NSG 5003 Final Exam Paper

NSG 5003 Final Exam Paper

NSG 5003 Final Exam

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Question 1

Which component of the cell produces hydrogen peroxide
(H2O2) by using oxygen to remove hydrogen atoms from specific substrates in an
oxidative reaction?

Question 1 options:

Lysosomes

Peroxisomes

Ribosomes

Oxyhydrosomes

Question 2

What is a consequence of plasma membrane damage to the mitochondria?

Question 2 options:

Enzymatic digestion halts deoxyribonucleic acid (DNA)
synthesis.

Influx of calcium ions halts adenosine triphosphate (ATP)
production.

Edema from an influx in sodium causes a reduction in ATP
production.

Potassium shifts out of the mitochondria, which destroys the
infrastructure.

Question 3

Which statement is a description of one of the
characteristics of apoptosis?

Question 3 options:

Apoptosis involves programmed cell death of scattered single
cells.

Apoptosis is characterized by the swelling of the nucleus
and the cytoplasm.

Apoptosis involves unpredictable patterns of cell death.

Apoptosis results in benign malignancies.

Question 4

During cell injury caused by hypoxia, sodium and water move
into the cell because:

Question 4 options:

During cell injury caused by hypoxia, sodium and water move
into the cell because:

The pump that transports sodium out of the cell cannot
function because of a decrease in adenosine triphosphate (ATP) levels.

The osmotic pressure is increased, which pulls additional
sodium across the cell membrane

Oxygen is not available to bind with sodium to maintain it
outside of the cell.

Question 5

What is an effect of ionizing radiation exposure?

Question 5 options:

Respiratory distress

Sun intolerance

Deoxyribonucleic acid (DNA) aberrations

Death

Question 6

Obesity creates a greater risk for dehydration in people
because:

Question 6 options: chapter 3 q.2

?Adipose cells contain little water because fat is water
repelling.

The metabolic rates of obese adults are slower than those of
lean adults.

The rates of urine output of obese adults are higher than
those of lean adults.

The thirst receptors of the hypothalamus do not function
effectively.

Question 7

In addition to osmosis, what force is involved in the
movement of water between the plasma and interstitial fluid spaces?

Question 7 options:

a) Oncotic
pressure

b) Buffering

c) Net
filtration

d) Hydrostatic
pressure

Question 8

Venous obstruction is a cause of edema because of an
increase in which pressure? NSG 5003 Final Exam Paper

Question 8 options:

a) Capillary
hydrostatic

b) Interstitial
hydrostatic

c) Capillary
oncotic

d) Interstitial
oncotic

Question 9

At the arterial end of capillaries, fluid moves from the
intravascular space into the interstitial space because:

Question 9 options:

a) The
interstitial hydrostatic pressure is higher than the capillary hydrostatic
pressure.

b) The
capillary hydrostatic pressure is higher than the capillary oncotic pressure.

c) The
interstitial oncotic pressure is higher than the interstitial hydrostatic
pressure.

d) The
capillary oncotic pressure is lower than the interstitial hydrostatic pressure.

Question 10

It is true that natriuretic peptides:

Question 10 options:

a) Decrease
blood pressure and increase sodium and water excretion.

b) Increase
blood pressure and decrease sodium and water excretion.

c) Increase
the heart rate and decrease potassium excretion.

d) Decrease
the heart rate and increase potassium excretion.

Question 11

What causes the clinical manifestations of confusion,
convulsions, cerebral hemorrhage, and coma in hypernatremia?

Question 11 options:

a) High
sodium in the blood vessels pulls water out of the brain cells into the blood
vessels, causing brain cells to shrink.

b) High
sodium in the brain cells pulls water out of the blood vessels into the brain
cells, causing them to swell.

c) High
sodium in the blood vessels pulls potassium out of the brain cells, which slows
the synapses in the brain.

d) High
sodium in the blood vessels draws chloride into the brain cells followed by
water, causing the brain cells to swell.

Question 12

A major determinant of the resting membrane potential
necessary for the transmission of nerve impulses is the ratio between:

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Question 12 options:

a) Intracellular
and extracellular Na+

b) .
Intracellular and extracellular K+

c) Intracellular
Na+ and extracellular K+

d) Intracellular
K+ and extracellular Na+

Question 13

In hyperkalemia, what change occurs to the cells’ resting
membrane potential?

