NR 507 Midterm Exam 50+ Questions {UPDATED} - Answers & Explanations | NR507 Midterm Exam 50+ Questions {UPDATED} - Graded A

NR 507 Midterm Exam 50+ Questions {UPDATED} Question 1. Question : Which substance has been shown to increase the risk of cancer when used in combination with tobacco smoking? : Alcohol Steroids Antihistamines Antidepressants Instructor Explanation: Alcohol interacts with smoke, increasing the risk of malignant tumors, possibly by acting as a solvent for the carcinogenic chemicals in smoke products. No current research supports the remaining options as having an increased effect on the incidence of cancer when used in combination with tobacco smoking. Points Received: 2 of 2 Comments: Question 2. Question : Which term is used to describe a muscle cell showing a reduced ability to form new muscle while appearing highly disorganized? : Dysplasia Hyperplasia Myoplasia Anaplasia Instructor Explanation: Anaplasia is defined as the loss of cellular differentiation, irregularities of the size and shape of the nucleus, and the loss of normal tissue structure. In clinical specimens, anaplasia is recognized by a loss of organization and a significant increase in nuclear size with evidence of ongoing proliferation. The remaining options refer to specific changes in the cell. Points Received: 2 of 2 Comments: Question 3. Question : What is the final stage of the infectious process? : Colonization Invasion Multiplication Spread Instructor Explanation: From the perspective of the microorganisms that cause disease, the infectious process undergoes four separate stages of progression: (1) colonization, (2) invasion, (3) multiplication, and (4) spread. Points Received: 2 of 2 Comments: Question 4. Question : What is the most common cause of insufficient erythropoiesis in children? : Folic acid deficiency Iron deficiency Hemoglobin abnormality Erythrocyte abnormality Instructor Explanation: Similar to the anemias of adulthood, ineffective erythropoiesis or premature destruction of erythrocytes causes the anemias of childhood. The most common cause of insufficient erythropoiesis is iron deficiency. The other options may be causes but are not common ones. Points Received: 2 of 2 Comments: Question 5. Question : Which statement is true concerning the IgM? : IgM is the first antibody produced during the initial response to an antigen. IgM mediates many common allergic responses. IgM is the most abundant class of immunoglobulins. IgM is capable of crossing the human placenta. Instructor Explanation: Typically, IgM is produced first (primary immune response), followed by IgG against the same antigen. The other options are not true statements regarding IgM. Points Received: 2 of 2 Comments: Question 6. Question : Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge? : Trachea Left lung Bronchus Bronchioles Instructor Explanation: Approximately 75% of aspirated foreign bodies lodge in a bronchus. The other options are not locations where children aspirate the majority of foreign objects. Points Received: 2 of 2 Comments: Question 7. Question : What is the role of caretaker genes? : Maintenance of genomic integrity Proliferation of cancer cells Secretion of growth factors Restoration of normal tissue structure Instructor Explanation: Caretaker genes are responsible for the maintenance of genomic integrity. The other options are not roles assumed by caretaker genes. Points Received: 2 of 2 Comments: Question 8. Question : During an IgE-mediated hypersensitivity reaction, which leukocyte is activated? : Neutrophils Monocytes Eosinophils T lymphocytes Instructor Explanation: Of the options provided, only eosinophils are activated during IgE-mediated hypersensitivity reactions. Points Received: 2 of 2 Comments: Question 9. Question : When a patient has small, vesicular lesions that last between 10 and 20 days, which sexually transmitted infection is suspected? : Genital herpes Chancroid Syphilis Chlamydia Instructor Explanation: If symptoms occur, the individual may have small (1 to 2 mm), multiple, vesicular lesions that are generally located on the labia minora, fourchette, or penis. They may also appear on the cervix, buttocks, and thighs and are often painful and pruritic. These lesions usually last approximately 10 to 20 days. The other options do not demonstrate these symptoms. Points Received: 2 of 2 Comments: Question 10. Question : What is the action of urodilatin? : Urodilatin causes vasoconstriction of afferent arterioles. It causes vasodilation of the efferent arterioles. Urodilatin inhibits antidiuretic hormone secretion. It inhibits salt and water reabsorption. Instructor Explanation: Urodilatin (a natriuretic peptide) inhibits sodium and water reabsorption from the medullary part of collecting duct, thereby producing diuresis. It is not involved in the actions described by the