Question 1

2 / 2 pts

The lung is innervated by the parasympathetic nervous system via which nerve?

Correct!

  

Vagus

 

  

Phrenic

 

  

Brachial

 

  

Pectoral

 

Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel only in the vagus nerve to the lung.

 

Question 2

2 / 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.

 

Correct!

  

It inhibits salt and water reabsorption.

 

Urodilatin (a natriuretic peptide) inhibits sodium and water reabsorption from the medullary part of collecting duct, thereby producing diuresis. It is not involved in the actions described by the other options.

 

Question 3

2 / 2 pts

What is the direct action of atrial natriuretic hormone?

  

Sodium retention

 

Correct!

  

Sodium excretion

 

  

Water retention

 

  

Water excretion

 

Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) inhibit the secretion of renin, inhibit angiotensin-induced secretion of aldosterone, vasodilate the afferent and constrict the efferent glomerular arterioles, and inhibit sodium and water absorption by kidney tubules. The other actions are not a result of the atrial natriuretic hormone.

 

Question 4

2 / 2 pts

Which statement best describes a Schilling test?

Correct!

 

Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B 12  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.

The Schilling test indirectly evaluates vitamin B 12  absorption by administering radioactive B 12  and measuring excretion in the urine. This selection is the only option that accurately describes a Schilling test.

 

Question 5

2 / 2 pts

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

  

Is Rh-positive and the fetus is Rh-negative

 

Correct!

  

Is Rh-negative and the fetus is Rh-positive

 

  

Has type A blood and the fetus has type O

 

  

Has type AB blood and the fetus has type B

 

HDN can occur only if antigens on fetal erythrocytes differ from antigens on maternal erythrocytes. Maternal-fetal incompatibility exists only if the mother and fetus differ in ABO blood type or if the fetus is Rh-positive and the mother is Rh-negative. This erythrocyte incompatibility does not exist in any of the other options.

 

Question 6

2 / 2 pts

Which T-lymphocyte phenotype is the key determinant of childhood asthma?

  

Cluster of differentiation (CD) 4 T-helper Th 1  lymphocytes

Correct!

  

CD4 T-helper Th 2  lymphocytes

  

CD8 cytotoxic T lymphocytes

 

  

Memory T lymphocytes

 

Asthma develops because the Th 2  response (in which CD4 T-helper cells produce specific cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and allergic response in the airways. This selection is the only option that accurately identifies the appropriate T-lymphocyte phenotype.

 

Question 7

2 / 2 pts

Perceived stress elicits an emotional, anticipatory response that begins where?

  

Prefrontal cortex

 

  

Anterior pituitary

 

Correct!

  

Limbic system

 

  

Hypothalamus

 

Perceived stressors elicit an anticipatory response that begins in the limbic system of the brain, the only option responsible for emotions and cognition.

 

Question 8

2 / 2 pts

Hypersensitivity  is best defined as a(an):

  

Disturbance in the immunologic tolerance of self-antigens

 

  

Immunologic reaction of one person to the tissue of another person

 

Correct!

  

Altered immunologic response to an antigen that results in disease

 

  

Undetectable immune response in the presence of antigens

 

Hypersensitivity  is an altered immunologic response to an antigen that results in disease or damage to the host. The other options are not accurate definitions of hypersensitivity.

 

Question 9

2 / 2 pts

It has been determined that a tumor is in stage 2. What is the meaning of this finding?

  

Cancer is confined to the organ of origin.

 

  

Cancer has spread to regional structures.

 

Correct!

  

Cancer is locally invasive.

 

  

Cancer has spread to distant sites

 

Cancer confined to the organ of origin is stage 1; cancer that is locally invasive is stage 2; cancer that has spread to regional structures, such as the lymph nodes, is stage 3; and cancer that has spread to distant sites, such as a liver cancer spreading to the lung or a prostate cancer spreading to bone, is stage 4.

 

Question 10

2 / 2 pts

An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect?

  

Atrial septal defect (ASD)

 

Correct!

  

Ventricular septal defect (VSD)

 

  

Patent ductus arteriosus (PDA)

 

  

Atrioventricular canal (AVC) defect

 

On physical examination, a loud, harsh, holosystolic murmur and systolic thrill can be detected at the left lower sternal border. The intensity of the murmur reflects the pressure gradient across the VSD. An apical diastolic rumble may be present with a moderate-to-large defect, reflecting increased flow across the mitral valve. The presentations of the other congenital heart defects are not consistent with the described symptoms.

 

Question 11

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.

 

Correct!

  

Exotoxins are released during bacterial growth.

 

Exotoxins are proteins released during bacterial growth. The other options are not true of exotoxins.

 

Question 12

2 / 2 pts

The function of the foramen ovale in a fetus allows what to occur?

Correct!

  

Right-to-left blood shunting

 

  

Left-to-right blood shunting

 

  

Blood flow from the umbilical cord

 

  

Blood flow to the lungs

 

The nonfused septum secundum and ostium secundum result in the formation of a flapped orifice known as the  foramen ovale, which allows the right-to-left shunting necessary for fetal circulation. The foramen ovale is not involved in the blood flow described by the other options.

 

Question 13

2 / 2 pts

Which laboratory test is considered adequate for an accurate and reliable diagnosis of gonococcal urethritis in a symptomatic man?

  

Ligase chain reaction (LCR)

 

Correct!

  

Gram-stain technique

 

  

Polymerase chain reaction (PCR)

 

  

DNA testing

 

Microscopic evaluation of Gram-stained slides of clinical specimens is deemed positive for  Neisseria gonorrhoeae if gram-negative diplococci with the typical “kidney bean” morphologic appearance are found inside polymorphonuclear leukocytes. Such a finding is considered adequate for the diagnosis of gonococcal urethritis in a symptomatic man. The other options are not relevant to the diagnosis of this condition.

 

Question 14

2 / 2 pts

Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in infants?

  

Atelectasis and pneumonia

 

Correct!

  

Edema of the hands and feet

 

  

Stasis ulcers of the hands, ankles, and feet

 

  

Splenomegaly and hepatomegaly

 

Symmetric, painful swelling of the hands and feet (hand-foot syndrome) caused by infarction in the small vessels of the extremities is often the initial manifestation of SCD in infants. This selection is the only option that accurately identifies the manifestations of a vasoocclusive crisis associated with SCD in infancy.

 

Question 15

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.

 

Correct!

  

The cells are well-differentiated.

 

A benign tumor is well-differentiated with its tissue appearing similar to the tissue from which it arose. The other options are characteristic of a malignant tumor.

 

Question 16

2 / 2 pts

Which primary characteristic is unique for the immune response?

  

The immune response is similar each time it is activated.

 

Correct!

  

The immune response is specific to the antigen that initiates it.

 

  

The response to a specific pathogen is short term.

 

  

The response is innate, rather than acquired.

 

Unlike inflammation, which is nonspecifically activated by cellular damage and pathogenic microorganisms, the immune response is primarily designed to afford long-term specific protection (i.e., immunity) against particular invading microorganisms; that is, it has a  memory function. The other options are not unique characteristics of the immune response.

 

Question 17

2 / 2 pts

Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child?

  

Parental history of asthma

 

 

Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels

Correct!

  

Reduced expiratory flow rates confirmed by spirometry testing

 

  

Improvement on a trial of asthma medication

 

Confirmation of the diagnosis of asthma relies on pulmonary function testing using spirometry, which can be accomplished only after the child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities. For younger children, an empiric trial of asthma medications is commonly initiated. The remaining options are major historical and physical factors that contribute but do not confirm the diagnosis of asthma in children.

 

Question 18

0 / 2 pts

Where are antibodies produced?

  

Helper T lymphocytes

 

  

Thymus gland

 

Correct Answer

  

Plasma cells

 

You Answered

  

Bone marrow

 

An antibody or immunoglobulin is a serum glycoprotein produced only by plasma cells in response to a challenge by an immunogen.

 

Question 19

2 / 2 pts

How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness?

  

75 to 100 ml

 

  

100 to 150 ml

 

Correct!

  

250 to 300 ml

 

  

350 to 400 ml

 

When the bladder accumulates 250 to 300 ml of urine, it contracts and the internal urethral sphincter relaxes through activation of the spinal reflex arc (known as the  micturition reflex).

