Posted: December 20th, 2021

MN551 Midterm-Advanced Physiology and Pathophysiology Across the Life Span midterm

MN 551 Midterm

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Advanced Physiology and Pathophysiology Across the Life Span
midterm

1. A student nurse practitioner asks her preceptor about the
origins of different tissues, and their cellular origins during the process of
development. Which of the following statements by the preceptor best describes
the process of cell differentiation? (Points : 3)
“Cells of the
hematopoietic system produce the appropriate body cells that are required at
each stage of development.”

“A single stem
cell differentiates into approximately 200 different types of cells.”

“A fertilized
ovum undergoes a series of divisions, yielding many different cell types.”

“Cells
differentiate into necessary body cells, peaking after conception, and ceasing
near the time of birth.”

Question 2.2. A 77-year-old male patient with a diagnosis of
stomach cancer has been found to have metastases in his liver. The patient and
his family are surprised at this turn of events, stating that they don’t see
how he could have developed cancer in his liver. Which of the following facts
would underlie the reply that the care team provides? (Points : 3)
The parenchymal
tissue of the liver is particularly susceptible to secondary malignancies.

The portal
circulatory system brings venous blood from the gastrointestinal tract into the
liver.

Hepatic stromal tissue shares characteristics
with cancerous cells, including lack of anchorage dependence.

The proximity
of the liver to the stomach allows for direct spread of cancerous cells due to
a lack of contact inhibition.

Question 3.3. The NP is teaching a group of older adults
about the value of including foods containing antioxidants in their diet. Which
of the following statements best captures the rationale underlying the NPs
advice?(Points : 3)
Antioxidants
inhibit the actions of reactive oxygen species (ROS).

Antioxidants
prevent the formation of superoxide dismutase.

Antioxidants
react nonspecifically with molecules.

Antioxidants
prevent the occurrence of cell dysplasia.

Question 4.4. The nurse practitioner is providing care for a
patient with a diagnosis of cirrhosis, and he notes that the patient’s sclerae
are jaundiced. The nurse practitioner recalls that jaundice is caused by excess
accumulation of bilirubin, a pigment that can accumulate in which part of the
cell? (Points : 3)
Nucleus

Cytoplasm

Golgi apparatus

Rough
endoplasmic reticulum (ER)

Question 5.5. Which of the following patients of a primary
care nurse practitioner would not require extra screening for cancer? (Points :
3)
A 51-year-old
woman whose grandmother died of breast cancer

A 48-year-old
man who takes immunosuppressant drugs following a kidney transplant

A 50-year-old
male who is obese and has a low-fiber, high-fat diet

A 38-year-old
female with Down syndrome and congenital scoliosis

Question 6.6. A new older female patient at a long-term care
facility has a diagnosis of type 1 neurofibromatosis (NF-1). As part of the
intake assessment protocol for the facility, the clinical educator is teaching
the care staff about the diagnosis. Which of the following statements most
accurately conveys an aspect of neurofibromatosis? (Points : 3)
“The
neurofibroma lesions are unsightly for the patient, but they are not painful.

“Her diagnosis
puts her at higher risk of developing a malignant neoplasm.”

“She is living
with an example of an autosomal recessive disorder.”

“The patient is
likely to be photosensitive as a result of the disease.”

Question 7.7. A child possesses a trait that is the result
of the interaction of two different genes, neither of which could have produced
the trait independently. Which of the following explanations best captures the
genetic explanation for this?

(Points : 3)
The trait is an
expression of multiple alleles.

Epistasis has
dictated the phenotypic outcome.

The phenomenon
is an example of polygenic inheritance.

The outcome is
the result of the interaction between collaborative genes.

Question 8.8. Which of the following statements most
accurately conveys an aspect of cell injury due to impaired calcium
homeostasis? (Points : 3)
Normal
intracellular calcium ion levels are higher than extracellular levels.

Ischemia and
certain toxins cause a decrease in cytosolic calcium.

Injured cells
tend to accumulate calcium.

Low calcium
levels cause an activation of damaging enzymes.

