NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
Week 1: Altered Immune System and Altered Inflammatory Response
– Discussion Part One
This week’s graded topics relate to the following Course Outcomes (COs).
1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)
2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)
3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)
6 Distinguish risk factors associated with selected disease states. (PO 1)
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5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)
6 Distinguish risk factors associated with selected disease states. (PO 1)
7 Explore age-specific and developmental alterations in physiologic
and disease states. (PO 1, 4)
Discussion
Discussion Part One (graded)
John is a 19-year-old college football player who presents with sneezing, itchy eyes, and nasal congestion that worsens at night. He states that he has a history of asthma, eczema and allergies
to pollen. There is also one other person on the football team that has similar symptoms. His vitals are BP 110/70, P 84, R 18, T 100 F. Write a differential of at least five (5) possible items from the most likely to less likely. For each disease include information about the epidemiology, pathophysiology and briefly argue why this disease fits the presentation and why it might not fit the presentation. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
Week 1: Altered Immune System and Altered Inflammatory Response – Discussion
Part Two
A patient has been admitted into the emergency room that was in the passenger side of a car that collided with another car head on. The patient is pale, barely conscious and has a weak and thready pulse. An IV is started. The vitals are BP 80/50, P 140, T 96.0 and R 26. As the team fights to keep the patient alive they have to remove the spleen. Blood is given but it has been mistyped. A transfusion reaction occurs. Describe the type of hypersensitivity reaction that has occurred and discuss the molecular pathophysiology of the specific type of hypersensitive reaction you have chosen.
In the event that this patient survived the car accident and the transfusion reaction which organs are most likely to be damaged and why?
Week 1: Altered Immune System and Altered Inflammatory
Response – Discussion Part Three
This week’s graded topics relate to the following Course Outcomes (COs).
1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)
2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)
3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1,
4 Distinguish risk factors associated with selected disease states.(PO 1)
5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)
6 Distinguish risk factors associated with selected disease states. (PO 1)
7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)
Discussion
A 44-year-old patient presents with lump in the chest of approximately 2 cm in diameter. There is a slight dimple over the location of the lump and when the lump is manipulated it seems to be attached to the surrounding tissue. A lumpectomy is performed and the mass is sent to pathology. The pathology report comes back and the mass is confirmed to be an estrogen receptor negative, a progesterone receptor negative and a her2/neu receptor positive breast cancer. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
What are some of the risk factors for breast cancer?
What tumor suppressor genes are associated with breast cancer?
What tumor oncogenes are associated with breast cancer?
Compare and contrast tumor suppressor genes from oncogenes?
Week2
Week 2: Respiratory Disorders and Alterations in Acid/Base Balance,
Fluid and Electrolytes – Discussion Part One
This week’s graded topics relate to the following Course Outcomes (COs).
Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)
Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)
Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)
Distinguish risk factors associated with selected disease states. (PO1)
Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)
Distinguish risk factors associated with selected disease states. (PO1)
Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)
Discussion Part One (graded)
A five-month-old Caucasian female is brought into the clinic as the parent complain that she has been having ongoing foul-smelling , greasy diarrhea. She seems to be small for her age and a
bit sickly but, her parent’s state that she has a huge appetite. Upon examination you find that
the patient is wheezing and you observe her coughing.
Write a differential diagnosis of at least five (5) disorders and explain why each might be
a possibility and any potential weaknesses of each differential.
Why is it that the later in age this disease manifest itself, the less severe the disease is?
What tests would you run to clarify your differential and potentially come to a definitive
diagnosis?
If the same child was African in ancestry would this change your initial differential? Why
or why not?
Week 2: Respiratory Disorders and Alterations in Acid/Base Balance, Fluid and Electrolytes – Discussion Part Two
This week’s graded topics relate to the following Course Outcomes (COs). NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)
2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)
3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)
4 Distinguish risk factors associated with selected disease states. (PO 1)
5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)
6 Distinguish risk factors associated with selected disease states. (PO 1)
7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)
Tammy is a 33-year-old who presents for evaluation of a cough. She reports that about 3 weeks ago she developed a “really bad cold” with rhinorrhea. The cold seemed to go away but then she developed a profound, deep, mucus-producing cough. Now, there is no rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Tammy has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
Write a differential of at least five (5) possible diagnosis’s and explain how each may be a possible answer to the clinical presentation above.
