BIO 669 Exam 1 Questions and Accurate Answers (100% Correct) Latest Version.

BIO 669 Exam 1 Questions and Accurate Answers (100% Correct) Latest Version. Hypotension, tachycardia and low urine output are signs of hypovolemia 7.36 ph, high CO2 and high bicarbonate indicates fully compensated respiratory acidosis If water consists of 60% of TBW. Choose and assign corresponding percentages (40, 5,15 and 20). ICF = ECF= Interstitial = Intravascular = ICF=40; ECF=20; Interstitial = 15 and Intravascular = 5 Adaptive Immunity is programmed to respond to damage to the body whether the damaged tissue is septic or sterile False . Adaptive (Acquired) Immunity is the third line of defense in human body also called the immune response or immunity. Whereas the Innate Immune system is programmed to respond to damage to the body whether the damaged tissue is septic or sterile. 1. A patient in the Medical ICU has +3 pitting edema in the extremities, jaundice, icterus, and a grossly distended abdomen. Labs show that his albumin levels are 1.2. Which option below describe the process behind the ascites and pitting edema ? A. Decreased hydrostatic pressure B. Decreased capillary oncotic pressure C. Increased Interstitial hydrostatic pressure D. Decreased interstitial oncotic pressure B- decreased capillary oncotic pressure Which of the following is NOT a non volatile acid in the body? A. Lactic acid B. Phosphoric acid C. Hydroxybutyric acid D. Carbonic acid D- carbonic acid In one of the major acid/base buffering systems; the lungs will decrease __________ _________ by blowing off carbon dioxide and leaving water and the kidneys will regulate the levels of __________ to maintain a safe pH. Carbonic acid/bicarbonate A patient presents to your office you find; dysthymia, fatigue, decrease bowel sounds, thirst, and weakness. What potassium imbalance is this? Hypokalemia Hyponatremia usually causes the movement of _________into ____ Answer: water, cells Causes of hypernatremia, include: A excessive free water intake. B inappropriate administration of hypertonic saline solution. C over secretion of the hormone aldosterone. D Cushing syndrome. E ingesting large amounts of dietary sodium. Answer: B, C, D (some Causes of Hypernatremia) B inappropriate administration of hypertonic saline solution. C over secretion of the hormone aldosterone. D Cushing syndrome. Early changes of___________ includes tall __________ Hyperkalemia, peaked T waves A _______ is caused by an excess protein that is found in the skin during healing. Keloid Your pt has an ST depression as a well as an inverted T-wave, and prominent U wave on EKG monitoring. What lab value is likely responsible? a.) Magnesium 2.2 b.) Phosphorous 2.0 c.) Potassium 2.2 d.) Potassium 5.6 c.) Potassium 2.2 What is an electrolyte? a.) A substance that is responsible for controlling appetite and mood. b.) A hormone that is responsible for feelings of alertness throughout the day. c.) A mineral that has an electric charge, found dissolved in bodies of water d.) All of the above c.) A mineral that has an electric charge, found dissolved in bodies of water Alzheimer's disease is the result of a decrease in which neurotransmitter A. Dopamine B. Acetylcholine C. Norepinephrine D. Serotonin B. Acetylcholine An excessive amount of this electrolyte can contribute to decreased urine formation, the formation of SIADH, weakness, muscle twitching and cerebral edema A. Potassium B. Calcium C. Water D. Sodium D. Sodium All of these are causes of edema except: A: Increase in capillary hydrostatic pressure B: Decreased in plasma oncotic pressure C: Increased in capillary permeability D: Decrease in hydrostatic pressure D: Decrease in hydrostatic pressure _________ have similar effects to histamine in later stages A: prostaglandins B: Eosinaphils C: Leukotrienes D: Platelet-activating factors C: Leukotrienes Causes of metabolic alkalosis include all the following except: a) Mineralocorticoid deficiency B) Hypokalemia c) Thiazide diuretic therapy d) Recurrent vomiting a) Mineralocorticoid deficiency All are true about metabolic alkalosis except one: a) Associated with hyperkalemia b) Associated with decreased ionic calcium concentration c) Can be caused due to Primary hyperaldosteronism d) Can be caused due to Renin secreting tumor a) Associated with hyperkalemia Which of the following are 2 forces that favor filtration? A. Capillary hydrostatic pressure B. Plasma (capillary ) oncotic pressure C. Interstitial hydrostatic pressure D. Interstitial oncotic pressure A. Capillary hydrostatic pressure D. Interstitial oncotic pressure Immunization is an example of which type of immunity? A. Active B. Passive A. Active Immunity In order for someone to be diagnosed with AIDS what criteria must be met? a. CD4 T Cells 400 b. CD4 T Cells 150 c. CD4 T Cells 200 d. CD4 T Cells 400 c. CD4 T Cells 200 A 60 year old woman presents with a complicated wound to her left calf. Throughout the assessment you gather information from the patient and find out the patient is currently smoking. What information would you give to the patient in regards to her current smoking habits and her complicated wound? a. You can continue to smoke even with your current wound because it will not effect the healing process in any way. b. Smoking during the healing process can cause vasoconstriction therefore causing ischemia and interrupt the healing process. c. There are no reason for you to quit smoking since smoking does not effect our health in any way. d. You should stop smoking because it can increase your risk factors of getting lung disease and cardiovascular disease as well. b. Smoking during the healing process can cause vasoconstriction therefore causing ischemia and interrupt the healing process. Non-volatile acids such as lactic acid cannot be converted into a gas and excreted as __________, so they must be buffered through the __________. a) C02, kidneys b) HC03, respiratory system c) C02, respiratory system d) HC03, kidneys a) C02, kidneys As Na+ travels into the cell, ions travel outside to maintain equality which may lead to acid/base imbalances. a) Cl- b) H+ c) Ca++ d) HCO3 b) H+ What is the most abundant cation in the extracellular space? a. Potassium b. Chloride c. Sodium d. Magnesium c. Sodium Papilledema is an indicator of which of the following problem? a. Increased sodium retention b. Increased intracranial pressure c. Dehydration d. Widening of the foramen magnum b. Increased intracranial pressure Both _______ and ________ would be considered physical and/or mechanical barriers that contribute to the body's defense mechanisms. a.) normal body flora; cytokines b.) respiratory tract ciliary movement; neurons c.) Natural Killer Cells; epithelial cells of the skin d.) epithelial cells of the skin; respiratory tract ciliary movement d.) epithelial cells of the skin; respiratory tract ciliary movement Physical barriers are composed of tightly associated epithelial cells that comprise the skin and the lining of the GI tract which prevent entry of outside pathogens. Mechanical barriers remove pathogens that attempt to invade the physical barrier. Which of the following would not be a contributing factor to dysfunctional wound healing? a.) Infection b.) Minerals & Vitamins use c.) Diabetes d.) Ischemia b.) Minerals & Vitamins use Infection causes cell damage, diabetes impairs circulation, and ischemia causes cell death with collagen impairment. What is NOT true in regards to action potentials? a. Na+ gates are open b. Na+ gates are closed c. K+ gates are open d. it is an all or none event b. Na+ gates are closed The sympathetic nervous system is known for its _________ or ________ phenomenon. Whereas the parasympathetic nervous system is focuses on ______ and _____ response. fight-or-flight; rest and