NUR 631 FINAL EXAM, PRACTICE EXAM AND STUDY GUIDE NEWEST 2024 ACTUAL EXAM 350 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+

Which disorder is characterized by damage to the mucosa of the duodenum and jejunum and impaired secretion of secretin, cholecystokinin, and pancreatic enzymes? a. Wilson disease b. Cystic fibrosis c. Gluten/sensitive enteropathy d. Galactosemia - ....ANSWER...c. Gluten/sensitive enteropathy EXPLANATION: Gluten/sensitive enteropathy is characterized by damage to the mucosa of the duodenum and jejunum and has secondary effects that exacerbate malabsorption. The secretion of intestinal hormones, such as secretin and cholecystokinin, may be diminished. Because these chemical messengers are scarce, secretion of pancreatic enzymes and expulsion of bile from the gallbladder decrease. These statements are not true of the other options. page 1495 What factor associated with gluten/sensitive enteropathy (celiac sprue) causes an infant to bruise and bleed easily? a. Vitamin K deficiency from fat malabsorption b. Bone marrow function depression c. Iron, folate, and B12 deficiency anemias d. Prescribed daily warfarin ;Coumadin - ....ANSWER...a. Vitamin K deficiency from fat malabsorption Explanation: Deficiencies of fat/soluble vitamins (such as vitamin K) are common in children with gluten/sensitive enteropathy. Vitamin K malabsorption leads to hypoprothrombinemia, causing the child to bruise and bleed easily. This selection is the only option that accurately describes the mechanism that causes bruising and bleeding in children diagnosed with celiac sprue. page 1497 In an infant who is 6 weeks old, an increase in bilirubin production and persistent jaundice support which diagnosis? a. Pathologic hyperbilirubinemia b. Physiologic Jaundice c. Hepatitis A d. Infantile cirrhosis - ....ANSWER...a. Pathologic hyperbilirubinemia Explanation: Physiologic jaundice develops during the second or third day after birth and usually subsides in 1 to 2 weeks in full/term infants and in 2 to 4 weeks in premature infants. After this development, increased bilirubin values and persistent jaundice indicate pathologic hyperbilirubinemia. This selection is the only option that accurately identifies the diagnosis associated with these symptoms and timeline. page Physiologic jaundice in a newborn is caused by: a. Reabsorption of bilirubin in the small intestine b. Impaired hepatic uptake and excretion of bilirubin c. Increased bilirubin production d. Mild conjugated (indirect-reacting) hyperbilirubinemia - ....ANSWER...d. Mild conjugated (indirect-reacting) hyperbilirubinemia In children, the risk factors for hepatitis B virus (HBV) are primarily associated with: a. Living in urban communities b. Mothers who are hepatitis C carriers c. Transfusion therapy for hemophilia d. Those of hispanic ethnic background - ....ANSWER...c. Transfusion therapy for hemophilia Explanation: Risk factors for HBV infection include infants of mothers who are carriers of chronic hepatitis B surface antigen (HBsAg), hemophiliacs who receive frequent blood transfusions, children who abuse parenteral drugs, and children who live in residences for those who are mentally delayed. HBV is endemic in China and other parts of Asia where most infections occur in infants and children as a result of maternal/neonatal transmission. page 1502 Cystic fibrosis is directly responsible for complications to which structures? (Select all that apply.) a. Muscles b. Kidneys c. Lymph nodes d. Cervix e. Liver - ....ANSWER...d. Cervix e. Liver Explanation: Of the options available, only cervical inflammation and portal hypertension (liver) are complications directly related to cystic fibrosis. page 1495 Table 42-1 What type of fracture occurs at a site of a preexisting bone abnormality and is a result of a force that would not normally cause a fracture? a. Idiopathic b. Incomplete c. Pathologic d. Greenstick - ....ANSWER...c. Pathologic Explanation: Only a pathologic fracture is a break at the site of a preexisting abnormality, usually by force that would not fracture a normal bone. page 1541 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% Explanation: Generally, osteoporosis is radiographically detected as increased radiolucency of bone. By the time abnormalities are detected by x-ray examination, as much as 25% to 30% of bone tissue may have been lost. page 1555 A bone density of 645mg/cm would support which diagnosis? a. Osteoplasia b. Osteoporosis c. Osteopenia d. Osteomalacia - ....ANSWER...b. Osteoporosis Explanation: The World Health Organization (WHO) has defined osteoporosis on the basis of bone density. Normal bone is greater than 833 mg/cm ; osteopenia, or decreased bone mass is 633 to 648 mg/cm; osteoporosis is less than 648 mg/cm. This selection is the only accepted option. page 1550 Considering the pathophysiologic process of osteoporosis, after being activated by receptor activator of nuclear factor κB ligand (RANKL) receptor activator of nuclear factor κB (RANK) activates which of the following? a. Osteoclast apoptosis b. Osteoblast survival c. Osteoprotegerin d. Osteoclast survival - ....ANSWER...d. Osteoclast survival Explanation: RANKL activates the receptor RANK which is expressed on osteoclasts and their precursors and suppresses apoptosis, which leads to activation and the prolongation of osteoclast survival. This statement is not true of any of the other options. page 1553 Considering the pathophysiologic process of osteoporosis, which hormone exerts antiapoptotic effects on osteoblasts but proapoptotic effects on osteoclasts? a. Parathyroid hormone b. Glucocorticoid c. Growth hormone d. Estrogen - ....ANSWER...d. Estrogen Explanation: Data reveal that sex steroids (e.g. estrogens) exert antiapoptotic effects on osteoblasts but exert proapoptotic effects on osteoclasts; in both scenarios activating the extracellular signal-regulated kinases (ERKs) accomplish these effects. This process is not true of any of the other options. page 1553 Considering the pathophysiologic process of osteoporosis, what are the effects of extracellular signal-regulated kinases (ERKs) and receptor activator of nuclear factor κB 2 ligand (RANKL) on osteoblasts and osteoclasts? a. ERKs increase the life span of osteoclasts, and RANKL decreases the life span of osteoblasts. b. ERKs and RANKL increase the life span of osteoclasts and decrease the life span of osteoblasts. c. ERKs and RANKL increase the life span of osteoblasts and decrease the life span of osteoclasts. d. ERKs increase the life span of osteoblasts, and RANKL decreases the life span of osteoclasts - ....ANSWER...b. ERKs and RANKL increase the life span of osteoclasts and decrease the life span of osteoblasts. Exp: page 1553 What is the most common clinical manifestation of osteoporosis? a. Bone deformity b. Bone pain c. Pathologic fracture d. Muscle strain - ....ANSWER...a. Bone deformity Exp: page 1555 Which disorder is characterized by the formation of abnormal new bone at an accelerated rate beginning with excessive resorption of spongy bone? a. Osteomalacia b. Paget disease c. Osteoporosis d. Osteosarcoma - ....ANSWER...b. Paget disease Exp: Of the available options, only Paget disease (osteitis deformans) is a state of increased metabolic activity in bone characterized by abnormal and excessive bone remodeling, both resorption and formation. Chronic accelerated