Remember, to list the differential in the order of most likely to less likely.
Based upon what you have at the top of the differential how would you treat this patient?
Suppose now, the patient has a fever of 100.4 and complains of foul smelling mucous and breath. Indeed, she complains of producing cups of mucous some days. She has some trouble breathing on moderate exertion but this is only a minor complaint to her. How does this change your differential and why?
Week 2: Respiratory Disorders and Alterations in Acid/Base Balance,
Fluid and Electrolytes – Discussion Part Three
This week’s graded topics relate to the following Course Outcomes (COs).
Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)
Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)
Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)
Distinguish risk factors associated with selected disease states.
Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)
Distinguish risk factors associated with selected disease states. (PO
Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)
A nursing student comes into your office because they are struggling with the concept of pulmonary function. They know you as an experienced FNP and so they are comfortable asking if you could clarify the terms residual volume (RV), functional reserve capacity (FRC), total lung capacity (TLC) inspiratory reserve volume (IRV), and expiratory reserve volume (ERV).
Give her a definition of each?
List three (3) disorders that can alter the residual volume and explain how they do so?
Week 3: Cardiovascular, Cellular, and Hematologic Disorders – Discussion
Week 3
Part One
This week’s graded topics relate to the following Course Outcomes (COs).
1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)
2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1). NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)
4 Distinguish risk factors associated with selected disease states. (PO 1)
5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)
6 Distinguish risk factors associated with selected disease states. (PO 1)
7 Explore age-specific and developmental alterations in physiologic and disease states
A 17-year-old African American from the inner city complains of severe chest and abdominal pain. Upon examination the attending physician performs and EKG, chest x-ray, and an abdominal and chest clinical examination and finds nothing. Assuming, she is drug seeking he sends her home. She comes back to the ER 4 hours later and now you see the patient. She explains that she was running track this past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts feeling extensive pain in her chest and abdomen. She has jaundiced eyes, her blood pressure is 98/50, pulse is 112, T = 99.9 F, R = 28. The pain seems out of proportion to the physical findings.
What is your list of differential diagnoses in this case and explain how each of these fits with the case patient as described above. Be sure to list at least four (4) pertinent differential diagnoses. Indicate which of these you would select as the most likely diagnosis and explain why.
Now, as she is in the ER she begins to exhibit stroke like features. ? Does this change your differential? How do you treat this patient now? Are they any preventative actions that could have been taken?
Week 3: Cardiovascular, Cellular, and Hematologic Disorders –
Discussion Part Two
This week’s graded topics relate to the following Course Outcomes (COs).
1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)
2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)
3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)
4 Distinguish risk factors associated with selected disease states. (PO 1)
5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)
6 Distinguish risk factors associated with selected disease states. (PO 1)
7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)
Jesse is a 57-year-old male who presents with gradual onset of dyspnea on exertion and fatigue. He also complains of frequent dyspepsia with nausea and occasional epigastric pain. He states that at night he has trouble breathing especially while lying on his back. This is relieved by him sitting up. His vitals are 180/110, P = 88, T = 98.0 C, R = 20.
Write a differential in this case and explain how each item in your differential fits and how it might not fit.
What tests would you order? What immediate treatment would you consider giving this patient and what treatment when he went home? Assume your first differential is definitive. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
Now, he comes back to your clinic 3 months later and both his ankles are slightly swollen. What possible explanations are there for this observation?
Week 3: Cardiovascular, Cellular, and Hematologic Disorders –
Discussion Part Three
A new patient is brought into the office for their annual evaluation. The child is a 6-year-old and appears a bit small for their age but not so small that any alarm bells are set off. The vitals are: P = 116, R = 22, T = 98.6 F, BP = 110/50. (The normal vitals in a 6-year-old are P = 75 – 120, R = 16 – 22, T = 98.6 , BP = (85-115)/(48-64). Examination of the lungs is normal, HEENT is normal, as is the abdominal exam. The heart however, seems laterally displaced and there appears to be only a continuous murmur which can be described as crescendo/decrescendo systolic murmur that extends into diastole. Because, you were trained at Chamberlain College of Nursing you immediately know that this is probably a patent ductus arteriosus. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
Week 5
Week 5: Alterations in Endocrine Function – Discussion Part One
Ms. Blake is an older adult with diabetes and has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. She has a history of Type I diabetes. On admission her laboratory values show:
Sodium (Na+) | 156 mEq/L |
Potassium (K+) | 4.0 mEq/L |
Chloride (Cl–) | 115 mEq/L |
Arterial blood gases (ABGs) | pH- 7.30; Pco2-40; Po2-70; HCO3-20 |
Normal values | |
Sodium (Na+) | 136-146 mEq/L |
Potassium (K+) | 3.5-5.1 mEq/L |
Chloride (Cl–) | 98-106 mEq/L |
Arterial blood gases (ABGs) | pH- 7.35-7.45
Pco2- 35-45 mmHg Po2-80-100 mmHg HCO3–22-28 mEq/L |
- List three (3) reasons on why she may have become bed ridden?