other options. Points Received: 2 of 2 Comments: Question 11. Question : Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction? : I II III IV Instructor Explanation: Hypersensitivity reactions have been divided into four distinct types: type I (IgE-mediated) hypersensitivity reactions, type II (tissue-specific) hypersensitivity reactions, type III (immune complex–mediated) hypersensitivity reactions, and type IV (cell-mediated) hypersensitivity reactions. Points Received: 2 of 2 Comments: Question 12. Question : What is the life span of platelets (in days)? : 10 30 90 120 Instructor Explanation: A platelet circulates for approximately 10 days and ages. Macrophages of the mononuclear phagocyte system, mostly in the spleen, remove platelets. Points Received: 2 of 2 Comments: Question 13. Question : An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody? : IgG IgM IgA IgE Instructor Explanation: The IgA molecules found in bodily secretions are dimers anchored together through a J-chain and secretory piece. This secretory piece is attached to the IgA antibodies inside the mucosal epithelial cells and may function to protect these immunoglobulin antibodies against degradation by enzymes also found in the secretions, thus decreasing the risk of infections in the mucous membrane. The other options do not accurately identify the immunoglobulin antibody involved in mucous membrane infections. Points Received: 2 of 2 Comments: Question 14. Question : What is the role of collagen in the clotting process? : Initiates the clotting cascade. Activates platelets. Stimulates fibrin. Deactivates fibrinogen. Instructor Explanation: In the clotting process, collagen provides a particularly strong stimulus to activate platelets. Collagen does not bring about any of the other options. Points Received: 2 of 2 Comments: Question 15. Question : How high does the plasma glucose have to be before the threshold for glucose is achieved? : 126 mg/dl 150 mg/dl 180 mg/dl 200 mg/dl Instructor Explanation: When the plasma glucose reaches 180 mg/dl, as occurs in the individual with uncontrolled diabetes mellitus, the threshold for glucose is achieved. Points Received: 2 of 2 Comments: Question 16. Question : Carcinoma in situ is characterized by which changes? : Cells have broken through the local basement membrane. Cells have invaded immediate surrounding tissue. Cells remain localized in the glandular or squamous cells. Cellular and tissue alterations indicate dysplasia. Instructor Explanation: Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or squamous cell origin. These early stage cancers are localized to the epithelium and have not broken through the local basement membrane or invaded the surrounding tissue. Dysplasia refers to changes in mature cell structure. Points Received: 2 of 2 Comments: Question 17. Question : How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness? : 75 to 100 ml 100 to 150 ml 250 to 300 ml 350 to 400 ml Instructor Explanation: When the bladder accumulates 250 to 300 ml of urine, it contracts and the internal urethral sphincter relaxes through activation of the spinal reflex arc (known as the micturition reflex). Points Received: 2 of 2 Comments: Question 18. Question : Low plasma albumin causes edema as a result of a reduction in which pressure? : Capillary hydrostatic Interstitial hydrostatic Plasma oncotic Interstitial oncotic Instructor Explanation: Losses or diminished production of plasma albumin is the only option that contributes to a decrease in plasma oncotic pressure. Points Received: 0 of 2 Comments: Question 19. Question : Examination of the throat in a child demonstrating signs and symptoms of acute epiglottitis may contribute to which life-threatening complication? : Retropharyngeal abscess Laryngospasms Rupturing of the tonsils Gagging induced aspiration Instructor Explanation: Examination of the throat may trigger laryngospasm and cause respiratory collapse. Death may occur in a few hours. This selection is the only option that accurately identifies the life-threatening complication that can result from an examination of the throat of a child who demonstrates the signs and symptoms of acute epiglottitis. Points Received: 2 of 2 Comments: Question 20. Question : Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child? : Parental history of asthma Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels Reduced expiratory flow rates confirmed by spirometry testing Improvement on a trial of asthma medication Instructor Explanation: Confirmation of the diagnosis of asthma relies on pulmonary function testing using spirometry, which can be accomplished only after the child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities. For younger children, an empiric trial of asthma medications is commonly initiated. The remaining options are major historical and