Advanced Nursing Practice Practice Exam
Course Introduction
Advanced Nursing Practice explores the expanded roles and responsibilities of nurses in complex healthcare settings, emphasizing evidence-based practice, clinical decision-making, and leadership. The course covers advanced health assessment, diagnostic reasoning, pharmacology, and pathophysiology, equipping students with the skills needed for autonomous practice and the management of patient care across the lifespan. It also addresses topics such as healthcare policy, interprofessional collaboration, and ethical considerations, preparing nurses to provide high-quality, patient-centered care and to take on leadership roles within multidisciplinary teams.
Recommended Textbook
Pathophysiology The Biologic Basis for Disease in Adults and Children 8th Edition by Kathryn L. McCance
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50 Chapters
1557 Verified Questions
1557 Flashcards
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Chapter 1: Cellular Biology
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Sample Questions
Q1) A student asks for an explanation of the absolute refractory period of the action potential. What response by the professor is best?
A)A stronger than normal impulse will evoke another response.
B)No stimulus is able to evoke another response at this time.
C)Multiple stimuli can produce more rapid action potentials.
D)The hyperpolarized state means a weaker stimulus produces a response.
Answer: B
Q2) What is the best description of cell cycle arrest?
A)The cell cycle is stopped due to damaged DNA.
B)Programmed cell death is suppressed.
C)Macromolecule degradation is inhibited.
D)Production of growth factors is halted.
Answer: A
Q3) A muscle cell possesses which specialized function?
A)Movement
B)Conductivity
C)Secretion
D)Respiration
Answer: A
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Page 3
Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents
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Sample Questions
Q1) What is a consequence of leakage of lysosomal enzymes during chemical injury?
A)Enzymatic digestion of the nucleus and nucleolus occurs, halting DNA synthesis.
B)Influx of potassium ions into the mitochondria occurs, halting the ATP production.
C)Edema of the Golgi body prevents the transport of proteins out of the cell.
D)Shift of calcium out of the plasma membrane occurs, destroying the cytoskeleton.
Answer: A
Q2) Free radicals play a major role in the initiation and progression of which diseases?
A)Cardiovascular diseases such as hypertension and ischemic heart disease
B)Renal diseases such as acute tubular necrosis and glomerulonephritis
C)Gastrointestinal diseases such as peptic ulcer disease and Crohn disease
D)Muscular disease such as muscular dystrophy and fibromyalgia
Answer: A
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Chapter 3: The Cellular Environment: Fluids and Electrolytes,
Acids and Bases
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Sample Questions
Q1) A student asks about natriuretic peptides. Which statement by the professor is most accurate?
A)Decrease blood pressure and increase sodium and water excretion.
B)Increase blood pressure and decrease sodium and water excretion.
C)Increase heart rate and decrease potassium excretion.
D)Decrease heart rate and increase potassium excretion.
Answer: A
Q2) During acidosis, the body compensates for the increase in serum hydrogen ions by shifting hydrogen ions into the cell in exchange for which electrolyte?
A)Oxygen
B)Sodium
C)Potassium
D)Magnesium
Answer: C
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Chapter 4: Genes and Genetic Diseases
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Sample Questions
Q1) People diagnosed with neurofibromatosis have varying degrees of the condition because of which genetic principle?
A)Penetrance
B)Expressivity
C)Dominance
D)Recessiveness
Q2) Amniocentesis is recommended for pregnant with what history?
A)Have a history of chronic illness
B)Have a family history of genetic disorders
C)Have experienced in vitro fertilization
D)Had a late menarche
Q3) A person with 47, XXY karyotype has the genetic disorder resulting in which syndrome?
A)Turner
B)Klinefelter
C)Down
D)Fragile X
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Chapter 5: Genes, Environment-Lifestyle, and Common Diseases
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Sample Questions
Q1) A parent wants to know how to prevent type 1 diabetes in the newborn. The healthcare professional explains that prevention is not possible, because which of these is a major characteristic of type 1 diabetes mellitus?
A)Partial insulin secretion
B)An autoimmune cause factor
C)Insulin resistance
D)Obesity as a common risk factor
Q2) Which genes are responsible for an autosomal dominant form of breast cancer?
(Select all that apply.)
A)LCAT
B)CHK1
C)CHK2
D)BRCA1
E)BRCA2
Q3) Which type of cancer is said to aggregate among families?
A)Breast
B)Lung
C)Skin
D)Brain
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Chapter 6: Epigenetics and Disease
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Sample Questions
Q1) Which term refers to the silenced gene of a gene pair?
A)Activated
B)Altered
C)Mutated
D)Imprinted
Q2) What do hypomethylation and the resulting effect on oncogenes result in?
A)A decrease in the activity of the oncogene, thus suppressing cancer development.
B)A deactivation of MLH1 to halt DNA repair.
C)An increase in tumor progression from benign to malignant.
D)An over-expression of microRNA, resulting in tumorigenesis.
Q3) What is the belief regarding twins who adopt dramatically different lifestyles?