- Based on these reasons what tests would you order?
- Describe the molecular mechanism of the development of ketoacidosis.
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A three-month-old baby boy comes into your clinic with the main complaint that he frequently vomits after eating. He often has a swollen upper belly after feeding and acts fussy all the time. The vomiting has become more frequent this past week and he is beginning to lose weight. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
- Write three (3) differential diagnoses at this time?
- Is there any genetic component to the top of your differentials?
- What tests would you order?
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Write a one (1) paragraph case study of your own for a patient with Ulcerative Colitis?
Week 6
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You are contacted by an attorney representing a client who has been charged with child abuse and whom faces loss of her child and 15 years in prison. The record indicated that the child was 4 years old and presented to the ER room with a broken arm and a broken leg. There also appeared to be multiple previous fractures. Now, you examine the child and find blue sclera, a sunken chest wall, severe scoliosis, and you observe a triangular face and prominent forehead. You confirm that there have been multiple previous fractures by evaluating the previous X-rays. This is a genetic disorder.
- What is the most likely genetic disease that this presents and why?
- What is the molecular basis of this disease?
- Before, calling the police what should the initial clinician have done?
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Johnny is a 5-year-old Asian boy who is brought to a family practice office with a “runny” nose that started about 1 week ago but has not resolved. He has been blowing his nose quite frequently and “sores” have developed around his nose. His mother states, “The sores started as ‘big blisters’ that rupture; sometimes, a scab forms with a crust that looks like “dried maple syrup” but continues to seep and drain.” She is worried because the lesions are now also on his forearm. Johnny’s past medical and family histories are normal. He has been febrile but is otherwise asymptomatic. The physical examination was unremarkable except for moderate, purulent rhinorrhea and 0.5- to 1-cm diameter weeping lesions around the nose and mouth and on the radial surface of the right forearm. There is no regional lymphadenopathy. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
- Write a differential of at least three (3) possible diagnoses and explain how each may be a possible answer to the clinical presentation above. Remember, to list the differential in the order of most likely to less likely.
- Based upon what you have at the top of the differentials how would you treat this patient?
- When would you allow the student back to school? Elaborate on your reasoning?
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Keisha, a 13-year-old female, has come into your urgent care center. She has red conjunctiva, a cough and a fever of about 104 F, She also has a rash on her face a possibly the beginning of a rash on her arms. About 10 days ago she was around another student who had similar symptoms. NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
- Write three (3) differential diagnoses?
- What are some of the complications of this disease, assume that the top of your differential is the definitive?
- Assume that the second item you place on your differential is the definitive diagnosis. What are some complications of that disease?
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Reflect back over the past eight weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #, MSN Essential VIII, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies
Program Outcome #4: Evaluate the design, implementation, and outcomes of strategies developed to meet healthcare needs (MSN Essentials III, IV, VIII). NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
MSN Essential VIII: Clinical Prevention and Population Health for Improving Health
•Recognizes that the master’s-prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations.
Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies
1. Critically analyzes data and evidence for improving advanced nursing practice.
2. Integrates knowledge from the humanities and sciences within the context of nursing science.
3. Translates research and other forms of knowledge to improve practice processes and outcomes.
4. Develops new practice approaches based on the integration of research, theory, and practice knowledge.
Midverm
Question 1
2 / 2 pts
Examination of the throat in a child demonstrating signs and symptoms of acute epiglottitis may contribute to which life-threatening complication?
Retropharyngeal abscess
Laryngospasms
Rupturing of the tonsils
Gagging induced aspiration
Question 2
2 / 2 pts
Causes of hyperkalemia include:
Hyperparathyroidism and malnutrition
Vomiting and diarrhea
Renal failure and Addison disease
Hyperaldosteronism and Cushing disease
Question 3
2 / 2 pts
What is the life span of an erythrocyte (in days)?