tranquility What systems with the buffer system are regulators of acid base balance? A. neurologic and cardiac B. renal and respiratory C. gastrointestinal and musculoskeletal B. renal and respiratory ________________are the cell needed to kill bacteria in the early inflammation stages. A. neutrophils B. basophils C. eosinophils A. neutrophils Which of the following are treatment options for HIV? Select all that apply. a. Reverse-transcriptase inhibitors b. Entrance inhibitors c. Exit inhibitors d. AZT e. Integrase inhibitors f. Protease inhibitor A, B, D, E, F a. Reverse-transcriptase inhibitors b. Entrance inhibitors d. AZT e. Integrase inhibitors f. Protease inhibitor Breastfeeding is considered which type of immunity? a. Active Immunity b. Adaptive Immunity c. Passive Immunity d. Transferred Immunity c. Passive Immunity Which of the following is NOT true about potassium? A) Diabetic ketoacidosis is associated with high serum potassium B) Insulin administration increases the extracellular concentration of potassium C) Aldosterone causes potassium excretion in urine D) Potassium deficiency delays ventricular repolarization B) Insulin administration increases the extracellular concentration of potassium Which of the following is true about metabolic alkalosis? Select all that apply. A) Can be caused by vomiting with hydrochloric acid loss B) Associated with hyperkalemia C) High bicarbonate, high pH lab results D) Hypoventilation as a compensatory mechanism A, C, D A) Can be caused by vomiting with hydrochloric acid loss C) High bicarbonate, high pH lab results D) Hypoventilation as a compensatory mechanism What Plasma Protein system has similarities to histamine and assists inflammatory cells by causing dilation of blood vessels, pain, and smooth muscle contraction? a) Compliment system b) Clotting system c) Kinin system d) none of the above c) Kinin system (specifically bradykinin) What is the bodies defense to viral infections? a) Interleukins b) Tumor necrosis factor-alpha c) Basophils d) Interferon d) Interferon Fill in the correct blanks: ________________ are antimicrobial peptides that inhibit microbial growth and require activation by proteolytic enzymes. A. Interferons B. B-defensins C. Collectins D. A-defensins D. A-defensins What is a shared symptom of hyperphosphatemia and hypercalcemia? A. Seizures B. Anorexia C. Cardiac dysrhythmias D. Muscle Weakness B. Anorexia (blank) is secreted by the posterior pituitary in response to an increase in plasma osmolality or a decrease in circulating blood volume. a. ACE b. ADH c. H20 d. ECF b. ADH (antidiuretic hormone) (blank) is the most prevalent ICF ion. It is required in order for glycogen to be able cross liver and skeletal muscle cells. If insulin is given when levels are low this may lead to an dangerously low levels of this ion. Potassium Which type of pressure attracts water from the capillary into the interstitial space? A. Capillary hydrostatic pressure B. Capillary oncotic pressure C. Interstitial hydrostatic pressure D. Interstitial oncotic pressure D. Interstitial oncotic pressure Which of the following is NOT a quality of adaptive immunity? A. Inducible B. Specific C. No memory D. None of the above C. No memory To achieve an acid-base balance, pulmonary compensation is ________ (fast or slow); while renal compensation is __________ (fast or slow). fast, slow (respectively) MHC class I molecules offer___________ antigens; MHC class II molecules offer ____________ antigens. (endogenous or exogenous) endogenous, exogenous (respectively) Hypokalemia may be caused by ______ (increased, decreased) potassium intake, a shift of potassium from _____ (ICF, ECF), to the _____ (ICF, ECF), increased _____ (ADH, Aldosterone), increased renal excretion, and ____ (alkalosis, acidosis). decreased, ECF, ICF, Aldosterone, alkalosis What are the macroscopic and microscopic hallmarks of inflammation? Macro= redness, swelling, heat, pain and loss of function of the inflamed tissues Micro= vasodilation, increased capillary permeability, accumulation of fluid and cells at the site of inflammation What percentage of total body water (TBW) is in a pediatric patient? a. 25% b. 50% c. 60% d. 75% d. 75% Which of the following is not a sign of hypokalemia? a. decreased neuromuscular excitability b. smooth muscle atony c. tall peaked T wave d. skeletal weakness C. tall peaked T wave All of the following are contributing factors to acidosis except: a. Too Much Acid b. Too Little Base c. Too Much Base d. Too Much Carbon Dioxide C. Too Much Base True or False: Oncotic pressure is responsible for the movement of water intra cellular and extracellular. False, it is Osmotic pressure The Natriuretic Peptide System decreases blood pressure by: a) Releasing ANH from atrial endocrine cells b) Signaling the body to secrete Aldosterone c) Signaling the body to secrete ADH d) Blocking the conversion of Angiotensin 1 into Angiotensin 2 a) Releasing ANH - signals body to excrete Na and thus water, which lowers BP. In acute inflammation, which of the following plasma proteins protects the kidneys from severe damage in a trauma patient experiencing hemolysis? a) C-reactive protein b) Fibrinogen c) Haptoglobin d) Amyloid c) Haptoglobin During hemolysis, hemoglobin spills out into the plasma and starts to make its way to the kidneys. Haptoglobin binds any free hemoglobin, which blocks oxidation/chemical reactants from binding to hemoglobin. It also marks the hemoglobin to be 'recycled elsewhere, not by the kidneys.' This prevents hemoglobin from binding with chemical reactants and being excreted by the kidneys, which would otherwise cause severe damage. As proteins leave the vessels and there is an increase of loss of fluids, this is known as, a) Metabolic acidosis b) active immunity c) capillary permeability d) colloid osmotic pressure c. capillary permeability The type of leukocyte associated with allergic responses is the neutrophil. a) True b) False b. False (the type of leukocyte is eosinophil) The movement of fluid between the vascular, interstitial space and lymphatics is a result of? A. Capillary oncotic pressure B. Hydrostatic pressure C.Net filtration D. Osmotic forces C. Net filtration Increased osmolality stimulates ADH, what will the secretions result in? A. Increased water reabsorption B. Less concentrated blood plasma C. More concentrated urine D. All the above D. All of the above Your patient arrives from an outside hospital in DKA. Report from outside hospital is the patient received a bolus of Insulin and the patients blood sugar dropped from 520 to 198 over the last two hours. What would you be concerned about with the quick drop in blood sugar. A. ICP B. Kidney Function C. Liver Function D. UTI A. ICP What is the most common electrolyte imbalance in the elderly? A. Hyperkalemia B. Hypokalemia C. Hypernatremia D. Hypokalemia D. Hypokalemia Which systems together with the body's buffer systems are the principal regulators of acid-base balance? a. Lymphatic and Respiratory systems b. Renal and Respiratory systems c. Cardiac and Skeletal systems d. Immune and Urinary sysytms B. Renal and Respiratory Vomiting, gastrointestinal suctioning, excessive bicarbonate intake, hyperaldosteronism, and diuretic therapy could indicate which condition? a. Respiratory alkalosis b. Respiratory acidosis c. Metabolic acidosis d. Metabolic alkalosis Metabolic alkalosis When CD 4 (B-helper) cells are limited, what can this cause? A. an increase in the adaptive immune response B. a decrease for oppurtunistic infections C. a decrease in the adaptive immune response D. a decrease in the white blood cell count C- a decrease in the adaptive immune response What can cause increased intercranial pressure? 