 

Question 20

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)

 

Correct!

  

Acute lymphocytic leukemia (ALL)

 

  

Non-Hodgkin lymphoma (NHL)

 

  

Iron deficiency anemia (IDA)

 

Pallor, fatigue, petechiae, purpura, bleeding, and fever are generally present with the most common symptoms reflecting the consequence of bone marrow failure, which results in decreased red blood cells and platelets and changes in white blood cells. This selection is the only option that correctly identifies the disease with the symptoms described.

 

Question 21

2 / 2 pts

Carcinoma in situ is characterized by which changes?

  

Cells have broken through the local basement membrane.

 

  

Cells have invaded immediate surrounding tissue.

 

Correct!

  

Cells remain localized in the glandular or squamous cells.

 

  

Cellular and tissue alterations indicate dysplasia.

 

Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or squamous cell origin. These early stage cancers are localized to the epithelium and have not broken through the local basement membrane or invaded the surrounding tissue. Dysplasia refers to changes in mature cell structure.

 

Question 22

2 / 2 pts

What is the life span of platelets  (in days)?

Correct!

  

10

 

  

30

 

  

90

 

  

120

 

A platelet circulates for approximately 10 days and ages. Macrophages of the mononuclear phagocyte system, mostly in the spleen, remove platelets.

 

Question 23

2 / 2 pts

What is the primary cause of respiratory distress syndrome (RDS) of the newborn?

  

Immature immune system

 

  

Small alveoli

 

Correct!

  

Surfactant deficiency

 

  

Anemia

 

RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange. None of the other options are related to the cause of RDS.

 

Question 24

2 / 2 pts

What is the life span of an erythrocyte  (in days)?

  

20 to 30

 

  

60 to 90

 

Correct!

  

100 to 120

 

  

200 to 240

 

Because it cannot undergo mitotic division, the erythrocyte has a limited life span of approximately 120 days.

 

Question 25

2 / 2 pts

Low plasma albumin causes edema as a result of a reduction in which pressure?

  

Capillary hydrostatic

 

  

Interstitial hydrostatic

 

Correct!

  

Plasma oncotic

 

  

Interstitial oncotic

 

Losses or diminished production of plasma albumin is the only option that  contributes to a decrease in plasma oncotic pressure.

 

Question 26

2 / 2 pts

Which blood cell type is elevated at birth but decreases to adult levels during the first year of life?

Correct!

  

Monocytes

 

  

Platelets

 

  

Neutrophils

 

  

Lymphocytes

 

Only monocyte counts are high in the first year of life and then decrease to adult levels.

 

Question 27

2 / 2 pts

Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?

  

Adrenal cortex

 

Correct!

  

Hypothalamus

 

  

Anterior pituitary

 

  

Limbic system

 

The alarm phase of the GAS begins when a stressor triggers the actions of the hypothalamus and the sympathetic nervous system (SNS) (see Figure 11-1). The other organs are not stimulated by the alarm phase of GAS.

 

Question 28

2 / 2 pts

Phagocytosis involves neutrophils actively attacking, engulfing, and destroying which microorganisms?

Correct!

  

Bacteria

 

  

Fungi

 

  

Viruses

 

  

Yeasts

 

Invasion is the direct confrontation with an individual’s primary defense mechanisms against only bacteria, which include the complement system, antibodies, and phagocytes, such as neutrophils and macrophages.

 

Question 29

2 / 2 pts

What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?

  

Macula densa

 

  

Visceral epithelium

 

Correct!

  

Juxtaglomerular apparatus (JGA)

 

  

Filtration slits

 

Control of renal blood flow, glomerular filtration, and renin secretion occur at the JGA. Together, the juxtaglomerular cells and macula densa cells form the JGA. The control of renal blood flow, glomerular filtration, and renin secretion is not directed by any of the other options.

 

Question 30

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

 

Correct!

  

30 and 36

 

Surfactant is secreted into fetal airways between 30 and 36 weeks. The other options are not true regarding the timeframe when the risk for RDS decreases.

 

Question 31

2 / 2 pts

What is the functional unit of the kidney called?

  

Glomerulus

 

Correct!

  

Nephron

 

  

Collecting duct

 

  

Pyramid

 

The nephron is the functional unit of the kidney. Although the other options are also located in the kidney, they are not its functional units.

 

Question 32

2 / 2 pts

Which hepatitis virus is known to be sexually transmitted?

  

A

 

Correct!

  

B

 

  

C

 

  

D

 

Only hepatitis B virus (HBV) is known to be sexually transmitted.

 

Question 33

2 / 2 pts

Which statement is  true concerning the IgM?

Correct!

  

IgM is the first antibody produced during the initial response to an antigen.

 

  

IgM mediates many common allergic responses.

 

  

IgM is the most abundant class of immunoglobulins.

 

  

IgM is capable of crossing the human placenta.

 

Typically, IgM is produced first (primary immune response), followed by IgG against the same antigen. The other options are not true statements regarding IgM.

 

Question 34

2 / 2 pts

Apoptosis is a(an):

Correct!

  

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

 

Normal cells have a mechanism that causes them to self-destruct when growth is excessive and cell cycle checkpoints have been ignored. Diverse stimuli, including normal development and excessive growth, trigger this self-destruct mechanism, called  apoptosis. The remaining options do not describe apoptosis.

 

Question 35

2 / 2 pts

What are the abnormalities in cytokines found in children with cystic fibrosis (CF)?

 

Deficit of interleukin (IL)–1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-α)

 

Deficit of IL-6 and an excess of IL-2, IL-8, and granulocyte colony-stimulating factor (G-CSF)

Correct!

  

Deficit of IL-10 and an excess of IL-1, IL-8, and TNF-α

 

 

Deficit of IL-3 and an excess of IL-14, IL-24, and colony-stimulating factor (CSF)

 

Abnormal cytokine profiles have been documented in CF airway fluids, including deficient IL-10 and excessive IL-1, IL-8, and TNF-α, all changes conducive to promoting inflammation. This selection is the only option that accurately identifies the abnormalities in cytokines observed in children with CF.

 

Question 36

2 / 2 pts

Research supports the premise that exercise has a probable impact on reducing the risk of which cancer?

  

Liver

 

  

Endometrial

 

  

Stomach

 

Correct!

  

Colon

 

The World Cancer Research Fund summarizes the effects as  convincingfor cancers of the colon and  probable for postmenopausal breast cancer and endometrial cancer. The relationship is not supported for the remaining options.

 

Question 37

2 / 2 pts

Why is nasal congestion a serious threat to young infants?

Correct!

  

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.

 

Infants up to 2 to 3 months of age are obligatory nose breathers and are unable to breathe in through their mouths. Nasal congestion is therefore a serious threat to a young infant. This selection is the only option that accurately describes why nasal congestion is a serious threat to young infants.

 

Question 38

2 / 2 pts

Between which months of age does sudden infant death syndrome (SIDS) most often occur?

  

0 and 1

 

Correct!

  

2 and 4

 

  

5 and 6

 

  

6 and 7

 

The incidence of SIDS is low during the first month of life but sharply increases in the second month of life, peaking at 2 to 4 months and is unusual after 6 months of age.

 

Question 39

2 / 2 pts

In which primary immune deficiency is there a partial-to-complete absence of T-cell immunity?

  

Bruton disease

 

Correct!

  

DiGeorge syndrome

 

  

Reticular dysgenesis

 

  

Adenosine deaminase deficiency

 

The principal immunologic defect in DiGeorge syndrome is the partial or complete absence of T-cell immunity. The other options are not the result of either a partial or complete absence of T-cell immunity.

 

Question 40

2 / 2 pts

Blood vessels of the kidneys are innervated by the:

  

Vagus nerve

 

Correct!

  

Sympathetic nervous system

 

  

Somatic nervous system

 

  

Parasympathetic nervous system

 

The blood vessels of the kidney are innervated by the sympathetic noradrenergic fibers that cause arteriolar vasoconstriction and reduce renal blood flow. The other options are not involved in this process.

 

Question 41

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?

  

IgG

 

  

IgM

 

Correct!