physical factors that contribute but do not confirm the diagnosis of asthma in children. Points Received: 2 of 2 Comments: Question 21. Question : Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in infants? : Atelectasis and pneumonia Edema of the hands and feet Stasis ulcers of the hands, ankles, and feet Splenomegaly and hepatomegaly Instructor Explanation: Symmetric, painful swelling of the hands and feet (hand-foot syndrome) caused by infarction in the small vessels of the extremities is often the initial manifestation of SCD in infants. This selection is the only option that accurately identifies the manifestations of a vasoocclusive crisis associated with SCD in infancy. Points Received: 2 of 2 Comments: Question 22. Question : What process allows the kidney to respond to an increase in workload? : Glomerular filtration Secretion of 1,25-dihydroxyvitamin D3 Increased heart rate Compensatory hypertrophy Instructor Explanation: Compensatory hypertrophy allows the kidney to respond to an increase in workload throughout life. The remaining options are not relevant to accommodating an increased workload. Points Received: 0 of 2 Comments: Question 23. Question : If the sinoatrial (SA) node fails, then at what rate (depolarizations per minute) can the atrioventricular (AV) node depolarize? Question : If the sinoatrial (SA) node fails, then at what rate (depolarizations per minute) can the atrioventricular (AV) node depolarize? : 60 to 70 40 to 60 30 to 40 10 to 20 Instructor Explanation: If the SA node is damaged, then the AV node will become the heart’s pacemaker at a rate of approximately 40 to 60 spontaneous depolarizations per minute. Points Received: 0 of 2 Comments: Question 24. Question : How is most carbon dioxide (CO2) in the blood transported? : Attached to oxygen In the form of bicarbonate Combined with albumin Dissolved in the plasma Instructor Explanation: Approximately 60% of the CO2 in venous blood and 90% of the CO2 in arterial blood are carried in the form of bicarbonate. Points Received: 0 of 2 Comments: Question 25. Question : What is the trigone? : A smooth muscle that comprises the orifice of the ureter The inner mucosal lining of the kidneys A smooth triangular area between the openings of the two ureters and the urethra One of the three divisions of the loop of Henle Instructor Explanation: The trigone is a smooth triangular area lying between the openings of the two ureters and the urethra. The other options do not accurately identify the trigone. Points Received: 2 of 2 Comments: Question 26. Question : The Papanicolaou (Pap) test is used to screen for which cancer? : Ovarian Uterine Cervical Vaginal Instructor Explanation: The Pap test, an examination of cervical epithelial scrapings, readily detects early oncogenic human papillomavirus (HPV)infection. The Pap test is not used for screening the other cancer sites listed. Points Received: 2 of 2 Comments: Question 27. Question : The lung is innervated by the parasympathetic nervous system via which nerve? : Vagus Phrenic Brachial Pectoral Instructor Explanation: Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel only in the vagus nerve to the lung. Points Received: 2 of 2 Comments: Question 28. Question : Hypersensitivity is best defined as a(an): : Disturbance in the immunologic tolerance of self-antigens Immunologic reaction of one person to the tissue of another person Altered immunologic response to an antigen that results in disease Undetectable immune response in the presence of antigens Instructor Explanation: Hypersensitivity is an altered immunologic response to an antigen that results in disease or damage to the host. The other options are not accurate definitions of hypersensitivity. Points Received: 2 of 2 Comments: Question 29. Question : Causes of hyperkalemia include: : Hyperparathyroidism and malnutrition Vomiting and diarrhea Renal failure and Addison disease Hyperaldosteronism and Cushing disease Instructor Explanation: Hyperkalemia should be investigated when a history of renal disease, massive trauma, insulin deficiency, Addison disease, use of potassium salt substitutes, or metabolic acidosis exists. The other options are not known to be causes of hyperkalemia. Points Received: 2 of 2 Comments: Question 30. Question : Why is nasal congestion a serious threat to young infants? : Infants are obligatory nose breathers. Their noses are small in diameter. Infants become dehydrated when mouth breathing. Their epiglottis is proportionally greater than the epiglottis of an adult’s. Instructor Explanation: Infants up to 2 to 3 months of age are obligatory nose breathers and are unable to breathe in through their mouths. Nasal congestion is therefore a serious threat to a young infant. This selection is the only option that accurately describes why nasal congestion is a serious threat to young