20 to 30
60 to 90
100 to 120
200 to 240
Question 4
2 / 2 pts
Which substance has been shown to increase the risk of cancer when used in combination with tobacco smoking?
Alcohol
Steroids
Antihistamines
Antidepressants
Question 5
0 / 2 pts
Which hepatitis virus is known to be sexually transmitted?
A
B
C
D
Question 6
2 / 2 pts
What is the purpose of the spirometry measurement?
To evaluate the cause of hypoxia
To measure the volume and flow rate during forced expiration
To measures the gas diffusion rate at the alveolocapillary membrane
To determine pH and oxygen and carbon dioxide concentrations
Question 7
2 / 2 pts
What is the direct action of atrial natriuretic hormone?
Sodium retention
Sodium excretion
Water retention
Water excretion
Question 8
2 / 2 pts
What is the most important negative inotropic agent?
Norepinephrine
Epinephrine
Acetylcholine
Dopamine
Question 9
2 / 2 pts
What is the primary cause of respiratory distress syndrome (RDS) of the newborn?
Immature immune system
Small alveoli
Surfactant deficiency
Anemia
Question 10
2 / 2 pts
An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody?
NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
IgG
IgM
IgA
IgE
Question 11
2 / 2 pts
Low plasma albumin causes edema as a result of a reduction in which pressure?
Capillary hydrostatic
Interstitial hydrostatic
Plasma oncotic
Interstitial oncotic
Question 12
2 / 2 pts
Erythrocyte life span of less than 120 days, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiologic characteristics of which type of anemia?
Aplastic
Sideroblastic
Anemia of chronic disease
Iron deficiency
Question 13
2 / 2 pts
An infant’s hemoglobin must fall below ___ g/dl before signs of pallor, tachycardia, and systolic murmurs occur.
11
9
7
5
Question 14
2 / 2 pts
What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?
Macula densa
Visceral epithelium
Juxtaglomerular apparatus (JGA)
Filtration slits
Question 15
2 / 2 pts
The lung is innervated by the parasympathetic nervous system via which nerve?
Vagus
Phrenic
Brachial
Pectoral
Question 16
2 / 2 pts
Which statement best describes a Schilling test?
Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency
Measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia
Measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia
Administration of folate and measurement in 2 hours of its level in a blood sample to test for folic acid deficiency anemia.
Question 17
2 / 2 pts
Which disorder results in decreased erythrocytes and platelets with changes in leukocytes and has clinical manifestations of pallor, fatigue, petechiae, purpura, bleeding, and fever?
Idiopathic thrombocytopenic purpura (ITP)
Acute lymphocytic leukemia (ALL)
Non-Hodgkin lymphoma (NHL)
Iron deficiency anemia (IDA)
Question 18
2 / 2 pts
Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot to relieve hypoxic spells?
Lying on their left side
Performing the Valsalva maneuver
Squatting
Hyperventilating
Question 19
2 / 2 pts
Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct?
Antidiuretic hormone
Aldosterone
Cortisol
Adrenocorticotropin hormone
Question 20
2 / 2 pts
What is the fundamental physiologic manifestation of anemia?
Hypotension
Hyperesthesia
Hypoxia
Ischemia
Question 21
2 / 2 pts
Continuous increases in left ventricular filing pressures result in which disorder?
Mitral regurgitation
Mitral stenosis
Pulmonary edema
Jugular vein distention
Question 22
2 / 2 pts
Which T-lymphocyte phenotype is the key determinant of childhood asthma?
Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes
CD4 T-helper Th2 lymphocytes
CD8 cytotoxic T lymphocytes
Memory T lymphocytes
Question 23
2 / 2 pts
Innervation of the bladder and internal urethral sphincter is supplied by which nerves?
Peripheral nerves
Parasympathetic fibers
Sympathetic nervous system
Tenth thoracic nerve roots
Question 24
2 / 2 pts
Which of the following is classified as a megaloblastic anemia?
Iron deficiency
Pernicious
Sideroblastic
Hemolytic
Question 25
2 / 2 pts
When an individual aspirates food particles, where would the nurse expect to hear decreased or absent breath sounds?
