McCance Patho Review Qs

McCance Patho Review Qs Study online at quizlet.com/_s1m3q 1.

A 14-year-old male has been admitted to the emergency

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room suffering with acute-onset abdominal pain in the lower right quadrant. Abdominal rebound tenderness is intense, and he has a fever and leukocytosis. This individual most likely is suffering from: a. acute appendicitis b. diverticulitis c. ulcerative colitis d. cholelithiasis e. cholecystitis: a 2.

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complaining of difficulty sleeping. He reports that he wakes gasping for air and his wife is ready to divorce him because his snoring keeps her up at night. Which is the most likely diagnosis for this patient? a. Primary hypersomnia b. Parasomnia c. Somnambulism d. Obstructive sleep apnea: d Obstructive sleep apnea is due to upper airway obstruction and is accompanied by excessive snoring and episodic apnea. Primary hypersomnia is excessive daytime sleepiness. Parasomnia is unusual behavior during sleep. Somnambulism is sleepwalking.

A 20-year-old man presents with periumbilical pain, fever, and loss of appetite. Which of the following is the most likely cause of his abdominal discomfort? a. Diverticulosis b. Diverticulitis c. Appendicitis d. Mesenteric venous thrombosis: c Appendicitis is an inflammation of the vermiform appendix and commonly occurs between the ages of 20 and 30. There is often periumbilical pain that can be vague. Diverticulosis is asymptomatic diverticular disease, which is herniation or saclike outpouching of mucosa through the muscle layers of the colon wall. Diverticulitis is inflammation of the diverticula in the colon. Patients are usually older and have a crampy pain, often in the left lower quadrant. Mesenteric venous thrombosis usually occurs in older individuals with malignancies, right-sided heart failure, and deep vein thrombosis. A 23-year-old patient is hit in the temporal portion of his skull during an altercation. Although he initially loses consciousness, he soon awakens and is conversant. Three hours later he is experiencing vomiting, drowsiness, and confusion. These symptoms are most likely related to which type of brain injury? a. Diffuse axonal b. Intracerebral c. Subdural d. Epidural: d The classic presentation of an epidural hematoma is a person hit in the temporal area with damage to the middle meningeal artery. The patient will lose consciousness at the time of injury, but there may be a period where consciousness is regained. The patient will then become more confused and drowsy. This scenario is not typical with the other types of brain injury.

A 55-year-old obese male presents to a sleep clinic

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Abnormal findings in which of the following evaluations would indicate possible neurological dysfunction? Select all that apply. a. Level of consciousness b. Pattern of breathing c. Heart rate d. Eye position e. Skeletal muscle motor responses: all except c

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Acute otitis media (AOM): a. has no genetic determinants b. displays a tympanic membrane progressing from erythema to opaqueness with bulging c. has breast-feeding as a risk factor d. is commonly caused by Staphylococcus aureus: b

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Age-related macular degeneration (AMD): a. has a higher incidence in hypotensive individuals b. occurs in individuals before the age of 60 years c. exhibits retinal detachment and loss of photoreceptors d. exhibits loss of accommodation: c

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Although non-REM and REM sleep are defined by electrical recordings, they are characterized by physiologic events. Which does NOT occur? a. during non-REM sleep, muscle tone decreases b. Non-REM sleep is initiated by withdrawal of neurotransmitters from the reticular formation c. during non-REM, cerebral blood flow to the cortex decreases d. during non-REM, levels of corticosteroids increase: d

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Alzheimer disease: a. can be caused by increased cerebral levels of acetylcholine b. is most prevalent as a late-onset dementia c. manifests as nerve cell tangles d. manifests as neuron senile plaques e. all above: b

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The appropriate definition of perceptual dominance is: a. the duration of time or intensity of pain before overt pain responses are initiated. b. pain at one location that may cause an increase in threshold at another location. c. repeated exposure to a pain stimulus. d. the point at which pain is perceived.: b Perceptual dominance is pain at one location that may cause an increase in threshold at another location. For example, when a patient has severe pain in his leg, he may not feel neck pain. Pain tolerance is the duration of time or intensity of pain before overt pain responses are initiated. Repeated exposure to pain usually decreases pain tolerance. The pain threshold is the point at which pain is perceived.

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The appropriate term for pain that is present in an area distant from its point of origin is: a. acute pain. b. chronic pain. c. referred pain. d. somatic pain.: c Referred pain is pain that is present in an area removed or distant from its point of origin. Chronic pain is usually prolonged, lasting at least 3 months. Somatic pain arises from connective tissue, muscle, bone, and skin. It is may be sharp and well organized or dull, aching, and poorly localized. Acute pain arises from cutaneous, deep somatic, or visceral structures and is a protective mechanism.

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Cerebral death: a. is death of the cerebellum b. permits normal internal homeostasis c. no longer maintains respiratory and cardiovascular functions d. is death of the brainstem: b

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The characteristic lesion of Crohn disease is: a. found in the ileum b. precancerous c. granulomatous d. malignant e. a and c: e

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A characteristic of Alzheimer disease includes: Select all that apply. a. rapid onset of symptomology. b. short-term memory loss. c. increased irritability and agitation. d. anxiety and depression. e. remissions resulting in cognitive clarity.: b, c, and d

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Chronic constipation may be a result of: Select all that apply. a. low-residue diet b. sedentary lifestyle c. hyperthyroidism d. opiates use e. aging: all except c

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Chronic renal failure: a. may result from hypertension b. is usually the result of chronic inflammation of the kidney c. may be treated with dialysis or transplants d. all above e. a and c: d

A benefit of fever to human blood includes: a. decreased lymphocytic transformation. b. diminished phagocytosis. c. increased iron concentration. d. a switch to lipolysis and proteolysis.: d Fever has benefits. The higher body temperature decreases serum levels of iron, zinc, and copper, all of which are need for bacterial replication. It switches from burning glucose to lipolysis and proteolysis, thus depriving bacteria of a food source. There is increased lymphocytic transformation, increasing the immune response. Increased phagocytosis also occurs.

Causes of acute renal failure include: a. cholecystitis b. stones and strictures in kidneys or ureters c. heart failure leading to poor renal perfusion d. b and c e. a, b, and c: d

A basic neural system to cognitive function would include: Select all that apply. a. attentional systems. b. memory systems. c. affective or emotive systems. d. sensory systems. e. language systems.: all except d

A cause of a cerebral aneurysm includes: Select all that apply a. arteriosclerosis. b. heroin abuse. c. congenital anomaly. d. trauma. e. cocaine abuse.: all except b

Autonomic hyperreflexia is characterized by all of the following except: a. hypotension b. slower heart rate c. stimulation of sensory receptors below the level of the cord lesion d. precipitation because of a distended bladder or rectum: a

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The classification of acute pain includes: Select all that apply. a. acute visceral. b. pleuritic. c. referred. d. acute somatic. e. cutaneous.: all except b

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A client is diagnosed with a Cushing ulcer. What assessment information related to this client's current medical condition supports this diagnosis? a. Third-degree burns over 20% of the body b. Profound septicemia with high fever c. Severe head trauma resulting from auto accident d. Massive internal trauma as a result of a fall: c Cushing ulcer is a stress ulcer related to severe head trauma or brain surgery and is caused by overstimulation of the vagus nerve and decreased mucosal blood flow. Ischemic ulcers develop within hours of an event such as septicemia, hemorrhage, multisystem trauma, severe burns, or CHF.