  

IgA

 

  

IgE

 

The IgA molecules found in bodily secretions are dimers anchored together through a J-chain and secretory piece. This secretory piece is attached to the IgA antibodies inside the mucosal epithelial cells and may function to protect these immunoglobulin antibodies against degradation by enzymes also found in the secretions, thus decreasing the risk of infections in the mucous membrane. The other options do not accurately identify the immunoglobulin antibody involved in mucous membrane infections.

 

Question 42

2 / 2 pts

Which term is used to identify the movement of gas and air into and out of the lungs?

  

Perfusion

 

Correct!

  

Ventilation

 

  

Respiration

 

  

Diffusion

 

Of the options available, ventilation is the only term used to identify the mechanical movement of gas or air into and out of the lungs.

 

Question 43

2 / 2 pts

What is the first stage in the infectious process?

  

Invasion

 

Correct!

  

Colonization

 

  

Spread

 

  

Multiplication

 

From the perspective of the microorganisms that cause disease, the infectious process undergoes four separate stages of progression: (1) colonization, (2) invasion, (3) multiplication, and (4) spread.

 

Question 44

2 / 2 pts

What process allows the kidney to respond to an increase in workload?

  

Glomerular filtration

 

  

Secretion of 1,25-dihydroxyvitamin D 3

  

Increased heart rate

 

Correct!

  

Compensatory hypertrophy

 

Compensatory hypertrophy allows the kidney to respond to an increase in workload throughout life. The remaining options are not relevant to accommodating an increased workload.

 

Question 45

2 / 2 pts

Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome?

  

Coarctation of the aorta (COA) and pulmonary stenosis (PS)

 

  

Tetralogy of Fallot and persistent truncus arteriosus

 

  

Atrial septal defect (ASD) and dextrocardia

 

Correct!

  

Ventricular septal defect (VSD) and patent ductus arteriosus (PDA)

 

Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18, and Down syndrome include VSD and PDA (see Table 33-2). The other defects are not associated with dysfunction of trisomy 13, trisomy 18, and Down syndrome.

 

Question 46

2 / 2 pts

What is the trigone?

  

A smooth muscle that comprises the orifice of the ureter

 

  

The inner mucosal lining of the kidneys

 

Correct!

 

A smooth triangular area between the openings of the two ureters and the urethra

 

  

One of the three divisions of the loop of Henle

 

The trigone is a smooth triangular area lying between the openings of thetwo ureters and the urethra. The other options do not accurately identify the trigone.

 

Question 47

2 / 2 pts

The coronary ostia are located in the:

  

Left ventricle

 

  

Aortic valve

 

  

Coronary sinus

 

Correct!

  

Aorta

 

Coronary arteries receive blood through openings in the aorta, called the  coronary ostia.

 

Question 48

2 / 2 pts

What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn?

  

Low birth weight

 

  

Alcohol consumption during pregnancy

 

Correct!

  

Premature birth

 

  

Smoking during pregnancy

 

RDS of the newborn, also known as hyaline membrane disease (HMD), is a major cause of morbidity and mortality in premature newborns. None of the other options are considered the chief predisposing factors for RDS.

 

Question 49

2 / 2 pts

The most common site of metastasis for a patient diagnosed with prostate cancer is which location?

Correct!

  

Bones

 

  

Brain

 

  

Bladder

 

  

Kidney

 

The bone, especially the lumbar spine area, is the most common metastasis site for prostate cancer.

 

Question 50

2 / 2 pts

Which of the following is classified as a megaloblastic anemia?

  

Iron deficiency

 

Correct!

  

Pernicious

 

  

Sideroblastic

 

  

Hemolytic

 

Pernicious anemia is the most common type of megaloblastic anemia. The remaining options are not classified as megaloblastic anemias.

 

Question 51

2 / 2 pts

The glomerular filtration rate is directly related to which factor?

Correct!

  

Perfusion pressure in the glomerular capillaries

 

  

Diffusion rate in the renal cortex

 

  

Diffusion rate in the renal medulla

 

  

Glomerular active transport

 

The filtration of the plasma per unit of time is known as the  glomerular filtration rate (GFR), which is directly related to only the perfusion pressure in the glomerular capillaries.

 

Question 52

2 / 2 pts

In a normal, nonmutant state, an oncogene is referred to as a:

  

Basal cell

 

  

Target cell

 

  

Caretaker gene

 

Correct!

  

Proto-oncogene

 

In its normal nonmutant state, an oncogene is referred to as a  proto-oncogene. The other options are not terms used to identify a nonmutant oncogene.

 

Question 53

2 / 2 pts

What is the most common cause of iron deficiency anemia (IDA)?

  

Decreased dietary intake

 

Correct!

  

Chronic blood loss

 

  

Vitamin deficiency

 

  

Autoimmune disease

 

The most common cause of IDA in well-developed countries is pregnancy and chronic blood loss.

 

Question 54

2 / 2 pts

What effect do natriuretic peptides have during heart failure when the heart dilates?

  

Stimulates antidiuretic hormones.

 

  

Inhibits antidiuretic hormones.

 

  

Stimulates renin and aldosterone.

 

Correct!

  

Inhibits renin and aldosterone.

 

Natriuretic peptides inhibit renin and aldosterone during heart failure when the heart dilates. These make up a group of peptide hormones, including atrial natriuretic peptide (ANP), secreted from myocardial cells in the atria and brain natriuretic peptide (BNP) secreted from myocardial cells in the cardiac ventricles. When the heart dilates during volume expansion or heart failure, ANP and BNP inhibit sodium and water absorption by kidney tubules, inhibit the secretion of renin and aldosterone, vasodilate the afferent arterioles, and constrict the efferent arterioles. The result is increased urine formation, leading to decreased blood volume and blood pressure.

 

Question 55

2 / 2 pts

What is the major concern regarding the treatment of gonococci infections?

Correct!

  

Development of antibiotic resistance

 

  

Changes in virulence

 

  

Changes in pathogenicity

 

  

Mutations into different strains

 

Several types of drug-resistant strains have been identified; they are penicillinase-producing  Neisseria gonorrhoeae (PPNG), which is resistant to penicillin; tetracycline-resistant  N. gonorrhoeae (TRNG), which is resistant to tetracycline; chromosomal control of mechanisms of resistance of  N. gonorrhoeae (CMRNG), which is resistant to penicillin and tetracycline; and increasingly a fluoroquinolone-resistant  N. gonorrhoeae (QRNG). The other options are not major concerns.

 

Question 56

2 / 2 pts

Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction?

Correct!

  

I

 

  

II

 

  

III

 

  

IV

 

Hypersensitivity reactions have been divided into four distinct types: type I (IgE-mediated) hypersensitivity reactions, type II (tissue-specific) hypersensitivity reactions, type III (immune complex–mediated) hypersensitivity reactions, and type IV (cell-mediated) hypersensitivity reactions.

 

Question 57

2 / 2 pts

Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?

Correct!

  

IL–1 and IL-6

 

  

IL-2 and TNF-α

 

  

IFN and IL-12

 

  

TNF-ß and IL-4

 

Although a number of stress factors initiate the production of CRH, of the options available, only high levels of IL-1 and IL-6 initiate such a response.

 

Question 58

2 / 2 pts

What is the primary site for uncomplicated local gonococci infections in men?

  

Epididymis

 

  

Lymph nodes

 

Correct!

  

Urethra

 

  

Prostate

 

Uncomplicated local infections are observed primarily as urethral infections in men.

 

Question 59

2 / 2 pts

Continuous increases in left ventricular filing pressures result in which disorder?

  

Mitral regurgitation

 

  

Mitral stenosis

 

Correct!

  

Pulmonary edema

 

  

Jugular vein distention

 

Pressure changes are important because increased left ventricular filling pressures back up into the pulmonary circulation, where they force plasma out through vessel walls, causing fluid to accumulate in lung tissues (pulmonary edema). This selection is the only option that accurately identifies the disorder described in the question.

 

Question 60

2 / 2 pts

Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge?

  

Trachea

 

  

Left lung

 

Correct!

  

Bronchus

 

  

Bronchioles

 

Approximately 75% of aspirated foreign bodies lodge in a bronchus. The other options are not locations where children aspirate the majority of foreign objects.

