Advanced Medical-Surgical Nursing
Midterm Exam
Course Introduction
Advanced Medical-Surgical Nursing is designed to deepen students' understanding of complex health conditions and the advanced clinical skills required to manage critically ill adult patients. The course covers comprehensive assessment, diagnosis, and evidence-based interventions across a spectrum of acute and chronic illnesses affecting various body systems. Emphasis is placed on clinical reasoning, interprofessional collaboration, advanced pharmacological management, technology integration, and patient-centered care. Students will also explore leadership roles, ethical considerations, and holistic support strategies to optimize patient outcomes in high-acuity hospital environments.
Recommended Textbook
Pathophysiology 6th Edition by
Jacquelyn L. Banasik
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54 Chapters
1199 Verified Questions
1199 Flashcards
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Chapter 1: Introduction to Pathophysiology
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Sample Questions
Q1) An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise program.This is an example of
A) primary prevention.
B) secondary prevention.
C) tertiary prevention.
D) disease treatment.
Answer: B
Q2) Your patient's red blood cell is slightly elevated today.This might be explained by (Select all that apply.)
A) gender difference.
B) situational factors.
C) normal variation.
D) cultural variation.
E) illness.
Answer: A,B,C,E
Q3) When the cause is unknown,a condition is said to be idiopathic
A)True
B)False
Answer: True
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Page 3
Chapter 2: Homeostasis, Allostasis, and Adaptive
Responses to Stressors
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Sample Questions
Q1) The effect of stress on the immune system A) is unknown.
B) has been demonstrated to be non-existent in studies.
C) most often involves enhancement of the immune system.
D) may involve enhancement or impairment the immune system.
Answer: D
Q2) Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by A) norepinephrine.
B) cortisol.
C) glucagon.
D) ACTH.
Answer: A
Q3) The effects of excessive cortisol production include A) immune suppression.
B) hypoglycemia.
C) anorexia.
D) inflammatory reactions.
Answer: A
Page 4
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Chapter 3: Cell Structure and Function
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Sample Questions
Q1) Gap junctions are connecting channels that allow passage of small molecules from one cell to the next and are especially important for
A) distance signaling.
B) tissues requiring synchronized function.
C) communication within a cell.
D) passage of large molecules.
Answer: B
Q2) Glycolysis is the metabolic process of breaking down a glucose molecule to form A) CO and H O.
B) 2 ATP and 2 pyruvate.
C) 30 ATP.
D) oxygen.
Answer: B
Q3) GTP-binding proteins (G-proteins)function to A) activate receptors on the extracellular surface.
B) degrade second-messenger molecules.
C) activate intracellular enzyme systems.
D) synthesize ATP.
Answer: C
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Page 5
Chapter 4: Cell Injury, Aging, and Death
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Sample Questions
Q1) The cellular response indicative of injury because of faulty metabolism is A) hydropic swelling.
B) lactate production.
C) metaplasia.
D) intracellular accumulations.
Q2) The primary effect of aging on all body systems is
A) decreased functional reserve.
B) diseased function.
C) programmed senescence.
D) senility.
Q3) Coagulative necrosis is caused by A) dissolving of dead cells and cyst formation.
B) trauma or pancreatitis.
C) lung tissue damage.
D) interrupted blood supply.
Q4) The cellular component that is most susceptible to radiation injury is the A) membrane.
B) DNA.
C) RNA.
D) ribosomes.
Page 6
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Chapter 5: Genome Structure, Regulation, and Tissue
Differentiation
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Sample Questions
Q1) Calcium channel blocker drugs are often used to treat conditions associated with (Select all that apply.)
A) cardiac muscle.
B) smooth muscle.
C) epithelial tissue.
D) nervous tissue.
E) connective tissue.
Q2) Characteristics of cellular differentiation include which of the following? (Select all that apply.)
A) Specialization for different functions
B) Enhanced ability to replicate
C) Influenced by memory of developmental events
D) Dependent on cell-to-cell coordination
E) Generally not reversible
Q3) The primary role of genes is to
A) code for reproduction.
B) direct the synthesis of proteins.
C) determine differentiation.
D) determine cellular apoptosis.
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Chapter 6: Genetic and Developmental Disorders
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Sample Questions
Q1) Huntington disease is often transferred to offspring before a parent knows of the genetic possibility of this disease,because
A) symptoms are so mild that they are not recognized.
B) symptoms often do not occur until approximately 40 years of age.
C) genetic testing for the disease is not possible.
D) the genetic alteration is rarely expressed.
Q2) Information parents should be given about the consequences of PKU includes
A) high dietary phenylalanine may help induce enzyme production.
B) PKU is commonly associated with other congenital anomalies.
C) failure to avoid phenylalanine results in progressive mental retardation.
D) mental retardation is inevitable.
Q3) Characteristics of X-linked (sex-linked)recessive disorders include
A) all daughters of affected fathers' being carriers.
B) boys' and girls' being equally affected.
C) the son of a carrier female's having a 25% chance of being affected.
D) affected fathers' transmitting the gene to all their sons.