Left lung
Right lung
Trachea
Carina
Question 26
0 / 2 pts
The most common site of metastasis for a patient diagnosed with prostate cancer is which location?
Bones
Brain
Bladder
Kidney
Question 27
2 / 2 pts
Perceived stress elicits an emotional, anticipatory response that begins where?
Prefrontal cortex
Anterior pituitary
Limbic system
Hypothalamus
Question 28
2 / 2 pts
Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in infants?
Atelectasis and pneumonia
Edema of the hands and feet
Stasis ulcers of the hands, ankles, and feet
Splenomegaly and hepatomegaly
Question 29
2 / 2 pts
Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?
IL–1 and IL-6
IL-2 and TNF-?
IFN and IL-12
TNF-ß and IL-4
Question 30
2 / 2 pts
The generation of clonal diversity occurs primarily during which phase of life?
Fetal
Neonatal
Infancy
Puberty
Question 31
2 / 2 pts
Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge?
Trachea
Left lung
Bronchus
Bronchioles
Question 32
2 / 2 pts
Which immunoglobulin (Ig) is present in childhood asthma?
IgM
IgG
IgE
IgA
Question 33
2 / 2 pts
Between which months of age does sudden infant death syndrome (SIDS) most often occur?
0 and 1
2 and 4
5 and 6
6 and 7
Question 34
2 / 2 pts
Which complex (wave) represents the sum of all ventricular muscle cell depolarizations?
PRS
QRS
QT interval
P
Question 35
2 / 2 pts
When a patient has small, vesicular lesions that last between 10 and 20 days, which sexually transmitted infection is suspected?
Genital herpes
Chancroid
Syphilis
Chlamydia
Question 36
2 / 2 pts
What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn?
Low birth weight
Alcohol consumption during pregnancy
Premature birth
Smoking during pregnancy
Question 37
2 / 2 pts
Which statement concerning exotoxins is true?
Exotoxins are contained in cell walls of gram-negative bacteria.
Exotoxins are released during the lysis of bacteria.
Exotoxins are able to initiate the complement and coagulation cascades.
Exotoxins are released during bacterial growth.
Question 38
2 / 2 pts
Deficiencies in which element can produce depression of both B- and T-cell function?
Iron
Zinc
Iodine
Magnesium
Question 39
0 / 2 pts
The function of the foramen ovale in a fetus allows what to occur?
Right-to-left blood shunting
Left-to-right blood shunting
Blood flow from the umbilical cord
Blood flow to the lungs
Question 40
2 / 2 pts
Decreased lung compliance means that the lungs are demonstrating which characteristic?
Difficult deflation
Easy inflation
Stiffness
Inability to diffuse oxygen
Question 41
2 / 2 pts
60 to 70
40 to 60
30 to 40
10 to 20
Question 42
2 / 2 pts
Which statement concerning benign tumors is true?
The resulting pain is severe.
Benign tumors are not encapsulated.
Benign tumors are fast growing.
The cells are well-differentiated.
Question 43
2 / 2 pts
How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness?
75 to 100 ml
100 to 150 ml
250 to 300 ml
350 to 400 ml
Question 44
2 / 2 pts
How high does the plasma glucose have to be before the threshold for glucose is achieved?
126 mg/dl
150 mg/dl
180 mg/dl
200 mg/dl
Question 45
0 / 2 pts
Apoptosis is a(an):
Normal mechanism for cells to self-destruct when growth is excessive
Antigrowth signal activated by the tumor-suppressor gene Rb
Mutation of cell growth stimulated by the TP53 gene
Transformation of cells from dysplasia to anaplasia
Question 46
0 / 2 pts
What is the role of collagen in the clotting process?
Initiates the clotting cascade.
Activates platelets.
Stimulates fibrin.
Deactivates fibrinogen.
Question 47
0 / 2 pts
Infants are most susceptible to significant losses in total body water because of an infant’s:
High body surface–to–body size ratio
Slow metabolic rate
Kidneys are not mature enough to counter fluid losses
Inability to communicate adequately when he or she is thirsty
Question 48
0 / 2 pts
What is the action of urodilatin?
Urodilatin causes vasoconstriction of afferent arterioles.
It causes vasodilation of the efferent arterioles.
Urodilatin inhibits antidiuretic hormone secretion.
It inhibits salt and water reabsorption.
Question 49
0 / 2 pts
Which cardiac chamber has the thinnest wall and why?