1. An increase in protein 2. an increase in sodium 3. a decrease in blood pressure 4. a decrease in sodium D. a decrease in sodium Which of the following is NOT considered an antimicrobial peptide as a chemical barrier in the first line of defense? A. Defensins B. Collectins C. Cathelicidins D. Kinin D. Kinin What is the role of the Renin-angiotensin-aldosterone system in the sodium and chloride balance? A. Regulates intracellular electrical neutrality in relation to Na+ and H+ B. Causes sodium and water excretion C. Control Na+ retention and thus volume/pressure in the vascular system D. Increases capillary permeability C. Control Na+ retention and thus volume/pressure in the vascular system How is fluid maintained in the body? a.) Kidneys filtering electrolytes and water from the blood. b.) The thirst mechanism that stimulate thirst in response to increase the blood volume concentration. c.) Movement of fluid from intravascular to interstitial fluid a-Kidneys filtering electrolytes and water from the blood What is the importance of having electrolytes? a.) Balance the body's acid/base pH levels b.) Move nutrients out of cells c.) Move waste out of cells d.) Make sure that nerves, the heart, and brain work correctly e.) A, C, and D f.) All the above A, C, D a.) Balance the body's acid/base pH levels c.) Move waste out of cells d.) Make sure that nerves, the heart, and brain work correctly All immunogens are antigens, but not all _____________are_________________ Antigens, immunogens You have a patient that you admitted to the telemetry floor and you place them on the cardiac monitor to find peaked T-waves and ST segment changes. You know that ______________is the likely cause of the peaked T waves because this electrolyte shifts from ICF to ECF which will cause an increase in the ability of the heart to repolarize. a. Hypokalemia b. Hyperkalemia c. Hyponatremia d. Hypercalcemia B. Hyperkalemia _____________ positioning is flexion of arms, wrists, fingers with adduction in upper extremities. a. ) Decerebrate b. ) Decorticate c.) Tonic Clonic d.) Extensor B. Decorticate ____________ reactions are mediated by antigen-specific _____ and the products of tissue mast cells. a. ) Type 1 hypersensitivity, IgE b.) Type 2 hypersensitivity, IgE c.) Type 1 hypersensitivity, IgG d.) Type 2 hypersensitivity, IgG A. Type 1 hypersensitivity, IgE __________ is the main cation, ___________ charged ion in the blood. Chloride, positively Hydrogen, negatively Sodium, positively Potassium, negatively sodium, positively Which is most life threatening, causing cerebral edema, seizures and possible coma? Hyponatremia Hypercalcemia Hyperkalemia Hypocalcemia Hyponatremia Which medication for HIV blocks the step where HIV converts its RNA to DNA? a. Protease Inhibitors b. Reverse transcriptase inhibitors c. Integrase Inhibitors d. Fusion Inhibitors b. reverse transcriptase inhibitors Who are the first responders in the inflammatory process? a. Neutrophils b. Monocytes c. Macrophages d. Eosinophils a. Neutrophils While working a patient up for a suspected SCIDS diagnosis, which would you NOT expect to see: A,Increased WBC count on CBC B.. Decreased T Cell Production C.. Decrease B Cell Production D. Absent IgM and IgA levels A. a patient with SCIDs would be expected to have a very low WBC result. Your patient has required a significant increase in diuretic dosing due to increased blood pressures and fluid overload producing 4Liters of urine in the last 24 hours, what might you expect to see on morning lab work? A. Increased Potassium Levels B. Decreased potassium Levels C. Decreased WBC D. Decreased hemoglobin B. Decreased potassium Levels the kidneys are the most effective regulator of potassium, and increase in urine clearance would result in a lower K+ What is the total body water percentage for men, women, and children? Men- 60% Women- 50% Pediatrics- 75-80% What organ is the most efficient regulator of potassium levels? Kidney What is the name of the insoluble protein that is the main substance in coagulation? Fibrin The fluid within the cells is termed? What percentage of total body weight is this fluid? intracellular, 2/3 How many liters is the total volume of body water for a 70kg woman? Total body water percentage for woman is 50%. Answer is 35 liters A nurse is admitting a client who reports nausea, vomiting, and weakness. Upon assessment, the client has dry oral mucous membranes, temperature 38.5 C (101.3 F), pulse 92/min, respirations 24/min, skin cool with tenting present, and blood pressure 102/64. His urine is concentrated with a high specific gravity. Which of the following are clinical manifestions of fluid volume deficit? (Select all that apply) A. Decreased skin turgor B. Concentrated urine C. Bradycardia D. Low-grade E. Tachypnea A, B, D, E A. Decreased skin turgor B. Concentrated urine D. Low-grade E. Tachypnea A nurse is assessing a client who has hyperkalemia. Which of the following conditions is associated with this electrolyte imbalance? A. Diabetic ketoacidosis B. Heart failure C. Cushing's syndrome D. Thyroidectomy A. Diabetic Ketoacidosis Smoking delays the wound healing process due to this main reason a. Smoking increases bacterial growth on skin b. It causes vasodilation of blood vessels c. It causes vasoconstriction of blood vessels d. All of the above c. It causes vasoconstriction of blood vessels cannot be regulated by the lungs, and is therefore regulated by the kidneys (metabolic). a. Volatile acids b. Lactic acids c. Nonvolatile acids d. Carbonic acid C. Nonvolatile acids Bicarbonate to carbonate ratio should be 20:1. . helps maintain this ratio by breaking down carbonic acid into carbon dioxide and water for the lungs to blow off. a. Hydroxyl b. Carbonic anhydrase c. Angiotensin I d. Phosphate B. Carbonic Anhydrase __________ circulate in the blood and defend against extracellular microbes and microbial toxins. A.) Antigens B.) Lymphocytes C.) Plasma Cells D.) Antibodies D. Antibodies 2.) What are two early symptoms of metabolic acidosis? A.) Headache and Lethargy B.) Confusion and Coma C.) Diarrhea and Nausea D.)Blurred Vision and Dizziness A. Headache and Lethargy True or False: Autoimmune disease is more common in men and prevalence is decreasing. false: autoimmune disease is more common women and prevalence is increasing. The most severe complement deficiency is________ . The inability to activate____results in recurring life threatening infections. C3 deficiency: C5 Which of the following is true of nonvolatile acids such as sulfuric, phosphoric, lactic, and keto acids? A) They can be eliminated just as CO2 gas is on expiration B) They are not eliminated by the renal tubules C) They cannot be converted into a gas and therefore eliminated by the lungs D) You can regulate nonvolatile acids by simply making ventilation changes with patients needing respiratory support c. They cannot be converted into a gas and therefore eliminated by the lungs The respiratory system compensates by a)_______________ ventilation to expire carbon dioxide or by b)_______________ ventilation to retain carbon dioxide. In comparison, the renal system compensates by producing c)_________________ or d)_________________ urine. a. increasing b. decreasing c. acidic d. alkaline What should a patient suffering with liver failure be assessed for: a. Decreased oncotic pressure b. Increased hydrostatic pressure c. Increased oncotic pressure d. Decreased hydrostatic pressure A. Decreased oncotic pressure __________ phagocytes help to limit and control inflammation? a. Macrophage b. Lymphocyte c. Eosinophil d. Neutrophil C. Eosinophil True or False. Bradykinin is the most important product of the kinin system and causes vascular permeability, smooth muscle contraction, and pain. True Sodium balance is regulated by ___________, which increases reabsorption of sodium from the urine