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Chapter 7: Neoplasia
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Sample Questions
Q1) The most common tumor-suppressor gene defect identified in cancer cells is A) Rb.
B) P53.
C) DCC.
D) APC.
Q2) Your patient is scheduled for a staging procedure.She wants to know what that means.The correct response is which of the following?
A) It is a procedure for determining the extent of tumor spread.
B) It is a histologic examination of tissues to determine the degree of tumor differentiation.
C) It is based on exploratory surgery.
D) It is biochemical testing of tumor cells to determine the genetic basis of the tumor.
Q3) Cancer grading is based on A) tumor size.
B) local invasion.
C) cell differentiation.
D) metastasis.
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9
Chapter 8: Infectious Processes
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Sample Questions
Q1) Characteristics of immunization include which of the following? (Select all that apply.)
A) Giving injections of preformed antibodies provides immediate immunity.
B) Immunization provides life-long immunity.
C) Immunization with killed vaccines may lead to infection from the agent.
D) Herd immunity controls disease without immunizing everyone in the population.
E) Lack of immunization may lead to an epidemic.
Q2) Risk of infection is increased in (Select all that apply.)
A) use of corticosteroids.
B) diabetes mellitus.
C) spleen removal.
D) stomach removal.
E) stress.
Q3) Dietary zinc is an important defense against infection,because it maintains (Select all that apply.)
A) natural killer cell function.
B) lymphocyte activity.
C) antioxidant activity.
D) neutrophil activity.
E) complement activity.
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Chapter 9: Inflammation and Immunity
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Sample Questions
Q1) The primary function of kinins is
A) phagocytosis of antigens.
B) production of antibodies.
C) to limit immune reactions.
D) vasodilation to enhance inflammation.
Q2) Functions of antibodies include (Select all that apply.)
A) antigen agglutination.
B) antigen precipitation.
C) opsonization.
D) phagocytosis.
E) complement activation.
Q3) Characteristics of complement include (Select all that apply.)
A) stimulating chemotaxis.
B) lysing target cells.
C) having multiple plasma proteins.
D) being synthesized in the bone marrow.
E) enhancing phagocytosis.
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Chapter 10: Alterations in Immune Function
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Sample Questions
Q1) The principle Ig mediator of type I hypersensitivity reactions is A) IgA.
B) IgG.
C) IgM.
D) IgE.
Q2) Which disorder is considered a primary immunodeficiency disease?
A) HIV/AIDS
B) Malnutrition immunodeficiency
C) Cancer immunodeficiency
D) Radiation immunodeficiency
Q3) Patients with immunodeficiency disorders are usually first identified because they A) run high fevers.
B) have unusually high WBC counts.
C) develop brain infections.
D) develop recurrent infections.
Q4) Seasonal allergic rhinitis is most involved in type II hypersensitivity reactions.
A)True
B)False
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Chapter 11: Malignant Disorders of White Blood Cells
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Sample Questions
Q1) A patient is diagnosed with hairy cell leukemia.The patient's laboratory results would most likely indicate a decrease in (Select all that apply.)
A) granulocytes.
B) platelets.
C) white blood cells.
D) red blood cells.
E) melanocytes.
Q2) Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?
A) Pain in long bones, infection, fever, bruising
B) Vertebral fracture, hypercalcemia, bone pain
C) Elevated WBC count found on routine examination, asymptomatic
D) Painless enlarged cervical lymph node, fever, weight loss
Q3) A diagnostic laboratory finding in myeloma is
A) Bence Jones proteins in the urine.
B) decreased platelet count.
C) increased IgM antibody titer.
D) elevated blood glucose levels.
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13
Chapter 12: HIV Disease and Aids
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Sample Questions
Q1) As of 2014,_____ individuals worldwide have been infected with HIV infection.
A) 100,000
B) 1 million
C) slightly less than 16 million
D) nearly 35 million
Q2) The HIV nurse educator teaches a newly diagnosed patient about HIV.The nurse educator tells the patient that in the United States,those at greatest risk of HIV infection include (Select all that apply.)
A) infants born to infected fathers.
B) heterosexual women.
C) homosexual men.
D) restaurant workers.
E) men over age 50.
Q3) Cleaning dirty needles prior to use helps prevent the spread of HIV.When using bleach,the user must rinse out all the blood first and then fill the needle and syringe with full-strength bleach three times for 10 to 20 seconds.
A)True
B)False
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Chapter 13: Alterations in Oxygen Transport
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Sample Questions
Q1) Hapten mechanisms are found in which medications? (Select all that apply.)
A) Ibuprofen
B) Narcotics
C) Penicillin
D) Cephalosporins
E) Tetracycline
Q2) Most carbon dioxide is transported in the bloodstream as
A) carboxyhemoglobin.
B) bicarbonate ion.
C) dissolved carbon dioxide.
D) carbonic acid.
Q3) A patient is diagnosed with aplastic anemia.The nurse expects to find what patient symptoms upon assessment? (Select all that apply.)