A)They may experience very different aging processes.
B)They will retain very similar methylation patterns.
C)They will experience identical phenotypes throughout their lifespans.
D)They may never demonstrate similar DNA sequences of their somatic cells.
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Chapter 7: Innate Immunity: Inflammation and Wound Healing
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Sample Questions
Q1) Which cytokine is produced and released from virally infected host cells?
A)IL-1
B)IL-10
C)TNF-a
D)IFN-a
Q2) Which secretion is a first line of defense against pathogen invasion that involves antibacterial and antifungal fatty acids, as well as lactic acid?
A)Optic tears
B)Oral saliva
C)Sweat gland perspiration
D)Sebaceous gland sebum
Q3) The acute inflammatory response is characterized by fever that is produced by the hypothalamus being affected by what?
A)Endogenous pyrogens
B)Bacterial endotoxin
C)Antigen-antibody complexes
D)Exogenous pyrogens
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Page 9
Chapter 8: Adaptive Immunity
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Sample Questions
Q1) The portion of the antigen that is configured for recognition and binding is referred to as what type of determinant?
A)Immunotope
B)Paratope
C)Epitope
D)Antigenitope
Q2) How do antibodies protect the host from bacterial toxins?
A)Lysing the cell membrane of the toxins
B)Binding to the toxins to neutralize their biologic effects
C)Inhibiting the synthesis of DNA proteins needed for growth
D)Interfering with the DNA enzyme needed for replication
Q3) When a person is exposed to most antigens, antibodies can be usually detected in their circulation within what timeframe?
A)12 hours
B)24 hours
C)3 days
D)6 days
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10
Chapter 9: Alterations in Immunity and Inflammation
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Sample Questions
Q1) Which statement is true regarding immunodeficiency?
A)Immunodeficiency is generally not present in other family members.
B)Immunodeficiency is never acquired; rather, it is congenital.
C)Immunodeficiency is almost immediately symptomatic.
D)Immunodeficiency is a result of a postnatal mutation.
Q2) When soluble antigens from infectious agents enter circulation, what is tissue damage a result of?
A)Complement-mediated cell lysis
B)Phagocytosis by macrophages
C)Phagocytosis in the spleen
D)Neutrophil granules and toxic oxygen products
Q3) Deficiencies in which element can produce depression of both B- and T-cell function?
A)Iron
B)Zinc
C)Iodine
D)Magnesium
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11
Chapter 10: Infection
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Sample Questions
Q1) Which statements are true regarding the development of HIV symptoms? (Select all that apply.)
A)Symptoms generally appear in the clinical latency stage.
B)Symptoms are generally observable within 5 years of the initial infection.
C)T cells levels, particularly those of memory T cells, progressively decrease.
D)Untreated infected individuals may remain asymptomatic for up to10 years.
E)Secondary lymphoid organs experience damage and resulting malfunction.
Q2) A healthcare professional student is learning about fungal infections. What information should the student use to help another student understand?
A)Fungal infections occur only on skin, hair, and nails.
B)Phagocytes and T lymphocytes control fungal infections.
C)Fungal infections release endotoxins.
D)Vaccines prevent fungal infections.
Q3) After sexual transmission of HIV, how soon can lab results detect the infection?
A)1 to 2 days
B)4 to 10 days
C)4 to 8 weeks
D)2 to 4 months
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Chapter 11: Stress and Disease
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Sample Questions
Q1) A student asks the healthcare professional how immunity is decreased by stress. The professional responds that during a stress response, the helper T (Th) 1 response is suppressed by which hormone?
A)ACTH
B)Cortisol
C)Prolactin
D)Growth hormone
Q2) Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?
A)Norepinephrine
B)Epinephrine
C)Cortisol
D)Adrenocorticotropic hormone (ACTH)
Q3) Released stress-induced cortisol results in the stimulation of gluconeogenesis by affecting which structure?
A)Adrenal cortex
B)Pancreas
C)Liver
D)Anterior pituitary
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Page 13
Chapter 12: Cancer Biology
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Sample Questions
Q1) In childhood neuroblastoma, the N-myc oncogene undergoes which type of mutation of normal gene to oncogene?
A)Point mutation
B)Chromosome fusion
C)Gene amplification
D)Chromosome translocation
Q2) How does the ras gene convert from a proto-oncogene to an oncogene?
A)Designating a chromosome that has a piece of one chromosome fused to a piece of another chromosome
B)Duplicating a small piece of a chromosome, repeatedly making numerous copies
C)Altering one or more nucleotide base pairs
D)Promoting proliferation of growth signals by impairing tumor-suppressor genes
Q3) Autocrine stimulation is the ability of cancer cells to do what?
A)Stimulate angiogenesis to create their own blood supply
B)Encourage secretions that turn off normal growth inhibitors
C)Secrete growth factors that stimulate their own growth
D)Divert nutrients away from normal tissue for their own use
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Page 14
Chapter 13: Cancer Epidemiology
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Sample Questions
Q1) Research data support the relationship between the exposure of ultraviolet light (UVL) and the development of what? (Select all that apply.)