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that apply. a. unresponsive coma. b. no spontaneous respiration. c. isoelectric EEG. d. pupils are reactive but unequal. e. ocular response to head turning.: a, b, and c

During vomiting, there is: a. forceful diaphragm and abdominal muscle contractions, airway closure, esophageal sphincter relaxation, and deep inspiration b. deep inspiration, airway closure, forceful diaphragm and abdominal muscle contractions, and esophageal sphincter relaxation c. airway closure, forceful diaphragm and abdominal muscle contractions, deep inspiration, and esophageal sphincter relaxation d. esophageal sphincter relaxation, forceful diaphragm and abdominal muscle contractions, deep inspiration, and airway closure.: b

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Common manifestation of hiatal hernia is:

Criteria for determining brain death include: Select all

Duodenal ulcers: a. occur 4 times more often in females than in males b. may be complicated by hemorrhage c. are associated with sepsis d. may cause inflammation and scar tissue formation around the sphincter of Oddi: b

Dystonia is: a. abnormal posture maintained by muscular contractions b. flexed posture c. stooped, hyperflexed posture d. a spastic gait: a

a. gastroesophageal reflux b. diarrhea c. belching d. postprandial substernal pain: e 28.

A diabetic child with 4.0 grams of protein in her urine each day is experiencing edema and vitamin D deficiency. Which is the most likely diagnosis? a. Nephritic syndrome b. Nephrotic syndrome c. Acute renal failure d. Rapidly progressive glomerulonephritis: b Nephrotic syndrome is characterized by excretion of 3.5 grams or more of protein in the urine per day due to glomerular injury. Nephritic syndrome is characterized by blood in the urine with red and white cell casts and varying degrees of protein. Acute renal failure presents with oliguria and a reduction in GFR and BUN. Rapidly progressive glomerulonephritis usually affects adults in their 50s and 60s and presents with hematuria.

A common cause of both pyelonephritis and cystitis is: a. urinary calculi b. invading, ascending microorganisms, such as E. coli c. allergy reactions d. heavy metals: b

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A client presents with epigastric pain and vomiting. He is hyperglycemic and tachycardic. Client reports he is "a heavy drinker but never had problems like this before." Which disease process is supported by this client's symptoms? a. Cholelithiasis b. Cholecystitis c. Acute pancreatitis d. Appendicitis: c The classic presenting symptom of pancreatitis is midepigastric pain and vomiting. This patient admits to heavy alcohol consumption, which can lead to pancreatitis. The history and assessment do not support the other options.

Depressed T cell function is associated with: a. follicular cysts b. endometrial polyps c. leiomyomas d. adenomyosis e. endometriosis: e

A client is diagnosed with hematochezia. Which assessment finding confirms this diagnosis? a. Bloody vomitus b. Bright red rectal bleeding c. Presence of tarry stools d. Positive testing for occult blood: b Hematemesis is blood in the vomitus. Hematochezia is bright red or burgundy-colored blood from the rectum. Melena is the description for dark or tarry stools. Occult bleeding is usually caused by slow, chronic bleeding, and it is not obvious.

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The earliest symptom of chronic renal failure is: a. pruritus b. oliguria c. polyuria d. decreased BUN: c

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An elderly alcoholic man falls and experiences a hematoma that is on the top of his brain. The hematoma is most likely a: a. subdural. b. epidural. c. extradural. d. intracerebral.: a Subdural hematomas are commonly found in the elderly and persons who abuse alcohol. The remaining options are injuries not generally observed in this population after experiencing an alcohol-induced fall.

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Hepatic encephalopathy is manifested by: a. ascites b. splenomegaly c. dark urine d. oliguria e. cerebral dysfunction: e

In blunt head trauma: a. brain tissues are exposed b. only focal injury occurs c. the dura is severed d. the dura remains intact: d

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In cerebral vasogenic edema: a. active transport fails b. there is autodigestion c. plasma proteins leak into extracellular spaces d. cerebrospinal fluid leaves the ventricles: c

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In chronic renal failure, tubulointerstitial disease leads to: a. sodium retention b. sodium wasting c. no significant changes in sodium levels d. increased phosphate excretion: d

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In heatstroke: a. core temperature usually doesn't exceed 101F b. sodium loss follows sweating c. core temperature increases as the regulatory center fails d. both b and c: c

H. pylori is discovered in the GI tract of a client experiencing an inflammation of the gastric mucosa. These findings support which diagnosis? a. Chronic diarrhea b. Paralytic ileus c. Chronic gastritis d. Pyloric obstruction: c Helicobacter pylori infection is associated with gastritis. The other options are not related to this organism.

In benign prostatic hyperplasia, enlargement of periurethral tissue of the prostate causes: a. obstruction of the urethra b. inflammation of the testis c. decreased urinary outflow from the bladder d. abnormal dilation of a vein within the spermatic cord e. tension of the spermatic cord and testis: a

Gastroesophageal reflux is: a. caused by rapid gastric emptying b. excessive lower esophageal sphincter functioning c. associated with abdominal surgery d. caused by spontaneously relaxing lower esophageal sphincter: d

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Gastric ulcers: a. may lead to malignancy b. occur at a younger age than duodenal ulcers c. always have increased acid production d. exhibit nocturnal pain e. both a and c: a

In bacterial meningitis, the CSF has: a. normal glucose levels b. an elevated number of lymphocytes c. neutrophilic infiltration d. none above e. a, b, and c: c

Endorphins: a. increase pain sensations b. decrease pain sensations c. may increase or decrease pain sensations d. have no effect on pain sensations: b

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Endometriosis: a. has the ectopic endometrium responding to hormonal fluctuations of the menstrual cycle b. occurs primarily in the pleural cavity c. causes infertility in most women having the disorder d. does not reoccur after treatment: a

In an automobile accident, an individual's forehead struck the windshield. The coup/contrecoup injury would be in the: a. frontal/parietal region b. frontal/occipital region c. parietal/occipital region d. occipital/frontal region: b

Endogenous opioids include: Select all that apply. a. enkephalins. b. endorphins. c. dynorphins. d. endomorphins. e. denkephalins.: all except e

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In hypothermia: a. the viscosity of blood is decreased b. acidosis can develop c. hypothalamic center prevents shivering d. all above: b

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In malabsorption syndrome, flatulence and abdominal distension are likely caused by: a. protein deficiency and electrolyte imbalance b. undigested lactose fermentation by bacteria c. fat irritating the bowel d. impaired absorption of amino acids and accompanying edema: b

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In moderate diffuse axonal injury:

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a. coma lasts more than 24 hours b. coma lasts less than 24 hours c. disruption of axons occurs in cerebral spheres and those extending into the diencephalon and brain stem d. tearing of axons in the cerebral hemisphere e. a and d: e 53.

In pancreatitis:

because of: a. increased intracranial pressure b. disrupted reflexes c. spinal shock d. loss of bladder and rectal control e. diaphragmatic impairment: e 61.

a. the tissue damage likely results from release of pancreatic enzymes b. high cholesterol intake is causative c. diabetes is uncommon in chronic pancreatitis d. bacterial infection is the etiologic cause: a 54.