A) Lethargy
B) Heart palpitations
C) Transient murmurs
D) Bradycardia
E) Orthopnea
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15
Chapter 14: Alterations in Homeostasis and Blood
Coagulation
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Sample Questions
Q1) A commonly ingested substance associated with prolongation of the bleeding time is
A) acetaminophen.
B) tobacco.
C) caffeine.
D) aspirin.
Q2) Which diseases may be associated with a bleeding problem? (Select all that apply.)
A) Urinary retention
B) Renal failure
C) Cirrhosis
D) Systemic lupus erythematosus
E) Ovarian cancer
Q3) A normal bleeding time in association with normal platelet count,and increased prothrombin time (PT)and INR,is indicative of
A) vitamin K deficiency.
B) hemophilia B.
C) hemophilia A.
D) idiopathic thrombocytopenia.
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Chapter 15: Alterations in Blood Flow
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Sample Questions
Q1) What is the effect on resistance if the radius of a vessel is halved?
A) Resistance doubles.
B) Resistance decreases by a factor of 16.
C) Resistance decreases by half.
D) Resistance increases by a factor of 16.
Q2) Which clinical finding is indicative of compartment syndrome?
A) Peripheral edema
B) Absent peripheral pulses
C) Redness and swelling
D) Atrophy of distal tissues
Q3) Venous obstruction leads to edema because it ________ pressure.
A) increases capillary oncotic
B) increases arterial blood
C) decreases tissue
D) increases capillary hydrostatic
Q4) Which condition enhances lymphatic flow?
A) Increased tissue hydrostatic pressure
B) Increased interstitial fluid colloid osmotic pressure
C) Decreased capillary hydrostatic pressure
D) Increased capillary oncotic pressure
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Chapter 16: Alterations in Blood Pressure
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Sample Questions
Q1) Angiotensin-converting enzyme (ACE)inhibitors block the A) release of rennin.
B) conversion of angiotensin I to angiotensin II.
C) conversion of angiotensinogen to angiotensin I.
D) effect of aldosterone on the kidney.
Q2) Which blood pressure reading is considered to be indicative of prehypertension according to the JNC-7 criteria?
A) 118/78
B) 128/82
C) 140/88
D) 138/94
Q3) The ingestion of certain drugs,foods,or chemicals can lead to secondary hypertension.
A)True
B)False
Q4) Hypertension is closely linked to
A) obstructive sleep apnea.
B) urinary tract infection.
C) de Quervain syndrome.
D) spinal stenosis.
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Chapter 17: Cardiac Function
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Sample Questions
Q1) Myocardial cells are connected by gap junctions enabling them to A) all be stimulated simultaneously.
B) function as a coordinated syncytium.
C) be affected by the autonomic nervous system.
D) share ATP.
Q2) Which is true about blood flow from the atria?
A) Occurs primarily during systole, because perfusion pressure is high
B) Is controlled primarily by the autonomic nervous system
C) Is increased with elevated right atrial pressure
D) Occurs primarily during ventricular diastole
Q3) A vessel that normally contains desaturated (venous)blood is the
A) bronchial artery.
B) pulmonary artery.
C) pulmonary vein.
D) coronary artery.
Q4) Automatic pacemaker cells spontaneously depolarize,because
A) leak channels (If) allow calcium and sodium ions into the cell.
B) they lack efficient sodium/potassium pumps.
C) voltage-sensitive sodium channels open spontaneously.
D) chloride leaks into the cell during rest.
Page 19
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Chapter 18: Alterations in Cardiac Function
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Sample Questions
Q1) Which serum biomarker(s)are indicative of irreversible damage to myocardial cells?
A) Elevated CK-MB, troponin I, and troponin T
B) Markedly decreased CK-MB and troponin I
C) Elevated LDL
D) Prolonged coagulation time
Q2) The most reliable indicator that a person is experiencing an acute myocardial infarction (MI)is
A) severe, crushing chest pain.
B) ST-segment elevation.
C) dysrhythmias.
D) pain radiating to the lower legs.
Q3) Constrictive pericarditis is associated with
A) impaired cardiac filling.
B) cardiac hypertrophy.
C) increased cardiac preload.
D) elevated myocardial oxygen consumption.
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Chapter 19: Heart Failure and Dysrhythmias: Common Sequelae of Cardiac Diseases
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Q1) Which statement is true about the incidence of heart failure? (Select all that apply.)
A) Heart failure affects about 2 million Americans.
B) Heart failure is the fastest-growing cardiac disorder.
C) There are more than 400,000 new cases of heart failure diagnosed each year in the United States.
D) The increasing incidence and hospitalization rates of heart failure reflect the aging population in the United States.
E) The incidence of heart failure is 10 per 1000 population after age 65.
Q2) A patient with pure left-sided heart failure is likely to exhibit
A) jugular vein distention.
B) pulmonary congestion with dyspnea.
C) peripheral edema.
D) hepatomegaly.
Q3) Low cardiac output to the kidneys stimulates the release of _____ from juxtaglomerular cells.
