone marrow in their completed state.
Stem cells in the lymph nodes initiate and regulate the process of white cell synthesis.
Leukocytes bypass vascular circulation and are distributed instead by the lymphatic system.
Question 3.
3. A 30-year-old man has spent 5 hours on a cross-country flight seated next to a passenger who has been sneezing
and coughing, and the man has been inhaling viral particles periodically. Which of the following situations would most
likely result in the stimulation of the man's T lymphocytes and adaptive immune system? (Points : 0.4)
Presentation of a foreign antigen by a familiar immunoglobulin
Recognition of a foreign MHC molecule
Recognition of a foreign peptide bound to a self MHC molecule
Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell mediation
Question 4.
4. Following a course of measles, a 5-year-old girl developed scattered bruising over numerous body surfaces and
was diagnosed with immune thrombocytopenic purpura (ITP). As part of her diagnostic workup, blood work was
performed. Which of the following results is most likely to be considered unexpected by the health care team? (Points
: 0.4)
Increased thrombopoietin levels
Decreased platelet count
Normal vitamin K levels
Normal leukocyte levels
Question 5.
5. A 24-year-old woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates
neutrophilia with a shift to the left. She most likely has: (Points : 0.4)
A mild parasitic infection
A severe bacterial infection
A mild viral infection
A severe fungal infection
Question 6.
6. A nurse practitioner is providing prenatal care and education for a first-time expectant mother, 22 weeks' gestation,
who has a diagnosis of a sexually transmitted infection. Which of the following statements by the expectant mother
demonstrates an adequate understanding of vertical disease transmission and congenital infections? (Points : 0.4)
“Gonorrhea and chlamydia pose the greatest risks of transmission from mother to child.”
“I know that my baby will need observation for HIV signs and symptoms in the weeks following my delivery.”
“My baby could become infected either across the placenta or during the birth itself.”
“Prophylactic immunization will reduce my baby's chance of being born with an illness.”
,Question 7.
7. A 16-year-old female has been brought to her primary care nurse practitioner by her mother due to the girl's
persistent sore throat and malaise. Which of the following facts revealed in the girl's history and examination would
lead the nurse practitioner to rule out infectious mononucleosis? (Points : 0.4)
The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes.
Her liver and spleen are both enlarged.
Blood work reveals an increased white blood cell count.
Chest auscultation reveals crackles in her lower lung fields bilaterally.
Question 8.
8. Which of the following phenomena would be least likely to result in activation of the complement system? (Points :
0.4)
Recognition of an antibody bound to the surface of a microbe
The binding of mannose residues on microbial glycoproteins
Activation of Toll-like receptors (TLRs) on complement proteins
Direct recognition of microbial proteins
Question 9.
9. Which of the following patients is most likely to benefit from transplantation of thymic tissue or major
histocompatibility complex (MHC)-compatible bone marrow? (Points : 0.4)
A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use
A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM
A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells
A 9-year-old girl who has a diagnosis of IgA deficiency
Question 10.
10. A 29-year-old construction worker got a sliver under his fingernail four days ago. The affected finger is now
reddened, painful, swollen, and warm to the touch. Which of the following hematological processes is most likely
occurring in response to the infection? (Points : 0.4)
Proliferation of immature neutrophils
High circulatory levels of myeloblasts
Increased segmented neutrophil production
Phagocytosis by myelocytes
Question 11.
11. The blood work of a 44-year-old male patient with a diagnosis of liver disease secondary to alcohol abuse
indicates low levels of albumin. Which of the following phenomena would a clinician be most justified in anticipating?
(Points : 0.4)
Impaired immune function
Acid-base imbalances
Impaired thermoregulation
Fluid imbalances
Question 12.
12. A 2-year-old girl has had repeated ear and upper respiratory tract infections since she was born. A pediatrician
has determined a diagnosis of transient hypogammaglobulinemia of infancy. What is the physiological origin of the
child's recurrent infections? (Points : 0.4)
Antibody production by plasma cells is compromised because of impaired communication between B and T
cells.
The child had a congenital absence of immunoglobulin G (IgG) antibodies and her body is only slowly
beginning to produce them independently.
The child was born with immunoglobulin A (IgA) and immunoglobulin (IgM) antibodies, suggesting
intrauterine infection.
The child lacks the antigen presenting cells integral to normal B-cell antibody production.
, Question 13.
13. A 22-year-old female who adheres to a vegan diet has been diagnosed with iron-deficiency anemia. Which of the
following components of her diagnostic blood work would be most likely to necessitate further investigation? (Points :
0.4)
Decreased mean corpuscular volume (MCV)
Decreased hemoglobin and hematocrit
Microcytic, hypochromic red cells
Decreased erythropoietin levels
Question 14.
14. A 66-year-old female patient has presented to the emergency department because of several months of
intermittently bloody stools that has recently become worse. The woman has since been diagnosed with a
gastrointestinal bleed secondary to overuse of nonsteroidal anti-inflammatory drugs that she takes for her arthritis.
The health care team would realize that which of the following situations is most likely? (Points : 0.4)
The woman has depleted blood volume due to her ongoing blood loss.
She will have iron-deficiency anemia due to depletion of iron stores.
The patient will be at risk for cardiovascular collapse or shock.
She will have delayed reticulocyte release.
Question 15.
15. A 60-year-old woman is suspected of having non-Hodgkin lymphoma (NHL). Which of the following aspects of her
condition would help to rule out Hodgkin lymphoma? (Points : 0.4)
Her neoplasm originates in secondary lymphoid structures.
The lymph nodes involved are located in a large number of locations in the lymphatic system.
The presence of Reed-Sternberg cells has been confirmed.
The woman complains of recent debilitating fatigue.
Question 16.
16. A child has been diagnosed with thalassemia. Which of the following other health problems is the child at risk for?
(Points : 0.4)
Hypocoagulation
Iron and ferritin deficiencies
Splenomegaly and hepatomegaly
Neutropenia
Question 17.
17. A tourist presented to a primary care health clinic complaining of malaise, fever, and headache. She has
subsequently been diagnosed with Rocky Mountain spotted fever, a pathology caused by Rickettsiaceae. Which of
the followed statements best captures a characteristic trait of Rickettsiaceae? (Points : 0.4)
They are eukaryotic.
They have both RNA and DNA.
They have a distinct spiral-shaped morphology.
They are neither gram-negative nor gram-positive.
Question 18.
18. A 60-year-old male patient with an acute viral infection is receiving interferon therapy. The nurse practitioner is
teaching the family of the patient about the diverse actions of the treatment and the ways that it differs from other
anti-infective therapies. Which of the following teaching points should the nurse practitioner exclude? (Points : 0.4)
“Interferon can help your father's unaffected cells adjacent to his infected cells produce antiviral proteins that
limit the spread of the infection.”
“Interferon can help limit the replication of the virus that's affecting your father.”
“Interferon helps your father's body recognize infected cells more effectively.”
“Interferon can bolster your father's immune system by stimulating natural killer cells that attack viruses.”