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Individuals affected by sleep apnea may experience: a. polycythemia b. cyanosis c. pulmonary hypertension d. all above: d

Intervertebral disk herniation: a. usually occurs at the thoracic level b. in the lumbosacral area causes pain over the gluteal region and into the calf or ankle c. is infrequent in the lumbosacral disks d. both b and c are correct e. a, b, and c: b

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Intestinal obstruction causes: a. decreased intraluminal tension b. hyperkalemia c. decreased nutrient absorption d. a and b e. a, b, and c: c

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Involuntary unilateral or bilateral rhythmic movement of the eyes is referred to as: a. nystagmus. b. amblyopia. c. glaucoma. d. strabismus.: a Nystagmus may be present when at rest or when the eyes move. Amblyopia is reduced vision in an eye secondary to uncorrected strabismus. Strabismus is when one eye deviates from the other when a person is looking at an object. Glaucoma is increased intraocular pressure.

An individual with increased intracranial pressure from a head injury shows small and reactive pupils, widened pulse pressure, and slowed breathing. Which stage of ICP exists? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4: c

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An individual shows flexion in upper extremities and extension in lower extremities. This is: a. decorticate posturing b. decerebrate posturing c. excitation posturing d. caloric posturing: a

Interleukin-1: a. raises hypothalmic set point b. endogenous pyrogen c. stimulated by exogenous pyrogens d. none above e. a, b, and c: e

An individual has an elevated blood level of urea and creatinine because of complete calculi blockage of one ureter. This is referred to as: a. prerenal disease b. intrarenal disease c. postrenal disease d. preeclampsia e. hypercalcemia: c

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Increased serum levels of epinephrine increase body temperature by: a. increasing shivering b. increasing muscle tone c. increasing heat production d. decreasing basal metabolic rate: c

Intellectual function is impaired in the dementing process. Which intellectual function is NOT impaired? a. anterograde memory b. retrograde memory c. abstraction d. language deficits e. all above impaired: e

In the gate control theory of pain: a. a "closed gate" increases pain perception b. stimulation of large A fibers "closes the gate." c. Both a and b d. Neither a nor b: b

Injury of the cervical cord may be life threatening

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It is correct to assume that a saccular aneurysm: a. occurs commonly in childhood. b. grows rapidly. c. can be due to a combination of congenital and degenerative changes. d. occurs in about 10% of the general population.: c Saccular (berry) aneurysms can be due to a combination of congenital and degenerative changes. They affect approximately 2% of the general population. They grow slowly over time and are rare in childhood.

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It is correct to assume that a subarachnoid hemorrhage

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is: a. a risk for individuals with an intracranial aneurysm. b. seldom experienced in individuals with hypertension. c. not caused by trauma to the head. d. rarely fatal.: a Individuals with intracranial aneurysms are at risk for subarachnoid hemorrhage. Hypertension and trauma are also risk factors. The mortality is over 50%. 68.

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It is TRUE that an oligodendroglioma: a. accounts for 20% of all brain tumors. b. is fast growing. c. usually is undifferentiated. d. rarely includes cysts or calcifications.: d They often have cysts and calcifications but are slow growing, well-differentiated tumors that comprise 2% of all brain tumors.

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It is TRUE that encephalitis is: a. an afebrile illness. b. caused by bacteria. c. a result of arthropod borne viruses. d. caused exclusively by herpes simplex II.: c It is caused by a virus, often arthropod borne (tick/mosquito borne). Herpes simplex I can also cause the illness; type I is more common than type II. Encephalitis is an acute febrile illness.

It is TRUE that a hemorrhagic stroke: a. is the most common cause of CVA. b. accounts for 50% of all CVA. c. is commonly caused by hypertension. d. is often caused by a microinfarct.: c Chronic, untreated hypertension is generally the cause of hemorrhagic stroke. Hemorrhagic stroke is the third most common cause of CVA. It accounts for 10% to 15% of strokes in whites and 30% in blacks and Asians. An infarct is a type of occlusive stroke.

It is true that an acute cerebrovascular accident (CVA) is: a. the leading cause of disability in the United States. b. the fifth most common cause of death in the United States. c. likely to be followed by a second stroke within 1 year. d. experienced by 2 million individuals each year.: a CVAs are the leading cause of disability and the third leading cause of death. There are 500,000 stroke victims a year, and 5% to 14% have a second stroke within 1 year.

It is correct to assume that Grade III and Grade IV astrocytomas are: a. commonly found in the frontal lobe and cerebral hemisphere. b. generally seen more in women than in men. c. usually neurotic as a result of an absence of vascularity. d. bluish gray in color with a hard purplish center.: a They are commonly found in the frontal lobe and cerebral hemisphere and are found twice as often in men as in women. They are often large and well circumscribed with a variegated pattern. The rim is pinkish gray and solid with a soft, yellow, necrotic center. There is vascular proliferation.

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a. an uncommon neurologic disorder. b. not believed to have a genetic relationship. c. a result of neuronal proteins becoming distorted and tangled. d. the cause of plaques increasing nerve impulse transmission.: c Neurofibrillary tangles occur when the proteins in neurons become tangled and distorted. There is a genetic relationship in late-onset familial Alzheimer dementia. It is a common neurologic disorder; nearly 6 million Americans had the disease in 2000. With the formation of plaques, there is decreased nerve impulse transmission.

It is correct to assume that Cheyne-Stokes respirations (CSR): a. involve a pathologically increased ventilatory response. b. result in hypocapnia and increased ventilatory stimulus. c. cause changes in PaO2 that produce irregular breathing. d. increase PaCO2 level when overbreathing occurs.: a The pathophysiology of CSR includes an increased ventilatory response to carbon dioxide stimulation. This causes hypercapnia and diminished ventilatory stimulus. Changes in PaCO2 produce irregular breathing, not changes in PaO2. The PaCO2 level decreases to below normal when overbreathing occurs.

It is TRUE that Alzheimer disease is:

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It is TRUE that spinal shock: a. is characterized by an incomplete loss of reflex function. b. involves all skeletal muscles. c. causes increased muscle tone below the lesion. d. results in no disruption of thermal control.: b Spinal shock does involve function of skeletal muscles resulting in paralysis and flaccidity. Such an injury is characterized by a complete loss of reflex function below the level of the lesion, and impairment of control of thermal regulation is observed.

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It is TRUE that the specificity theory of pain: a. focuses on the attention of pain. b. focuses on previous experience of pain. c. relates the amount of pain to the amount of soft tissue injury. d. relates to the emotions exhibited toward pain.: c The specificity theory of pain postulates that the intensity of pain is directly related to the amount of associated tissue injury. It does not take into account previous experience, emotions, or attention to pain.

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A mechanism that does not result in heat loss is: a. increased respiration. b. conduction. c. convection. d. vasoconstriction.: d Vasoconstriction is a mechanism of heat conservation. Increased respiration, conduction, and convection are all mechanisms of heat loss.