A) aldosterone
B) norepinephrine
C) angiotensinogen
D) renin
Page 21
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Chapter 20: Shock
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Sample Questions
Q1) Tachycardia is an early sign of low cardiac output that occurs because of A) tissue hypoxia.
B) anxiety.
C) baroreceptor activity.
D) acidosis.
Q2) A patient presenting with fever,hypotension,and lactic acidosis is most likely to be experiencing what type of shock?
A) Cardiogenic
B) Septic
C) Anaphylactic
D) Neurogenic
Q3) The effect of nitric oxide on systemic arterioles is A) vasodilation.
B) vasoconstriction.
C) not significant.
D) opposed by nitrate drugs.
Q4) A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.
A)True
B)False
Page 22
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Chapter 21: Respiratory Function and Alterations in Gas Exchange
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Sample Questions
Q1) Secondary pulmonary hypertension is most often caused by A) increased pulmonary blood flow.
B) increased pulmonary vascular resistance.
C) increased left atrial pressure.
D) decreased alveolar compliance.
Q2) Right-sided heart failure secondary to pulmonary hypertension is also called
A) diastolic heart failure.
B) high output failure.
C) coronary disease.
D) cor pulmonale.
Q3) Which person is at greatest risk for developing a pulmonary embolism?
A) A 25-year-old man with asthma
B) A 28-year-old woman in the first trimester of a normal pregnancy
C) A 42-year-old woman with a broken ankle
D) A 67-year-old man with a deep vein thrombosis in the femoral vein
Q4) Primary pulmonary hypertension is
A) more common in men.
B) readily treatable.
C) caused by genetic mutation.
D) rapidly progressive.
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Chapter 22: Obstructive Pulmonary Disorders
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Sample Questions
Q1) Croup is characterized by
A) a productive cough.
B) a barking cough.
C) an inability to cough.
D) drooling, sore throat, and difficulty swallowing.
Q2) Allergic (extrinsic)asthma is associated with
A) hyporesponsiveness of airways.
B) unknown precipitating factors.
C) IgE-mediated airway inflammation.
D) irreversible airway obstruction.
Q3) Which complication of asthma is life threatening?
A) Exercise-induced asthma
B) Late phase response
C) Status asthmaticus
D) Mast cell degranulation
Q4) Which pulmonary function test result is consistent with a diagnosis of asthma?
A) Reduced forced expiratory volume in 1 second (FEV1)
B) Decreased functional residual capacity
C) Increased FEV1
D) Reduced total lung volume
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Chapter 23: Restrictive Pulmonary Disorders
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Sample Questions
Q1) The characteristic x-ray findings in tuberculosis include
A) diffuse white-out.
B) Ghon tubercles.
C) bibasilar infiltrates.
D) tracheal deviation.
Q2) Bacterial pneumonia leads to hypoxemia caused by
A) cardiogenic pulmonary edema.
B) upper airway obstruction.
C) accumulation of alveolar exudates.
D) interstitial edema.
Q3) Common characteristics of sarcoidosis include (Select all that apply.)
A) presence of CD4<sup>+</sup> T cells.
B) a non-productive cough.
C) leukocytosis.
D) granulomas in multiple body systems.
E) fatigue, weight loss, and fever.
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Chapter 24: Fluid and Electrolyte Homeostasis and Imbalances
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Sample Questions
Q1) Which electrolyte imbalances cause increased neuromuscular excitability?
A) Hypokalemia and hyperphosphatemia
B) Hyperkalemia and hypophosphatemia
C) Hypocalcemia and hypomagnesemia
D) Hypercalcemia and hypermagnesemia
Q2) The fraction of total body water (TBW)volume contained in the intracellular space in adults is
A) three fourths.
B) two thirds.
C) one half.
D) one third.
Q3) Signs and symptoms of extracellular fluid volume excess include
A) tachycardia.
B) increased serum sodium concentration.
C) bounding pulse.
D) increased hematocrit.
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Chapter 25: Acid-Base Homeostasis and Imbalances
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Sample Questions
Q1) Respiratory alkalosis is caused by A) hyperventilation.
B) pneumonia.
C) chest muscle weakness.
D) pulmonary edema.
Q2) If an individual has a fully compensated metabolic acidosis,the blood pH is A) high.
B) low.
C) in the normal range.
D) either high or low, depending on the type of compensation.
Q3) A person with acute hypoxemia may hyperventilate and develop A) respiratory acidosis.
B) respiratory alkalosis.
C) metabolic alkalosis.
D) metabolic acidosis.
Q4) Diarrhea and other lower intestinal fluid losses will contribute to A) metabolic alkalosis.
B) metabolic acidosis.
C) respiratory acidosis.
D) mixed acid-base disorders.
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Chapter 26: Renal Function
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Q1) Serious renal impairment generally does not occur until ____ of the total nephrons have been damaged.
A) 20%
B) 40%
C) 60%
D) 80%
Q2) Serum creatinine may be increased by
A) carbohydrate intake.
B) fat intake.
C) muscle breakdown.
D) fluid intake.
Q3) Renin is released from
A) the posterior pituitary gland.