A)Basal cell carcinoma
B)Squamous cell carcinoma
C)Hodgkin lymphoma
D)Non-Hodgkin lymphoma
E)Soft tissue sarcoma
Q2) What are the significant risk factors associated with the development of skin cancers? (Select all that apply.)
A)Light-colored hair
B)Pale eyes
C)Fair skin
D)Freckles
E)History of acne
Q3) Research has shown a link between cancer and which sexually transmitted disease?
A)Syphilis
B)Gonorrhea
C)Human papillomavirus
D)Pelvic inflammatory disease
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Page 15
Chapter 14: Cancer in Children
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Sample Questions
Q1) What congenital malformation is commonly linked to acute leukemia in children?
A)Down syndrome
B)Wilms tumor
C)Retinoblastoma
D)Neuroblastoma
Q2) Which statement is likely true regarding children being treated for cancer with radiation therapy?
A)They will most likely have a successful remission of tumor growth.
B)They seldom require follow-up maintenance treatments.
C)They are prone to experience severe developmental delays.
D)They are at increased risk for developing childhood cancers.
Q3) Currently, what percentage of children with cancer can be cured?
A)40%
B)50%
C)60%
D)85%
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Chapter 15: Structure and Function of the Neurologic System
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Sample Questions
Q1) What is a Schwann cell? (Select all that apply.)
A)Can form the myelin sheath
B)Is also referred to as a neurolemma
C)Affects the function of the nodes of Ranvier
D)Is located in the peripheral nervous system
E)Is responsible of decreasing conduction velocity
Q2) Which cranial nerves contain parasympathetic nerves? (Select all that apply.)
A)I (olfactory)
B)III (oculomotor)
C)VII (facial)
D)IX (glossopharyngeal)
E)X (vagus)
Q3) Where is the cerebrospinal fluid (CSF) produced?
A)Arachnoid villi
B)Choroid plexuses
C)Ependymal cells
D)Pia mater
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Page 17
Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function
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Sample Questions
Q1) Pricking one's finger with a needle would cause minimal pain, whereas experiencing abdominal surgery would produce more pain. This distinction is an example of which pain theory?
A)Gate control theory
B)Intensity theory
C)Specificity theory
D)Pattern theory
Q2) A healthcare professional is working in a health tent at a marathon. A person enters the tent and reports profuse sweating for the last hour. How much fluid does the healthcare professional advise the person to drink to replace this fluid loss?
A)2 L
B)4 cups
C)6 L
D)8 cups
Q3) Where in the CNS does a person's learned pain response occur?
A)Cerebral cortex
B)Frontal lobe
C)Thalamus
D)Limbic system
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Chapter 17: Alterations in Cognitive Systems, Cerebral
Hemodynamics, and Motor Function
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Sample Questions
Q1) To quickly assess a patient's nervous system for dysfunction, what assessment should the healthcare professional perform as the priority?
A)Size and reactivity of pupils
B)Pattern of breathing
C)Motor response
D)Level of consciousness
Q2) Dementia is commonly characterized by the deterioration in which abilities? (Select all that apply.)
A)Sociability
B)Balance
C)Memory
D)Speech
E)Decision making
Q3) Which assessment finding marks the end of spinal shock?
A)Return of blood pressure and heart rate to normal
B)Gradual return of spinal reflexes
C)Return of bowel and bladder function
D)Evidence of diminished deep tendon reflexes and flaccid paralysis
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Chapter 18: Disorders of the Central and Peripheral Nervous
Systems and the Neuromuscular Junction
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Q1) What event is most likely to occur when a person experiences a closed head injury?
A)Brief period of vital sign instability
B)Cerebral edema throughout the cerebral cortex
C)Cerebral edema throughout the diencephalon
D)Disruption of axons extending from the diencephalon and brainstem
Q2) Which clinical manifestations are characteristic of cluster headaches? (Select all that apply.)
A)Preheadache aura
B)Severe unilateral tearing
C)Gradual onset of a tight band around the head
D)Can be associated with vomiting
E)Pain lasting from 20 to 120 min
Q3) Atrial fibrillation, rheumatic heart disease, and valvular prosthetics are risk factors for which type of stroke?
A)Hemorrhagic
B)Thrombotic
C)Embolic
D)Lacunar
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Chapter 19: Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders
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Sample Questions
Q1) The common property among the three types of medications used to treat depression is that they do what?
A)Increase neurotransmitter levels within the synapse
B)Increase neurotransmitter levels in the presynapse
C)Decrease neurotransmitter levels in the postsynapse
D)Decrease neurotransmitter levels within the synapse
Q2) A patient is starting on a new prescription for sertraline. What side effects does the healthcare professional educate the patient about? (Select all that apply.)
A)Orthostatic hypotension
B)Dry mouth
C)Sleep disturbances
D)Agitation
E)Nausea
Q3) A decrease in receptor binding for which neurotransmitter is found in individuals with depression?