Question 13 options:

a) Hypopolarization

b) Hyperexcitability

c) Depolarization

d) Repolarization

Question 14

Physiologic pH is maintained at approximately 7.4 because
bicarbonate (HCO3) and carbonic acid (H2CO3) exist in a ratio of:

Question 14 options:

a) 20:1

b) 1:20

c) 10:2

d) 10:5

Question 15

Increased capillary hydrostatic pressure results in edema
because of:

Question 15 options:

a) Losses or
diminished production of plasma albumin

b) Inflammation
resulting from an immune response

c) Blockage
within the lymphatic channel system

d) Sodium
and water retention

Question 16

Hypomethylation and the resulting effect on oncogenes result
in:

Question 16 options:

a) A
decrease in the activity of the oncogene, thus suppressing cancer development

b) Deactivation of MLH1 to halt deoxyribonucleic
acid (DNA) repair

c) An
increase in tumor progression from benign to malignant

d) Overexpression
of micro-ribonucleic acid (miRNA), resulting in tumorigenesis

Question 17

The functions of the major histocompatibility complex (MHC)
and CD1 molecules are alike because both:

Question 17 options:

a) Are
antigen-presenting molecules

b) Bind
antigens to antibodies

c) Secrete
interleukins (ILs) during the immune process

d) Are
capable of activating cytotoxic T lymphocytes

Question 18

The B-cell receptor (BCR) complex functions uniquely by:

Question 18 options:

a) Communicating
information about the antigen to the helper T (Th) cell

b) Secreting
chemical signals to help cells communicate

c) Recognizing
the antigen on the surface of the B lymphocyte

d) Communicating
information about the antigen to the cell nucleus

Question 19

The generation of clonal diversity includes a process that:

Question 19 options:

a) Involves
antigens that select lymphocytes with compatible receptors

b) Allows
the differentiation of cells into antibody-secreting plasma cells or mature T
cells

c) Takes
place in the primary (central) lymphoid organs

d) Causes
antigens to expand and diversify their populations

Question 20

Vaccinations are able to provide protection against certain
microorganisms because of the:

Question 20 options:

a) Strong
response from immunoglobulin M (IgM)

b) Level of
protection provided by immunoglobulin G (IgG)

c) Memory
cells for immunoglobulin E (IgE)

d) Rapid
response from immunoglobulin A (IgA)

Question 21

What is the mechanism that results in type II
hypersensitivity reactions?

Question 21 options:

a) Antibodies
coat mast cells by binding to receptors that signal its degranulation, followed
by a discharge of preformed mediators.

b) Antibodies
bind to soluble antigens that were released into body fluids, and the immune
complexes are then deposited in the tissues.

c) Cytotoxic
T (Tc) lymphocytes or lymphokine-producing helper T 1 (Th1) cells directly
attack and destroy cellular targets.

d) Antibodies
bind to the antigens on the cell surface.

Question 22

When soluble antigens from infectious agents enter
circulation, tissue damage is a result of:

Question 22 options:

a) Complement-mediated
cell lysis

b) Phagocytosis
by macrophages

c) Phagocytosis
in the spleen

d) Neutrophil
granules and toxic oxygen products

Question 23

? Considering the hypothalamus, a fever is produced by:

Question 23 options:

a) Endogenous
pyrogens acting directly on the hypothalamus

b) Exogenous
pyrogens acting directly on the hypothalamus

c) Immune
complexes acting indirectly on the hypothalamus

d) Cytokines
acting indirectly on the hypothalamus

Question 24

Vaccines against viruses are created from:

Question 24 options:

a) Killed
organisms or extracts of antigens

b) Live
organisms weakened to produce antigens

c) Purified
toxins that have been chemically detoxified

d) Recombinant
pathogenic protein

Question 25

Carcinoma in situ is characterized by which changes?

Question 25 options:

a) Cells
have broken through the local basement membrane.

b) Cells
have invaded immediate surrounding tissue.

c) Cells
remain localized in the glandular or squamous cells

d) Cellular
and tissue alterations indicate dysplasia.

Question 26

Two “hits” are required to inactivate tumor-suppressor genes
because:

Question 26 options:

a) Each
allele must be altered and each person has two copies, or alleles, of each
gene, one from each parent.

b) The first
hit stops tissue growth and the second hit is needed to cause abnormal tissue
growth.

c) Tumor-suppressor
genes are larger than proto-oncogenes, requiring two hits to effect
carcinogenesis.

d) The first
hit is insufficient to cause enough damage to cause a mutation.

Question 27

What is the skin-related health risk induced by some types
of chemotherapy?

Question 27 options:

a) Infection

b) Ultraviolet
damage

c) Pain

d) Erythema

Question 28

When a child is diagnosed with cancer, which intervention
has the greatest influence on the child’s mortality rate?

Question 28 options:

a) Age at
the time of diagnosis

b) Participation
in clinical trials

c) Proximity
to a major cancer treatment center

d) Parental
involvement in the treatment planning

Question 29

Reflex activities concerned with the heart rate, blood
pressure, respirations, sneezing, swallowing, and coughing are controlled by
which area of the brain?

Question 29 options:

a) Pons

b) Midbrain

c) Cerebellum

d) Medulla
oblongata

Question 30

The edema of the upper cervical cord after a spinal cord
injury is considered life threatening because of which possible outcome?

Question 30 options:

a) Hypovolemic
shock from blood lost during the injury

b) Breathing
difficulties from an impairment to the diaphragm

c) Head
injury that likely occurred during the injury

d) Spinal
shock immediately after the injury

Question 31

What term is used to describe the complication that can
result from a spinal cord injury above T6 that is producing paroxysmal
hypertension, as well as piloerection and sweating above the spinal cord
lesion?

Question 31 options:

a) Craniosacral
dysreflexia

b) Parasympathetic
dysreflexia

c) Autonomic
hyperreflexia

d) Retrograde
hyperreflexia

Question 32

Atheromatous plaques are most commonly found:

Question 32 options:

a) . In
larger veins

b) Near
capillary sphincters

c) At
branches of arteries

d) On the
venous sinuses

Question 33

Multiple sclerosis is best described as:

Question 33 options:

a) A CNS
demyelination, possibly from an immunogenetic virus

b) Inadequate
supply of acetylcholine at the neurotransmitter junction as a result of an
autoimmune disorder

c) The
depletion of dopamine in the CNS as a result of a virus

d) A
degenerative disorder of lower and upper motor neurons caused by viral-immune
factors

Question 34

Graves disease develops from:

Question 34 options:

a) A viral
infection of the thyroid gland that causes overproduction of thyroid hormone

b) An
autoimmune process during which lymphocytes and fibrous tissue replace thyroid
tissue

c) Thyroid-stimulating
immunoglobulin, which causes overproduction of thyroid hormones

d) Ingestion
of goitrogens, which inhibits the synthesis of the thyroid hormones, causing
goiter

Question 35

Pathologic changes associated with Graves disease include:

Question 35 options:

a) High
levels of circulating thyroid-stimulating immunoglobulins

b) Diminished
levels of TRH

c) High
levels of TSH

d) Diminished
levels of thyroid-binding globulin

Question 36

A patient diagnosed with diabetic ketoacidosis (DKA) has the
following laboratory values: arterial pH 7.20, serum glucose 500 mg/dl,
positive urine glucose and ketones, serum potassium (K+) 2 mEq/L, and serum
sodium (Na+) 130 mEq/L. The patient

reports that he has been sick with the “flu” for a week.
What relationship do these values have to his insulin deficiency?

Question 36 options:

a) Increased
glucose use causes the shift of fluid from the intravascular to the
intracellular space.

b) .
Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis,
and osmotic diuresi

c) Increased
glucose and fatty acids stimulate renal diuresis, electrolyte loss, and
metabolic alkalosis.

d) Decreased
glucose use results in protein catabolism, tissue wasting, respiratory
acidosis, and electrolyte loss.

Question 37

Type 2 diabetes mellitus is best described as:

Question 37 options:

a) Resistance
to insulin by insulin-sensitive tissues

b) The need
for lispro instead of regular insulin

c) An
increase in glucagon secretion from ? cells of the pancreas

d) The
presence of insulin autoantibodies that destroy ? cells in the pancreas

Question 38

The common hay fever allergy is expressed through a reaction
that is mediated by which class of immunoglobulins?

Question 38 options:

a) Immunoglobulin
E (IgE)

b) Immunoglobulin
G (IgG)

c) Immunoglobulin
M (IgM)

d) T cells

Question 39

A person diagnosed with type 1 diabetes experiences hunger,
lightheadedness, tachycardia, pallor, headache, and confusion. The most
probable cause of these symptoms is:

Question 39 options:

a) Hyperglycemia
caused by incorrect insulin administration

b) The dawn
phenomenon from eating a snack before bedtime

c) Hypoglycemia
caused by increased exercise

d) Somogyi
effect from insulin sensitivity

Question 40

Hypoglycemia, followed by rebound hyperglycemia, is observed
in those with:

Question 40 options:

a) The
Somogyi effect

b) The dawn
phenomenon

c) Diabetic
ketoacidosis (DKA)

d) Hyperosmolar
hyperglycemic nonketotic syndrome

Question 41

Which structure is lined with columnar epithelial cells

Question 41 options:

a) Perimetrium

b) Endocervical
canal

c) Myometrium

d) Vagina

Question 42

Where is the usual site of cervical dysplasia or cancer in
situ?

Question 42 options:

a) Where the
squamous epithelium of the cervix meets the cuboidal epithelium of the vagina

b) Where the
columnar epithelium of the cervix meets the squamous epithelium of the uterus

c) Where the
squamous epithelium of the cervix meets the columnar epithelium of the uterus

d) Where the
columnar epithelium of the cervix meets the squamous epithelium of the vagina

Question 43

Which statement best describes a Schilling test?

Question 43 options:

a) Administration
of radioactive cobalamin and the measurement of its excretion in the urine to
test for vitamin B12 deficiency

b) Measurement
of antigen-antibody immune complexes in the blood to test for hemolytic anemia

c) Measurement
of serum ferritin and total iron-binding capacity in the blood to test for iron
deficiency anemia

d) Administration
of folate and measurement in two hours of its level in a blood sample to test
for folic acid deficiency anemia

Question 44

In aplastic anemia (AA), pancytopenia develops as a result
of which of the following?

Question 44 options:

a) Suppression
of erythropoietin to produce adequate amounts of erythrocytes

b) Suppression
of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and
thrombocytes

c) Lack of
deoxyribonucleic acid (DNA) to form sufficient quantities of erythrocytes,
leukocytes, and thrombocytes

d) Lack of
stem cells to form sufficient quantities of leukocytes

Question 45

Which statement is true regarding warm autoimmune hemolytic
anemia?

Question 45 options:

a) Warm
autoimmune hemolytic anemia occurs primarily in men. NSG 5003 Final Exam Paper

b) It is
self-limiting and rarely produces hemolysis.

c) Erythrocytes
are bound to macrophages and sequestered in the spleen.

d) Immunoglobulin
M (IgM) coats erythrocytes and binds them to receptors on monocytes.

Question 46

Hemolytic disease of the newborn (HDN) can occur if the
mother:

Question 46 options:

a) Is
Rh-positive and the fetus is Rh-negative

b) Is
Rh-negative and the fetus is Rh-positive

c) Has type
A blood and the fetus has type O blood

d) Has type
AB blood and the fetus has type B blood

Question 47

When diagnosed with hemolytic disease of the newborn (HDN),
why does the newborn develop hyperbilirubinemia after birth but not in utero?

Question 47 options:

a) Excretion
of unconjugated bilirubin through the placenta into the mother’s circulation is
no longer possible.

b) Hemoglobin
does not break down into bilirubin in the intrauterine environment.

c) The liver
of the fetus is too immature to conjugate bilirubin from a lipid-soluble form
to a water-soluble form.

d) The
destruction of erythrocytes producing bilirubin is greater after birth.

Question 48

How does angiotensin II increase the workload of the heart
after a myocardial infarction (MI)?

Question 48 options:

a) By
increasing the peripheral vasoconstriction

b) By
causing dysrhythmias as a result of hyperkalemia

c) By
reducing the contractility of the myocardium

Question 49

What event is a characteristic of the function in Zone I of
the lung?

Question 49 options:

a) Blood
flow through the pulmonary capillary bed increases in regular increments.

b) Alveolar
pressure is greater than venous pressure but not greater than arterial
pressure.

c) The
capillary bed collapses, and normal blood flow ceases.

d) Blood
flows through Zone I, but it is impeded to a certain extent by alveolar
pressure.

Question 50

What factor associated with gluten-sensitive enteropathy
(celiac sprue) causes an infant to bruise and bleed easily?

Question 50 options:

a) Vitamin K
deficiency from fat malabsorption

b) Bone
marrow function depression

c) Iron,
folate, and B12 deficiency anemias