B) the liver.
C) juxtaglomerular cells.
D) macula densa cells.
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Chapter 27: Intrarenal Disorders
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Q1) Risk factors for renal carcinoma include (Select all that apply.)
A) genetics.
B) hypotension.
C) cigarette smoking.
D) obesity.
E) chemicals.
Q2) Which condition is caused by a genetic defect?
A) Acute pyelonephritis
B) Hydroureter
C) Incontinence
D) Polycystic kidney disease
Q3) The type of glomerulonephritis which is most likely to result in a swift decline in renal function that then progresses to acute kidney injury is
A) acute glomerulonephritis.
B) crescentic glomerulonephritis.
C) post-streptococcal glomerulonephritis.
D) chronic glomerulonephritis.
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Page 29
Chapter 28: Acute Kidney Injury and Chronic Kidney Disease
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Q1) Anemia in people who have end-stage chronic renal disease is caused by A) chronic loss of blood in the urine.
B) poor appetite, with lack of iron intake.
C) decreased secretion of erythropoietin.
D) increased secretion of aldosterone.
Q2) The risk for contrast media-induced acute tubular necrosis (ATN)is highest in A) a 70-year-old patient with heart failure.
B) a 50-year-old patient post gallbladder surgery.
C) a 12-year-old patient with recurrent bladder infections.
D) a 30-year-old patient with appendicitis.
Q3) Acute tubular necrosis can occur from (Select all that apply.)
A) increased ammonia levels from liver failure.
B) contrast dyes used for radiologic studies.
C) ischemia because of hypovolemia.
D) antibiotics that are nephrotoxic.
Q4) The most likely cause of anemia in a patient with end-stage renal disease is
A) insufficient erythropoietin.
B) blood loss secondary to hematuria.
C) vitamin B deficiency secondary to deficient intrinsic factor.
D) iron deficiency.
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Chapter 29: Disorders of the Lower Urinary Tract
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Q1) Cystitis symptoms include (Select all that apply.)
A) CVA tenderness.
B) suprapubic pain.
C) dysuria.
D) fever.
Q2) A patient who has difficulty walking without assistance is incontinent of urine when help doesn't get to her quickly enough.The term for this type of incontinence is A) extraurethral.
B) functional.
C) urge.
D) stress.
Q3) Urinary retention with consistent or intermittent dribbling of urine is called A) mixed incontinence.
B) enuresis.
C) stress incontinence.
D) overflow incontinence.
Q4) Infection can lead to bladder stone formation.
A)True
B)False
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Chapter 30: Male Genital and Reproductive Function
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Q1) The male penis is innervated by the ________ nerve.
A) sciatic
B) sacral
C) pudendal
D) caudal
Q2) An important function of the scrotum is to
A) regulate the temperature of the testes.
B) provide support to the prostate gland.
C) regulate blood supply to the penis.
D) supply antibacterial secretions.
Q3) Erectile function is most likely to be impaired if spinal cord injury occurs at A) L<sub>1</sub>-L<sub>2</sub>.
B) L<sub>2</sub>-L<sub>3</sub>.
C) S<sub>1</sub>-S .
D) S -S .
Q4) The thick covering of the ovum is called the zona pellucid.
A)True
B)False
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Chapter 31: Alterations in Male Genital and Reproductive Function
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Q1) Phimosis is a disorder of the penis characterized by A) sustained, painful erection.
B) inability to retract the foreskin.
C) inability to achieve erection.
D) malpositioning of the urinary meatus.
Q2) The most common cause of urinary obstruction in male newborns and infants is urethral valves.
A)True
B)False
Q3) Cryptorchidism is
A) associated with an increased incidence of testicular cancer.
B) an extremely uncommon disorder.
C) rarely treated.
D) a consequence of gonorrhea.
Q4) The prognosis of penile carcinoma depends upon the stage of the disease.
A)True B)False
Q5) The majority of penile cancer cases are classified as basal cell carcinoma. A)True B)False
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Chapter 32: Female Genital and Reproductive Function
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Q1) From the time of fertilization until the end of the eighth week,the developing organism is referred to as the A) zygote.
B) fetus.
C) infant.
D) embryo.
Q2) The purpose of the placenta during pregnancy is to
A) protect the developing fetus.
B) provide nutrients to the mother.
C) provide nutrients to the fetus and remove wastes.
D) remove excess estrogen during pregnancy.
Q3) Pregnancy is associated with
A) decreased oxygen consumption and ventilation.
B) decreased basal metabolic rate.
C) decreased absorption of sodium and water.
D) increased cardiac output and blood volume.
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Chapter 33: Alterations in Female Genital and Reproductive Function
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Sample Questions
Q1) It is true that fibrocystic breast disease
A) commonly progresses to breast cancer.
B) may be exacerbated by methylxanthines.
C) is characterized by painless breast lumps.
D) is a contraindication for progesterone birth control pills.
Q2) Which symptom would be manifested in a woman diagnosed with pregnancy-induced hypertension? (Select all that apply.)