A)Norepinephrine
B)Serotonin
C)Dopamine
D)Acetylcholine
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Chapter 20: Alterations of Neurologic Function in Children
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Sample Questions
Q1) The neural groove closes dorsally during which week of gestational life?
A)Second
B)Fourth
C)Eighth
D)Twelfth
Q2) What is the anomaly in which the soft bony component of the skull and much of the brain is missing?
A)Anencephaly
B)Myelodysplasia
C)Cranial meningocele
D)Hydrocephaly
Q3) Which defect of neural tube closure is most common?
A)Anterior
B)Posterior
C)Lateral
D)Midline
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22
Chapter 21: Mechanisms of Hormonal Regulation
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Sample Questions
Q1) Which hormone triggers uterine contractions?
A)Thyroxine
B)Oxytocin
C)Growth hormone
D)Insulin
Q2) Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone (TH) and is inhibited when plasma levels of TH are adequate. What is this an example of?
A)Positive feedback
B)Negative feedback
C)Neural regulation
D)Physiologic regulation
Q3) To ensure optimal thyroid health and function, which mineral does the health care professional advise a nutrition class to include in the daily diet?
A)Iron
B)Zinc
C)Iodide
D)Copper
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Chapter 22: Alterations of Hormonal Regulation
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Sample Questions
Q1) A healthcare professional reads a chart that notes the patient has panhypopituitarism. What does the professional understand that term to mean?
A)The patient has a lack of all hormones associated with the anterior pituitary gland.
B)The patient has a lack of all hormones associated with the lateral pituitary gland.
C)The patient has total adrenocorticoptropic hormone deficiency.
D)The patient has a dysfunction of the posterior pituitary gland due to a tumor.
Q2) A patient has a suspected thyroid carcinoma. What diagnostic test does the healthcare professional prepare the patient for?
A)Measurement of serum thyroid levels
B)Radioisotope scanning
C)Ultrasonography
D)Fine-needle aspiration biopsy
Q3) Why does giantism occur only in children and adolescents?
A)Their growth hormones are still diminished.
B)Their epiphyseal plates have not yet closed.
C)Their skeletal muscles are not yet fully developed.
D)Their metabolic rates are higher than in adulthood.
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Chapter 23: Obesity and Disorders of Nutrition
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Q1) A patient weighs 82 pounds and is hospitalized for anorexia. In order to prevent refeeding syndrome, how many calories should the person eat in the first two days?
A)400
B)745
C)936
D)1200
Q2) A family is concerned that their most elderly member is not eating. What information about the anorexia of aging does the health care professional provide the family? (Select all that apply.)
A)Usually there is a direct cause that can be treated successfully.
B)Is not related to age-related changes and signifies illness
C)Decreases in saliva and the sense of taste are contributing factors.
D)Age-related loss of appetite is common finding.
E)Social stimulation at meals might promote better eating habits.
Q3) Which individual does the health care professional determine is obese?
A)Body mass index 23 kg/m<sup>2</sup>
B)Body mass index 25 kg/m<sup>2</sup>
C)Body mass index 29 kg/m<sup>2</sup>
D)Body mass index 32 kg/m<sup>2</sup>
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Page 25
Chapter 24: Structure and Function of the Reproductive Systems
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Sample Questions
Q1) Where in the male body does spermatogenesis occur?
A)Epididymis
B)Rete testis
C)Seminiferous tubules
D)Vas deferens
Q2) Which change is a result of puberty and defends the vagina from infection?
A)The pH stabilizes between 7 and 8.
B)A thin squamous epithelial lining develops.
C)Vaginal pH becomes more acidic.
D)Estrogen levels are low.
Q3) When does the male body begin to produce sperm?
A)Before birth
B)Shortly after birth
C)At puberty
D)When erection is possible
Q4) Which structure is lined with columnar epithelial cells?
A)Perimetrium
B)Endocervical canal
C)Myometrium
D)Vagina
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Chapter 25: Alterations of the Female Reproductive System
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Q1) In the majority of children experiencing delayed puberty, what is the problem caused by?
A)Disruption in the hypothalamus
B)Disruption of the pituitary
C)Deficit in estrogen or testosterone
D)Physiologic delays in maturation
Q2) A woman has been diagnosed with cervical carcinoma in situ and asks the healthcare professional to explain it to her. What description by the professional is best?
A)It involves the full epithelial thickness of the cervix.
B)It involves abnormal cells growing on the cervix.
C)It is when cancer has spread to the peritoneum.
D)It is when only the top layer of the cervix is affected.
Q3) A woman has been diagnosed with a simple fibroadenoma. What treatment does the healthcare provider educate the woman about?
A)A repeat biopsy in 6 months
B)More frequent mammograms
C)Nothing; no treatment is needed.
D)Rapid surgical excision and chemotherapy
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Chapter 26: Alterations of the Male Reproductive System
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Q1) Which information about urethritis does the student learn? (Select all that apply.)
A)A purulent drainage may be present.
B)A clear mucus-like discharge may be present.
C)Symptoms include urethral tingling and itching or burning on urination.
D)A 24-hour urine test is required to diagnose the disorder.
E)Treatment includes appropriate antibiotic therapy.
Q2) The risk of which cancer is greater if the man has a history of cryptorchidism?
A)Penile
B)Testicular
C)Prostate
D)Epididymal
Q3) Priapism has been associated with the abuse of what substance?
A)Marijuana
B)Alcohol
C)Cocaine
D)Heroin
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Chapter 27: Sexually Transmitted Infections
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Sample Questions
Q1) What unique factor causes adolescent girls to have a high risk for sexually transmitted infections (STIs)?
A)They are in an experimental phase and believe they are resistant to developing STIs.
B)The position of susceptible cells on the adolescent cervix is different than in older women.
C)The length of the vaginal canal is short in adolescents
D)In adolescent girls, the anus to the vaginal introitus is in close proximity.
Q2) Which hepatitis virus is most commonly known to be sexually transmitted?
A)A
B)B
C)C
D)D
Q3) Which of these causes condylomata acuminata or genital warts?
A)Chlamydia
B)Adenovirus
C)Human papillomavirus (HPV)
D)Herpes simplex virus 1 (HSV-1)
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Chapter 28: Structure and Function of the Hematologic System
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Sample Questions
Q1) A patient has chronic anemia associated with chronic renal failure. What substance does the healthcare professional tell the patient is needed to treat this anemia?
A)Iron
B)Erythropoietin
C)Cobalamin (vitamin B12)
D)Folate
Q2) What does the student learn about erythrocytes?
A)Erythrocytes contain a nucleus, mitochondria, and ribosomes.
B)Erythrocytes synthesize proteins.
C)Erythrocytes have the ability to change shape to squeeze through microcirculation.
D)Erythrocytes are more abundant in women than men.
Q3) Which characteristics allow erythrocytes to function as gas carriers? (Select all that apply.)
A)Permanent shape
B)Compactness
C)Reversible deformability
D)Presence of hyperactive mitochondria
E)Biconcavity
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Chapter 29: Alterations of Erythrocytes, Platelets, and Hemostatic Function
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Q1) A student asks the professor what the most common pathophysiologic process is that triggers aplastic anemia (AA). What response by the professor is most accurate?
A)Autoimmune disease against hematopoiesis by activated cytotoxic T (Tc) cells
B)Malignancy of the bone marrow in which unregulated proliferation of erythrocytes crowd out other blood cells
C)Autoimmune disease against hematopoiesis by activated immunoglobulins
D)Inherited genetic disorder with recessive X-linked transmission
Q2) What term is used to describe the capacity of some erythrocytes to vary in size, especially in relationship to some anemias?
A)Poikilocytosis
B)Isocytosis
C)Anisocytosis
D)Microcytosis
Q3) Which anemia produces small, pale erythrocytes?
A)Folic acid
B)Hemolytic
C)Iron deficiency
D)Pernicious
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Chapter 30: Alterations of Leukocyte and Lymphoid Function
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Q1) A person comes to the healthcare clinic and reports night sweats and fever. The healthcare professional obtains a chest x-ray which shows a mediastinal mass. What other assessment or diagnostic test does the professional provide as a priority?
A)Listen to heart sounds.
B)Assess the patient's skin.
C)Arrange for familial DNA testing.
D)Test blood for anemia.
Q2) Which description is consistent with chronic myelogenous leukemia (CML)?
A)Defects exist in the ras oncogene, TP53 tumor-suppressor gene, and INK4A, the gene encoding a cell-cycle regulatory protein.
B)Leukocytosis and a predominance of blast cells characterize the bone marrow and peripheral blood. As the immature blasts increase, they replace normal myelocytic cells, megakaryocytes, and erythrocytes.
C)B cells fail to mature into plasma cells that synthesize immunoglobulins.
D)The translocation of genetic material from genes 9 and 22 creates an abnormal, fused protein identified as BCR-ABL1.
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Chapter 31: Alterations of Hematologic Function in Children
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Q1) A healthcare professional is teaching a community group about inherited disorders. What pattern of inheritance does the professional describe for sickle cell disease?
A)Inherited X-linked recessive disorder
B)Inherited autosomal recessive disorder
C)Disorder initiated by hypoxemia and acidosis
D)Disorder that is diagnosed equally in men and women
Q2) A pediatric patient presents with pallor, fatigue, fever, petechiae, and purpura. What diagnostic testing does the healthcare professional help prepare the patient for? (Select all that apply.)
A)Complete blood count
B)Renal function studies
C)Bone marrow biopsy
D)Chest x-ray
E)Joint fluid sampling
Q3) Hemophilia B is caused by a deficiency of which clotting factor?
A)V
B)VIII
C)IX
D)X
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Page 33
Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems
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Q1) What is the major effect of a calcium channel blocker such as verapamil on cardiac contractions?
