NUR 5461 Final Practice Exam and
Modules 1, 2, 3 and 4 Answer Key
Questions and Correct Verified An
Question 1
Which bone cells produce osteocalcin when stimulated by 1,25-dihydroxyvitamin
D and synthesize osteoid?
A) Osteoclasts
B) Osteocytes
C) Fibrocytes
D) Osteoblasts
Answer: D) Osteoblasts
Rationale: Osteoblasts are the bone-forming cells that synthesize osteoid (the
organic bone matrix) and, when stimulated by 1,25-dihydroxyvitamin D, produce
osteocalcin, a non-collagenous protein important in bone mineralization.
Osteoclasts are responsible for bone resorption, not formation .
Question 2
A chronic complication of diabetes mellitus is likely to result in microvascular
complications in which areas?
A) Eyes only
B) Coronary arteries only
C) Eyes, renal system, and nerves
D) Peripheral vascular system only
Answer: C) Eyes, renal system, and nerves
Rationale: Chronic hyperglycemia damages capillary beds, leading to retinopathy
(eyes), nephropathy (kidneys), and neuropathy (nerves). Coronary and peripheral
vascular disease are macrovascular, not microvascular, complications .
,Question 3
Autonomic hyperreflexia-induced bradycardia is a result of stimulation of what?
A) Parasympathetic nervous system to the glossopharyngeal nerve to the
atrioventricular node
B) Sympathetic nervous system to β-adrenergic receptors to the sinoatrial node
C) Carotid sinus to the vagus nerve to the sinoatrial node
D) Bundle branches to the α-adrenergic receptors to the sinoatrial node
Answer: C) Carotid sinus to the vagus nerve to the sinoatrial node
Rationale: Autonomic hyperreflexia involves massive sympathetic discharge
below a spinal cord lesion, triggering baroreceptors in the carotid sinus, which
stimulates the vagus nerve to the sinoatrial node, causing reflex bradycardia .
Question 4
What is a hypersensitivity reaction that produces an allergic response called?
A) Hemolytic shock
B) Anaphylaxis
C) Necrotizing vasculitis
D) Systemic erythematosus
Answer: B) Anaphylaxis
Rationale: Anaphylaxis is an acute, systemic, IgE-mediated hypersensitivity
reaction characterized by widespread mast cell degranulation, vasodilation, and
bronchoconstriction, producing the classic "allergic" emergency .
Question 5
Where is the "gate" in the gate control theory (GCT) of pain located?
A) Substantia gelatinosa
B) Dorsolateral tract of Lissauer
C) Marginal layer
D) Nucleus proprius
Answer: A) Substantia gelatinosa
,Rationale: Gate control theory proposes that a "gate" in the substantia gelatinosa
of the dorsal horn modulates transmission of pain impulses to higher centers,
integrating input from large and small sensory fibers .
Question 6
What are blood transfusion reactions an example of?
A) Autoimmunity
B) Alloimmunity
C) Homoimmunity
D) Hypersensitivity
Answer: B) Alloimmunity
Rationale: Transfusion reactions occur when the recipient's immune system
recognizes donor antigens (e.g., ABO) as foreign and mounts an immune
response. This is alloimmunity—immunity against antigens from members of the
same species .
Question 7
By the time osteoporosis is visible on an x-ray examination, up to what percent of
bone has been lost?
A) 30%
B) 40%
C) 50%
D) 60%
Answer: A) 30%
Rationale: Plain radiographs are relatively insensitive; bone density must
decrease by about 25–30% before osteoporotic changes become evident, which is
why DEXA scanning is preferred for early detection .
Question 8
What is the term for cancer originating in connective tissues?
, A) Carcinoma
B) Sarcoma
C) Lymphoma
D) Adenoma
Answer: B) Sarcoma
Rationale: Sarcomas are malignant tumors arising from mesenchymal tissues such
as bone, muscle, fat, and connective tissue, distinct from carcinomas (epithelial
origin). Lymphomas arise from lymphoid tissue .
Question 9
Which antibody binds to a mast cell?
A) IgG
B) IgM
C) Cytotropic IgE
D) IgA
Answer: C) Cytotropic IgE
Rationale: Cytotropic IgE binds with high affinity to Fc receptors on mast cells and
basophils. On subsequent allergen exposure, cross-linking of bound IgE triggers
mast-cell degranulation and type I hypersensitivity reactions .
Question 10
Which statement best describes the cells and their functions in the humoral arm
of the immune system?