A) Excessive vomiting
B) Proteinuria
C) Peripheral edema
D) Increased arterial pressure
E) Hemorrhage
Q3) Absence of menstruation is called
A) amenorrhea.
B) metrorrhagia.
C) menorrhagia.
D) dysmenorrhea.
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Page 35
Chapter 34: Sexually Transmitted Infections
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Q1) The first choice of treatment for the management of syphilis is
A) penicillin G.
B) doxycycline.
C) antiviral agents.
D) antimicrobial agents.
Q2) A painless ulceration called a chancre is a lesion associated with infection by A) human papillomavirus.
B) N. gonorrhoeae.
C) C. trachomatis.
D) T. pallidum.
Q3) Central nervous system degeneration,blindness,and paresis are associated with untreated
A) HSV.
B) LGV.
C) syphilis.
D) gonorrhea.
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Chapter 35: Gastrointestinal Function
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Sample Questions
Q1) Pancreatic secretions are high in A) hydrochloric acid.
B) bicarbonate ions.
C) intrinsic factor.
D) secretin.
Q2) The action of bile is to A) emulsify fats.
B) digest cellulose.
C) convert sucrose.
D) release free amino acids.
Q3) Absorption of glucose and amino acids across the intestinal epithelium occurs by A) endocytosis.
B) ATP-driven transporters.
C) sodium-dependent carriers.
D) passive diffusion.
Q4) The primary stimulus for pancreatic secretion is A) gastrin.
B) histamine.
C) acetylcholine.
D) secretin.
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Chapter 36: Gastrointestinal Disorders
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Q1) A patient receiving chemotherapy may be at greater risk for development of
A) gastroesophageal reflux.
B) stomatitis.
C) esophageal varices.
D) Mallory-Weiss syndrome.
Q2) A disorder of the esophageal smooth muscle function where dysphagia is a symptom is (Select all that apply.)
A) esophageal stricture.
B) achalasia.
C) esophageal tumors.
D) Mallory-Weiss syndrome.
E) hiatal hernia.
Q3) What clinical finding would suggest an esophageal cause of a client's report of dysphagia?
A) Nasal regurgitation
B) Airway obstruction with swallowing
C) Chest pain during meals
D) Coughing when swallowing
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Chapter 37: Alterations in Function of the Gallbladder and Exocrine Pancreas
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Sample Questions
Q1) A patient with pancreatitis may experience muscle cramps secondary to A) alkalosis.
B) hyperglycemia.
C) hypocalcemia.
D) hypermagnesemia.
Q2) It is true that gallstones are
A) a minimal risk for Native Americans.
B) more common in women.
C) more common in men.
D) at highest risk among Asians.
Q3) Untreated acute cholecystitis may lead to ________ of the gallbladder wall.
A) gangrene
B) infection
C) distention
D) inflammation
Q4) Elevated serum lipase and amylase levels are indicative of A) gallbladder disease.
B) appendicitis.
C) pancreatitis.
D) peritonitis.
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Chapter 38: Liver Diseases
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Q1) Pathophysiologically,esophageal varices can be attributed to A) elevated bilirubin.
B) diminished protein metabolism.
C) fluid accumulation.
D) portal hypertension.
Q2) Steatohepatitis is caused by an accumulation of ________ in the liver cells.
A) fat
B) bile
C) acetaminophen
D) ferritin
Q3) A patient admitted with bleeding related to esophageal varices could be expected to receive a continuous intravenous infusion of A) glucose.
B) octreotide acetate.
C) anticoagulants.
D) proton pump inhibitors.
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Page 40
Chapter 39: Endocrine Physiology and Mechanisms of
Hypothalamic-Pituitary Regulation
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Q1) Thyroid hormones are derived from A) peptides.
B) tyrosine amino acids.
C) globulin.
D) catecholamines.
Q2) Up-regulation of target cell receptors results in
A) decreased target cell sensitivity to hormone.
B) reduced production of hormone.
C) increased target cell responsiveness to hormone.
D) an increased hormone half-life.
Q3) What suppresses the normal secretion of growth hormone?
A) Hypoglycemia
B) Somatostatin
C) Somatomedin
D) Amino acids
Q4) _________ is the hormone which causes uterine and milk duct contractions.
A) Vasopressin
B) Prolactin
C) Oxytocin
D) Antidiuretic
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Chapter 40: Disorders of Endocrine Function
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Sample Questions
Q1) Myxedema coma is a severe condition associated with A) hypothyroidism.
B) hyperthermia.
C) acute cortisol insufficiency.
D) pheochromocytoma.
Q2) Propylthiouracil may be used to treat hyperthyroidism,because it
A) destroys thyroid gland cells.
B) inhibits the release of TSH.
C) suppresses production of autoantibodies.
D) inhibits thyroid hormone synthesis.
Q3) Which are major classifications of deficiencies in growth hormone secretion? (Select all that apply.)
A) Increased IGF-1
B) Decreased GH secretion
C) Defective GH action
D) Decreased IGG secretion
E) Defective IGF-1 generation
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42
Chapter 41: Diabetes Mellitus
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Sample Questions
Q1) Diabetes mellitus is the ________ leading cause of death and a major cause of disability in the United States.