Question 9.9. A group of researchers has identified that the
prevalence of two particular genetic disorders share a statistical correlation.
Which of the following statements best conveys the genetic rationale for this
situation? (Points : 3)
There is likely
a cause-and-effect relationship between the two genes responsible.

The chromosomes
containing each gene are likely closely situated.

The genes
causing each disorder are likely in the same section of the same chromosome.

The disorders
likely share the same locus.

Question 10.10. A male patient of a nurse practitioner has
an autosomal dominant disorder. The patient and his partner are considering
starting a family. Which of the patient’s following statements indicates the
patient has an adequate understanding of the genetic basis of this health
problem? (Points : 3)
“I know there’s
no way of accurately determining the chance that my child will inherit the
disease.”

“My children
who don’t have the disease still run the risk of passing it on to their
children.”

“I know that
new genetic mutations won’t occur between generations.”

“I know that a single mutant allele is to
blame for the health problem.”

Question 11.11. As part of an orientation to a genetic
counseling practice, a group of medical students is differentiating between
autosomal recessive disorders and autosomal dominant disorders. Which of the
following statements is true of autosomal recessive disorders? (Points : 3)
They can
manifest when present in one or both gene pairs.

There is a one
in two chance of an affected child in each pregnancy with an affected mother.

They tend to
have a more uniform symptomatology than autosomal dominant disorders.

The associated
disorders are usually attributable to abnormalities in structural proteins.

Question 12.12. The nurse practitioner working in
occupational health has been asked to speak to a group of factory workers about
the importance of wearing gloves when working with strong chemicals such as
turpentine and paint thinner. Which of the following characteristics of cell
membranes underlies the nurse’s teaching?

(Points : 3)
Cell membranes
are impermeable to all but lipid-soluble substances.

Cell membranes
have lipids that have a hydrophilic head and a hydrophobic tail.

Cell membranes
contain receptors for hormones and biologically active substances.

Transmembrane
proteins can pass through the cell membrane into the intracellular environment.

Question 13.13. The NP is providing care for a 21-year-old
female patient with gas gangrene of a compound fracture in her arm. Which of
the following assessment findings would the nurse most reasonably expect to
find when caring for a patient with a diagnosis of gas gangrene? (Points : 3)
Inflammation of
the affected tissue

A positive
culture for Staphylococcus

Spreading edema

Impaired
alveolar gas exchange

Question 14.14. A community health nurse practitioner is
teaching a group of female high school students about the importance of regular
Papanicolaou (Pap) smears. The nurse recognizes that which of the following
items underlies the rationale for this teaching? (Points : 3)
The active
substitution of normal cells in the cervix correlates to cancer risk.

Undifferentiated stem cells are an early indicator of cervical cancer.

Cancer of the
uterine cervix develops incrementally at a cellular level.

Dysplasia in
the connective tissue of the cervix is a strong precursor to cancer.

Question 15.15. Which target of both chemotherapy and
radiation treatment accounts for adverse as well as therapeutic effects?
(Points : 3)
Cell-surface
receptors

Circulating
hormone levels

Blood vessels

Rapidly
proliferating cells

Question 16.16. A patient who has a diagnosis of lung cancer
is scheduled to begin radiation treatment. The NP providing pretreatment
education is explaining some of the potential unwanted effects of the
treatment. Which of the following statements by the nurse is most accurate?
(Points : 3)
“Some patients
experience longer-term irritation of skin adjacent to the treatment site.”

“Sometimes you
might find that your blood takes longer to clot than normal.”

“The changes
that you might see are normally irreversible.”

“The unwanted
effects will be limited to the exposed portions of your skin.”

Question 17.17. The family of a 68-year-old man who is in
the end stages of small cell lung cancer is distraught at his visible body
wasting that has worsened in recent weeks. Which of the following phenomena
best accounts for the patient’s anorexia and cachexia? (Points : 3)
Inadequate
cellular metabolism of glucose results from tumor factors

High fat losses
coupled with preservation of muscle mass exaggerate the appearance of wasting

Products of the
tumor itself as well as a hypermetabolic state cause cachexia

Inadequate food
intake due to symptoms and treatment results in loss of both muscle and fat

Question 18.18. The nurse practitioner is seeing a client
who has an acute exacerbation of Crohn’s disease. The NP recognizes the fact
that the disease involves the inflammation and irritation of the intestinal
lining. Which of the following types of tissue is most likely involved in the
patient’s pathology? (Points : 3)
Simple columnar
epithelium

Glandular epithelium

Simple cuboidal
epthelium

Stratified
epithelium

Question 19.19. Which of the following pregnant women has
most likely encountered the greatest increase in the risk that her child will
have a fetal anomaly? (Points : 3)
A woman with
diagnoses of syphilis and cirrhosis of the liver

A woman who has
herpes simplex and recently recovered from endocarditis

A woman with
chronic obstructive pulmonary syndrome and tuberculosis

A woman with
diagnoses of insulin-dependent diabetes mellitus and peripheral neuropathy

Question 20.20. A nurse practitioner employed in the
emergency department admits a patient who has experienced severe frostbite to
his hands and toes after becoming lost on a ski trail. The NP recognizes that
which of the following phenomena has caused the tissue damage? (Points : 3)
Decreased blood
viscosity has resulted in interstitial bleeding.

Reactive
vasodilation has compromised perfusion.

Autonomic
nervous stimulation has resulted in injury.

Decreased blood
flow has induced hypoxia.

Question 21.21. A nurse practitioner employed in a
hospitalist notices that a patient is experiencing muscle atrophy following 2
weeks in traction after a motor vehicle accident. Which of the following
factors has most likely contributed to the atrophy of the patient’s muscle
cells? (Points : 3)
High levels of
insulin and IGF-1 in the patient’s blood during immobilization

Denervation of
the affected muscles during the time of traction

A reduction of
skeletal muscle use secondary to the traction treatment

Reduced oxygen
consumption and cellular function that ensures muscle cell survival

Question 22.22. An infant who is four days postpartum has
been diagnosed with a single-gene disorder. The parents of the child have a
number of questions about the etiology of the health problem, which the
physician is attempting to address in detail. Which of the following teaching
points most accurately captures an aspect of single-gene congenital disorders?
(Points : 3)
Affected genes are present on autosomal
chromosomes rather than sex chromosomes.

The majority of
single-gene disorders manifest near the time of puberty.

A particular
defect can be caused by mutations at one of several different loci.

Single-gene
disorders are associated with existing rather than new mutations.

Question 23.23. A researcher is involved in the production
of insulin through recombinant DNA technology. Which of the following
statements could the researcher best provide as a rationale for her work?
(Points : 3)
The gene
fragment responsible for insulin production can be isolated and reproduced.

Particular
bacteria are capable of insulin production.

It is possible
to reproduce the chromosome responsible for insulin production.

Recombination
of DNA base pairs can result in a gene that will produce insulin.

Question 24.24. A 6-year-old girl with a diagnosis of Marfan
syndrome is being assessed at a community health clinic. Which of the following
assessments would be the health care professional’s lowest priority? (Points :
3)
A test of the
child’s visual acuity

A
musculoskeletal assessment

Tests of kidney
function

Cardiovascular
assessment

Question 25.25. Following a biopsy, a 54-year-old man has
been diagnosed as having a benign neoplastic tumor. Which of the following
characteristics most likely applies to his tumor? (Points : 3)
The tumor is
poorly approximated and has the potential to break loose.

The tumor may
secrete hormones or cytokines.

The
well-differentiated neoplastic cells are clustered together in a single mass.

It has a rapid
rate of growth and can induce ischemia.

1. A 40-year-old woman who experiences severe seasonal
allergies has been referred by her family physician to an allergist for weekly
allergy injections. The woman is confused as to why repeated exposure to
substances that set off her allergies would ultimately benefit her. Which of
the following phenomena best captures the rationale for allergy desensitization
therapy? (Points : 3)
Repeated
exposure to offending allergens binds the basophils and mast cells that mediate
the allergic response.

Exposure to allergens in large, regular
quantities overwhelms the IgE antibodies that mediate the allergic response.

Repeated
exposure stimulates adrenal production of epinephrine, mitigating the allergic
response.

Injections of
allergens simulate production of IgG, which blocks antigens from combining with
IgE.

Question 2.2. A 14-year-old boy has been diagnosed with
infectious mononucleosis. Which of the following pathophysiological phenomena
is most responsible for his symptoms? (Points : 3)
The
Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils.

Viruses are
killing some of his B cells and becoming incorporated into the genomes of
others.

The EBV
inhibits the maturation of white cells within his peripheral lymph nodes.

The virus
responsible for mononucleosis inhibits the maturation of myeloblasts into
promyelocytes.

Question 3.3. A 66-year-old female patient has presented to
the emergency department because of several months of intermittently bloody
stools that has recently become worse. The woman has since been diagnosed with
a gastrointestinal bleed secondary to overuse of nonsteroidal anti-inflammatory
drugs that she takes for her arthritis. The health care team would realize that
which of the following situations is most likely?(Points : 3)
The woman has
depleted blood volume due to her ongoing blood loss.

She will have
iron-deficiency anemia due to depletion of iron stores.

The patient
will be at risk for cardiovascular collapse or shock.

She will have
delayed reticulocyte release.

Question 4.4. Which of the following patients is most likely
to benefit from transplantation of thymic tissue or major histocompatibility
complex (MHC)-compatible bone marrow? (Points : 3)
A 12-year-old
girl with a history of epilepsy and low IgG levels secondary to phenytoin use

A 7-year-old
boy whose blood work indicates decreased IgA and IgG with increased IgM

A 6-year-old boy whose pre-B cells are
incapable of translation to normal B cells

A 9-year-old
girl who has a diagnosis of IgA deficiency

Question 5.5. A 29-year-old construction worker got a sliver
under his fingernail four days ago. The affected finger is now reddened,
painful, swollen, and warm to the touch. Which of the following hematological
processes is most likely occurring in response to the infection? (Points : 3)
Proliferation
of immature neutrophils

High circulatory
levels of myeloblasts

Increased
segmented neutrophil production

Phagocytosis by
myelocytes

Question 6.6. Sputum samples from a patient with pneumonia
contain an infective agent that has a peptidoglycan cell wall, expresses
endotoxins, replicates readily in broth and on agar, grows in clusters, has
pili, and does not stain when exposed to crystal violet. This pneumonia is most
likely: (Points : 3)
Chlamydial

Viral

Mycoplasmal

Bacterial

Question 7.7. A child has been diagnosed with thalassemia.
Which of the following other health problems is the child at risk for? (Points
: 3)
Hypocoagulation

Iron and
ferritin deficiencies

Splenomegaly
and hepatomegaly

Neutropenia

Question 8.8. A nurse practitioner is providing prenatal
care and education for a first-time expectant mother, 22 weeks’ gestation, who
has a diagnosis of a sexually transmitted infection. Which of the following
statements by the expectant mother demonstrates an adequate understanding of
vertical disease transmission and congenital infections? (Points : 3)
“Gonorrhea and
chlamydia pose the greatest risks of transmission from mother to child.”

“I know that my
baby will need observation for HIV signs and symptoms in the weeks following my
delivery.”

“My baby could
become infected either across the placenta or during the birth itself.”

“Prophylactic
immunization will reduce my baby’s chance of being born with an illness.”

Question 9.9. As part of his diagnostic workup, a
77-year-old man’s nurse practitioner has ordered blood work that includes
ferritin levels. The man is very interested in the details of his health care
and is unfamiliar with ferritin and its role. He asks his nurse practitioner to
explain the significance of it and the rationale for testing it. Which of the
following explanations by the nurse practitioner is most accurate?(Points : 3)
“Ferritin is
the activated and usable form of iron that your red blood cells can use to
transport oxygen.”

“Ferritin is a
stored form of iron that indirectly shows me whether you would benefit from
iron pills.”

“Ferritin is a
protein-iron complex that allows your red blood cells to make use of the iron
that you consume in your diet.”

“Ferritin is
the form of iron that is transported in your blood plasma to the red blood
cells that need it.”

Question 10.10. A 16-year-old female has been brought to her
primary care nurse practitioner by her mother due to the girl’s persistent sore
throat and malaise. Which of the following facts revealed in the girl’s history
and examination would lead the nurse practitioner to rule out infectious
mononucleosis? (Points : 3)
The girl has a
temperature of 38.1°C (100.6°F) and has enlarged lymph nodes.

Her liver and
spleen are both enlarged.

Blood work
reveals an increased white blood cell count.

Chest
auscultation reveals crackles in her lower lung fields bilaterally.

Question 11.11. A 30-year-old man has spent 5 hours on a
cross-country flight seated next to a passenger who has been sneezing and
coughing, and the man has been inhaling viral particles periodically. Which of
the following situations would most likely result in the stimulation of the
man’s T lymphocytes and adaptive immune system? (Points : 3)
Presentation of
a foreign antigen by a familiar immunoglobulin

Recognition of
a foreign MHC molecule

Recognition of
a foreign peptide bound to a self MHC molecule

Cytokine
stimulation of a T lymphocyte with macrophage or dendritic cell mediation

Question 12.12. A 22-year-old female who adheres to a vegan
diet has been diagnosed with iron-deficiency anemia. Which of the following
components of her diagnostic blood work would be most likely to necessitate
further investigation? (Points : 3)
Decreased mean
corpuscular volume (MCV)

Decreased
hemoglobin and hematocrit

Microcytic,
hypochromic red cells

Decreased
erythropoietin levels

Question 13.13. A couple who are expecting their first child
have been advised by friends to consider harvesting umbilical cord blood in
order to have a future source of stem cells. The couple have approached their
nurse practitioner with this request and are seeking clarification of exactly
why stem cells are valuable and what they might expect to gain from harvesting
them. How can the nurse practitioner best respond to the couple’s inquiry?
(Points : 3)
“Stem cells can
help correct autoimmune diseases and some congenital defects.”

“Stem cells can
be used to regenerate damaged organs should the need ever arise.”

“Stem cells can
be used as a source of reserve cells for the entire blood production system.”

“Stem cells can
help treat some cancers and anemias, but they must come from your child himself
or herself.”

Question 14.14. A 23-year-old man has received a recent
diagnosis of appendicitis following 24 hours of acute abdominal pain. The nurse
practitioner providing care for the man is explaining that while it is
unpleasant, the inflammation of his appendix is playing a role in his body’s
fight against the underlying infectious process. Which of the following
teaching points should the nurse practitioner eliminate from his teaching for
the patient? (Points : 3)
“Inflammation
can help to remove the body tissue cells that have been damaged by infection.”

“Inflammation
will start your body on the path to growing new, healthy tissue at the site of
infection.

“Inflammation
helps your body to produce the right antibodies to fight the infection.”

“Inflammation
ultimately aids in eliminating the initial cause of the cell injury in your
appendix.”

Question 15.15. A 60-year-old woman is suspected of having
non-Hodgkin lymphoma (NHL). Which of the following aspects of her condition
would help to rule out Hodgkin lymphoma? (Points : 3)
Her neoplasm
originates in secondary lymphoid structures.

The lymph nodes
involved are located in a large number of locations in the lymphatic system.

The presence of
Reed-Sternberg cells has been confirmed.

The woman
complains of recent debilitating fatigue.

Question 16.16. Which of the following statements most
accurately conveys an aspect of lymphatic system activity? (Points : 3)
B and T
lymphocyte development begins in the bone marrow and ends in the peripheral
lymphoid structures.

B cells and
macrophages are released from the bone marrow in their completed state.

Stem cells in
the lymph nodes initiate and regulate the process of white cell synthesis.

Leukocytes
bypass vascular circulation and are distributed instead by the lymphatic
system.

Question 17.17. A nurse practitioner is explaining to a
40-year-old male patient the damage that Mycobacterium tuberculosis could do to
lung tissue. Which of the following phenomena would underlie the nurse
practitioner’s explanation? (Points : 3)
Tissue
destruction results from neutrophil deactivation.