 

 

Question 1

2 / 2 pts

The lung is innervated by the parasympathetic nervous system via which nerve?

Correct!

  

Vagus

 

  

Phrenic

 

  

Brachial

 

  

Pectoral

 

Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel only in the vagus nerve to the lung.

 

Question 2

2 / 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.

 

Correct!

  

It inhibits salt and water reabsorption.

 

Urodilatin (a natriuretic peptide) inhibits sodium and water reabsorption from the medullary part of collecting duct, thereby producing diuresis. It is not involved in the actions described by the other options.

 

Question 3

2 / 2 pts

What is the direct action of atrial natriuretic hormone?

  

Sodium retention

 

Correct!

  

Sodium excretion

 

  

Water retention

 

  

Water excretion

 

Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) inhibit the secretion of renin, inhibit angiotensin-induced secretion of aldosterone, vasodilate the afferent and constrict the efferent glomerular arterioles, and inhibit sodium and water absorption by kidney tubules. The other actions are not a result of the atrial natriuretic hormone.

 

Question 4

2 / 2 pts

Which statement best describes a Schilling test?

Correct!

 

Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B 12  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.

The Schilling test indirectly evaluates vitamin B 12  absorption by administering radioactive B 12  and measuring excretion in the urine. This selection is the only option that accurately describes a Schilling test.

 

Question 5

2 / 2 pts

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

  

Is Rh-positive and the fetus is Rh-negative

 

Correct!

  

Is Rh-negative and the fetus is Rh-positive

 

  

Has type A blood and the fetus has type O

 

  

Has type AB blood and the fetus has type B

 

HDN can occur only if antigens on fetal erythrocytes differ from antigens on maternal erythrocytes. Maternal-fetal incompatibility exists only if the mother and fetus differ in ABO blood type or if the fetus is Rh-positive and the mother is Rh-negative. This erythrocyte incompatibility does not exist in any of the other options.

 

Question 6

2 / 2 pts

Which T-lymphocyte phenotype is the key determinant of childhood asthma?

  

Cluster of differentiation (CD) 4 T-helper Th 1  lymphocytes

Correct!

  

CD4 T-helper Th 2  lymphocytes

  

CD8 cytotoxic T lymphocytes

 

  

Memory T lymphocytes

 

Asthma develops because the Th 2  response (in which CD4 T-helper cells produce specific cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and allergic response in the airways. This selection is the only option that accurately identifies the appropriate T-lymphocyte phenotype.

 

Question 7

2 / 2 pts

Perceived stress elicits an emotional, anticipatory response that begins where?

  

Prefrontal cortex

 

  

Anterior pituitary

 

Correct!

  

Limbic system

 

  

Hypothalamus

 

Perceived stressors elicit an anticipatory response that begins in the limbic system of the brain, the only option responsible for emotions and cognition.

 

Question 8

2 / 2 pts

Hypersensitivity  is best defined as a(an):

  

Disturbance in the immunologic tolerance of self-antigens

 

  

Immunologic reaction of one person to the tissue of another person

 

Correct!

  

Altered immunologic response to an antigen that results in disease

 

  

Undetectable immune response in the presence of antigens

 

Hypersensitivity  is an altered immunologic response to an antigen that results in disease or damage to the host. The other options are not accurate definitions of hypersensitivity.

 

Question 9

2 / 2 pts

It has been determined that a tumor is in stage 2. What is the meaning of this finding?

  

Cancer is confined to the organ of origin.

 

  

Cancer has spread to regional structures.

 

Correct!

  

Cancer is locally invasive.

 

  

Cancer has spread to distant sites

 

Cancer confined to the organ of origin is stage 1; cancer that is locally invasive is stage 2; cancer that has spread to regional structures, such as the lymph nodes, is stage 3; and cancer that has spread to distant sites, such as a liver cancer spreading to the lung or a prostate cancer spreading to bone, is stage 4.

 

Question 10

2 / 2 pts

An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect?

  

Atrial septal defect (ASD)

 

Correct!

  

Ventricular septal defect (VSD)

 

  

Patent ductus arteriosus (PDA)

 

  

Atrioventricular canal (AVC) defect

 

On physical examination, a loud, harsh, holosystolic murmur and systolic thrill can be detected at the left lower sternal border. The intensity of the murmur reflects the pressure gradient across the VSD. An apical diastolic rumble may be present with a moderate-to-large defect, reflecting increased flow across the mitral valve. The presentations of the other congenital heart defects are not consistent with the described symptoms.

 

Question 11

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.

 

Correct!

  

Exotoxins are released during bacterial growth.

 

Exotoxins are proteins released during bacterial growth. The other options are not true of exotoxins.

 

Question 12

2 / 2 pts

The function of the foramen ovale in a fetus allows what to occur?

Correct!

  

Right-to-left blood shunting

 

  

Left-to-right blood shunting

 

  

Blood flow from the umbilical cord

 

  

Blood flow to the lungs

 

The nonfused septum secundum and ostium secundum result in the formation of a flapped orifice known as the  foramen ovale, which allows the right-to-left shunting necessary for fetal circulation. The foramen ovale is not involved in the blood flow described by the other options.

 

Question 13

2 / 2 pts

Which laboratory test is considered adequate for an accurate and reliable diagnosis of gonococcal urethritis in a symptomatic man?

  

Ligase chain reaction (LCR)

 

Correct!

  

Gram-stain technique

 

  

Polymerase chain reaction (PCR)

 

  

DNA testing

 

Microscopic evaluation of Gram-stained slides of clinical specimens is deemed positive for  Neisseria gonorrhoeae if gram-negative diplococci with the typical “kidney bean” morphologic appearance are found inside polymorphonuclear leukocytes. Such a finding is considered adequate for the diagnosis of gonococcal urethritis in a symptomatic man. The other options are not relevant to the diagnosis of this condition.

 

Question 14

2 / 2 pts

Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in infants?

  

Atelectasis and pneumonia

 

Correct!

  

Edema of the hands and feet

 

  

Stasis ulcers of the hands, ankles, and feet

 

  

Splenomegaly and hepatomegaly

 

Symmetric, painful swelling of the hands and feet (hand-foot syndrome) caused by infarction in the small vessels of the extremities is often the initial manifestation of SCD in infants. This selection is the only option that accurately identifies the manifestations of a vasoocclusive crisis associated with SCD in infancy.

 

Question 15

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.

 

Correct!

  

The cells are well-differentiated.

 

A benign tumor is well-differentiated with its tissue appearing similar to the tissue from which it arose. The other options are characteristic of a malignant tumor.

 

Question 16

2 / 2 pts

Which primary characteristic is unique for the immune response?

  

The immune response is similar each time it is activated.

 

Correct!

  

The immune response is specific to the antigen that initiates it.

 

  

The response to a specific pathogen is short term.

 

  

The response is innate, rather than acquired.

 

Unlike inflammation, which is nonspecifically activated by cellular damage and pathogenic microorganisms, the immune response is primarily designed to afford long-term specific protection (i.e., immunity) against particular invading microorganisms; that is, it has a  memory function. The other options are not unique characteristics of the immune response.

 

Question 17

2 / 2 pts

Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child?

  

Parental history of asthma

 

 

Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels

Correct!

  

Reduced expiratory flow rates confirmed by spirometry testing

 

  

Improvement on a trial of asthma medication

 

Confirmation of the diagnosis of asthma relies on pulmonary function testing using spirometry, which can be accomplished only after the child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities. For younger children, an empiric trial of asthma medications is commonly initiated. The remaining options are major historical and physical factors that contribute but do not confirm the diagnosis of asthma in children.

 

Question 18

0 / 2 pts

Where are antibodies produced?

  

Helper T lymphocytes

 

  

Thymus gland

 

Correct Answer

  

Plasma cells

 

You Answered

  

Bone marrow

 

An antibody or immunoglobulin is a serum glycoprotein produced only by plasma cells in response to a challenge by an immunogen.

 

Question 19

2 / 2 pts

How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness?

  

75 to 100 ml

 

  

100 to 150 ml

 

Correct!

  

250 to 300 ml

 

  

350 to 400 ml

 

When the bladder accumulates 250 to 300 ml of urine, it contracts and the internal urethral sphincter relaxes through activation of the spinal reflex arc (known as the  micturition reflex).

 

Question 20

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)

 

Correct!

  

Acute lymphocytic leukemia (ALL)

 

  

Non-Hodgkin lymphoma (NHL)

 

  

Iron deficiency anemia (IDA)

 

Pallor, fatigue, petechiae, purpura, bleeding, and fever are generally present with the most common symptoms reflecting the consequence of bone marrow failure, which results in decreased red blood cells and platelets and changes in white blood cells. This selection is the only option that correctly identifies the disease with the symptoms described.

 

Question 21

2 / 2 pts

Carcinoma in situ is characterized by which changes?

  

Cells have broken through the local basement membrane.

 

  

Cells have invaded immediate surrounding tissue.

 

Correct!

  

Cells remain localized in the glandular or squamous cells.

 

  

Cellular and tissue alterations indicate dysplasia.

 

Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or squamous cell origin. These early stage cancers are localized to the epithelium and have not broken through the local basement membrane or invaded the surrounding tissue. Dysplasia refers to changes in mature cell structure.

 

Question 22

2 / 2 pts

What is the life span of platelets  (in days)?

Correct!

  

10

 

  

30

 

  

90

 

  

120

 

A platelet circulates for approximately 10 days and ages. Macrophages of the mononuclear phagocyte system, mostly in the spleen, remove platelets.

 

Question 23

2 / 2 pts

What is the primary cause of respiratory distress syndrome (RDS) of the newborn?

  

Immature immune system

 

  

Small alveoli

 

Correct!

  

Surfactant deficiency

 

  

Anemia

 

RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange. None of the other options are related to the cause of RDS.

 

Question 24

2 / 2 pts

What is the life span of an erythrocyte  (in days)?

  

20 to 30

 

  

60 to 90

 

Correct!

  

100 to 120

 

  

200 to 240

 

Because it cannot undergo mitotic division, the erythrocyte has a limited life span of approximately 120 days.

 

Question 25

2 / 2 pts

Low plasma albumin causes edema as a result of a reduction in which pressure?

  

Capillary hydrostatic

 

  

Interstitial hydrostatic

 

Correct!

  

Plasma oncotic

 

  

Interstitial oncotic

 

Losses or diminished production of plasma albumin is the only option that  contributes to a decrease in plasma oncotic pressure.

 

Question 26

2 / 2 pts

Which blood cell type is elevated at birth but decreases to adult levels during the first year of life?

Correct!

  

Monocytes

 

  

Platelets

 

  

Neutrophils

 

  

Lymphocytes

 

Only monocyte counts are high in the first year of life and then decrease to adult levels.

 

Question 27

2 / 2 pts

Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?

  

Adrenal cortex

 

Correct!

  

Hypothalamus

 

  

Anterior pituitary

 

  

Limbic system

 

The alarm phase of the GAS begins when a stressor triggers the actions of the hypothalamus and the sympathetic nervous system (SNS) (see Figure 11-1). The other organs are not stimulated by the alarm phase of GAS.

 

Question 28

2 / 2 pts

Phagocytosis involves neutrophils actively attacking, engulfing, and destroying which microorganisms?

Correct!

  

Bacteria

 

  

Fungi

 

  

Viruses

 

  

Yeasts

 

Invasion is the direct confrontation with an individual’s primary defense mechanisms against only bacteria, which include the complement system, antibodies, and phagocytes, such as neutrophils and macrophages.

 

Question 29

2 / 2 pts

What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?

  

Macula densa

 

  

Visceral epithelium

 

Correct!

  

Juxtaglomerular apparatus (JGA)

 

  

Filtration slits

 

Control of renal blood flow, glomerular filtration, and renin secretion occur at the JGA. Together, the juxtaglomerular cells and macula densa cells form the JGA. The control of renal blood flow, glomerular filtration, and renin secretion is not directed by any of the other options.

 

Question 30

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

 

Correct!

  

30 and 36

 

Surfactant is secreted into fetal airways between 30 and 36 weeks. The other options are not true regarding the timeframe when the risk for RDS decreases.

 

Question 31

2 / 2 pts

What is the functional unit of the kidney called?

  

Glomerulus

 

Correct!

  

Nephron

 

  

Collecting duct

 

  

Pyramid

 

The nephron is the functional unit of the kidney. Although the other options are also located in the kidney, they are not its functional units.

 

Question 32

2 / 2 pts

Which hepatitis virus is known to be sexually transmitted?

  

A

 

Correct!

  

B

 

  

C

 

  

D

 

Only hepatitis B virus (HBV) is known to be sexually transmitted.

 

Question 33

2 / 2 pts

Which statement is  true concerning the IgM?

Correct!

  

IgM is the first antibody produced during the initial response to an antigen.

 

  

IgM mediates many common allergic responses.

 

  

IgM is the most abundant class of immunoglobulins.

 

  

IgM is capable of crossing the human placenta.

 

Typically, IgM is produced first (primary immune response), followed by IgG against the same antigen. The other options are not true statements regarding IgM.

 

Question 34

2 / 2 pts

Apoptosis is a(an):

Correct!

  

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

 

Normal cells have a mechanism that causes them to self-destruct when growth is excessive and cell cycle checkpoints have been ignored. Diverse stimuli, including normal development and excessive growth, trigger this self-destruct mechanism, called  apoptosis. The remaining options do not describe apoptosis.

 

Question 35

2 / 2 pts

What are the abnormalities in cytokines found in children with cystic fibrosis (CF)?

 

Deficit of interleukin (IL)–1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-α)

 

Deficit of IL-6 and an excess of IL-2, IL-8, and granulocyte colony-stimulating factor (G-CSF)

Correct!

  

Deficit of IL-10 and an excess of IL-1, IL-8, and TNF-α

 

 

Deficit of IL-3 and an excess of IL-14, IL-24, and colony-stimulating factor (CSF)

 

Abnormal cytokine profiles have been documented in CF airway fluids, including deficient IL-10 and excessive IL-1, IL-8, and TNF-α, all changes conducive to promoting inflammation. This selection is the only option that accurately identifies the abnormalities in cytokines observed in children with CF.

 

Question 36

2 / 2 pts

Research supports the premise that exercise has a probable impact on reducing the risk of which cancer?

  

Liver

 

  

Endometrial

 

  

Stomach

 

Correct!

  

Colon

 

The World Cancer Research Fund summarizes the effects as  convincingfor cancers of the colon and  probable for postmenopausal breast cancer and endometrial cancer. The relationship is not supported for the remaining options.

 

Question 37

2 / 2 pts

Why is nasal congestion a serious threat to young infants?

Correct!

  

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.

 

Infants up to 2 to 3 months of age are obligatory nose breathers and are unable to breathe in through their mouths. Nasal congestion is therefore a serious threat to a young infant. This selection is the only option that accurately describes why nasal congestion is a serious threat to young infants.

 

Question 38

2 / 2 pts

Between which months of age does sudden infant death syndrome (SIDS) most often occur?

  

0 and 1

 

Correct!

  

2 and 4

 

  

5 and 6

 

  

6 and 7

 

The incidence of SIDS is low during the first month of life but sharply increases in the second month of life, peaking at 2 to 4 months and is unusual after 6 months of age.

 

Question 39

2 / 2 pts

In which primary immune deficiency is there a partial-to-complete absence of T-cell immunity?

  

Bruton disease

 

Correct!

  

DiGeorge syndrome

 

  

Reticular dysgenesis

 

  

Adenosine deaminase deficiency

 

The principal immunologic defect in DiGeorge syndrome is the partial or complete absence of T-cell immunity. The other options are not the result of either a partial or complete absence of T-cell immunity.

 

Question 40

2 / 2 pts

Blood vessels of the kidneys are innervated by the:

  

Vagus nerve

 

Correct!

  

Sympathetic nervous system

 

  

Somatic nervous system

 

  

Parasympathetic nervous system

 

The blood vessels of the kidney are innervated by the sympathetic noradrenergic fibers that cause arteriolar vasoconstriction and reduce renal blood flow. The other options are not involved in this process.

 

Question 41

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?

  

IgG

 

  

IgM

 

Correct!