infants. Points Received: 2 of 2 Comments: Question 31. Question : Innervation of the bladder and internal urethral sphincter is supplied by which nerves? : Peripheral nerves Parasympathetic fibers Sympathetic nervous system Tenth thoracic nerve roots Instructor Explanation: The innervation of the bladder and internal urethral sphincter is supplied by parasympathetic fibers of the autonomic nervous system. The process is not dependent on any of the other options. Points Received: 2 of 2 Comments: Question 32. Question : What effect do natriuretic peptides have during heart failure when the heart dilates? : Stimulates antidiuretic hormones. Inhibits antidiuretic hormones. Stimulates renin and aldosterone. Inhibits renin and aldosterone. Instructor Explanation: Natriuretic peptides inhibit renin and aldosterone during heart failure when the heart dilates. These make up a group of peptide hormones, including atrial natriuretic peptide (ANP), secreted from myocardial cells in the atria and brain natriuretic peptide (BNP) secreted from myocardial cells in the cardiac ventricles. When the heart dilates during volume expansion or heart failure, ANP and BNP inhibit sodium and water absorption by kidney tubules, inhibit the secretion of renin and aldosterone, vasodilate the afferent arterioles, and constrict the efferent arterioles. The result is increased urine formation, leading to decreased blood volume and blood pressure. Points Received: 2 of 2 Comments: Question 33. Question : Infants are most susceptible to significant losses in total body water because of an infant’s: : High body surface–to–body size ratio Slow metabolic rate Kidneys are not mature enough to counter fluid losses Inability to communicate adequately when he or she is thirsty Instructor Explanation: Renal mechanisms that regulate fluid and electrolyte conservation are often not mature enough to counter the losses; consequently, dehydration may rapidly develop. Infants can be susceptible to changes in total body water because of their high metabolic rate and the turnover of body fluids caused by their greater body surface area in proportion to their total body size. The inability to communicate their thirst is a problem only when they are poorly cared for. Points Received: 2 of 2 Comments: Question 34. Question : What is the first stage in the infectious process? : Invasion Colonization Spread Multiplication Instructor Explanation: From the perspective of the microorganisms that cause disease, the infectious process undergoes four separate stages of progression: (1) colonization, (2) invasion, (3) multiplication, and (4) spread. Points Received: 2 of 2 Comments: Question 35. Question : Which statement concerning benign tumors is true? : The resulting pain is severe. Benign tumors are not encapsulated. Benign tumors are fast growing. The cells are well-differentiated. Instructor Explanation: A benign tumor is well-differentiated with its tissue appearing similar to the tissue from which it arose. The other options are characteristic of a malignant tumor. Points Received: 2 of 2 Comments: Question 36. Question : Perceived stress elicits an emotional, anticipatory response that begins where? : Prefrontal cortex Anterior pituitary Limbic system Hypothalamus Instructor Explanation: Perceived stressors elicit an anticipatory response that begins in the limbic system of the brain, the only option responsible for emotions and cognition. Points Received: 2 of 2 Comments: Question 37. Question : Between which months of age does sudden infant death syndrome (SIDS) most often occur? : 0 and 1 2 and 4 5 and 6 6 and 7 Instructor Explanation: The incidence of SIDS is low during the first month of life but sharply increases in the second month of life, peaking at 2 to 4 months and is unusual after 6 months of age. Points Received: 2 of 2 Comments: Question 38. Question : The most common site of metastasis for a patient diagnosed with prostate cancer is which location? : Bones Brain Bladder Kidney Instructor Explanation: The bone, especially the lumbar spine area, is the most common metastasis site for prostate cancer. Points Received: 2 of 2 Comments: Question 39. Question : An infant’s hemoglobin must fall below ___ g/dl before signs of pallor, tachycardia, and systolic murmurs occur. : 11 9 7 5 Instructor Explanation: When the hemoglobin falls below 5 g/dl, pallor, tachycardia, and systolic murmurs may occur. Points Received: 2 of 2 Comments: Question 40. Question : Continuous increases in left ventricular filing pressures result in which disorder? : Mitral regurgitation Mitral stenosis Pulmonary edema Jugular vein distention Instructor Explanation: Pressure changes are important because increased left ventricular filling pressures back up into the pulmonary circulation, where they force plasma out through vessel walls, causing fluid to