into the blood by the distal tubule of the kidney. a. potassium b. aldosterone c. ADH d. natriuretic hormones B. aldosterone Today, HIV is most commonly contracted via? a. homosexual intercourse b. heterosexual intercourse c. IV drug use d. in utero from infected mother to infant B. heterosexual intercourse A patient with c/o fever and lower back pain reports to the ER. Upon initial lab results, a/an _________ ESR rate would be a good indicator of the __________________ . a. decreased, acute inflammatory response b. increased, adaptive immune response c. increased, acute inflammatory response d. none of the above C. increased, acute inflammatory response Insulin promotes cellular entry of _________ Potassium EKG changes typically occur when serum potassium is 3 mEq/L, and include____segment sagging, ____wave depression, and ______ wave elevation. ST, T, U True or False: Phagocytes are produced in the bone marrow, enter the circulation, and migrate to the inflammatory site, where they develop into macrophages False (monocytes) What is the most common cause of hypochloremia? a) Vomiting b) Diarrhea c) Excessive drinking A. vomiting (causes loss of HCL) H2 receptors induce production of gastric acid in the stomach. Which medication is an H2 antagonist? a)Prilosec b)Tagamet c) Milk of Magnesia B. Tagamet (H2 antagonist) Following administration of insulin to correct an episode of diabetic ketoacidosis, the effect on potassium is a/an: a) decrease in intracellular potassium, increase in serum potassium concentration b) increase in intracellular potassium, decrease in serum potassium concentration c) no change in intracellular or extracellular potassium levels d) inrease in intracellular potassium, and an increase in serum potassium concentration b) increase in intracellular potassium, decrease in serum potassium concentration. It is important to monitor patients for hypokalemia following episodes of ketoacidosis - because insulin not only metabolizes glucose, but also potassium (driving in into the cells) - which results in a decrease in serum potassium levels. This results in effects suck as peaked T-waves and increased neuromuscular excitability, placing patients at risk for experiencing cardiac dysrhythmias. To correct the imbalance, potassium supplementation will likely need to be administered. Diabetics with elevated blood glucose levels are at risk of developing diabetic ketoacidosis, which is a form of: a) Respiratory acidosis b) Respiratory alkalosis c) Metabolic acidosis d) None of the above C. metabolic acidosis ______ helps balance out the sodium in terms of electrical effects, providing electroneutrality. a) Potassium b) Chloride c) Calcium d) Magnesium B. Chloride If sodium levels rise too much, this hormone will be triggered to try and increase the retention of water in attempt to balance out. a) ADH b) PRL c) ACTH d) TSH A. ADH (antidiuretic hormone) A patient in the emergency department is being treated for DKA. An insulin drip has been sent from pharmacy and the patient has 1 L of normal saline infusing. Patient's blood glucose is 633 and potassium is 3.1. What is your next priority step? A. initiate insulin infusion to address hyperglycemia B. replace potassium C. start a second L of normal saline D. perform a finger stick to reevaluate blood glucose B. Replace potassium potassium levels must be replaced prior to administering insulin due to the fact insulin causes potassium shifts True or false? To adjust pH levels, the lungs can efficiently excrete lactic acid to improve acidosis? False, the lungs are unable to excrete sulfuric acid, phosphoric acid, or lactic acid. These acids must be excreted by the kidneys. Which electrolyte is the most abundant in the extracellular fluid? Potassium Sodium Calcium Sodium Retaining carbon dioxide (CO2) causes a _________ in the PH of the body, also known as ___________ decrease, acidosis Giving insulin for a high potassium level pushes the potassium ________ the cell. inside A __________ is a chemical that can bind excessive _______ or OH- without a significant change in PH. Buffer, H+ Elevation of PCO2 as a result of ventilation depression is _____________________? Respiratory Acidosis A patient presents with SIADH. What finding would you NOT expect to see? A. Low serum sodium B. Decreased urine output C. Elevated serum sodium D. Edema C. Elevated serum sodium A patient present with deep ,labored breathing and a significantly elevated glucose. What alteration would you expect ABG's to show? A. Respiratory acidosis B. Metabolic acidosis C. Metabolic alkalosis D. Respiratory alkalosis B. Metabolic Acidosis What is the portion of the neuron called that receives a signal? a. Axon b. Nucleus c. Soma d. Dendrite D. Dendrite A patient reports to the emergency department with stroke-like symptoms, upon evaluation the patient is found to have expressive aphasia (difficulty forming words/sentences), what area of the brain has most likely been affected? a. Broca's b. Temporal c. Occipital d. Frontal A. Broca's A Patient has Metabolic Alkalosis. Which of the following best describes that condition A. HCO3 32, pH 7.50, CO2 37 B. HCO3 26, ph 7.45, CO2 35 C. HCO3 24, pH 7.35, CO2 40 D. HCO3 19, pH 7.30, CO2 50 A. HCO3 32, pH 7.50, CO2 37 Which plasma protein doesn't move across the capillary membrane and is responsible for generating plasma oncotic pressure? Albumin The treatment of hypernatremia and water deficit is to: a) give oral fluids b) give D5W c) give fluids quickly for dilution d) none of the above e) a and b only E. A and B only A. give oral fluids B. give D5W What operates in the lungs and the kidneys as a major extracellular buffer? carbonic acid - bicarbonate buffer What two forces favor filtration? A. Capillary hydrostatic pressure and Capillary oncotic pressure B. Interstitial hydrostatic pressure and Interstitial oncotic pressure C. Capillary hydrostatic pressure and Interstitial oncotic pressure D. Capillary oncotic pressure and Interstitial Hydrostatic Pressure C. capillary hydrostatic pressure and interstitial oncotic pressure Which of the following pH is indicative of high concentration of H+? A. 7.32 B. 7.40 C. 7.36 D. 7.48 A. 7.32 Besides sodium, aldosterone also regulates which electrolyte? A) Chloride B) Potassium C) Calcium D) Phosphorus B. Potassium The humoral immune response consists of molecules produced by T cells. True or False False (B cells) Hypokalemia is characterized by: a) slow repolarization and a spiked T-wave b) slow repolarization and a shallow T-wave c) rapid repolarization and a spiked T-wave d) rapid repolarization and a shallow T-wave B (slow repolarization and shallow T-wave) Which of the following is NOT true of Natural Killer Cells? a) they recognize and eliminate cells infected with viruses b) they produce cytokines and toxic molecules c) they are a vital component of the adaptive immune system d) forcing apoptosis, or cell suicide, of infected cell is one way NK cells operate C (they are a vital component of the adaptive immune system) What electrolyte should be closely monitored during insulin administration to an insulin dependent diabetic patient? potassium Sodium Chloride Magnesium Potassium An invading antigen would stay away from all of the following except: Red blood cells Immunoglobulins Neutrophils Red Blood Cells True or False: Starling Forces also known as net filtration is composed of 4 components, Capillary hydrostatic pressure, blood pressure, interstitial hydrostatic pressure, and interstitial oncotic pressure. FALSE, blood pressure is considered capillary hydrostatic pressure the real answer would include capillary oncotic pressure where blood pressure is placed in the statement. In severe hyperkalemia: a. Causes acute, chronic renal failure b. Causes hyperparathyroidism c. Causes