Nonspecific
macrophage activity leads to pulmonary tissue destruction and resulting
hemoptysis.

Macrophages are
unable to digest the bacteria, resulting in immune granulomas.

Neutrophils are
ineffective against the Mycobacterium tuberculosis antigens.

Question 18.18. A 2-year-old girl has had repeated ear and
upper respiratory tract infections since she was born. A pediatrician has
determined a diagnosis of transient hypogammaglobulinemia of infancy. What is
the physiological origin of the child’s recurrent infections? (Points : 3)
Antibody
production by plasma cells is compromised because of impaired communication
between B and T cells.

The child had a
congenital absence of immunoglobulin G (IgG) antibodies and her body is only
slowly beginning to produce them independently.

The child was
born with immunoglobulin A (IgA) and immunoglobulin (IgM) antibodies,
suggesting intrauterine infection.

The child lacks
the antigen presenting cells integral to normal B-cell antibody production.

Question 19.19. Following a course of measles, a 5-year-old
girl developed scattered bruising over numerous body surfaces and was diagnosed
with immune thrombocytopenic purpura (ITP). As part of her diagnostic workup,
blood work was performed. Which of the following results is most likely to be
considered unexpected by the health care team? (Points : 3)
Increased
thrombopoietin levels

Decreased
platelet count

Normal vitamin
K levels

Normal
leukocyte levels

Question 20.20. A 60-year-old male patient with an acute
viral infection is receiving interferon therapy. The nurse practitioner is
teaching the family of the patient about the diverse actions of the treatment
and the ways that it differs from other anti-infective therapies. Which of the
following teaching points should the nurse practitioner exclude? (Points : 3)
“Interferon can
help your father’s unaffected cells adjacent to his infected cells produce
antiviral proteins that limit the spread of the infection.”

“Interferon can help limit the replication
of the virus that’s affecting your father.”

“Interferon
helps your father’s body recognize infected cells more effectively.”

“Interferon can
bolster your father’s immune system by stimulating natural killer cells that
attack viruses.”

Question 21.21. A 24-year-old woman presents with fever and
painful, swollen cervical lymph nodes. Her blood work indicates neutrophilia
with a shift to the left. She most likely has: (Points : 3)
A mild parasitic
infection

A severe
bacterial infection

A mild viral
infection

A severe fungal
infection

Question 22.22. A nurse practitioner student is
familiarizing herself with the overnight admissions to an acute medical unit of
a university hospital. Which of the following patients would the student
recognize as being least likely to have a diagnosis of antiphospholipid
syndrome in his or her medical history? (Points : 3)
A 66-year-old
obese male with left-sided hemiplegia secondary to a cerebrovascular accident

A 90-year-old
female resident of a long-term care facility who has been experiencing
transient ischemic attacks

A 30-year-old
female with a diagnosis of left leg DVT and a pulmonary embolism

A 21-year-old
male with a diagnosis of cellulitis and suspected endocarditis secondary to
intravenous drug use

Question 23.23. The blood work of a 44-year-old male patient
with a diagnosis of liver disease secondary to alcohol abuse indicates low
levels of albumin. Which of the following phenomena would a clinician be most
justified in anticipating? (Points : 3)
Impaired immune
function

Acid-base
imbalances

Impaired
thermoregulation

Fluid
imbalances

Question 24.24. A nurse practitioner is teaching her
colleagues about the role of cytokines in a variety of pathologies. Which of
the following teaching points best captures an aspect of the functions and
nature of cytokines? (Points : 3)
“A particular
cytokine can have varied effects on different systems, a fact that limits their
therapeutic use.”

“Cytokine
production is constant over time, but effects are noted when serum levels cross
a particular threshold.”

“Most cytokines
are produced by granular leukocytes, and different cells are capable of
producing the same cytokine.”

“Cytokine
actions are self-limiting in that activation of one precludes activation of
other cytokines with similar actions.”