accumulate in lung tissues (pulmonary edema). This selection is the only option that accurately identifies the disorder described in the question. Points Received: 2 of 2 Comments: Question 41. Question : What is the primary cause of respiratory distress syndrome (RDS) of the newborn? : Immature immune system Small alveoli Surfactant deficiency Anemia Instructor Explanation: RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange. None of the other options are related to the cause of RDS. Points Received: 2 of 2 Comments: Question 42. Question : Which blood cell type is elevated at birth but decreases to adult levels during the first year of life? : Monocytes Platelets Neutrophils Lymphocytes Instructor Explanation: Only monocyte counts are high in the first year of life and then decrease to adult levels. Points Received: 2 of 2 Comments: Question 43. Question : What physical sign is the result of turbulent blood flow through a vessel? : Increased blood pressure during periods of stress Bounding pulse felt on palpation Cyanosis observed on excretion Murmur heard on auscultation Instructor Explanation: Where flow is obstructed, the vessel turns or blood flows over rough surfaces. The flow becomes turbulent with whorls or eddy currents that produce noise, causing a murmur to be heard on auscultation, such as occurs during blood pressure measurement with a sphygomanometer. This selection is the only option that accurately identifies the physical sign of turbulent vascular blood flow. Points Received: 0 of 2 Comments: Question 44. Question : What is the life span of an erythrocyte (in days)? : 20 to 30 60 to 90 100 to 120 200 to 240 Instructor Explanation: Because it cannot undergo mitotic division, the erythrocyte has a limited life span of approximately 120 days. Points Received: 2 of 2 Comments: Question 45. Question : What is the most important negative inotropic agent? : Norepinephrine Epinephrine Acetylcholine Dopamine Instructor Explanation: Chemicals affecting contractility are called inotropic agents. The most important negative inotropic agent is acetylcholine released from the vagus nerve. The most important positive inotropic agents produced by the body are norepinephrine released from the sympathetic nerves that supply the heart and epinephrine released by the adrenal cortex. Other positive inotropes include thyroid hormone and dopamine. Many medications have positive or negative inotropic properties that can have profound effects on cardiac function. This selection is the only option that accurately identifies the regulation that is involved in the described process. Points Received: 0 of 2 Comments: Question 46. Question : Which term is used to identify the movement of gas and air into and out of the lungs? : Perfusion Ventilation Respiration Diffusion Instructor Explanation: Of the options available, ventilation is the only term used to identify the mechanical movement of gas or air into and out of the lungs. Points Received: 2 of 2 Comments: Question 47. Question : What effects do exercise and body position have on renal blood flow? : Exercise and body position activate renal parasympathetic neurons and cause mild vasoconstriction. They activate renal sympathetic neurons and cause mild vasoconstriction. Both activate renal parasympathetic neurons and cause mild vasodilation. They activate renal sympathetic neurons and cause mild vasodilation. Instructor Explanation: Exercise and change of body position activate renal sympathetic neurons and cause mild vasoconstriction. The other options do not have these effects on renal blood flow. Points Received: 2 of 2 Comments: Question 48. Question : What substance stimulates renal hydroxylation in the process of producing vitamin D? : Erythropoietin Thyroid hormone Calcitonin Parathyroid hormone Instructor Explanation: Parathyroid hormone stimulates renal hydroxylation in the process of producing vitamin D. The first step occurs in the liver with hydroxylation at the 25th carbon (calcifediol); the second step in hydroxylation occurs at the first carbon position in the kidneys. The other options are not involved in this process. Points Received: 2 of 2 Comments: Question 49. Question : Which hepatitis virus is known to be sexually transmitted? : A B C D Instructor Explanation: Only hepatitis B virus (HBV) is known to be sexually transmitted. Points Received: 0 of 2 Comments: Question 50. Question : Which statement concerning exotoxins is true? : Exotoxins are contained in cell walls of gram-negative bacteria. Exotoxins are released during the lysis of bacteria. Exotoxins are able to initiate the complement and coagulation cascades. Exotoxins are released during bacterial growth. Instructor Explanation: Exotoxins are proteins released during bacterial growth. The other options are not true of exotoxins. Points Received: 0 of 2 Comments: