In general, with aging, organ size and function

decrease

C.Q. was recently exposed to group A hemolytic Streptococcus and subsequently developed a pharyngeal infection. His clinic examination reveals an oral temperature of 102.3°F, skin rash, dysphagia, and reddened throat mucosa with multiple pustules. He complains of sore throat, malaise, and joint stiffness. A throat culture is positive for Streptococcus, and antibiotics have been prescribed. The etiology of C.Q.’s disease is

streptococcal infection.

A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of

primary prevention

An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise program. This is an example of

secondary prevention

A disease that is native to a particular region is called

endemic

A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium intake. This is an example of

secondary prevention

Indicators that an individual is experiencing high stress include all the following except

pupil constriction

Persistence of the alarm stage will ultimately result in

permanent damage and death.

Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by

norepinephrine

Which is not normally secreted in response to stress?

Insulin

Chronic activation of stress hormones can lead to (Select all that apply

cardiovascular disease. depression. impaired cognitive function. autoimmune disease.

Aldosterone may increase during stress, leading to (Select all that apply.)

increased blood volume, increased sodium retention. decreased urinary output.

Events which occur during the alarm stage of the stress response include secretion of (Select all that apply.)

catecholamines. Correct! ACTH. Correct Answer glucocorticoids. Correct! immune cytokines.

All the following stress-induced hormones increase blood glucose except

aldosterone

Allostasis is best defined as

the overall process of adaptive change necessary to maintain survival and well-being.

Selye’s three phases of the stress response include all the following except

allostasis

The cardiac drug digitalis enhances myocardial contraction, because it

increases intracellular calcium level in cardiac cells.

The resting membrane potential in nerve and skeletal muscle is determined primarily by

the ratio of intracellular to extracellular potassium ions.

An increase in extracellular potassium ion from 4.0 to 6.0 mEq/L would

hypopolarize the resting membrane potential

Some individuals inherit a gene that results in dangerously high blood cholesterol caused by impaired endocytosis of low-density lipoproteins (LDLs).

true

Phospholipids spontaneously form lipid bilayers, because they are

amphipathic

During conditions of prolonged insufficient oxygen availability (e.g., respiratory or cardiovascular disease) anaerobic glycolysis accumulated pyruvate can lead to lactic acidosis.

true

The benefit of glycolysis is that this second stage of catabolism supplies

pyruvate to the citric acid cycle.

Cell-to-cell communication through secretion of chemical signals into the bloodstream to target cells throughout the body is called _____ signaling.

endocrine

Metaplasia is

the replacement of one differentiated cell type with another.

Reperfusion injury to cells

involves formation of free radicals.

The primary effect of aging on all body systems is

decreased functional reserve

Coagulative necrosis is caused by

interrupted blood supply.

The cellular response indicative of injury because of faulty metabolism is

intracellular accumulations.

Viruses differ from most bacteria in that they (Select all that apply.)

enter the host cell. use the host’s metabolic processes to survive and replicate.do not produce toxins

Somatic death refers to death

of the entire organism

The main principle of the fluid mosaic model is that:

proteins float in a fluid lipid bilayer.

The chief function of the Golgi apparatus is:

packaging proteins into secretory vesicles.

Signaling molecules such as hormones and growth factors influence their target cells by binding to their:

receptors.

Why is ongoing synthesis of ATP necessary for cell survival?

ATP provides energy for ion pumping and other cellular processes.

A white blood cell can ingest bacteria or cellular debris through the process of:

phagocytosis

Approximately what percentage of the human DNA chromosomes code for proteins?

1%

Characteristics of cellular differentiation include which of the following? (Select all that apply.)

Specialization for different functions, influenced by memory of developmental events, dependent on cell-to-cell coordination, Generally not reversibl

Protein synthesis involves (Select all that apply.)

direction from mRNA, nucleotide triplets, RNA polymerase, removal of introns from the DNA template

Calcium channel blocker drugs are often used to treat conditions associated with (Select all that apply.)

cardiac muscle, smooth muscle

In DNA replication DNA polymerase functions to (Select all that apply.)

match appropriate bases to the template base.Correct! proofread the newly developed DNA for errors in base pairing.

Characteristics of stem cells include that they (Select all that apply.)

may differentiate into any type of cell, have greater capacity to proliferate than more differentiated cells, are dependent upon environmental cues for proliferation., can die in the absence of an appropriate environment.

The primary role of genes is to

direct the synthesis of proteins.

Males are more likely than females to be affected by ________ disorders.

X-linked

Results of biochemical tests indicate an infant has phenylketonuria (PKU). The parents ask what PKU means. Correct responses would include all the following except PKU

results from a chromosome abnormality called nondisjunction.

The parents of a child with PKU are concerned about the risk of transmitting the disorder in future pregnancies. The correct assessment of the risk is

each child has a 25% chance of being affected.

Information parents should be given about the consequences of PKU includes

failure to avoid phenylalanine results in progressive mental retardation.

The risk period for maternal rubella infection leading to congenital problems begins

prior to conception.

Characteristics of Marfan syndrome include that it (Select all that apply.)

is a single-gene disorder, involves alterations in connective tissue, leads to skeletal and joint deformities, results in dangerous cardiovascular disorders.

Huntington disease is often transferred to offspring before a parent knows of the genetic possibility of this disease, because

symptoms often do not occur until approximately 40 years of age.

Huntington disease primarily affects the _____ system.

neurologic

The chief function of ribosomes is:

protein synthesis

The two primary locations of active ribosomes in a cell are:

attached to endoplasmic reticulum and free in cytoplasm

Growth factors influence a cell by:

binding to receptors

The primary function of the Golgi apparatus is:

processing and packaging of proteins into vesicles.

Since the nucleus is surrounded by a nuclear membrane, how do most molecules leave the nucleus?

Through nuclear pores

Malignant neoplasms of epithelial origin are known as

carcinomas

The most common tumor-suppressor gene defect identified in cancer cells is

p53

Side effects of chemotherapy include (Select all that apply.)

anemia, nausea, bleeding, infections

Cancer grading is based on

cell differentiation.

Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following?

It is a procedure for determining the extent of tumor spread.

Deficits in immune system function occur in cancer as a result of (Select all that apply.)

• chemotherapy
• cancer cells
• cancer metastasis to bone marrow
• malnutrition.

Characteristics of telomerase include (Select all that apply.)

• repairs the end caps of chromosomes.
• contributes to cancer cell immortality.
• activity allows a cell to replicate indefinitely

Paraneoplastic syndromes in cancer involve excessive production of substances by multiple means. A common substance found in excessive amounts resulting from cancer paraneoplastic syndromes is

calcium

Your patient eats “lots of fat,” leads a “stressful” life, and has smoked “about two packs a day for the last 40 years.” Her chronic morning cough recently worsened, and she was diagnosed with a lung mass. The most likely contributing factor for development of lung cancer in this patient is

cigarette smoking

After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will

kill rapidly dividing cells.

Proto-oncogenes

are normal cellular genes that promote growth.

A patient with metastatic lung cancer wants to know her chances for survival. Which response is correct?

“Lung cancer has about a 15% survival rate.”

The hypermetabolic state leading to cachexia in terminal cancer is thought to be because of

tumor necrosis factor

Retroviruses are associated with human cancers, including

Burkitt lymphoma.

Tumor markers (Select all that apply.)

• are produced by normal cells.
• help determine cancer origin.
• help identify progression of cancer.
• nclude prostatic-specific antigen.

Apoptosis is the process by which damaged cells:

die by orderly disassembly.

What cells are made from precursor cells in bone marrow?

• Erythrocytes
• leukocytes
• thrombocytes

Free radical injury can be caused by:

ionizing radiation.

What is the importance of a sequence of three base pairs (a codon) in DNA?

It ultimately determines which amino acid will be placed in a protein.

Plasma membrane receptors are available to bind to:

extracellular chemicals.

The primary function of kinins is

vasodilation to enhance inflammation.

Antigen-presenting cells function to

display foreign antigen on their cell surfaces bound to MHC.

Activation of the complement cascade results in (Select all that apply.)

A. inflammation

C. chemotaxis

Interleukin-1, interleukin-6, and tumor necrosis factor-α are inflammatory cytokines secreted by

macrophages

Functions of antibodies include (Select all that apply.)

a. antigen agglutination.

b. antigen precipitation. c. opsonization. d. complement activation.

The spleen is an important defense against infection, because it

filters the blood.

Functions of B cells include

synthesizing antibodies

The membrane attack complex formed by complement is similar in function to

perforin

Which clinical finding is most indicative of an acute bacterial infection?

Increased (band) neutrophils

Passive immunity is provided by (Select all that apply.)

• transfer of preformed human antibodies.
• injection of human immune globulin. i
• injection with preformed animal antibodies.

The primary function of eosinophils is to

kill parasitic helminths (worms).

Leukocytosis with a “shift to the left” refers to

elevated immature neutrophils.

Functions of T cells include (Select all that apply.)

all apply

Proteins that are increased in the bloodstream during acute inflammation are called

acute phase proteins

Characteristics of complement include (Select all that apply.)

• a. stimulating chemotaxis
• b. lysing target cells.
• c. having multiple plasma proteins.
• e. enhancing phagocytosis.

What is a lysosome?

A membrane-bound bag of degradative enzymes within a cell

The cell structure that contains DNA is called the:

nucleus

What is a gene?

A section of DNA that has the code for making a protein

Proteins are made of:

amino acids.

Most receptors in cell membranes are made of:

protein.

Immune function is likely to be most effective in a

30-year-old.

An infectious disease that is common in a community is termed

endemic

Drug resistance of microbes occurs secondary to

mutation of the microb

A characteristic of some bacteria

contains cell wall endotoxin.

Dietary zinc is an important defense against infection, because it maintains (Select all that apply.)

• a. natural killer cell function.
• b. lymphocyte activity.
• d. neutrophil activity.
• e. complement activity.

The most common method of disease transmission is

droplet

Risk of infection is increased in (Select all that apply.)

• use of corticosteroids.
• diabetes mellitus.
• spleen removal.
• stress.

The term used to describe fungal infections is

mycoses

Rickets is characterized by soft, weak bones resulting from a deficiency of

vitamin d

Bone healing may be impaired by

nicotine use

The disorders characterized by softening and then enlargement of bones is referred to as

Paget disease.

Compartment syndrome occurs secondary to

soft-tissue damage.

Pain with passive stretching of a muscle is indicative of

noncontractile tissue injury

The pathophysiology of osteomalacia involves

inadequate mineralization in the osteoid

Characteristics of scoliosis include (Select all that apply.)

• involvement of lateral curvature of the spine.
• increase during periods of rapid growth.
• identifiable by uneven shoulders or scapular prominence
• possibility of leading to respiratory complications

When mast cells degranulate, they release:

histamine and other inflammatory mediators.

Which of the following cells are strong phagocytes?

Macrophages

What is a lysosome?

A membrane-bound bag of degradative enzymes within a cell

Which of the following terms indicates cell death that occurs by severe cell swelling and the breakdown of organelles?

necrosis

The process of programmed cellular self-destruction is called:

apoptosis

Which disorder is associated with a type III hypersensitivity mechanism of injury?

Systemic lupus erythematosus

Transfusion reactions involve RBC destruction caused by

recipient bodies

Secondary immune deficiency problems may be caused by (Select all that apply.)

• surgery
• high blood sugar
• corticosteroids
• low protein level

Myasthenia gravis is a type II hypersensitivity disorder that involves

impaired muscle function.

Severe combined immunodeficiency (SCID) syndrome is an example of a(n)

deficient immune response

The effects of histamine release include

increased vascular permeability.

Autoimmune diseases result from (Select all that apply.)

• overactive immune function.
• failure of the immune system to differentiate self and nonself molecules

Anaphylaxis may occur in certain hypersensitivity reactions, including type (Select all that apply.)

• I
• II

RhoGAM (an Rh antibody) would be appropriate in an Rh-_____ woman with an _____ Rh-_____ antibody titer carrying an Rh-_____ fetus.

negative; negative; positive

which disorder is considered a primary immunodeficiency disease?

HIV/AIDS

Dramatic hypotension sometimes accompanies type I hypersensitivity reactions, because

massive histamine release from mast cells leads to vasodilation.

The principle Ig mediator of type I hypersensitivity reactions i

IgE

A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction.

III

A primary effector cell of the type I hypersensitivity response is

mast cells

An important mediator of a type I hypersensitivity reaction is

histamine

The predominant antibody of a typical allergic response is:

IgE

What is the major function of T helper cells?

Secreting cytokines that regulate immune response

Which of the following cells produce antibodies?

Plasma cells

When antigen-antibody complexes are formed in the blood, which of the following processes can occur?

All of the above

Which of the following cells are strong phagocytes?

Macrophages

Which statement about HIV testing is correct?

Significant exposure to infected blood or body fluids requires HIV testing.

As of 2014, _____ individuals worldwide have been infected with HIV infection.

nearly 35 million

The CDC defines three CD4+ T-cell categories of T cell ranges. Which values are correct? (Select all that apply.)

• In category 1, the CD4⁺ T-cell count is greater than or equal to 500/mL.
• In category 2, the CD4⁺ T-cell counts range from 200 to 499/mL
• In category 3, the CD4⁺ T-cell count is less than 200/mL

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.)

heterosexual women.

homosexual men.

A nurse who works in an assisted living facility is preparing to teach the residents about safe sex practices. What resident criteria should the nurse take into consideration when creating a teaching plan? (Select all that apply.)

Age! Ethnicity! Culture! Sexual preference

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.

false

Which HIV-positive patient should be given a diagnosis of AIDS?

One who has Mycobacterium tuberculosis

A patient presents to the clinic with flulike symptoms and a rash. The nurse knows that the type of rash associated with HIV may include (Select all that apply.)

• maculopapular
• vesicular
• urticarial

HIV replicates very quickly from the onset of infection. What is the major site of HIV replication?

GI trac

Opportunistic infections are a hallmark of HIV and AIDS. Which infections are considered opportunistic? (Select all that apply.)

• Cytomegalovirus
• Candida albicans
• Pneumocystis carinii
• Clostridium difficile

Which modes of transmission occur with HIV infection? (Select all that apply.)

• Sexual transmission
• Parenteral transmission
• Perinatal transmission to fetus

HIV infection causes immunodeficiency because it

causes the destruction of T-helper cells

A patient is infected with the retrovirus HIV. The patient may have contracted HIV as it was transmitted via (Select all that apply.)

semen

cervical secretions

Which statement best describes the etiologic development and transmission of AIDS?

AIDS is caused by a retrovirus and transmitted through body fluids.

Which drugs are used for the management of HIV? (Select all that apply.)

• Nucleoside reverse transcriptase inhibitors
• Protease inhibitors
• Nonnucleoside reverse transcriptase inhibitors

What is the major function of T_H1 cells?

Secrete cytokines that stimulate cytotoxic T cells, NK cells, and macrophages

What is the major function of T helper cells?

Secreting cytokines that regulate immune response

The process of programmed cell self-destruction is called:

apoptosis.

What is the major function of T_H2 cells?

The major function of T_H2 cells is to secrete cytokines that stimulate antibody production and activate eosinophils.

What are CD4+ T cells?

What are CD4+ T cells?

A diagnostic laboratory finding in myeloma is

Bence Jones proteins in the urine.

The only known curative treatment for CML is allogeneic bone marrow transplantation from a suitable donor.

true

A patient is diagnosed with hairy cell leukemia. The patient’s laboratory results would most likely indicate a decrease in (Select all that apply.)

• granulocytes.
• platelets
• red blood cells.

A patient is diagnosed with stage IIA Hodgkin disease. This patient’s clinical stage was most likely determined by (Select all that apply.)

• patient history.
• CT scan.
• physical examination.

Autologous stem cell transplantation is a procedure in which

stem cells are harvested from the patient and then returned to the same patient.

A 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is

myeloma

Burkitt lymphoma is most closely associated with

Epstein–Barr virus

A patient is diagnosed with CML (chronic myeloid leukemia). The patient may experience which of these symptoms? (Select all that apply.)

• Fatigue
• Weight loss
• Abdominal discomfort
• Sweats

A 5-year-old patient’s parents report loss of appetite and fatigue in their child. The parents also state that the child refuses to walk as a result of pain. The child’s most likely diagnosis is

ALL (acute lymphoid leukemia)

Which viruses have been implicated as cancer-causing agents? (Select all that apply.)

• Epstein–Barr
• Human T-cell leukemia
• Human immunodeficiency

Which type of leukemia primarily affects children?

ALL (acute lymphoid leukemia

While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is

activity restriction

A patient is diagnosed with myeloma. The nurse teaches the patient about the multiple tumor sites that can develop with this cancer. The possible tumor sites in myeloma include the (Select all that apply.)

• liver
• spleen
• kidneys

The patient is a 12-year-old boy with acute lymphoblastic leukemia (ALL). Manifestations of the patient’s leukemia prior to treatment may include (Select all that apply.)

• anemia
• leukocytosis
• thrombocytopenia

A patient is diagnosed with stage III non-Hodgkin lymphoma and is preparing to undergo treatment. Which treatments may be used to treat this patient’s cancer? (Select all that apply.)

• Radiation
• Bone marrow transplant
• Chemotherapy
• Monoclonal antibody therap

Macrophages interact with T helper cells by:

presenting antigens and secreting cytokines.

Which of the following cells are strong phagocytes?

Macrophages

Which of the following cells produce antibodies?

Plasma cells

Which answer describes adaptive immunity?

Each immune cell can respond to only one antigen.

What type of a cell is a B cell?

Lymphocyte

The anemia resulting from a deficiency of either vitamin B₁₂ (cobalamin) or folate is caused by a disruption in DNA synthesis of the blast cells in the bone marrow that produces very large abnormal bone marrow cells called megaloblasts.

True

Thalassemia may be confused with iron-deficiency anemia, because they are both

microcytic

Which condition is associated with an elevated reticulocyte count?

Hemolytic anemia

Red blood cells obtain nearly all their energy from metabolism of

glucose

Vaccination for pneumococcal pneumonia should be performed before 1 year of age in patients with sickle cell anemia

false

Regarding iron-deficiency anemia, what laboratory features are typically decreased? (Select all that apply.)

• MCV
• MCH
• MCHC

What is necessary for red blood cell production?

iron

The most effective therapy for anemia associated with kidney failure is

erythropoietin administration.

The activated partial thromboplastin time (aPTT) is a measure of the integrity of

the intrinsic pathway

Treatment for hemophilia A includes

factor VIII replacement.

Activation of the extrinsic pathway of coagulation is initiated by

tissue thromboplastin.

A cause of thrombocytopenia includes

chemotherapy

A patient presents to the physician’s office with pinpoint hemorrhages on the skin. The patient is most likely between the ages of _____ years.

4 and 7

Disseminated intravascular coagulation may be treated with heparin therapy to

inhibit clotting factor consumption.

A 3-year-old boy who exhibits prolonged bleeding after minor trauma and a prolonged aPTT, but a normal platelet count, is likely to be diagnosed with

hemophilia

What is a megakaryocyte?

A large bone marrow cell that breaks apart into platelets

Which of the following proteins is not a normal component of plasma?

Collagen

What is a thrombocyte?

A platelet

In adults, hematopoiesis occurs in the bone marrow of all of the following bones except the:

shaft of the femur.

Where in the body are clotting factors synthesized?

liver