A)Increases the rate of cardiac contractions
B)Decreases the strength of cardiac contractions
C)Stabilizes the rhythm of cardiac contractions
D)Stabilizes the vasodilation during cardiac contractions
Q2) A healthcare professional cares for older adults in a skilled nursing facility. What should the professional assess for in these individuals related to cardiovascular functioning?
A)Increased rate of falling and dizzy spells
B)Improved exercise tolerance
C)A gradual slowing of the heart rate
D)Progressive ECG changes
Q3) Where are the coronary ostia located?
A)Left ventricle
B)Aortic valve
C)Coronary sinus
D)Aorta
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Chapter 33: Alterations of Cardiovascular Function
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Q1) A patient in the clinic reports fever, arthralgia, a rash, and nosebleeds. What other information should the healthcare professional elicit from this patient?
A)Family history of Marfan's disease
B)History of a recent bacterial infection
C)History of any recent chest trauma
D)Any illnesses in family members
Q2) Which statement is true concerning the cells' ability to synthesize cholesterol?
A)Cell production of cholesterol is affected by the aging process.
B)Cells produce cholesterol only when dietary fat intake is low.
C)Most body cells are capable of producing cholesterol.
D)Most cholesterol produced by the cells is converted to the low-density form.
Q3) What is the cause of the dyspnea resulting from a thoracic aneurysm?
A)Pressure on surrounding organs
B)Poor oxygenation
C)Formation of atherosclerotic lesions
D)Impaired blood flow
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Chapter 34: Alterations of Cardiovascular Function in Children
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Q1) The student studying pathophysiology learns which fact about circulation at birth?
A)Systemic resistance and pulmonary resistance fall.
B)Gas exchange shifts from the placenta to the lung.
C)Systemic resistance falls and pulmonary resistance rises.
D)Systemic resistance and pulmonary resistance rise.
Q2) An infant has a crescendo-decrescendo systolic ejection murmur located between the second and third intercostal spaces along the left sternal border. The healthcare professional suspects an atrial septal defect (ASD). For what other manifestation does the healthcare professional assess to confirm the suspicion?
A)Wide, fixed splitting of the second heart sound
B)Loud, harsh holosystolic murmur
C)Cyanosis with crying and feeding
D)Rapid deterioration with acidosis
Q3) The presence of the foramen ovale in a fetus allows what to occur?
A)Right-to-left blood shunting
B)Left-to-right blood shunting
C)Blood flow from the umbilical cord
D)Blood flow to the lungs
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Chapter 35: Structure and Function of the Pulmonary System
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Q1) Which describes the pressure in the pleural space?
A)Atmospheric
B)Below atmospheric
C)Above atmospheric
D)Variable
Q2) Which receptors are located in the aortic bodies, aortic arch, and carotid bodies?
A)Central chemoreceptors
B)Stretch receptors
C)J-receptors
D)Peripheral chemoreceptors
Q3) What event is characteristic of the function in Zone 1 of the lung?
A)Blood flow through the pulmonary capillary bed increases in regular increments.
B)Alveolar pressure is lesser than venous and arterial pressures.
C)The capillary bed collapses, and normal blood flow ceases.
D)Blood flows through Zone 1, but it is impeded by alveolar pressure.
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Chapter 36: Alterations of Pulmonary Function
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Q1) Pulmonary artery hypertension (PAH) results from which alteration?
A)Narrowed pulmonary capillaries
B)Narrowed bronchi and bronchioles
C)Destruction of alveoli
D)Ischemia of the myocardium
Q2) What medical term is used for a condition that results from pulmonary hypertension, creating chronic pressure overload in the right ventricle?
A)Hypoxemia
B)Hypoxia
C)Bronchiectasis
D)Cor pulmonale
Q3) A patient has pneumonia. For which clinical manifestations should the healthcare professional assess for? (Select all that apply.)
A)Inspiratory crackles
B)Fremitus
C)Egophony
D)Whispered pectoriloquy
E)Absence of breath sounds
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Chapter 37: Alterations of Pulmonary Function in Children
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Q1) A student asks the healthcare professional why researchers are trying to link specific genes to specific asthma phenotypes. What response by the professional is best?
A)Some types of asthma are easier to treat than others.
B)Some people could use cheaper medications.
C)It can lead to personalized approaches to treatment.
D)More and more asthma phenotypes are being recognized.
Q2) Which statement best describes cystic fibrosis?
A)Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
B)Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging
C)Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens
D)Pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency
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Chapter 38: Structure and Function of the Renal and Urologic Systems
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Q1) What is the trigone?
A)A smooth muscle that comprises the orifice of the ureter
B)The inner mucosal lining of the kidneys
C)A smooth triangular area between the openings of the two ureters and the urethra
D)One of the three divisions of the loop of Henle
Q2) What substance stimulates renal hydroxylation in the process of producing vitamin D?