A) first
B) second
C) fourth
D) seventh
Q2) Insulin binding to its receptor on target cells results in
A) increased active transport of glucose into the cell.
B) glycogen breakdown within target cells.
C) increased facilitated cellular diffusion of glucose.
D) gluconeogenesis.
Q3) In the United States,nearly ________ people have diabetes mellitus.
A) 7 million
B) 29.1 million
C) 366 million
D) 176 billion
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Chapter 42: Alterations in Metabolism and Nutrition
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Q1) A patient with a fever of 3°F above normal would be expected to have increased energy expenditure of
A) 3%.
B) 15%.
C) 21%.
D) 50%.
Q2) Acute physiologic stress is associated with A) preferential use of glycogen.
B) catabolism of body proteins.
C) decreased basal metabolic rate.
D) conservation of body energy stores.
Q3) Starvation is associated with
A) loss of visceral protein.
B) low serum albumin levels.
C) loss of somatic fat and protein.
D) generalized edema.
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Chapter 43: Structure and Function of the Nervous System
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Q1) The entire human nervous system develops from the A) brainstem.
B) neural ectoderm.
C) mesoderm.
D) telencephalon.
Q2) The peripheral nervous system contains a total of ____ nerves.
A) 12
B) 31
C) 24
D) 86
Q3) It is true that the arachnoid layer of the meninges (Select all that apply.)
A) is thick and tough for support and protection.
B) lies between the dura and the skull.
C) contains spaces that are only evident in the presence of pathologic processes.
D) is semitransparent and weblike.
E) contains collagenous connective tissue.
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Chapter 44: Acute Disorders of Brain Function
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Q1) A college student living in a dormitory reports a stiff neck and headache and is found to have a fever of 102°F.This information is most consistent with A) encephalitis.
B) meningitis.
C) skull fracture.
D) cerebral ischemia.
Q2) Intracranial pressure normally ranges from ______ mm Hg.
A) 0 to 15
B) 10 to 20
C) 15 to 25
D) 20 to 30
Q3) A tool used to assess levels of consciousness is A) magnetic resonance imaging (MRI).
B) intracranial pressure (ICP) monitoring.
C) Glasgow Coma Scale (GCS).
D) central perfusion pressure (CPP).
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Chapter 45: Chronic Disorders of Neurologic Function
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Sample Questions
Q1) Ascending paralysis with no loss of sensation is characteristic of A) multiple sclerosis.
B) Guillain-Barré syndrome.
C) myasthenia gravis.
D) amyotrophic lateral sclerosis.
Q2) Which are common causes of acquired parkinsonism? (Select all that apply.)
A) Degeneration of dopaminergic neurons
B) History of infection
C) History of intoxication
D) History of trauma
E) Seizure disorder
Q3) Parkinson disease is associated with A) demyelination of CNS neurons.
B) a pyramidal nerve tract lesion.
C) insufficient production of acetylcholine in the basal ganglia.
D) a deficiency of dopamine in the substantia nigra.
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Chapter 46: Alterations in Special Sensory Function
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Sample Questions
Q1) Hearing loss associated with aminoglycosides is known as A) sensorineural.
B) conductive.
C) presbycusis.
D) otosclerosis.
Q2) It is true that a conductive hearing loss
A) cannot be corrected.
B) is as a result of damage to hair cells in the inner ear.
C) usually results from chronic exposure to loud noise.
D) is because of dysfunction of outer and middle ear structures.
Q3) The nurse caring for an individual with vision impairment should be prepared to
A) keep the patient on bed rest to avoid injury.
B) speak to the patient with a clear, loud voice.
C) announcing himself or herself at all interactions.
D) provide as much bright light as possible.
Q4) Ménière disease is characterized by A) bilateral hearing impairment.
B) vertigo in association with hearing loss.
C) middle ear infection.
D) ossification of bones in the middle ear.
Page 48
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Chapter 47: Pain
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Q1) Which treatment is helpful in neuropathic pain but not used for acute pain?
A) Narcotic analgesics
B) Nonsteroidal anti-inflammatory drugs and aspirin
C) Anticonvulsants
D) Nonnarcotic analgesics
Q2) The physiologic mechanisms involved in the pain phenomenon are termed A) nociception.
B) sensitization.
C) neurotransmission.
D) proprioception.
Q3) Modulation of pain signals is thought to be mediated by the release of A) histamine.
B) endorphins.
C) cholecystokinin.
D) glutamine.
Q4) Slow pain sensation is transmitted primarily by A) group Ia afferents.
B) a motor neurons.
C) unmyelinated C fibers.
D) Ad fibers.
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Chapter 48: Neurobiology of Psychotic Illnesses
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Q1) A client who reported hearing voices,some of them saying bad and hurtful things,will now eat only food from unopened sealed packages.The behaviors described indicate that the patient may be experiencing _____ symptoms.