The most common manifestation of portal hypertension is: a. rectal bleeding b. cirrhosis c. intestinal bleeding d. duodenal bleeding e. vomiting of blood from esophageal bleeding: e

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Most spinal cord injuries occur in the: a. cervical and thoracic regions b. cervical and lumbar regions c. thoracic and lumbar regions d. lumbar and sacral regions: b

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Multiple sclerosis involves: a. degeneration of dopaminergic receptors b. activation of the syncytin gene c. depletion of GABA d. lower motor neuron muscle wasting: b

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Nephrotic syndrome is associated with ___ to plasma ___ . a. increased glomerular permeability; urea b. decreased glomerular permeability; proteins c. decreased glomerular permeability; tubular filtrate d. increased glomerular permeability; proteins: d

A means of classifying a seizure includes: Select all that apply. a. clinical manifestations. b. site of origin. c. response to therapy. d. length of activity. e. EEG correlates.: all except d

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Manifestations of subarachnoid hemorrhage include (more than 1 answer may be correct): a. an explosive headache b. muscle flaccidity c. neurologic deficits d. a delayed age of onset: a, c

The most common cause of TBI is: a. motor vehicle accidents. b. falls. c. sports-related events. d. violence.: a Motor vehicle accidents account for 50%. Falls account for 21%. Sports-related events and violence account for 10% and 12%, respectively.

Low-residue diets and chronic constipation play a role in the pathogenesis of: a. appendicitis b. diverticulitis c. ulcerative colitis d. Crohn disease e. cholecystitis: b

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Leptin: a. promotes insulin resistance b. binds to insulin receptors c. suppresses hunger/appetite at the hypothalamus d. a, b, and c e. none above: c

Melena is: a. bloody vomitus b. gaseous bowel distention c. blood in the stool d. loss of appetite e. black, tarry stools: e

Kussmaul respirations can be a result of: Select all that apply. a. Pulmonary edema b. Metabolic alkalosis c. Metabolic acidosis d. Dehydration e. Impaired protein metabolism: a and c

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Nephrotoxins, such as antibiotics, may be responsible for: a. acute tubular necrosis b. acute glomerulonephritis c. pyelonephritis d. cystitis: a

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Osmotic diarrhea is caused by: a. lactase deficiency b. bacterial enterotoxins c. ulcerative colitis d. crohn disease e. c and d: a

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A patient diagnosed with Parkinson disease initially

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experiences: a. difficulty walking. b. fine tremors. c. postural instability. d. rigidity of leg muscles.: b Tremor is often the first symptom to appear. The symptoms are often unilateral and then become bilateral, progressing to affect gait and include postural instability and the inability to walk. 92.

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A patient experiences diarrhea, which her physician contributes to increased mucosal discharge of chlorideor bicarbonate-rich fluid. Which of the following types of diarrhea is this? a. Osmotic b. Secretory c. Motility d. Parasitic: b Secretory diarrhea is a form of large-volume diarrhea caused by excessive mucosal secretion of chloride- or bicarbonate-rich fluid or inhibition of net sodium absorption. Osmotic diarrhea is due to a nonabsorbable substance in the intestine that draws water into the lumen by osmosis; an example is lactase deficiency. Motility diarrhea is caused by resection of the small intestine. This is often found after bypass surgery (bariatric). Parasitic diarrhea is caused by parasites in the gastrointenstinal (GI) tract.

A patient experiences abdominal pain that is very localized and intense. Which type of pain does this describe? a. Parietal b. Visceral c. Referred d. Phantom: a Parietal pain arises from the parietal peritoneum and is more localized and intense than visceral pain. Visceral pain is often poorly localized and dull and arises from the organs themselves. Referred pain is well-localized visceral pain felt at some distance from a diseased or an affected organ. Phantom pain does not refer to abdominal pain. It is felt after the loss of a limb.

A patient experiences demyelination of the peripheral nerves with sparing of the axons. This is characteristic of: a. Alzheimer disease. b. Guillain-Barré. c. myasthenia gravis. d. amyotrophic lateral sclerosis (ALS).: b Guillain-Barré is an idiopathic polyneuritis with acute inflammatory demyelinating characteristics. There is demyelination of the peripheral nerves with relative sparing of the axons. Alzheimer disease is a form of dementia caused by tangles. Myasthenia gravis is due to anti-acetylcholine-receptor antibodies. ALS is a degenerative disorder diffusely involving lower and upper motor neurons, resulting in progressive muscle weakness.

A patient experiences a vertebral fracture in which the C1 vertebra is fractured into several fragments. This type of fracture can be described as: a. simple. b. compressed. c. comminuted. d. dislocation.: c A comminuted fracture is also called a burst fracture, in which the vertebral body is shattered into several fragments. A simple fracture is a single break usually affecting the transverse or spinous process. A compressed fracture is also called a wedge. This occurs when there is a crush type of injury and the vertebrae loses height. A dislocation is when two bones at a joint are no longer in alignment.

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epigastric area when the stomach is empty and in the middle of the night. This history supports a diagnosis of: a. acute gastritis. b. chronic gastritis. c. gastric ulcer. d. duodenal ulcer.: d These symptoms support a diagnosis of a duodenal ulcer. Acute gastritis often has vague abdominal discomfort, epigastric tenderness, and bleeding. Chronic gastritis has symptoms that include anorexia, fullness, nausea, vomiting, and pain. Gastric ulcers have symptoms of epigastric pain and may occur immediately after eating.

A patient experiences a large hematoma from a motor vehicle accident. The patient develops jaundice due to increased breakdown (hemolysis) of red blood cells. Which statement the pathophysiology of hemolysis regarding this patient's condition is true? a. There is a decrease in conjugated bilirubin. b. Increased amounts of unconjugated bilirubin occur. c. Bilirubin is excreted in the urine. d. Hemolysis is identical to obstructive jaundice.: b Hemolysis increases the unconjugated bilirubin, which is not water soluble so it cannot be excreted in the urine. This does not affect the conjugated bilirubin, which is increased in obstructive jaundice.

A patient experiences chronic intermittent pain in the

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A patient experiences no nausea but significant vomiting with a CNS injury when the trauma: a. impinges directly on the floor of the third ventricle. b. causes a decrease in intracranial pressure. c. involves the vestibular nuclei. d. also involves the abdominal area.: c Vomiting associated with CNS injuries involves the vestibular nuclei. It can also be caused by impingement on the fourth ventricle or an increase in intracranial pressure. Vomiting with no associated nausea indicates direct involvement of the central neural mechanisms regardless of abdominal trauma.

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A patient experiencing the tonic phase of a seizure

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exhibits: a. muscle contraction with increased muscle tone. b. alternating contraction and relaxation of muscle. c. muscle contraction alternating with placidity. d. complete paralysis.: a The phase of muscle contraction with increased muscle tone is the tonic phase. Alternating contraction and muscle relaxation represents the clonic phase. The postictal phase immediately follows the seizure. There is no phase that is characterized with muscle contraction alternating with placidity. 100.

A patient has a brain abscess with a decreased necrotic center and mature collagen. This is most consistent with which stage? a. Early cerebritis b. Late cerebritis c. Early capsule formation d. Late capsule formation: c Early capsule formation occurs on days 10 to 13. The necrotic center decreases in size and inflammatory infiltrate changes in character. Mature collagen evolves, forming a capsule. Early cerebritis occurs on days 1 to 3 and is a localized inflammatory process. There are marked cerebral edema and a central core of necrosis. Late cerebritis occurs on days 4 to 9, and there is a necrotic center surrounded by inflammatory infiltrate of macrophages and fibroblasts. There is rapid new blood vessel formation. Late capsule formation occurs on day 14 and later. There is a well-formed necrotic center surrounded by a dense collagenous capsule.