  

IgA

 

  

IgE

 

The IgA molecules found in bodily secretions are dimers anchored together through a J-chain and secretory piece. This secretory piece is attached to the IgA antibodies inside the mucosal epithelial cells and may function to protect these immunoglobulin antibodies against degradation by enzymes also found in the secretions, thus decreasing the risk of infections in the mucous membrane. The other options do not accurately identify the immunoglobulin antibody involved in mucous membrane infections.

 

Question 42

2 / 2 pts

Which term is used to identify the movement of gas and air into and out of the lungs?

  

Perfusion

 

Correct!

  

Ventilation

 

  

Respiration

 

  

Diffusion

 

Of the options available, ventilation is the only term used to identify the mechanical movement of gas or air into and out of the lungs.

 

Question 43

2 / 2 pts

What is the first stage in the infectious process?

  

Invasion

 

Correct!

  

Colonization

 

  

Spread

 

  

Multiplication

 

From the perspective of the microorganisms that cause disease, the infectious process undergoes four separate stages of progression: (1) colonization, (2) invasion, (3) multiplication, and (4) spread.

 

Question 44

2 / 2 pts

What process allows the kidney to respond to an increase in workload?

  

Glomerular filtration

 

  

Secretion of 1,25-dihydroxyvitamin D 3

  

Increased heart rate

 

Correct!

  

Compensatory hypertrophy

 

Compensatory hypertrophy allows the kidney to respond to an increase in workload throughout life. The remaining options are not relevant to accommodating an increased workload.

 

Question 45

2 / 2 pts

Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome?

  

Coarctation of the aorta (COA) and pulmonary stenosis (PS)

 

  

Tetralogy of Fallot and persistent truncus arteriosus

 

  

Atrial septal defect (ASD) and dextrocardia

 

Correct!

  

Ventricular septal defect (VSD) and patent ductus arteriosus (PDA)

 

Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18, and Down syndrome include VSD and PDA (see Table 33-2). The other defects are not associated with dysfunction of trisomy 13, trisomy 18, and Down syndrome.

 

Question 46

2 / 2 pts

What is the trigone?

  

A smooth muscle that comprises the orifice of the ureter

 

  

The inner mucosal lining of the kidneys

 

Correct!

 

A smooth triangular area between the openings of the two ureters and the urethra

 

  

One of the three divisions of the loop of Henle

 

The trigone is a smooth triangular area lying between the openings of thetwo ureters and the urethra. The other options do not accurately identify the trigone.

 

Question 47

2 / 2 pts

The coronary ostia are located in the:

  

Left ventricle

 

  

Aortic valve

 

  

Coronary sinus

 

Correct!

  

Aorta

 

Coronary arteries receive blood through openings in the aorta, called the  coronary ostia.

 

Question 48

2 / 2 pts

What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn?

  

Low birth weight

 

  

Alcohol consumption during pregnancy

 

Correct!

  

Premature birth

 

  

Smoking during pregnancy

 

RDS of the newborn, also known as hyaline membrane disease (HMD), is a major cause of morbidity and mortality in premature newborns. None of the other options are considered the chief predisposing factors for RDS.

 

Question 49

2 / 2 pts

The most common site of metastasis for a patient diagnosed with prostate cancer is which location?

Correct!

  

Bones

 

  

Brain

 

  

Bladder

 

  

Kidney

 

The bone, especially the lumbar spine area, is the most common metastasis site for prostate cancer.

 

Question 50

2 / 2 pts

Which of the following is classified as a megaloblastic anemia?

  

Iron deficiency

 

Correct!

  

Pernicious

 

  

Sideroblastic

 

  

Hemolytic

 

Pernicious anemia is the most common type of megaloblastic anemia. The remaining options are not classified as megaloblastic anemias.

 

Question 51

2 / 2 pts

The glomerular filtration rate is directly related to which factor?

Correct!

  

Perfusion pressure in the glomerular capillaries

 

  

Diffusion rate in the renal cortex

 

  

Diffusion rate in the renal medulla

 

  

Glomerular active transport

 

The filtration of the plasma per unit of time is known as the  glomerular filtration rate (GFR), which is directly related to only the perfusion pressure in the glomerular capillaries.

 

Question 52

2 / 2 pts

In a normal, nonmutant state, an oncogene is referred to as a:

  

Basal cell

 

  

Target cell

 

  

Caretaker gene

 

Correct!

  

Proto-oncogene

 

In its normal nonmutant state, an oncogene is referred to as a  proto-oncogene. The other options are not terms used to identify a nonmutant oncogene.

 

Question 53

2 / 2 pts

What is the most common cause of iron deficiency anemia (IDA)?

  

Decreased dietary intake

 

Correct!

  

Chronic blood loss

 

  

Vitamin deficiency

 

  

Autoimmune disease

 

The most common cause of IDA in well-developed countries is pregnancy and chronic blood loss.

 

Question 54

2 / 2 pts

What effect do natriuretic peptides have during heart failure when the heart dilates?

  

Stimulates antidiuretic hormones.

 

  

Inhibits antidiuretic hormones.

 

  

Stimulates renin and aldosterone.

 

Correct!

  

Inhibits renin and aldosterone.

 

Natriuretic peptides inhibit renin and aldosterone during heart failure when the heart dilates. These make up a group of peptide hormones, including atrial natriuretic peptide (ANP), secreted from myocardial cells in the atria and brain natriuretic peptide (BNP) secreted from myocardial cells in the cardiac ventricles. When the heart dilates during volume expansion or heart failure, ANP and BNP inhibit sodium and water absorption by kidney tubules, inhibit the secretion of renin and aldosterone, vasodilate the afferent arterioles, and constrict the efferent arterioles. The result is increased urine formation, leading to decreased blood volume and blood pressure.

 

Question 55

2 / 2 pts

What is the major concern regarding the treatment of gonococci infections?

Correct!

  

Development of antibiotic resistance

 

  

Changes in virulence

 

  

Changes in pathogenicity

 

  

Mutations into different strains

 

Several types of drug-resistant strains have been identified; they are penicillinase-producing  Neisseria gonorrhoeae (PPNG), which is resistant to penicillin; tetracycline-resistant  N. gonorrhoeae (TRNG), which is resistant to tetracycline; chromosomal control of mechanisms of resistance of  N. gonorrhoeae (CMRNG), which is resistant to penicillin and tetracycline; and increasingly a fluoroquinolone-resistant  N. gonorrhoeae (QRNG). The other options are not major concerns.

 

Question 56

2 / 2 pts

Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction?

Correct!

  

I

 

  

II

 

  

III

 

  

IV

 

Hypersensitivity reactions have been divided into four distinct types: type I (IgE-mediated) hypersensitivity reactions, type II (tissue-specific) hypersensitivity reactions, type III (immune complex–mediated) hypersensitivity reactions, and type IV (cell-mediated) hypersensitivity reactions.

 

Question 57

2 / 2 pts

Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?

Correct!

  

IL–1 and IL-6

 

  

IL-2 and TNF-α

 

  

IFN and IL-12

 

  

TNF-ß and IL-4

 

Although a number of stress factors initiate the production of CRH, of the options available, only high levels of IL-1 and IL-6 initiate such a response.

 

Question 58

2 / 2 pts

What is the primary site for uncomplicated local gonococci infections in men?

  

Epididymis

 

  

Lymph nodes

 

Correct!

  

Urethra

 

  

Prostate

 

Uncomplicated local infections are observed primarily as urethral infections in men.

 

Question 59

2 / 2 pts

Continuous increases in left ventricular filing pressures result in which disorder?

  

Mitral regurgitation

 

  

Mitral stenosis

 

Correct!

  

Pulmonary edema

 

  

Jugular vein distention

 

Pressure changes are important because increased left ventricular filling pressures back up into the pulmonary circulation, where they force plasma out through vessel walls, causing fluid to accumulate in lung tissues (pulmonary edema). This selection is the only option that accurately identifies the disorder described in the question.

 

Question 60

2 / 2 pts

Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge?

  

Trachea

 

  

Left lung

 

Correct!

  

Bronchus

 

  

Bronchioles

 

Approximately 75% of aspirated foreign bodies lodge in a bronchus. The other options are not locations where children aspirate the majority of foreign objects.

 

 

Question 1

2 / 2 pts

The lung is innervated by the parasympathetic nervous system via which nerve?

Correct!

  

Vagus

 

  

Phrenic

 

  

Brachial

 

  

Pectoral

 

Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel only in the vagus nerve to the lung.

 

Question 2

2 / 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.

 

Correct!

  

It inhibits salt and water reabsorption.

 

Urodilatin (a natriuretic peptide) inhibits sodium and water reabsorption from the medullary part of collecting duct, thereby producing diuresis. It is not involved in the actions described by the other options.

 

Question 3

2 / 2 pts

What is the direct action of atrial natriuretic hormone?

  

Sodium retention

 

Correct!

  

Sodium excretion

 

  

Water retention

 

  

Water excretion

 

Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) inhibit the secretion of renin, inhibit angiotensin-induced secretion of aldosterone, vasodilate the afferent and constrict the efferent glomerular arterioles, and inhibit sodium and water absorption by kidney tubules. The other actions are not a result of the atrial natriuretic hormone.

 

Question 4

2 / 2 pts

Which statement best describes a Schilling test?

Correct!

 

Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B 12  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.

The Schilling test indirectly evaluates vitamin B 12  absorption by administering radioactive B 12  and measuring excretion in the urine. This selection is the only option that accurately describes a Schilling test.

 

Question 5

2 / 2 pts

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

  

Is Rh-positive and the fetus is Rh-negative

 

Correct!

  

Is Rh-negative and the fetus is Rh-positive

 

  

Has type A blood and the fetus has type O

 

  

Has type AB blood and the fetus has type B

 

HDN can occur only if antigens on fetal erythrocytes differ from antigens on maternal erythrocytes. Maternal-fetal incompatibility exists only if the mother and fetus differ in ABO blood type or if the fetus is Rh-positive and the mother is Rh-negative. This erythrocyte incompatibility does not exist in any of the other options.

 

Question 6

2 / 2 pts

Which T-lymphocyte phenotype is the key determinant of childhood asthma?

  

Cluster of differentiation (CD) 4 T-helper Th 1  lymphocytes

Correct!

  

CD4 T-helper Th 2  lymphocytes

  

CD8 cytotoxic T lymphocytes

 

  

Memory T lymphocytes

 

Asthma develops because the Th 2  response (in which CD4 T-helper cells produce specific cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and allergic response in the airways. This selection is the only option that accurately identifies the appropriate T-lymphocyte phenotype.

 

Question 7

2 / 2 pts

Perceived stress elicits an emotional, anticipatory response that begins where?

  

Prefrontal cortex

 

  

Anterior pituitary

 

Correct!

  

Limbic system

 

  

Hypothalamus

 

Perceived stressors elicit an anticipatory response that begins in the limbic system of the brain, the only option responsible for emotions and cognition.

 

Question 8

2 / 2 pts

Hypersensitivity  is best defined as a(an):

  

Disturbance in the immunologic tolerance of self-antigens

 

  

Immunologic reaction of one person to the tissue of another person

 

Correct!

  

Altered immunologic response to an antigen that results in disease

 

  

Undetectable immune response in the presence of antigens

 

Hypersensitivity  is an altered immunologic response to an antigen that results in disease or damage to the host. The other options are not accurate definitions of hypersensitivity.

 

Question 9

2 / 2 pts

It has been determined that a tumor is in stage 2. What is the meaning of this finding?

  

Cancer is confined to the organ of origin.

 

  

Cancer has spread to regional structures.

 

Correct!

  

Cancer is locally invasive.

 

  

Cancer has spread to distant sites

 

Cancer confined to the organ of origin is stage 1; cancer that is locally invasive is stage 2; cancer that has spread to regional structures, such as the lymph nodes, is stage 3; and cancer that has spread to distant sites, such as a liver cancer spreading to the lung or a prostate cancer spreading to bone, is stage 4.

 

Question 10

2 / 2 pts

An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect?

  

Atrial septal defect (ASD)

 

Correct!

  

Ventricular septal defect (VSD)

 

  

Patent ductus arteriosus (PDA)

 

  

Atrioventricular canal (AVC) defect

 

On physical examination, a loud, harsh, holosystolic murmur and systolic thrill can be detected at the left lower sternal border. The intensity of the murmur reflects the pressure gradient across the VSD. An apical diastolic rumble may be present with a moderate-to-large defect, reflecting increased flow across the mitral valve. The presentations of the other congenital heart defects are not consistent with the described symptoms.

 

Question 11

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.

 

Correct!

  

Exotoxins are released during bacterial growth.

 

Exotoxins are proteins released during bacterial growth. The other options are not true of exotoxins.

 

Question 12

2 / 2 pts

The function of the foramen ovale in a fetus allows what to occur?

Correct!

  

Right-to-left blood shunting

 

  

Left-to-right blood shunting

 

  

Blood flow from the umbilical cord

 

  

Blood flow to the lungs

 

The nonfused septum secundum and ostium secundum result in the formation of a flapped orifice known as the  foramen ovale, which allows the right-to-left shunting necessary for fetal circulation. The foramen ovale is not involved in the blood flow described by the other options.

 

Question 13

2 / 2 pts

Which laboratory test is considered adequate for an accurate and reliable diagnosis of gonococcal urethritis in a symptomatic man?

  

Ligase chain reaction (LCR)

 

Correct!

  

Gram-stain technique

 

  

Polymerase chain reaction (PCR)

 

  

DNA testing

 

Microscopic evaluation of Gram-stained slides of clinical specimens is deemed positive for  Neisseria gonorrhoeae if gram-negative diplococci with the typical “kidney bean” morphologic appearance are found inside polymorphonuclear leukocytes. Such a finding is considered adequate for the diagnosis of gonococcal urethritis in a symptomatic man. The other options are not relevant to the diagnosis of this condition.

 

Question 14

2 / 2 pts

Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in infants?

  

Atelectasis and pneumonia

 

Correct!

  

Edema of the hands and feet

 

  

Stasis ulcers of the hands, ankles, and feet

 

  

Splenomegaly and hepatomegaly

 

Symmetric, painful swelling of the hands and feet (hand-foot syndrome) caused by infarction in the small vessels of the extremities is often the initial manifestation of SCD in infants. This selection is the only option that accurately identifies the manifestations of a vasoocclusive crisis associated with SCD in infancy.

 

Question 15

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.

 

Correct!

  

The cells are well-differentiated.

 

A benign tumor is well-differentiated with its tissue appearing similar to the tissue from which it arose. The other options are characteristic of a malignant tumor.

 

Question 16

2 / 2 pts

Which primary characteristic is unique for the immune response?

  

The immune response is similar each time it is activated.

 

Correct!

  

The immune response is specific to the antigen that initiates it.

 

  

The response to a specific pathogen is short term.

 

  

The response is innate, rather than acquired.

 

Unlike inflammation, which is nonspecifically activated by cellular damage and pathogenic microorganisms, the immune response is primarily designed to afford long-term specific protection (i.e., immunity) against particular invading microorganisms; that is, it has a  memory function. The other options are not unique characteristics of the immune response.

 

Question 17

2 / 2 pts

Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child?

  

Parental history of asthma

 

 

Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels

Correct!

  

Reduced expiratory flow rates confirmed by spirometry testing

 

  

Improvement on a trial of asthma medication

 

Confirmation of the diagnosis of asthma relies on pulmonary function testing using spirometry, which can be accomplished only after the child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities. For younger children, an empiric trial of asthma medications is commonly initiated. The remaining options are major historical and physical factors that contribute but do not confirm the diagnosis of asthma in children.

 

Question 18

0 / 2 pts

Where are antibodies produced?

  

Helper T lymphocytes

 

  

Thymus gland

 

Correct Answer

  

Plasma cells

 

You Answered

  

Bone marrow

 

An antibody or immunoglobulin is a serum glycoprotein produced only by plasma cells in response to a challenge by an immunogen.

 

Question 19

2 / 2 pts

How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness?

  

75 to 100 ml

 

  

100 to 150 ml

 

Correct!

  

250 to 300 ml

 

  

350 to 400 ml

 

When the bladder accumulates 250 to 300 ml of urine, it contracts and the internal urethral sphincter relaxes through activation of the spinal reflex arc (known as the  micturition reflex).