The right and left atria; they are low-pressure chambers that serve as storage units and conduits for blood.
The right and left atria; they are not directly involved in the preload, contractility, or afterload of the heart.
The left ventricle; the mean pressure of blood coming into this ventricle is from the lung, which has a low pressure.
The right ventricle; it pumps blood into the pulmonary capillaries, which have a lower pressure compared with the systemic circulation.
Question 50
0 / 2 pts
Research supports the premise that exercise has a probable impact on reducing the risk of which cancer?
Liver
Endometrial
Stomach
Colon
Question 51
0 / 2 pts
What is the trigone?
A smooth muscle that comprises the orifice of the ureter
The inner mucosal lining of the kidneys
A smooth triangular area between the openings of the two ureters and the urethra
One of the three divisions of the loop of Henle
Question 52
2 / 2 pts
What is the most abundant class of plasma protein?
Globulin
Albumin
Clotting factors
Complement proteins
Question 53
2 / 2 pts
The glomerular filtration rate is directly related to which factor?
Perfusion pressure in the glomerular capillaries
Diffusion rate in the renal cortex
Diffusion rate in the renal medulla
Glomerular active transport
Question 54
0 / 2 pts
Which cells have phagocytic properties similar to monocytes and contract like smooth muscles cells, thereby influencing the glomerular filtration rate?
Principle cells
Podocin cells
Mesangial cells
Intercalated cells
Question 55
0 / 2 pts
Why is nasal congestion a serious threat to young infants?
Infants are obligatory nose breathers.
Their noses are small in diameter.
Infants become dehydrated when mouth breathing.
Their epiglottis is proportionally greater than the epiglottis of an adult’s.
Question 56
2 / 2 pts
The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born between how many weeks of gestation?
16 and 20
20 and 24
24 and 30
30 and 36
Question 57
2 / 2 pts
What is the ratio of coronary capillaries to cardiac muscle cells?
1:1 (one capillary per one muscle cell)
1:2 (one capillary per two muscle cells)
1:4 (one capillary per four muscle cells)
1:10 (one capillary per ten muscle cells)
Question 58
2 / 2 pts
A person with type O blood is considered to be the universal blood donor because type O blood contains which of the following?
NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)
No antigens
No antibodies
Both A and B antigens
Both A and B antibodies
Question 59
2 / 2 pts
The drug heparin acts in hemostasis by which processes?
Inhibiting thrombin and antithrombin III (AT-III)
Preventing the conversion of prothrombin to thrombin
Shortening the fibrin strands to retract the blood clot
Degrading the fibrin within blood clots
Question 60
2 / 2 pts
What effects do exercise and body position have on renal blood flow?
Exercise and body position activate renal parasympathetic neurons and cause mild vasoconstriction.
They activate renal sympathetic neurons and cause mild vasoconstriction.
Both activate renal parasympathetic neurons and cause mild vasodilation.
They activate renal sympathetic neurons and cause mild vasodilation.
Final exam
Question 1
2 / 2 pts
What is the major virus involved in the development of cervical cancer?
Herpes simplex virus type 6
Herpes simplex virus type 2
Human papillomavirus
Human immunodeficiency virus
Question 2
2 / 2 pts
Which statement accurately describes childhood asthma?
An obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
A pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging
A pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that lines the airways, pancreas, sweat ducts, and vas deferens
An obstructive airway disease characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency
Question 3
0 / 2 pts
The ability of the pathogen to invade and multiply in the host is referred to as:
Infectivity
Toxigenicity
Pathogenicity
Virulence
Question 4
2 / 2 pts
Obesity creates a greater risk for dehydration in people because:
Adipose cells contain little water because fat is water repelling.
The metabolic rate of obese adults is slower than the rate of lean adults.
The rate of urine output of obese adults is higher than the rate of output of lean adults.
The thirst receptors of the hypothalamus do not function effectively.
Question 5
2 / 2 pts
Continued therapy of pernicious anemia (PA) generally lasts how long?
6 to 8 weeks
8 to 12 months
Until the iron level is normal
The rest of one’s life
Question 6
2 / 2 pts
Which statement best describes cystic fibrosis?
Obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation
Respiratory disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging
Pulmonary disorder involving an abnormal expression of a protein-producing viscous mucus that obstructs the airways, pancreas, sweat ducts, and vas deferens
Pulmonary disorder characterized by atelectasis and increased pulmonary resistance as a result of a surfactant deficiency
Question 7
2 / 2 pts
What pulmonary defense mechanism propels a mucous blanket that entraps particles moving toward the oropharynx?
Nasal turbinates
Alveolar macrophages
Cilia
Irritant receptors on the nares
Question 8
2 / 2 pts
As stated in the Frank-Starling law, a direct relationship exists between the _____ of the blood in the heart at the end of diastole and the _____ of contraction during the next systole.
Pressure; force
Volume; strength
Viscosity; force
Viscosity; strength
Question 9
2 / 2 pts
The tonic neck reflex observed in a newborn should no longer be obtainable by:
2 years
1 year
10 months
5 months
Question 10
2 / 2 pts
Carcinoma refers to abnormal cell proliferation originating from which tissue origin?
Blood vessels
Epithelial cells
Connective tissue
Glandular tissue
Question 11
2 / 2 pts
Which of the following describes how the body compensates for anemia?
Increasing rate and depth of breathing
Decreasing capillary vasoconstriction
Hemoglobin holding more firmly onto oxygen
Kidneys releasing more erythropoietin
Question 12
2 / 2 pts
What term is used to describe a hernial protrusion of a saclike cyst that contains meninges, spinal fluid, and a portion of the spinal cord through a defect in a posterior arch of a vertebra?
Encephalocele
Meningocele
Spina bifida occulta
Myelomeningocele
Question 13
2 / 2 pts
Chvostek and Trousseau signs indicate which electrolyte imbalance?
Hypokalemia
Hyperkalemia
Hypocalcemia
Hypercalcemia
Question 14
2 / 2 pts
After sexual transmission of HIV, a person can be infected yet seronegative for how many months?
1 to 2
6 to 14
18 to 20
24 to 36
Question 15
2 / 2 pts
Which hormone prompts increased anxiety, vigilance, and arousal during a stress response?
Norepinephrine
Epinephrine
Cortisol
Adrenocorticotropic hormone (ACTH)
Question 16
2 / 2 pts
Which blood cells are the chief phagocytes involved in the early inflammation process?
Neutrophils
Monocytes
Eosinophils
Erythrocytes
Question 17
2 / 2 pts
Where are alveolar macrophages found?
Skin
Breasts
Gastrointestinal tract
Lungs
Question 18
2 / 2 pts
Which normal physiologic change occurs in the aging pulmonary system?
Decreased flow resistance
Fewer alveoli
Stiffening of the chest wall
Improved elastic recoil
Question 19
0 / 2 pts
An infant diagnosed with a small patent ductus arteriosus (PDA) would likely exhibit which symptom?
Intermittent murmur
Lack of symptoms
Need for surgical repair
Triad of congenital defects
Question 20
2 / 2 pts
Hemophilia B is caused by a deficiency of which clotting factor?
V
VIII
IX
X
Question 21
2 / 2 pts
A hypersensitivity reaction that produces an allergic response is called:
Hemolytic shock
Anaphylaxis
Necrotizing vasculitis
Systemic erythematosus
Question 22
2 / 2 pts
Which statement is true regarding pain and cancer?
Pain is primarily a result of pressure caused by the tumor.
Pain indicates the metastasis of a cancer.
Pain is usually the initial symptom of cancer.
Pain is generally associated with late-stage cancer.
Question 23
2 / 2 pts
What is the anomaly in which the soft bony component of the skull and much of the brain is missing?
Anencephaly
Myelodysplasia
Cranial meningocele
Hydrocephaly
Question 24
0 / 2 pts
At birth, which statement is true?
Systemic resistance and pulmonary resistance fall.
Gas exchange shifts from the placenta to the lung.
Systemic resistance falls and pulmonary resistance rises.
Systemic resistance and pulmonary resistance rise.
Question 25
2 / 2 pts
What is the most commonly reported symptom of cancer treatment?
Nausea
Fatigue
Hair loss
Weight loss
Question 26
0 / 2 pts
The common property among the three types of medications used to treat depression is that they:
Increase neurotransmitter levels within the synapse.
Increase neurotransmitter levels in the presynapse.
Decrease neurotransmitter levels in the postsynapse.
Decrease neurotransmitter levels within the synapse.
Question 27
0 / 2 pts
NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)