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A patient is brought to the emergency room following a motor vehicle accident in which he sustained diffuse brain injury. Which of the following symptoms would be expected to accompany his injury? Select all that apply. a. Memory deficits b. Swallowing disorders c. Agitation d. Fatigue e. Short attention span: all except d

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A patient is diagnosed with a kidney stone that is composed of magnesium, ammonium, and phosphate. What type of urinary calculus is this? a. Calcium b. Struvite c. Uric acid d. Indinavir: b Calcium oxalate or calcium phosphate stones account for 70% to 80% of stones. Struvite stones account for about 15% and are composed of magnesium, ammonium, and phosphate. Uric acid stones account for about 7% of stones. Less common stone elements include cystine, 2,8-dihydroxyadeninuria, triameterene, indinavir, and ammonium acid urate.

A patient has sustained a traumatic brain injury but is able to follow simple commands and can manipulate objects. The term used to describe this state is: a. coma b. vegetative c. minimally conscious d. locked-in syndrome: c The term minimally conscious refers to severely altered consciousness in which the person demonstrates minimal but defined behavioral evidence of self or environmental awareness. The clinical features include following simple commands, manipulation of objects, gestural or verbal yes/no responses, intelligible verbalization, and stereotypical movements. Lockedin syndrome describes an individual who has both the content of thought and the level of arousal intact. The efferent pathways are disrupted, which means the individual cannot communicate through speech or body movement. Coma is a state of neurobehavioral unresponsiveness. Vegetative state is a wakeful unconscious state.

A patient has uncontrolled or premature contractions of the detrusor muscle. Which condition is associated with this medical problem? a. Spinal cord injury b. Immune system dysfunction c. Congestive heart failure d. Renal carcinoma: a This patient's condition is neurogenic detrusor overactivity. Spinal cord injury contributes to uncontrolled or premature contractions of the detrusor muscle associated with a neurological disorder. This can also be from Guillain-Barré or transverse myelitis.

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A patient is diagnosed with a meningioma. The most likely site of the tumor is the: Select all that apply. a. sella turcica. b. olfactory groove. c. tuberculum sellae. d. sphenoidal wing. e. cerebellopontine angle.: all

106.

A patient is diagnosed with a peptic ulcer. Which assessment data confirms this diagnosis? Select all that apply. a. Presence of H. pylori in the duodenum b. Advanced age c. Follows a strict vegetarian diet d. History of alcohol abuse e. Diagnosis of rheumatoid arthritis: all except c

107.

A patient is diagnosed with colorectal cancer and is

112.

told that it is limited to the bowel wall. This is characteristic of which stage of cancer? a. Stage A b. Stage B c. Stage C d. Stage D: a Stage A is cancer limited to the bowel wall. Stage B is cancer extending through the bowel wall. Stage C is nodal metastasis regardless of extension into the bowel wall. Stage D is distant metastasis. 108.

A patient is diagnosed with hepatitis A. Transmission of this form of hepatitis occurs via: a. fecal-oral route. b. infected blood or body fluids. c. sexual contact. d. intravenous drug use.: a Hepatitis A is transmitted most commonly by the fecal-oral route.

109.

113.

A patient is diagnosed with portal hypertension due to liver disease. Which assessment observation supports this diagnosis? a. Hematemesis b. Abdominal pain from splenomegaly c. Ascites d. Altered mental status: a The most common clinical manifestation of portal hypertension is vomiting of blood (hematemesis) from bleeding esophageal varices. The other options are not associated with this disorder.

111.

114.

A patient who fell and hit his head 2 days ago is now restless and irritable. This scenario is characteristic of: a. Alzheimer disease. b. dementia. c. delirium. d. coma.: c Delirium is an acute state of confusion. It is abrupt in its onset. The patient may have difficulty in concentration, restlessness, irritability, tremulousness, insomnia, and poor appetite. Dementia is a more chronic problem in which there is progressive failure of many cerebral functions. Alzheimer disease is a type of dementia. A coma is a loss of consciousness.

A patient is experiencing pain that courses over the buttocks and into the calf and ankle. This is suggestive of a herniated disc at which vertebral level? a. Cervical b. Thoracic c. Lumbar d. Coccyx: c A herniated disc in the lumbosacral area is associated with pain that radiates along the sciatic nerve and courses over the buttock and into the calf and ankle. Both a cervical and thoracic injury would indicate pain that originated higher on the body. A herniated coccyx vertebrate would result in pain beginning a point lower than that described.

A patient who exhibits involuntary twisting movements caused by slow muscle contraction on the right side of the body is experiencing: a. hypertonia. b. spasticity. c. hemidystonia. d. paratonia.: c Injury to the putamen or its outflow tracts would result in hemidystonia. Hypertonia is increased muscle tone. Spasticity results from hyperexcitability of the stretch reflexes. Paratonia is resistance to passive movement that is proportional to the force applied.

A patient is diagnosed with Huntington disease. Which of the following is a TRUE statement? Huntington's disease is: a. a commonly diagnosed neurological disorder. b. a nonhereditary disease. c. also known as chorea. d. asymptomatic until the 2nd decade of life.: c Huntington disease is also called chorea. It is relatively rare and is a hereditary degenerative disorder. It most commonly affects those between the ages of 30 and 50.

110.

A patient presents with a wide-based gait in which the feet were turned outward. She staggers when walking and holds her pelvis stiff. These characteristics are representative of: a. cerebellar gait. b. basal ganglion gait. c. decorticate posture. d. apraxia.: a Cerebellar dysfunction results in a wide-based gait in which the feet are turned inward or outward. Basal ganglion gait is a widebased gait in which the person walks with small steps and decreased arm swing. Decorticate posture occurs when the upper extremities are flexed at the elbows and held close to the body while the lower extremities are externally rotated and extended. Apraxia is the inability to perform purposeful or skilled motor acts in the absence of paralysis, sensory loss, abnormal posture, or tone.

115.

A patient who is experiencing a loss of comprehension or the production of language is described as having: a. dysphasia. b. aphasia. c. expressive dysphasia. d. transcortical dysphasia.: a Aphasia is complete inability to speak. Dysphasia is impairment in comprehension or production of language. Expressive dysphasia is characterized primarily by deficits in expression, but comprehension may be present. Transcortical dysphasia involves the ability to repeat and to recite.

116.

A patient who is experiencing difficulty in recognizing

120.

a pattern's form and the nature of objects is exhibiting characteristics of: a. agnosia. b. aphasia. c. dysphasia. d. Alzheimer disease.: a Agnosia is a defect of pattern recognition. Aphasia is the complete absence of speech. Dysphasia is impairment of comprehension or production of language. Alzheimer disease is a disease of dementia. 117.

A patient who reports a loss of childhood memories is describing a characteristic of: a. selective attention deficit. b. retrograde amnesia. c. anterograde amnesia. d. executive attention deficits.: b Retrograde amnesia is the loss of past memories, whereas anterograde amnesia is the inability to form new memories. Selective attention deficit is the ability to select specific information to be processed from environmental and internal stimuli. Executive attention deficit is the inability to maintain sustained attention, inability to set goals and recognize when an object meets a goal, and a deficit in working memory.

118.

119.

121.

122.

The person at highest risk for traumatic brain injury (TBI) is: a. African American and economically disadvantaged. b. male and disabled. c. female and 20 years of age. d. an economically advantaged young adult.: a Those at highest risk for TBI are children 0 to 4 years of age, older adolescents aged 15 to 19 years, and adults aged 65 years and older. Males have the highest incidence in every age group. TBI is highest among African Americans and in lower- and median-income families.

123.

Pinhole-sized pupils can be a result of an overdose of: a. atropine. b. scopolamine. c. opiates. d. amphetamines.: c Opiates (heroin and morphine) cause pinhole or constricted pupils. The other choices cause large dilated pupils.

A patient who reports that 'everything tastes unpleasant' is exhibiting symptoms of: a. hyposmia. b. anosmia. c. hypogeusia. d. dysgeusia.: d Dysgeusia is a perversion of taste in which everything has an unpleasant flavor. Hyposmia is an impaired sense of smell. Anosmia is a complete loss of smell. Hypogeusia is a decrease in taste sensation.

Peptic ulcers may be located in the: a. stomach b. esophagus c. duodenum d. colon e. a, b, and c: e

A patient who reports abdominal and back pain has been diagnosed with bacteria in the urine. What is the appropriate term for involvement of the upper urinary tract that is likely to cause such symptoms? a. Cystitis b. Pyelonephritis c. Urinary tract infection d. Asymptomatic bacteriuria: b Cystitis is inflammation of the bladder. A urinary tract infection is inflammation of the urinary epithelium, followed by invasion and colonization by some pathogen. Pyelonephritis indicates involvement of the upper tracts. Asymptomatic bacteriuria is urine with bacteria that do not provoke infection.

A patient who was outside on a summer day and is now experiencing increased sweating and thirst, weakness, and dizziness is exhibiting signs of: a. heat cramps. b. heat exhaustion. c. hyperthermic stroke. d. malignant hyperthermia.: b Heat exhaustion is the result of prolonged high core temperatures. There is often dehydration, feelings of weakness, dizziness, nausea, and fainting. Heat cramps are severe, spasmodic cramps in the abdomen and the extremities that follow prolonged sweating and associated sodium loss. Heat stroke may be lethal and is caused by exposure to excessive heat and loss of the body's protective mechanisms for cooling. Malignant hyperthermia is a lethal complication of a rare inherited muscle disorder.

124.

The poor absorption of vitamin A will result in: a. osteoporosis. b. neurological deficiencies. c. night blindness. d. petechiae.: c A deficiency in vitamin A can result in night blindness. Vitamin D is involved in osteoporosis, vitamin E in neurological development, and vitamin K in petechiae formation.

125.

Postical sleeping can be seen in ____ seizures. a. partial b. unilateral c. grand mal d. psychomotor: d

126.

Precipitating causes of seizure include all of the

134.

following except: a. meningitis b. stroke c. hyperglycemia d. hyperthermia e. all above: c 127.

Predisposing factors in the development of colon cancer include all of the following EXCEPT: a. familial polyposis b. ulcerative colitis c. low-fiber/high-fat diet d. high-fiber diet e. high refined CHO diet: d

128.

129.

131.

Renal function tests include: a. the urinalysis b. BUN and serum creatinine c. SGOT/SGPT d. a and b e. a, b, and c: d

133.

Risk factors for a CVA includes: Select all that apply. a. obesity. b. smoking. c. diabetes. d. arterial hypertension. e. atrial fibrillation.: all except a

Short-term starvation involves: a. glycogenolysis b. gluconeogenesis c. proteolysis d. a and b e. a, b, and c: d

137.

Sleep apnea: a. is lack of breathing during sleep b. can result from airway obstruction during sleep c. is associated with jet-lag syndrome d. all above e. both a and b: e

138.

Supratentorial processes reduce arousal by: a. destroying the reticular activating system b. displacement of the brainstem c. destroying the brainstem d. both a and c e. none of the above: b

139.

Symptoms of cholelithiasis include all of the following EXCEPT: a. nausea and vomiting b. right upper quadrant tenderness c. jaundice d. decreased serum bilirubin levels e. abdominal distress: d

Renal calculi may be composed of: a. calcium oxalate b. uric acid c. cholesterol d. all above e. a and b: e

132.

136.

Referred pain from upper abdominal diseases involves: a. sacral region b. L2 to L4 c. T8, L1, and L2 d. gluteal regions, posterior thighs, calves: c

Ruptured aneurysms are most likely in ___ cerebrovascular accidents. a. TIA b. thrombotic c. embolic d. hemorrhagic: d

Pyelonephritis is: (More than 1 answer may be correct.) a. an inflammation and infection of the urinary bladder b. characterized by fever, chills, and flank pain c. characterized by pyuria, bacteriuria, and hematuria d. more common in young women than in young men: b,c,d

130.

135.

The presence of albumin in the urine would indicate probable damage to: a. glomeruli b. renal columns c. collecting tubules d. pyramids e. none above: a

Risk factors for esophageal carcinoma would include: Select all that apply. a. alcohol abuse. b. tobacco use. c. thin body habitus. d. zinc deficiency. e. sliding hiatal hernia.: all except c

140.

The term used to describe a patient who sustains a cerebrovascular accident and is paralyzed on the left side is: a. hemiplegia. b. paraplegia. c. diplegia. d. quadriplegia.: a Hemiplegia means loss of motor function on one side of the body. Paraplegia refers to loss of motor function of the lower extremities. Diplegia is the paralysis of both upper or both lower extremities as a result of cerebral hemisphere injuries. Quadriplegia refers to paralysis of all four extremities.

141.

Transient ischemic attacks (TIAs) are:

147.

a. unilateral neurologic deficits that slowly resolve b. generalized neurologic deficits that occur a few seconds every hour c. focal neurologic deficits that develop suddenly, last for several minutes, and clear in 24 hours d. neurologic deficits that slowly evolve or develop: c 142.

A trauma patient diagnosed with a brain contusion experiences changes in attention, memory, affect, and emotion. In which region of the brain is the contusion most likely located? a. Cerebral b. Frontal c. Cerebellum d. Midbrain: b Contusions are most commonly found in the frontal lobes, particularly at the poles and along the inferior orbital surfaces. They result in changes in attention, memory, and executive attentional functioning.

143.

148.

149.

Uremia exhibits:

Uremia, as seen in chronic renal failure, would

150.

146.

When a client reports jaundice, fatigue, anorexia, nausea and vomiting, a diagnosis of hepatitis is made. Which stage of the disease process is supported by these symptoms? a. Prodromal phase b. Icteric phase c. Recovery phase d. Chronic active hepatitis: a The prodromal phase begins about 2 weeks after exposure and includes the symptoms described. The icteric phase begins 1 to 2 weeks after the prodromal phase and includes jaundice, dark urine, clay-colored stools, and hepatomegaly. The recovery phase begins with resolution of jaundice and other symptoms. Chronic active hepatitis is persistence of clinical manifestations and liver inflammation after acute infection.

Which are possible causes of prostate cancer? Select all that apply. a. Elevated androgen levels b. Reduced levels of 5α-dihydrotestosterone c. High exposure to ultraviolet light rays d. Chronic prostatic inflammation e. Genetic predisposition: all except c

Vestibular nystagmus: a. is the constant, involuntary movement of the eyeball caused by ear disturbances b. is the sensation of spinning c. may be caused by alterations in nervous system from receptor to the cerebral cortex d. causes a diminished sense of the position of body parts: a

Which are frequent sites for distant metastasis for prostate cancer? Select all that apply. a. Brain b. Lymph nodes c. Liver d. Bones e. Lungs: all except a

include: a. metabolic acidosis b. elevated BUN and creatinine c. cardiovascular disturbances d. all above: d 145.

Which are characteristics of anorexia nervosa? Select all that apply. a. Fear of becoming obese b. Distorted body image c. Body weight 25% less than normal d. Absence of three consecutive menstrual periods e. Diagnosed chronic depression: a, b, d

a. polycythemia b. retention of metabolic acids c. low plasma calcium levels d. increased erythropoiesis e. a and d: b 144.

Which activity has been documented to increase the levels of circulating endogenous endorphins? a. Cough b. Stress c. Sleep d. Pain: b Stress, sexual intercourse, acupuncture, and excessive physical exertion have all been linked to increased levels of circulating endorphins. Drinking behavior and cough are actually moderated by endorphins. Sleep and pain are not linked with excessive amounts of endorphins.

151.

Which are predisposing factors for acute urinary tract infections? (More than 1 answer may be correct.) a. congenital deformities of urinary tract b. the sex of the patient c. decreased urine flow d. increased urine flow e. increased fluid intake: a,b,c

152.

Which assessment question demonstrates an understanding of a possible cause of achalasia? a. "Are you chronically constipated?" b. "What types of high fiber foods do you eat?" c. "Do you become 'gassy' after meals?" d. "Have you been under a lot of stress lately?": d Psychosocial achalasia has been documented and may be the result of life stressors. The other options are not associated with this disorder.

153.

Which can be characteristic of urethral stones? a. severe pain in the back b. severe pain in abdomen c. nausea and vomiting d. all above e. a and c: d

154.

Which condition may cause obstructed urine flow? Select all that apply. a. Prostate enlargement b. Pelvic organ prolapse c. Low bladder wall compliance d. Detrusor areflexia e. Detrusor hyperflexia: all except d

155.

157.

163.

164.

165.

159.

Which is a determinant of severity for obstructive

Which is a factor that is required before a stone is formed? Select all that apply. a. Supersaturation of one of the salts b. Precipitation from a liquid to a solid c. Aggregation d. Low concentration of salt e. Presence or absence of Tamm-Horsfall protein: all except d

160.

Which is a risk factor for the development of CVAs? a. polycythemic vera b. hypertension c. diabetes mellitus d. hyperhomocysteinemia e. all above: e

161.

Which is involved in fever? a. tumor necrosis factor b. endotoxins c. elevation of the set point in the hypothalamus d. both a and b e. a, b, and c: e

Which is the most important difference between proliferative and non-proliferative breast tissue changes? a. Genetic aberrations are more common in nonproliferative lesions. b. Cancer prognosis is better for non-proliferative breast tissue changes. c. Non-proliferative breast lesions do not increase the risk of breast cancer. d. Cancer resulting from non-proliferative breast lesions has a higher cure rate.: c Non-proliferative breast lesions do not increase the risk of breast cancer. The remaining statements are not true of this type of breast tissue change.

Which extraintestinal manifestations are found in

uropathy? Select all that apply. a. Location of the blockage b. Degree of completeness of the blockage c. Type of blockage d. Duration of the blockage e. Cause of the lesion: all except c

Which is NOT a primary intracerebral neoplasm? a. astrocytoma b. meningioma c. oligodendroglioma d. ependymoma: b

ulcerative colitis? Select all that apply. a. Gallstones b. Uveitis c. Polyarthritis d. Cutaneous lesions e. Liver disorders: c, d, e 158.

Which is not a neuromodulator of pain? a. prostaglandins b. 5-hydroxytryptamine c. norepinephrine d. lymphokines e. heparin: e

Which does NOT cause constipation? a. opiates b. megacolon c. sedentary lifestyle d. hyperthyroidism e. emotional depression: d

Which is NOT a characteristic of chronic renal failure? a. hyperkalemia b. anuria c. anemia d. pruritus e. acidosis: b

Which describe a patient in acute renal failure? (More than 1 answer may be correct) a. elevated serum creatinine b. leukocystitis c. low BUN d. fever e. oliguria: a,e

156.

162.

166.

Which is TRUE regarding meningitis? a. Bacterial meningitis is a primary infection of the gray matter. b. Aseptic meningitis is most commonly caused by a fungus. c. Fungal meningitis is very common. d. Tubercular meningitis has a 90% recovery rate, if diagnosed early.: d Tubercular meningitis has a 90% recovery rate with early diagnosis and treatment. Fungal meningitis is uncommon. Aseptic meningitis is most commonly caused by a virus. Bacterial meningitis is caused by primary infection of the pia mater and arachnoid.

167.

Which is TRUE regarding metastatic tumors that are located in the brain? a. Carcinomas are disseminated to the brain from the circulation. b. One-third of metastatic tumors are located within the brain. c. Two-thirds of metastatic tumors are located in the extradural spaces. d. Tumors of the pelvis tend to involve the frontal lobe.: a Carcinomas disseminate to the brain from the circulation. Twothirds of metastatic tumors are located within the brain, and onethird are located in the extradural spaces. Tumors of the pelvis tend to metastasize to the cerebellum and pons.

168.

172.

173.

Which most often causes biliary cirrhosis?

Which most typically characterizes the victims of a cerebral embolic stroke? a. individuals older than 65 years of age with a history of hypertension b. individuals with a long history of TIAs c. middle-aged individuals with a history of heart disease d. individuals with gradually occuring symptoms that then rapidly disappear: c

170.

171.

174.

175.

Which of the following statements is TRUE regarding grading of the astrocytoma? a. Grade I is not treated. b. Grade II is treated with radiation only. c. Grades III and IV are treated with surgery. d. Grade III is not well circumscribed.: c Grade I is treated with surgery and then follow-up CT scans for recurrence. Grade II is treated surgically if accessible and then with radiation. Grade III and IV are treated with surgery. Grade III is well circumscribed.

Which of the following is a TRUE statement regarding Crohn disease? a. It involves the mucosa only. b. Skip lesions are common. c. It affects only the rectum. d. The most common site is the rectum.: b Crohn disease affects the entire GI tract and can affect all layers of the mucosa and serosa. Skip lesions are common, meaning the disease is not continuous; it skips parts of the colon. The most common area for the disease is the ileocolon

Which of the following regarding chronic gastritis is true? a. There are four types. b. Type A, or fundal gastritis, is the most severe. c. Type B, or antral gastritis, is the most rare. d. It tends to occur in young individuals.: b Chronic gastritis is classified as type A (fundal) or type B (antral). Fundal is the more rare and severe of the two types. It occurs most frequently in the elderly.

Which of the following genes have been linked with the development of breast cancer? Select all that apply. a. BRCA1 b. BRCA2 c. p53 d. PSA e. Her-2/neu: all except d

Which of the following is considered a risk factor for vaginal cancer? a. Human papillomavirus (HPV) b. Endometriosis c. Concurrent breast cancer d. Birth control pills: a HPV infection and prior carcinoma of the cervix place a woman at higher risk for developing vaginal cancer. Research has not linked the other options to this form of cancer

a. malnutrition b. alcoholism c. Hep A or C d. autoimmunity e. biliary obstruction: e 169.

Which of the following is a TRUE statement regarding ulcerative colitis? a. It extends throughout the entire GI tract. b. It generally appears in childhood. c. African-Americans are more commonly affected. d. Bloody, purulent diarrhea is a common symptom.: d Frequent diarrhea, with passage of small amounts of blood and purulent mucus, is common. Ulcerative colitis is a chronic inflammatory condition that is common in those of Jewish or European descent. The lesions usually begin appearing between 20 and 40 years of age and are located from the rectum to the colon proximally.

176.

Which pair of structures regulates the complex emotional responses to pain? a. Frontal and cerebellar lobes b. Limbic and reticular system c. Thalamus and brainstem d. Midbrain and nuclei of thalamus: b The reticular and limbic systems regulate what we feel about pain. The remaining structures are not involved.

177.

Which renal condition usually has a history of recent infection with beta-hemolytic streptococci? a. pyelonephritis b. chronic renal failure c. nephrosis d. glomerulonephritis e. calculi: d

178.

Which statement is NOT true concerning

183.

glomerulonephritis? a. Significant damage to kidneys occurs during the body's response to an infection b. Fever and flank pain occur c. Complement activation attracts neutrophils d. It is characterized by hematuria, proteinuria, and the presence of casts e. Approximately 90% of individuals develop chronic disease: e 179.

Which statement is NOT true concerning urinary tract infections? a. Once cystitis develops, pyelonephritis will certainly occur b. They are usually caused by coliforms, especially E. coli c. Organisms probably enter the bladder by way of the urethra d. The patient may be asymptomatic: a

180.

181.

185.

Which statement regarding benign prostatic hyperplasia (BPH) is TRUE? a. Ten percent of men will have it by age 80 years. b. It is an uncommon condition. c. The prostate is largest at birth and continues to shrink. d. It may be problematic if urethral compression occurs.: d BPH is a common condition. It may be a problem if there is compression of the urethra. Eighty percent of men will have it before age 80. The prostate increases in size throughout life and is the smallest at birth.

186.

Which statement regarding cirrhosis is true? Select all that apply. a. Cirrhosis develops rapidly. b. The causes are not clearly understood. c. Portal hypertension is a complication. d. Severity is determined by amount of the toxin. e. Prognosis is poor even when contaminant is removed.: b, c, d

Which statement is TRUE regarding cancer of the colon? a. It is the most frequent cause of cancer death. b. It accounts for 25% of all cancer deaths. c. It tends to occur in young individuals less than 40 years of age. d. Treatment will include surgical resection of the colon.: d Treatment for cancer of the colon is always surgical. Colorectal cancer is the second most frequent cause of cancer death in the United States; it accounts for 10% to 15% of all cancer deaths. It also occurs in individuals older than 50 years.

Which statement is TRUE regarding the act of retching? a. It begins with a shallow respiration. b. Hypersalivation and tachycardia are common. c. The esophagus becomes distended. d. Reverse peristalsis seldom occurs.: c Retching begins with a deep inspiration, followed by distention of the esophagus, contraction and spasm of abdominal muscles, lower esophageal relaxation, and reverse peristalsis. Hypersalivation and tachycardia are common during nausea.

Which statement is TRUE regarding breast cancer? a. The older the age at a woman's first childbirth, the lower the risk. b. It is the second most common cause of cancer in women. c. The incidence has been declining since 1955. d. African-American women have the highest mortality rate.: d African-American women in all age groups experience the highest mortality rate. It has been on the rise since 1955. It is the most common cause of cancer in women. Early childbirth lowers the risk of having cancer.

182.

184.

Which statement is NOT true regarding increasing intracranial pressure? a. accumulating CO2 causes vasoconstriction b. the brain volume increases c. the blood volume in the vessels increases d. brain tissue shifts from the compartment of greater pressure to one of lesser pressure e. both b and c: a

Which statement is true regarding hiatal hernia? a. There are three common types of such a hernia. b. The most common type is paraesophageal. c. Paraesophageal is herniation of the greater curvature of the stomach. d. Sliding hernia is triggered by standing.: c There are two types of hiatal hernia: sliding and paraesophageal. Sliding is the most common and reverses with standing. It moves into the thoracic cavity with sitting, bending, tight clothing, ascites, and obesity. Paraesophageal is caused by herniation of the greater curvature of the stomach through a second opening in the diaphragm.

187.

Which statement regarding renal cell carcinoma is correct? a. It is associated with p53. b. Symptoms include hematuria. c. Early stages produce a large abdominal mass. d. Granular cell tumors have better prognosis.: b Symptoms include hematuria, flank pan, and flank/abdominal mass. Early stages are often silent, and clear cell tumors have a better prognosis. Overexpression of p53 is demonstrated in bladder tumors.

188.

Which substance is an abnormal constituent of urine? a. urea b. glucose c. sodium chloride d. creatinine: b

189.

Which type of hearing loss is a result of foreign body obstruction of the inner ear? a. Conductive b. Sensorineural c. Functional d. Presbycusis: a Conductive hearing loss occurs when a change in the outer or middle ear, such as a foreign body lodged in the ear canal, impairs conduction of the sound from the outer to inner ear. Sensorineural hearing loss is caused by impairment of the organ of Corti or its central connections. Presbycusis is a form of sensorineural hearing loss usually seen in elderly people. Functional hearing loss is believed to be caused by emotional or psychologic factors.

190.

Which type of jaundice is caused by the increased destruction of erythrocytes? a. obstructive b. hemolytic c. hepatocellular d. b and c: b

191.

Which viral hepatitis is NOT associated with a chronic state or carrier state? a. Hep A b. Hep B c. Hep C d. serum hepatitis e. Hep D: a

192.

Which would be consistent with a diagnosis of viral hepatitis? (More than 1 answer may be correct) a. elevated aspartate transaminase (AST) serum enzymes b. decreased serum albumin levels c. prolonged coagulation times d. increased serum bilirubin levels e. decreased alanine transaminase (ALT) serum enzymes: a, b,c, d

193.

With which bacteria is acute glomerulonephritis associated? a. E. coli b. Staphylococcus c. Group A streptococcus d. Klebsiella: c Glomerulonephritis is an inflammation of the glomeruli and is often caused by a streptococcal infection. It usually occurs 7 to 10 days after the infection.

194.

A young child presents with redness of the eyes. The parents indicate that this condition seems to be 'going around' the daycare. Which is the most likely diagnosis? a. Blepharitis b. Keratitis c. Trachoma d. Conjunctivitis: d Acute bacterial conjunctivitis, or pinkeye, is a highly contagious bacterial infection. Blepharitis is inflammation of the eyelids. Keratitis is an infection of the cornea. Trachoma is a bacterial infection caused by poor hygiene and is the leading cause of preventable blindness.