Question 25.25. Which of the following phenomena would be
least likely to result in activation of the complement system? (Points : 3)
Recognition of
an antibody bound to the surface of a microbe

The binding of
mannose residues on microbial glycoproteins

Activation of
Toll-like receptors (TLRs) on complement proteins

Direct
recognition of microbial proteins

1. The nurse practitioner for a cardiology practice is
responsible for providing presurgical teaching for patients who are about to
undergo a coronary artery bypass graft. Which of the following teaching points
best conveys an aspect of the human circulatory system? (Points : 3)
“Your blood
pressure varies widely between arteries and veins, and between pulmonary and
systemic circulation.”

“Only around one quarter of your blood is
in your heart at any given time.”

“Blood pressure
and blood volume roughly mimic one another at any given location in the
circulatory system.”

“Left-sided and
right-sided pumping action at each beat of the heart must equal each other to
ensure adequate blood distribution.”

Question 2.2. A physical assessment of a 28-year-old female
patient indicates that her blood pressure in her legs is lower than that in her
arms and that her brachial pulse is weaker in her left arm than in her right.
In addition, her femoral pulses are weak bilaterally. Which of the following
possibilities would her care provider be most likely to suspect? (Points : 3)

Pheochromocytoma

Essential
hypertension

Coarctation of
the aorta

An
adrenocortical disorder

Question 3.3. As part of the diagnostic workup for a male
patient with a complex history of cardiovascular disease, the care team has
identified the need for a record of the electrical activity of his heart,
insight into the metabolism of his myocardium, and physical measurements, and
imaging of his heart. Which of the following series of tests is most likely to
provide the needed data for his diagnosis and care? (Points : 3)
Echocardiogram,
PET scan, ECG

Ambulatory ECG,
cardiac MRI, echocardiogram

Serum
creatinine levels, chest auscultation, myocardial perfusion scintigraphy

Cardiac
catheterization, cardiac CT, exercise stress testing

Question 4.4. An older adult female patient has presented
with a new onset of shortness of breath, and the patient’s nurse practitioner
has ordered measurement of her BNP levels along with other diagnostic tests.
What is the most accurate rationale for the nurse practitioner’s choice of
blood work? (Points : 3)
BNP is released
as a compensatory mechanism during heart failure and measuring it can help
differentiate the patient’s dyspnea from a respiratory pathology.

BNP is an
indirect indicator of the effectiveness of the RAA system in compensating for
heart failure.

BNP levels
correlate with the patient’s risk of developing cognitive deficits secondary to
heart failure and consequent brain hypoxia.

BNP becomes
elevated in cases of cardiac asthma, Cheyne-Stokes respirations, and acute
pulmonary edema, and measurement can gauge the severity of pulmonary effects.

Question 5.5. A patient in the intensive care unit has a
blood pressure of 87/39 and has warm, flushed skin accompanying his sudden
decline in level of consciousness. The patient also has arterial and venous
dilation and a decrease in systemic vascular resistance. What is this patient’s
most likely diagnosis? (Points : 3)
Hypovolemic
shock

Septic shock

Neurogenic
shock

Obstructive
shock

Question 6.6. A number of patients have presented to the
emergency department in the last 24 hours with complaints that are
preliminarily indicative of myocardial infarction. Which of the following
patients is least likely to have an ST-segment myocardial infarction (STEMI)?
(Points : 3)
A 70-year-old
woman who is complaining of shortness of breath and vague chest discomfort

A 66-year-old
man who has presented with fatigue, nausea and vomiting, and cool, moist skin

A 43-year-old
man who woke up with substernal pain that is radiating to his neck and jaw

A 71-year-old
man who has moist skin, fever, and chest pain that is excruciating when he
moves but relieved when at rest

Question 7.7. A 54-year-old man with a long-standing
diagnosis of essential hypertension is meeting with his nurse practitioner. The
patient’s nurse practitioner would anticipate that which of the following
phenomena is most likely occurring? (Points : 3)
The patient’s
juxtaglomerular cells are releasing aldosterone as a result of sympathetic
stimulation.

Epinephrine
from his adrenal gland is initiating the renin-angiotensin-aldosterone system.

Vasopressin is
exerting

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