A)Erythropoietin
B)Thyroid hormone
C)Calcitonin
D)Parathyroid hormone
Q3) A patient's urinalysis came back positive for glucose. What does the healthcare professional expect the patient's blood glucose to be at a minimum?
A)126 mg/dL
B)150 mg/dL
C)180 mg/dL
D)200 mg/dL
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Page 40
Chapter 39: Alterations of Renal and Urinary Tract Function
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Q1) A patient has been diagnosed with a renal stone. Based on knowledge of common stone types, what self-care measure does the healthcare professional plan to teach the patient when stone analysis has returned?
A)Increase water intake.
B)Decrease soda intake.
C)Restrict animal protein in the diet.
D)Ingest 1000 mg of calcium a day.
Q2) A patient who has a history of mildly decreased renal function is admitted to the hospital for IV antibiotics. Which antibiotics would the healthcare professional avoid in this patient?
A)Penicillin and ampicillin
B)Vancomycin and bacitracin
C)Gentamicin and tobramycin
D)Cefazolin and cefepime
Q3) Goodpasture syndrome is an example of which of these?
A)Antiglomerular basement membrane disease
B)Acute glomerulonephritis
C)Chronic glomerulonephritis
D)Immunoglobulin A (IgA) nephropathy
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Chapter 40: Alterations of Renal and Urinary Tract Function in Children
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Q1) The excretion of urea is low in infants because of which features? (Select all that apply.)
A)Medullary nephrons with comparatively short loops
B)Immature tubular transport capacity impairing the excretion of urea
C)High anabolic state
D)Dilute urine as a result of the immaturity of an infant's glomeruli
E)Available protein used for physical growth
Q2) When does urine formation and excretion begin?
A)At birth
B)By 3 months' gestation
C)By 6 months' gestation
D)By 8 months' gestation
Q3) Which anomaly is often associated with Wilms tumor?
A)Renal anaplasia
B)Aniridia
C)Anemia
D)Hypothyroidism
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Page 42
Chapter 41: Structure and Function of the Digestive System
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Q1) Glucose transport enhances the absorption of which electrolyte?
A)Sodium
B)Phosphate
C)Potassium
D)Chloride
Q2) Which statement, made by a student, is correct regarding the state of the intestinal tract at birth?
A)The intestinal tract is colonized by Escherichia coli.
B)The intestinal tract is sterile.
C)Clostridium welchii is present in but in very small numbers.
D)Streptococcus colonization in the intestinal tract has begun.
Q3) Which elements in saliva protect against tooth decay? (Select all that apply.)
A)Salivary a-amylase
B)Ptyalin
C)Mucin
D)Exogenous fluoride
E)A pH of 7.4
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Chapter 42: Alterations of Digestive Function
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Q1) A patient in the clinic reports projectile vomiting without nausea or other gastrointestinal symptoms. What action by the healthcare professional is most appropriate?
A)Provide antiemetic medications.
B)Arrange a brain scan.
C)Administer intravenous hydration.
D)Schedule a GI consultation.
Q2) A patient reports feeling constipated. When assessing this patient, how often should the patient report bowel movements to be considered within the normal range?
A)Once a day
B)Once every 2 days
C)Once a week
D)Once every 2 weeks
Q3) By what mechanism does intussusception cause an intestinal obstruction?
A)Telescoping of part of the intestine into another section of intestine
B)Twisting the intestine on its mesenteric pedicle
C)Loss of peristaltic motor activity in the intestine
D)Fibrin and scar tissue that attaches to the intestinal omentum
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Chapter 43: Alterations of Digestive Function in Children
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Q1) A student asks the professor to explain the characteristic appearance of stools in people with cystic fibrosis. What explanation by the professor is best?
A)Bile ducts obstructed with mucus, leading to clay colored stools
B)Mechanical obstruction causes narrow, ribbon-like stool
C)Deficiency of pancreatic enzymes leads to steatorrhea.
D)Ischemia due to sodium blockages causes bloody stools.
Q2) Incomplete fusion of the nasomedial and intermaxillary process during the fourth week of embryonic development causes which condition in an infant?
A)Cleft palate
B)Sinus dysfunction
C)Cleft lip
D)Esophageal malformation
Q3) Which disorder is characterized by damage to the mucosa of the duodenum and jejunum and impaired secretion of secretin, cholecystokinin, and pancreatic enzymes?
A)Wilson disease
B)Cystic fibrosis
C)Gluten-sensitive enteropathy
D)Galactosemia
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Chapter 44: Structure and Function of the Musculoskeletal System
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Q1) Which factors influence the rate of protein synthesis of skeletal muscles? (Select all that apply.)
A)Insulin
B)Cortisol
C)Parathyroid hormone
D)Growth hormone
E)Amino acid substrates
Q2) A student has learned about aging and the musculoskeletal system. What statement by the student indicates a need for more study on the topic?
A)Haversian system erodes, the canals nearest the marrow cavity widen, and the endosteal cortex converts to spongy bone.