cerebral edema and increased intracranial pressure d. Causes muscle weakness, loss of muscle tone and paralysis D. causes muscle weakness, loss of muscle tone and paralysis Acute, chronic renal failure is results of hyperphosphatemia Hyperparathyroidism is result of hypercalcemia Cerebral Edema, and increased ICP result of hyponatremia During acidosis will move from the cell into the plasma in exchange for Hydrogen ions. A.) protein B.) potassium C.) Keloids D.) Chemotactic factors B. Potassium This will activate the plasma protein system bringing about damage to bacteria or more recognition by macrophages. A.) Normal microbiome B.) Mannose-binding lectin (MBL) C.) opportunistic microorganisms D.) chemotactic factors B. Mannose-binding Lectin (MBL) Water balance is regulated primarily by _________________ hormone? Adrenocorticotrophic Thyroid Stimulating Antidiuretic Human growth ADH (antidiuretic) B-type natriuretic peptide (BNP) is produced where? Kidneys Atria Myocardium Ventricles D. Ventricles Which immunoglobulin is the most abundant class of immunoglobulins and is also responsible for transporting across the placenta and protecting the newborn for the first 6 months of life? IgA IgG IgM IgE IgI IgG An increase in immature leukocytes caused by rapid production and release is known as a: a. midline shift b. left shift c. right shift B. Left shift A patient has stage V chronic kidney disease. Which two imbalances might they have? a. hypomagnesemia and hypophosphatemia b. hypermagnesemia and hypophosphatemia c. hypermagnesemia and hyperphosphatemia d. hypomagnesemia and hyperphosphatemia C. hypermagnesemia and hyperphosphatemia Which of the following cause edema? Increase in capillary hydrostatic pressure Decrease in plasma oncotic pressure Increase in capillary permeability Lymph obstruction All of the above All of the Above HIV damages _____ cells, which results in a loss of help and activation from _____ and _____. CD4 (t-helper), CD8 cells (cytotoxic t-cells), B cells How does Interleukin-1 (IL-1), a proinflammatory, stimulate fever? Resets hypothalamic set point 2. While performing an incision and drainage of an abscess, the patient states they can feel sharp pain. What could you do differently to effectively numb the patient? A. Inject the abscess with additional anesthetic B. Move further away from the abscess, out of the area of infection, and inject with anesthetic C. Expect the patient to feel sharp pain because you cannot completely numb the area D. Attempt to numb the area with a different anesthetic B. Move further away from the abscess, out of the area of infection, and inject with anesthetic the pH surrounding an area of infection is lowers creating an acidic environment that will not allow the anesthetic to enter the cell. By moving away from the infection, you can successfully numb the area. Which of the following risk factors would put a patient at higher risk for delayed wound healing? a. diabetes b. obesity c. malnourishment d. all of the above D. all of the above True or False. You will need more local anesthetic if your patient has an infection in the area needing to be numb. a. True b. False A. True A 60 year old male presents to his PCP with reports of confusion, dizziness, and tingling in his extremities. His lab results reveal and elevated pH, slightly decreased HCO3, and a decreased PCO2. Which of the following would likely be his diagnosis. a. metabolic acidosis with respiratory compensation b. metabolic alkalosis with respiratory compensation c. respiratory acidosis with renal compensation d. respiratory alkalosis with renal compensation a. metabolic acidosis with respiratory compensation A 72 year old female with chronic renal failure presents with edema. which of the following is the mostly likely cause.. a. increased interstitial hydrostatic pressure b. increased capillary hydrostatic pressure c. decreased interstitial oncotic pressure d. increased capillary oncotic pressure B. increased capillary hydrostatic pressure A client has a parasitic infection. When checking the patient's lab values, which antibody level can the nurse expect to be elevated? A. IgA B. IgG C. IgM D. IgE D. IgE A client injures the right hand. When can the nurse expect neutrophils to arrive at the site of injury? A. 1 to 2 hours B. 30 minutes C. 6 to 12 hours D. 24 to 48 hours C. 6 to 12 hours A 30-year-old patient presented to the emergency department and is experiencing increased thirst, weight gain, and hypertension. Before looking at the lab results, which lab finding would you expect to find due to the patient's symptoms? a. Hyponatremia b. Hypercalcemia c. Hypokalemia d. Hypernatremia D. hypernatremia A hospital patient recently had surgery and now has a dilaudid PCA. The nurse finds the patient unresponsive with respiratory depression. What results would you expect to find after drawing an ABG? a. Respiratory alkalosis b. Respiratory acidosis c. Metabolic alkalosis d. Metabolic acidosis B. Respiratory Acidosis Which of the following is NOT reason why the elderly have decreased TBW? a. diminished thirst b. increased fat c. diminished renal function B. increased fat Which antibody is the original source, prior to the alteration of the B cell? a. A b. E c. G d. M M Sodium depletion from the plasma causes ________________ , leading to water moving into cells, potentially causing the cell membrane to rupture. a. decreased total body water b. hypoosmolality c. hyperosmolality d. hypernatremia C. hyperosmolality A patient comes in with a blood glucose of 465 mg/dl. They are weak, nauseous, and very thirsty. They are having Kussmaul breaths. Results from an arterial blood gas show a pH of 7.29, PaCO2 of 58 mm Hg, and bicarbonate of 33 mEq/L. What does this indicate? a. respiratory acidosis b. respiratory alkalosis c. metabolic acidosis d. metabolic alkalosis C. metabolic acidosis Natriuretic peptides are primarily produced by which part of the heart? A. Myocardium B. Epicardium C. Endocardium D. Atria A. myocardium Inflammation is mediated by three key plasma protein systems: complement system, clotting system and _________. A . Kinin system B. Cardi B system C. Defensin system D. Barrier system A. Kinin System What type of EKG changes will be seen in a patient with hyperkalemia? a. prolonged QT interval b. peaked T waves c. inverted U wave d. absent P wave B. Peaked T-waves When Cl- is permeable to the membrane, which direction with Cl- ions move? a. extracellular b. intracellular c. equally in both directions d. from the plasma to the intersticial fluid C. Equally in both directions What hormone is released causing vasodilation, in an effort to increase sodium and water excretion, therefore decreasing blood pressure: a. aldosterone b. naturetic peptides c. ADH d. renin B. Naturetic peptides The bodies ability to completely regenerate epithelial (liver and bone marrow) cells back to normal tissue following damage is known as _________________. a. compensatory hyperplasia b. primary intention c. epithelialization d. epidermal restoration A. compesatory hyperplasia Which is an example of a second line of defense in the body's immunity? A. Vomiting B. Local calor and loss of function C. Sloughing off of cells D. Blood vessel dilation E. B & D F. A & C E - Both B & D are second line defense mechanisms, while A & C both fall under the 1st line of defense. Which of the following causes of edema is matched correctly to the changes in Starling Forces? A. Lymphedema, decreased capillary hydrostatic pressure B. Hayfever, increased capillary permeability C. Cirrhosis of the liver, increased capillary oncotic pressure D. Burns, increased capillary hydrostatic pressure B. Hayfever is related to increased capillary permeability; Lymphedema is related to lymph obstruction; Cirrhosis is