A) T-lymphocytes are primarily responsible for protection
B) Antibodies are primarily responsible for protection
C) Natural killer cells are primarily responsible for protection
D) Neutrophils are primarily responsible for protection
Answer: B) Antibodies are primarily responsible for protection
Modules 1, 2, 3 and 4 Answer Key
Questions and Correct Verified An
Question 1
Which bone cells produce osteocalcin when stimulated by 1,25-dihydroxyvitamin
D and synthesize osteoid?
A) Osteoclasts
B) Osteocytes
C) Fibrocytes
D) Osteoblasts
Answer: D) Osteoblasts
Rationale: Osteoblasts are the bone-forming cells that synthesize osteoid (the
organic bone matrix) and, when stimulated by 1,25-dihydroxyvitamin D, produce
osteocalcin, a non-collagenous protein important in bone mineralization.
Osteoclasts are responsible for bone resorption, not formation .
Question 2
A chronic complication of diabetes mellitus is likely to result in microvascular
complications in which areas?
A) Eyes only
B) Coronary arteries only
C) Eyes, renal system, and nerves
D) Peripheral vascular system only
Answer: C) Eyes, renal system, and nerves
Rationale: Chronic hyperglycemia damages capillary beds, leading to retinopathy
(eyes), nephropathy (kidneys), and neuropathy (nerves). Coronary and peripheral
vascular disease are macrovascular, not microvascular, complications .
,Question 3
Autonomic hyperreflexia-induced bradycardia is a result of stimulation of what?
A) Parasympathetic nervous system to the glossopharyngeal nerve to the
atrioventricular node
B) Sympathetic nervous system to β-adrenergic receptors to the sinoatrial node
C) Carotid sinus to the vagus nerve to the sinoatrial node
D) Bundle branches to the α-adrenergic receptors to the sinoatrial node
Answer: C) Carotid sinus to the vagus nerve to the sinoatrial node
Rationale: Autonomic hyperreflexia involves massive sympathetic discharge
below a spinal cord lesion, triggering baroreceptors in the carotid sinus, which
stimulates the vagus nerve to the sinoatrial node, causing reflex bradycardia .
Question 4
What is a hypersensitivity reaction that produces an allergic response called?
A) Hemolytic shock
B) Anaphylaxis
C) Necrotizing vasculitis
D) Systemic erythematosus
Answer: B) Anaphylaxis
Rationale: Anaphylaxis is an acute, systemic, IgE-mediated hypersensitivity
reaction characterized by widespread mast cell degranulation, vasodilation, and
bronchoconstriction, producing the classic "allergic" emergency .
Question 5
Where is the "gate" in the gate control theory (GCT) of pain located?
A) Substantia gelatinosa
B) Dorsolateral tract of Lissauer
C) Marginal layer
D) Nucleus proprius
Answer: A) Substantia gelatinosa
,Rationale: Gate control theory proposes that a "gate" in the substantia gelatinosa
of the dorsal horn modulates transmission of pain impulses to higher centers,
integrating input from large and small sensory fibers .
Question 6
What are blood transfusion reactions an example of?
A) Autoimmunity
B) Alloimmunity
C) Homoimmunity
D) Hypersensitivity
Answer: B) Alloimmunity
Rationale: Transfusion reactions occur when the recipient's immune system
recognizes donor antigens (e.g., ABO) as foreign and mounts an immune
response. This is alloimmunity—immunity against antigens from members of the
same species .
Question 7
By the time osteoporosis is visible on an x-ray examination, up to what percent of
bone has been lost?
A) 30%
B) 40%
C) 50%
D) 60%
Answer: A) 30%
Rationale: Plain radiographs are relatively insensitive; bone density must
decrease by about 25–30% before osteoporotic changes become evident, which is
why DEXA scanning is preferred for early detection .
Question 8
What is the term for cancer originating in connective tissues?
, A) Carcinoma
B) Sarcoma
C) Lymphoma
D) Adenoma
Answer: B) Sarcoma
Rationale: Sarcomas are malignant tumors arising from mesenchymal tissues such
as bone, muscle, fat, and connective tissue, distinct from carcinomas (epithelial
origin). Lymphomas arise from lymphoid tissue .
Question 9
Which antibody binds to a mast cell?
A) IgG
B) IgM
C) Cytotropic IgE
D) IgA
Answer: C) Cytotropic IgE
Rationale: Cytotropic IgE binds with high affinity to Fc receptors on mast cells and
basophils. On subsequent allergen exposure, cross-linking of bound IgE triggers
mast-cell degranulation and type I hypersensitivity reactions .
Question 10
Which statement best describes the cells and their functions in the humoral arm
of the immune system?
A) T-lymphocytes are primarily responsible for protection
B) Antibodies are primarily responsible for protection
C) Natural killer cells are primarily responsible for protection
D) Neutrophils are primarily responsible for protection
Answer: B) Antibodies are primarily responsible for protection