B)The remodeling cycle increases because of a decreased ability of the basic multicellular units to resorb and deposit bone.
C)Cartilaginous rigidity increases because of decreasing water content and decreasing concentrations of glycosaminoglycans.
D)Muscle ribonucleic acid (RNA) synthesis declines, although the regenerative function of muscle tissue is reportedly normal in older adults.
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Page 46
Chapter 45: Alterations of Musculoskeletal Function
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Q1) The pathophysiologic presentation of gout is closely linked to the metabolism of which chemical?
A)Purine
B)Pyrimidine
C)Vitamin E
D)Amino acid
Q2) A health care professional is providing education to a group of seasonal athletes. What type of fracture does the professional warn them to avoid?
A)Stress
B)Greenstick
C)Insufficiency
D)Pathologic
Q3) In osteoporosis, the receptor activator of nuclear factor kB (RANK) activates what?
A)Osteoclast apoptosis
B)Osteoblast survival
C)Osteoprotegerin
D)Osteoclast survival
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Chapter 46: Alterations of Musculoskeletal Function in Children
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Q1) What does the student learn about bone growth before adulthood? (Select all that apply.)
A)Growth in the length of bone occurs at the physeal plate.
B)Growth occurs through endochondral ossification.
C)Bone growth takes place under hormonal control.
D)Cartilage cells at the epiphyseal side of the physeal plate multiply and enlarge.
E)Cartilage cells at the metaphyseal side of the plate are replaced by bone.
Q2) What does a Ewing sarcoma arise from?
A)Bone marrow
B)Bone-producing mesenchymal cells
C)Metadiaphysis of long bones
D)Embryonal osteocytes
Q3) A newborn is diagnosed with osteomyelitis. What organism does the healthcare professional prepare to treat?
A)Staphylococcus aureus
B)Escherichia coli
C)Group B streptococcus
D)Bacillus anthracis
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Chapter 47: Structure, Function, and Disorders of the Integument
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Q1) A patient is brought to the Emergency Department with cold, white, waxy fingers and toes. The patient denies pain. Which intervention does the healthcare professional provide as the priority?
A)Applying local, dry heat
B)Rubbing or massaging the area
C)Immersing in warm water
D)Leaving the area uncovered
Q2) What term is used to identify skin lesions that are elevated, rounded, and firm with irregular clawlike margins that extend beyond the original site of injury?
A)Psoriasis
B)Dermatitis
C)Acne
D)Keloid
Q3) A patient has an onychomycosis. Where would the healthcare professional assess this disorder?
A)Scalp
B)Fingernail
C)Lower legs
D)Mucus membranes
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Chapter 48: Alterations of the Integument in Children
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Q1) Parents want their child vaccinated against chickenpox. The healthcare professional prepares to administer the vaccine against which organism?
A)Poxvirus
B)Varicella-zoster virus
C)Adenovirus
D)Human papillomavirus
Q2) Rubeola is a highly contagious acute disease in children caused by which type of infection?
A)Bacterial
B)Fungal
C)Yeast
D)Viral
Q3) A parent of a child in a crowded daycare is worried about the staff passing on a bacterial infection to the child. Which infection would be most likely?
A)Atopic dermatitis
B)Staphylococcal scalded-skin syndrome
C)Impetigo
D)Tinea capitis
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Chapter 49: Shock, Multiple Organ Dysfunction Syndrome, and Burns in
Adults
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Q1) A patient has an acute burn injury. What type of treatment for shock will the healthcare professional anticipate for this patient?
A)Intravenous fluids
B)Antibiotics
C)Intra-aortic balloon pump
D)Antihistamines and steroids
Q2) A student learns that a fatal burn injury has what effect on interleukins (ILs)?
A)Decreases levels of IL-2
B)Decreases levels of IL-4 lymphocytes
C)Increases levels of IL-6
D)Increases levels of IL-12
Q3) A healthcare professional is determining the disposition of four burn patients in the Emergency department. Which patients will the professional refer to the burn center? (Select all that apply.)
A)Partial thickness burn 20% TBSA
B)Burn of the genitals
C)Lightening injury
D)Both arms burned
E)Concomitant trauma
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Chapter 50: Shock, Multiple Organ Dysfunction Syndrome, and Burns in
Children
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Q1) A 33-pound child is in shock. Which fluid bolus should the healthcare professional prepare to administer to this child?
A)Hypotonic fluid, 150 mL
B)Hypotonic fluid, 300 mL
C)Isotonic fluid, 150 mL
D)Isotonic fluid, 300 mL
Q2) Which assessment findings would be recognized as late signs of shock in a child?
(Select all that apply.)
A)Metabolic (lactic) acidosis
B)Cool skin
C)Bradycardia
D)Prolonged capillary refill
E)Hypotension
Q3) A child has a burn injury. What does the healthcare provider assess for when determining the child's chance of surviving?
A)Immunosuppression
B)Hypermetabolism
C)Inhalation injury
D)Hypertrophic scarring
52
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