related to DECREASED plasma oncotic pressure, and Burns are related to increased capillary permeability Extracellular fluid is all of the fluid outside of the cells and includes the _________ fluid and ___________ fluid. interstitial and intravascular What lab result would help a clinician identify the type of acidosis their patient is experiencing? a. Bicarbonate b. Carbonic acid c. Anion gap d. Chloride C. anion gap The ability for neurons to conduct action potentials by skipping from a myelinated node of Ranvier to the next is called: a. saltatory conduction b. divergence c. convergence d. afferent pathway A. saltatory conduction Motor changes, including rigidity and posturing, may occur with Alzheimer disease if: a. the disease is of familial origin b. the posterior frontal lobes are involved c. the disease is not diagnosed quickly and treated with a cholinesterase inhibitor d. the temporal lobe is involved B. the posterior frontal lobes are involved True or False: Haptens become immunogenic after combining with larger molecules that function as carriers? True What is the most abundant protein in the body that aids in the healing of wounds? Collagen You should be concerned about what if you observe a patient with papilledema? a)kidney failure b)increased intracranial pressure c)cardiac arrest d)swelling of the hair follicles B. increased intracranial pressure (ICP) Symptoms of hyperkalemia include all of the following EXCEPT: a)loss of muscle tone b)intestinal cramping c)muscle weakness d)prolonged cardiac repolarization D. prolonged cardiac repolarization __________________ forces pull fluid from the capillaries in to the interstitial space and ______________ forces push fluid from the interstitial space back in to the capillaries. osmotic; hydrostatic Increased intracranial pressure, lethargy, confusion, seizures, decreased reflexes and sometimes coma are all symptoms of what? a. hypokalemia b. hyponatremia c. hypernatremia d. hypochloremia B. hyponatremia Hypovolemic hypernatremia occurs... a. With a loss of sodium without significant loss of water. Causes may include: SIADH, hypothyroidism, pneumonia, and glucocorticoid deficiency. b. With an increase in total body water and an increase in total sodium; resulting in hypervolemia. Common causes include: hypertonic saline, over secretion of ACTH or aldosterone, and near salt water drowning. c. With loss of free water with near normal body sodium concentration. Causes include: inadequate water intake, excessive sweating, fever, diarrhea, burns, vomiting, respiratory infections, DI. d. When there is a loss of sodium accompanied by a relatively greater loss of body water. Common causes would include: loop diuretics, osmotic diuretics, kidney failure, etc. d. When there is a loss of sodium accompanied by a relatively greater loss of body water. Common causes would include: loop diuretics, osmotic diuretics, kidney failure, etc. __________ arrive at the site of an injury/infection within 6-12 hours, are considered mature, are sensitive to acidic environments, and have a primary role of removing debris/dead cells. a. Eosinophils b. Neutrophils c. Monocytes d. Basophils B. Neutrophils Hypocalcemia shows clinical signs of ____________________? Neuromuscular excitability, tingling, spasm and intestinal cramping. Sodium concentration is regulated by the renal effects of ______________? Aldosterone Symptoms of hypomagnesemia include which of the following: (1) decreased reflexes, (2) nystagmus, (3) irritability, (4) muscle cramps ANSWER CHOICES: a) only 1 and 4 b) only 2 and 3 c) only 2, 3, and 4 d) All 4 listed are symptoms of hypomagnesemia C-only 2, 3, and 4 (hypomagnesemia causes increased reflexes, not decreased reflexes) Which statements are true relating to Reward Pathways in the brain: a) Reward Pathways are located in the limbic system (amygdala, hippocampus, and frontal cortex). b) Reward Pathways are the key to explaining why drug cravings can be so intense even years after the last drug use. c) Reward Pathways explain how drug usage is linked to places, smells, events, and other triggers of relapse. d) Reward Pathways are implicated in compulsive behaviors such as pathological gambling, sex, and overeating. e) Only b, c, and d are true f) a, b, c, and d are all true F- a, b, c, and d are true statements regarding the Reward Pathways in the brain The release of aldosterone promotes A. Water reabsorption B. Sodium Reabsorption C. Potassium Excretion D. All of the above D. all of the above Inflammation is only activated in response to specific types of injuries or infections. A. True B. False B. False The patient presents with recurrent sinus and pulmonary infections this could indicate what type of defect? a.) C9 b.) C3 c.) C2B d.) C2b B. C3 defect Which 3 types of cells are considered antigen-presenting cells? a.) B cells, T cells, phagocytes b.) T helper 2, T helper 1, NK cells c.) macrophages, B cells, dendritic cells d.) macrophages, RBC's, NK cells C. macrophages, B cells, dendritic cells Activated mast cells release ____________ inflammatory mediators immediately and release other inflammatory mediators more slowly after _____________ them? Preformed; synthesizing ___________ are the most effective in presenting antigen to naive immunocompetent Th cells? Dendritic Cells The principal mediators of fever in the inflammatory process include all the following EXCEPT: a. Interleukin-1 (IL-1) & interleukin-6 (IL-6) b. Tumor necrosis factor-alpha (TNF- a) c. bradykinin d. prostaglandins C. bradykinin An elderly woman presents to the ED with c/o headache, confusion and nausea with a recent diagnosis of pneumonia. On exam, papilledema, a swelling of the __________(a) is noted and hyponatremia is present. A possible cause of these symptoms is ___________ (b), the most common cause of hyponatremia in the elderly. a. optic nerve; b. SIADH (syndrome of inappropriate antidiuretic hormone) Write the type of immune cell beside its name. Choices are: Phagocytic innate, nonphagocytic innate, adaptive 1. Mast cell 2. Lymphocyte 3. Macrophage 4. Neutrophil Answers: 1. Nonphagocytic innate 2.Adaptive. 3. Phagocytic innate. 4. Phagocytic innate What is the difference between acidemia and acidosis? Acidemia is the state in which the PH of arterial blood is less than 7.35, but acidosis is the condition of having too much acid or too little base, regardless of PH. Excessive fluid within the intestitial space is called? Edema On the compliment cascade, a deficiency of ____ causes the most severe deficit due to its position at the merging site of three pathways. a. B2 b. C3 c. T4 d. CD8 B. C3 How do ACE inhibitors work to regulate water and sodium? a. ACE inhibitors block aldosterone secretion b. ACE inhibitors block natriuretic peptides in the myocardium c. ACE inhibitors block angiotensin-I from converting to angiotensin-II d. ACE inhibitors block the kidneys from producing renin c. ACE inhibitors block angiotensin-I from converting to angiotensin-II A 30 yo male presents in the ED with changes to his serum potassium levels. His EKG reveals a tall, peaked T wave. This finding on his EKG would be most consistent with: A) hypokalemia B) hyperkalemia B. Hyperkalemia a. Which synthesis of mediators induces pain? b.) And, which class of drugs are helpful in blocking this synthesis? a. prostaglandins; b. NSAIDS Upon assessment of your patient you notice she is taking quick short breaths and states she feel as though she can't catch her breath. You review her recent ABGs and they are as follows: pH 7.53, PaCO2: 23, and HCO3: 18. What could you assume this patient's acid-base imbalance would be? Is it partially compensated or uncompensated? Respiratory alkalosis partially compensated Solute contributes to the movement of water between cells and their surrounding medium by ______. a. Oncotic pressure b. Diffusion c. Osmotic pressure d. Hydrostatic pressure C. osmotic pressure An immune reaction to tissue of another individual would be considered what type of hypersensitivity response? a)Autoimmunity b) Alloimmunity c) Allergy B. alloimmunity Fever, increased respiration's, and urine output are the major causes of ________ in pediatric patients. Body water loss Which of the following can be symptoms of hyponatremia? a. cerebral edema b. lethargy and confusion c. joint pain d. tachycardia A, B, D joint pain not associated with hyponatremia Which of the following would indicate dysfunction in wound healing? a. granulation b. keloid scarring c. contraction d. epithelialization b. keloid scarring Edema is caused by all of the following EXCEPT: a) Increase in capillary hydrostatic pressure b) Increase in plasma oncotic pressure c) Increase in capillary pressure d) Lymph obstruction b) Increase in plasma oncotic pressure - Edema is caused by a decrease in plasma oncotic pressure The _______ histamine receptor is proinflammatory and stimulates the inflammatory response (such as hay fever) while the _________ histamine receptor is anti-inflammatory and stimulates gastric acid. H1, H2 What is the sodium level in the ECF and ICF? a) 145 mEq/L in ECF, 14 mEq/L in ICF b) 142 mEq/L in ECF, 12 mEq/L in ICF c) 136 mEq/L in ECF, 10 mEq/L in ICF d) 140 mEq/L in ECF, 20 mEq/L in ICF b) 142 mEq/L in ECF, 12 mEq/L in ICF Which of the following below influence the serum potassium levels in our body? i) aldosterone ii) insulin iii) epinephrine Answer choices a) i only b) i & ii c) i & iii d) all of the above D. all of the above TRUE or FALSE: Papilledema is associated with increased intracranial pressure and places the patient at higher risk for herniation. true Which antiretroviral therapy limits the ability of HIV to attack new cells: a. Protease inhibitors b. CCR5 Antagonist c. Integrase inhibitors d. Fusion inhibitors b. ccr5 antagonist There are several dysfunctions in wound healing. _____ is the development of tissues during wound healing that extend beyond original wound borders and will likely to reoccur. Dehiscence Hypertrophic scar Keloid scar Contracture scar keloid scar An 84 year old patient with COPD presents tachypneic, labored breathing, with increasing O2 requirements. Multiple tests are ordered, one being an ABG. ABG results are as followed: pH 7.23 CO2 70 HCO3 26 O2 60. What is the patient's ABG results displaying? Metabolic acidosis Acidotic neutrality Respiratory alkalosis Respiratory acidosis respiratory acidosis Which phagocytes are the main responders in early inflammatory response? Monocytes Macrophages Eosinophils Neutrophils Neutrophils Hypoventilation is a result of ___________ pco2 levels, causing_______________. Increased, respiratory alkalosis Decreased, respiratory alkalosis Increased, respiratory acidosis Decreased, respiratory acidosis Increased, respiratory acidosis What is it when the patient's pH is between 7.35-7.45, and both their HC03 and CO2 are abnormal? a. fully compensated b. partially compensated c. corrected d. uncompensated a. fully compensated Hypovolemic hypernatremia occurs when there is a loss of sodium and a greater loss of of the body's water, what can cause this? Select all that applies: a. use of loop diuretics b. infusion of hypertonic solution c. osmotic diuresis d. kidney failure (inability to concentrate urine) A, C, D a. use of loop diuretics c. osmotic diuresis d. kidney failure (inability to concentrate urine) List the clinical manifestations of inflammation Redness, swelling, heat and pain What is the difference in the T wave for hypokalemia and hyperkalemia Hyperkalemia- spiked T wave and Hypokalemia- shallow T wave The definition of AIDs includes a CD4 count less than ____? 200 Aldosterone not only conserves NA+, but also regulates ________ levels. potassium What three body systems are responsible for regulation of acid -base balance? A. Heart, lungs, liver B. Lungs, kidneys, bone C. Brain, heart, kidneys D. Lungs, heart, pancreas B. Lungs, kidneys, bone The most abundant cation in the ECF is ____________? A. Potassium B. Chloride C. Sodium D. Phosphorous C. Sodium Monocytes are produced where in the body? A. Liver B. Blood Steam C. Bone marrow D. GI system C. bone marrow What disease allows for the the organism to live within the phagosome and never merge with the lysosome unless accepted by the immune cells? A. Bovine spongiform encephalopathy B. Tuberculosis C. Steven Johnson Syndrome D. Acquired Neuromyotonia B. Tuberculosis _________ is the most abundant cation in the extracellular fluid? a. Ca++ b. Mg++ c. Na+ d. K+ C. Na+ These types of cells can detect signs of infection and go to activate lymphocytes to generate an acquired immune response. a. Monocytes b. Macrophages c. Dendritic cells d. Eosinophils C. Dendritic Cells All immunogens are ______, but not all ______ are immunogens. a. CD4 T Cells b. CD8 T Cells c. antigens d. immunoglobulins C. antigens Why do people with more body fat have proportionately less Total Body Water and tend to be more susceptible to dehydration? Fat is hydrophobic and very little water is contained in adipose cells When is aldosterone secreted? If the serum sodium concentration drops or if the vascular compartment loses volume or pressure. Autoimmunity is a disturbance in the immunologic tolerance of _______________. Examples are: __________________________________________________ self antigens Examples: Lupus, RA, Type I DM. What are the two most common causes of hypochloremia? 1. hyponatremia 2. elevated bicarbonate concentration Calcium serves an important role in the regulation of another electrolyte's function by blocking its channels. As a result, the effects of which electrolyte would be reduced in a state of hypercalcemia? a. Sodium b. Potassium c. Magnesium d. Phosphate a. sodium Which classes of drugs could you expect to see prescribed to assist in controlling symptoms caused by hypercalcemia? Select all that apply. a. Vitamin D supplementation b. Stool softeners c. Antiemetics d. Antidiarrheals B, C stool softeners, antiemetics Which deficiency has the most severe defect due to central role in compliment cascade? a. secondary deficiencies b. acquired immunodeficiency syndrome (AIDS) c. mannose-binding lectin (MBL) deficiency d. C3 deficiency d. c3 deficiency Serum potassium levels are influenced by a. Insulin b. Epinephrine c. Aldosterone d. all of the above e. A & C only d. all of the above Digitalis overdose (toxicity) may cause _______________ by inhibiting the Na-K ATPase pump and thus allowing potassium to remain outside the cell. Hyperkalemia Excessive Sodium intake resulting in hypervolemia presents with all of the following clinical manifestations EXCEPT: A) Increased Thirst B) Weight Loss C) Bounding pulse D) Increased Blood Pressure B) Weight loss---this actually results in weight gain because of the increase in TBW Which of the following is NOT an inflammatory response? A. Vasodilation B. Decreased WBC adherence C. Increase in vascular permeability B. Decreased WBC adherence B - The second line of defense is inflammation. Vascular responses of inflammation include: blood vessel dilation, increased vascular permeability and leakage, and WBC adherence to inner walls of vessels and migration through vessels. Proenzymes are enzymes that require ________. A. Activation B. Deactivation C. Reactivation A. Activation All proenzymes contain inactive enzymes that must be activated, once converted into an active enzyme, substrate of the activated enzyme becomes the next component in the cascade. Hyponatremia can be caused by? a) dehydration b) fluid shifts c) inadequate sodium intake d) all of the above d. all of the above _______________ causes muscle wasting (cachexia) and intravascular thrombosis TNF-alpha (tumor necrosis factor) Fevers can cause an increase in respiration rate (the second most common cause of fluid loss after urination), when referring to the pediatric patient why is this significant? (Explain) An infant's body weight is comprised of 75%-80% fluid, compared to an adult male where the body is only comprised of 60% fluid; this makes the child more susceptible to dehydration, change in electrolyte balance, and serious illness. A patient who presents with an anaphylactic reaction is often treated with Epinephrine, explain the benefits of using epi during a severe allergic reaction. A patient who is experiencing an anaphylactic reaction is often exhibiting a severe inflammatory response of the immune system causing constriction in the airway, swelling, and drop in blood pressure. The drug epi helps to reverse this reaction by constricting blood vessels which decreases swelling and increases blood pressure. It also works by relaxing muscles around the airways and lungs helping the patient to breath. In addition, it stops further progression of the reaction by inhibiting the release of additional antibodies from the body. Water movement between the ICF and ECF compartment is determined by: a.) Osmotic forces b.) plasma oncotic pressure c.) antidiuretic hormone d.) buffer system a. osmotic forces The directional migration of leukocytes along a chemical gradient is termed: a.) chemotaxis b.) endocytosis c.) margination e.) diapedesis a. chemotaxis Which of the following is a mechanism of edema formation: a. Increased capillary oncotic pressure b. Decreased tissue oncotic pressure c. Increased capillary hydrostatic pressure d. decreased capillary permeability C. increased capillary hydrostatic pressure which of the following makes changes to pressure/volume within the vasculature: a. natriuretic peptides b. renin-angiotensin-aldosterone-system c. baroreceptors d. all of the above D. all of the above a hypotonic alteration in extracellular sodium concentration is a. normal concentration of sodium. There is equal movements in and out. b. An increase in sodium concentration - results on movement of fluid out of the cells and cell shrinkage c. A decrease in sodium concentration- results in movement of fluid in the cells and cell swelling and possible bursting of cells. d. None of the above c. A decrease in sodium concentration- results in movement of fluid in the cells and cell swelling and possible bursting of cells. Which is incorrect about Lysozyme? Contained in mucous, tears, saliva, perspiration and ear wax Attacks the cell walls of gram-negative bacteria Attacks the walls of gram-positive bacteria Epithelial Cell-Derived Chemical Attacks the cell walls of gram-negative bacteria What acts as an antagonist to the renin-aldosterone cycle? Natriuretic Peptides Calcitonin Vasopressin Pepsin Natriuretic Peptides What is the blood test that measures acute inflammation? Sedimentation rate (ESR) or CRP T or F Men are more likely to get HIV by homosexual transmission. False, women acquire HIV more often through heterosexual transmission. Fluid moves out of capillaries by (osmosis or filtration) and into or out of cells by (osmosis or filtration). filtration; osmosis Hypercapnia means an excess of (metabolic acid or carbon dioxide) in the blood. carbon dioxide Which cytokine is responsible for causing fever by reacting with receptors cells on the hypothalamus that increases the body's thermostat? a. Tumor necrosis factor (TNF) b. chemokines c. interleukin 1 d. interferons C. interleukin 1 A 29 y/o patient arrives to the ED with symptoms of abdominal pain, recent weight loss of 10 pounds in 2 weeks, nausea and bouts of diarrhea. She states she just got back 2 days ago from a trip out of the country to Peru where she and her friends backpacked through indigenous forrest while eating "off the land", including drinking from streams and lakes they found along the way. Which class of immunoglobulins has a specialized function to defend against the suspected infection of this particular patient? a. IgM b. IgG c. IgD d. IgE D. IgE (parasitic infection) What happens at the early stages of bacterial infection before antigen processing: a. Migration of NK cells into defected area b. Migration of Neutrophils into the infected area c. TS, TC, and TH cells destroy invading bacteria in a non- specific way A & B a. Migration of NK cells into defected area b. Migration of Neutrophils into the infected area True or False, Follicle cells of the Thyroid gland produce Thyroglobulin while follicle cells of the parathyroid produce calcitonin. False Normal Sodium Level is ____ -_____ 135-145 Most serious health concern with hyponatremia is ________ _______ _________, which can be identified by _______ _______. increased intracranial pressure / Papilledema true/ false The body does not necessarily monitor sodium but instead monitors osmolarity to maintain homeostasis. true During the administration of a hypertonic IV solution, the mechanism involved in equalizing the fluid concentration between ECF and the cells is: A. Osmosis B. Diffusion C. Active Transport D. Facilitated Diffusion a. osmosis A patient has the following arterial blood gas results: pH 7.52; PaCO2 30 mmHg; HCO3 24 mEq/L. The nurse determines that these results indicate A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis d. respiratory alkalosis We have an expert-written solution to this problem! What facilitates the movement of water from the capillary into the interstitial space? a) Capillary Osmotic Pressure b) Net Filtration c) Capillary Hydrostatic Pressure d) Aldosterone c) Capillary Hydrostatic Pressure Hyperventilation can lead to? a) Metabolic Acidosis b) Respiratory Alkalosis c) Respiratory Acidosis d) Metabolic Alkalosis b) Respiratory Alkalosis The body monitors osmolarity and maintains homeostasis mostly through _______, ________, and _________. a. ADH, K+, Na+ b. ADH, aldosterone, natriuretic peptides c. Na+, aldosterone, K+ d. natriuretic peptides, aquaporins, colloids b. ADH, aldosterone, natriuretic peptides is a signaling molecule that attracts white blood cells? a. histamine b. eosinophil c. bradykinin d. chemokine d. chemokine True or False; Histamine H1 receptors present in smooth muscle of the bronchi and are responsible for pro-inflammatory response? a. True b. False a. true The exudate that results from the beginning stages of inflammation is: A) serous B) fibrinous C) Purulent D) Hemorrhagic a. serous Which line of immunity defense activates inflammation: A) First line B) second line C) third line D) fourth line b. second line What are key elements to distinguish AIDS from HIV? A) CD4 cells 200 cells/mm3, opportunistic cancers, opportunistic infections B) Having HIV longer than 10 years C)Requiring multiples drugs to treat HIV infection D) Positive Western Blot analysis A) CD4 cells 200 cells/mm3, opportunistic cancers, opportunistic infections What is the most important buffering system to maintain a homeostatic blood pH level? A) Protein buffering B) Renal buffering C) Carbonic acid-Bicarbonate Pair buffering D) Kussmaul Respiration buffering C) Carbonic acid-Bicarbonate Pair buffering The nursing instructor knows that the student understands Alloimmune disorders then the student correctly identifies ____________ and __________ as Alloimmune reactions? A. blood transfusion B. rash after poison ivy exposure C. rejection of a transplanted kidney D. Lupus A, C . Alloimmune reactions are reactions to tissue from another human What lab abnormality would the nurse expect to see in a 30 yr. old patient recently diagnosed with a hormone secreting adrenal cortex tumor? A. hypoglycemia B. hypokalemia C. hyponatremia D. hyperkalemia B. Hypokalemia The adr