A) bipolar
B) obsessive-compulsive
C) personality
D) psychotic
Q2) Depression is thought to be associated with A) abnormal personality development.
B) early childhood emotional trauma.
C) deficient brain norepinephrine and serotonin.
D) excessive stimulation of D and D receptors in the brain.
Q3) An elderly patient is taking antipsychotic drugs and begins to develop involuntary chewing motions.The patient is likely exhibiting signs of A) dementia.
B) Parkinson disease.
C) tardive dyskinesia.
D) dysthymia.
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Chapter 49: Neurobiology of Nonpsychotic Illnesses
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Q1) Which disorders are classified as anxiety related? (Select all that apply.)
A) Panic
B) Generalized anxiety
C) Obsessive-compulsive
D) Borderline personality
E) Attention-deficit hyperactivity disorder
Q2) The first-line treatment for posttraumatic stress disorder (PTSD)is
A) adrenergic blockers.
B) benzodiazepines
C) tricyclic antidepressants.
D) selective serotonin reuptake inhibitors.
Q3) Repetitive or ritualistic acts that a person performs with urgency are referred to as A) obsessions.
B) delusions.
C) hallucinations.
D) compulsions.
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Chapter 50: Structure and Function of the Musculoskeletal System
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Q1) Troponin is a muscle protein that
A) binds the myosin protein to form cross-bridges.
B) forms the noncontractile Z lines.
C) binds calcium and regulates tropomyosin.
D) hydrolyzes ATP to provide energy for contraction.
Q2) The epiphyseal plate
A) provides support to long bones.
B) prevents overactivity of osteoblasts.
C) allows for continued bone lengthening during maturation.
D) has an unknown function.
Q3) Osteoblastic activity is greatest
A) in areas of increased mechanical stress.
B) during menopause.
C) with vitamin D deficiency.
D) with disuse because of immobility.
Q4) Moderate stretching of a muscle at rest results in a(n)
A) more forceful contraction when stimulated.
B) inefficient use of ATP.
C) more rapid onset of muscle fatigue.
D) reduced force of contraction.
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Chapter 51: Alterations in Musculoskeletal Function:
Trauma, Infection, and Disease
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Q1) Pain in fibromyalgia involves A) muscle inflammation.
B) autoimmune destruction of muscle tissue.
C) nerve inflammation.
D) changes in pain transmission in the spinal cord.
Q2) A fracture in which bone breaks into two or more fragments is referred to as A) comminuted.
B) open.
C) greenstick.
D) stress.
Q3) What type of fracture generally occurs in children?
A) Greenstick
B) Stress
C) Nightstick
D) Colles
Q4) Anticholinesterase inhibitors may be used to manage
A) muscular dystrophy.
B) myasthenia gravis.
C) fibromyalgia.
D) rheumatoid arthritis.
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Chapter 52: Alterations in Musculoskeletal Function:
Rheumatic Disorders
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Q1) Signs/symptoms of Lyme disease include (Select all that apply.)
A) fever and chills.
B) migratory rash.
C) arthritic pain.
D) headache.
E) myalgia.
Q2) The earliest manifestation of scleroderma is
A) thick, tight, shiny skin.
B) skin hyper/hypopigmentation.
C) renal impairment.
D) Raynaud phenomenon.
Q3) The final stage of gout,characterized by crystalline deposits in cartilage,synovial membranes,and soft tissue,is called
A) tophaceous gout.
B) gouty arthritis.
C) complicated gout.
D) asymptomatic hyperuricemia.
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Chapter 53: Alterations in the Integumentary System
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Sample Questions
Q1) Impetigo is usually caused by a A) virus.
B) fungus.
C) protozoan.
D) bacteria.
Q2) The difference between chickenpox and measles is that chickenpox
A) is caused by a virus, whereas measles is caused by a bacterium.
B) causes a widespread rash, whereas measles causes a macular rash.
C) is a childhood infection, but measles can evolve into shingles in adults.
D) causes vesicles that scab, whereas measles remains a macular rash.
Q3) Which finding indicates a need for further evaluation of a nevus mole?
A) The presence of light pigmentation
B) Variations in color within the nevus
C) Very dark coloration of the mole
D) Diameter less than 2 mm
Q4) Conditions caused by a virus include
A) athlete's foot.
B) boils.
C) warts.
D) impetigo.
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Chapter 54: Burn Injuries
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Q1) Burn shock is the direct result of A) hypovolemia.
B) cardiac depression.
C) infection.
D) increased capillary permeability.
Q2) The majority of electrical burns in children are caused by A) playing with electrical outlets.
B) playing with defective electrical cords.
C) biting on extension cords.
D) putting fingers in electrical sockets.
Q3) The third element essential to survival after major burn injury is A) excision of the burn followed by skin grafting.
B) frequent wound debridement to encourage wound healing.
C) hyperbaric oxygen therapy.
D) continuous topical antibiotic therapy.
Q4) The first priority when rescuing a burned individual is A) establishing a patent airway.
B) removing his or her clothing.
C) eliminating the source of the burn.
D) covering the wounds with wet sheets.
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