 

Question 20

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)

 

Correct!

  

Acute lymphocytic leukemia (ALL)

 

  

Non-Hodgkin lymphoma (NHL)

 

  

Iron deficiency anemia (IDA)

 

Pallor, fatigue, petechiae, purpura, bleeding, and fever are generally present with the most common symptoms reflecting the consequence of bone marrow failure, which results in decreased red blood cells and platelets and changes in white blood cells. This selection is the only option that correctly identifies the disease with the symptoms described.

 

Question 21

2 / 2 pts

Carcinoma in situ is characterized by which changes?

  

Cells have broken through the local basement membrane.

 

  

Cells have invaded immediate surrounding tissue.

 

Correct!

  

Cells remain localized in the glandular or squamous cells.

 

  

Cellular and tissue alterations indicate dysplasia.

 

Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or squamous cell origin. These early stage cancers are localized to the epithelium and have not broken through the local basement membrane or invaded the surrounding tissue. Dysplasia refers to changes in mature cell structure.

 

Question 22

2 / 2 pts

What is the life span of platelets  (in days)?

Correct!

  

10

 

  

30

 

  

90

 

  

120

 

A platelet circulates for approximately 10 days and ages. Macrophages of the mononuclear phagocyte system, mostly in the spleen, remove platelets.

 

Question 23

2 / 2 pts

What is the primary cause of respiratory distress syndrome (RDS) of the newborn?

  

Immature immune system

 

  

Small alveoli

 

Correct!

  

Surfactant deficiency

 

  

Anemia

 

RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange. None of the other options are related to the cause of RDS.

 

Question 24

2 / 2 pts

What is the life span of an erythrocyte  (in days)?

  

20 to 30

 

  

60 to 90

 

Correct!

  

100 to 120

 

  

200 to 240

 

Because it cannot undergo mitotic division, the erythrocyte has a limited life span of approximately 120 days.

 

Question 25

2 / 2 pts

Low plasma albumin causes edema as a result of a reduction in which pressure?

  

Capillary hydrostatic

 

  

Interstitial hydrostatic

 

Correct!

  

Plasma oncotic

 

  

Interstitial oncotic

 

Losses or diminished production of plasma albumin is the only option that  contributes to a decrease in plasma oncotic pressure.

 

Question 26

2 / 2 pts

Which blood cell type is elevated at birth but decreases to adult levels during the first year of life?

Correct!

  

Monocytes

 

  

Platelets

 

  

Neutrophils

 

  

Lymphocytes

 

Only monocyte counts are high in the first year of life and then decrease to adult levels.

 

Question 27

2 / 2 pts

Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?

  

Adrenal cortex

 

Correct!

  

Hypothalamus

 

  

Anterior pituitary

 

  

Limbic system

 

The alarm phase of the GAS begins when a stressor triggers the actions of the hypothalamus and the sympathetic nervous system (SNS) (see Figure 11-1). The other organs are not stimulated by the alarm phase of GAS.

 

Question 28

2 / 2 pts

Phagocytosis involves neutrophils actively attacking, engulfing, and destroying which microorganisms?

Correct!

  

Bacteria

 

  

Fungi

 

  

Viruses

 

  

Yeasts

 

Invasion is the direct confrontation with an individual’s primary defense mechanisms against only bacteria, which include the complement system, antibodies, and phagocytes, such as neutrophils and macrophages.

 

Question 29

2 / 2 pts

What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?

  

Macula densa

 

  

Visceral epithelium

 

Correct!

  

Juxtaglomerular apparatus (JGA)

 

  

Filtration slits

 

Control of renal blood flow, glomerular filtration, and renin secretion occur at the JGA. Together, the juxtaglomerular cells and macula densa cells form the JGA. The control of renal blood flow, glomerular filtration, and renin secretion is not directed by any of the other options.

 

Question 30

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

 

Correct!

  

30 and 36

 

Surfactant is secreted into fetal airways between 30 and 36 weeks. The other options are not true regarding the timeframe when the risk for RDS decreases.

 

Question 31

2 / 2 pts

What is the functional unit of the kidney called?

  

Glomerulus

 

Correct!

  

Nephron

 

  

Collecting duct

 

  

Pyramid

 

The nephron is the functional unit of the kidney. Although the other options are also located in the kidney, they are not its functional units.

 

Question 32

2 / 2 pts

Which hepatitis virus is known to be sexually transmitted?

  

A

 

Correct!

  

B

 

  

C

 

  

D

 

Only hepatitis B virus (HBV) is known to be sexually transmitted.

 

Question 33

2 / 2 pts

Which statement is  true concerning the IgM?

Correct!

  

IgM is the first antibody produced during the initial response to an antigen.

 

  

IgM mediates many common allergic responses.

 

  

IgM is the most abundant class of immunoglobulins.

 

  

IgM is capable of crossing the human placenta.

 

Typically, IgM is produced first (primary immune response), followed by IgG against the same antigen. The other options are not true statements regarding IgM.

 

Question 34

2 / 2 pts

Apoptosis is a(an):

Correct!

  

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

 

Normal cells have a mechanism that causes them to self-destruct when growth is excessive and cell cycle checkpoints have been ignored. Diverse stimuli, including normal development and excessive growth, trigger this self-destruct mechanism, called  apoptosis. The remaining options do not describe apoptosis.

 

Question 35

2 / 2 pts

What are the abnormalities in cytokines found in children with cystic fibrosis (CF)?

 

Deficit of interleukin (IL)–1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-α)

 

Deficit of IL-6 and an excess of IL-2, IL-8, and granulocyte colony-stimulating factor (G-CSF)

Correct!

  

Deficit of IL-10 and an excess of IL-1, IL-8, and TNF-α

 

 

Deficit of IL-3 and an excess of IL-14, IL-24, and colony-stimulating factor (CSF)

 

Abnormal cytokine profiles have been documented in CF airway fluids, including deficient IL-10 and excessive IL-1, IL-8, and TNF-α, all changes conducive to promoting inflammation. This selection is the only option that accurately identifies the abnormalities in cytokines observed in children with CF.

 

Question 36

2 / 2 pts

Research supports the premise that exercise has a probable impact on reducing the risk of which cancer?

  

Liver

 

  

Endometrial

 

  

Stomach

 

Correct!

  

Colon

 

The World Cancer Research Fund summarizes the effects as  convincingfor cancers of the colon and  probable for postmenopausal breast cancer and endometrial cancer. The relationship is not supported for the remaining options.

 

Question 37

2 / 2 pts

Why is nasal congestion a serious threat to young infants?

Correct!

  

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.

 

Infants up to 2 to 3 months of age are obligatory nose breathers and are unable to breathe in through their mouths. Nasal congestion is therefore a serious threat to a young infant. This selection is the only option that accurately describes why nasal congestion is a serious threat to young infants.

 

Question 38

2 / 2 pts

Between which months of age does sudden infant death syndrome (SIDS) most often occur?

  

0 and 1

 

Correct!

  

2 and 4

 

  

5 and 6

 

  

6 and 7

 

The incidence of SIDS is low during the first month of life but sharply increases in the second month of life, peaking at 2 to 4 months and is unusual after 6 months of age.

 

Question 39

2 / 2 pts

In which primary immune deficiency is there a partial-to-complete absence of T-cell immunity?

  

Bruton disease

 

Correct!

  

DiGeorge syndrome

 

  

Reticular dysgenesis

 

  

Adenosine deaminase deficiency

 

The principal immunologic defect in DiGeorge syndrome is the partial or complete absence of T-cell immunity. The other options are not the result of either a partial or complete absence of T-cell immunity.

 

Question 40

2 / 2 pts

Blood vessels of the kidneys are innervated by the:

  

Vagus nerve

 

Correct!

  

Sympathetic nervous system

 

  

Somatic nervous system

 

  

Parasympathetic nervous system

 

The blood vessels of the kidney are innervated by the sympathetic noradrenergic fibers that cause arteriolar vasoconstriction and reduce renal blood flow. The other options are not involved in this process.

 

Question 41

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?

  

IgG

 

  

IgM

 

Correct!

  

IgA

 

  

IgE

 

The IgA molecules found in bodily secretions are dimers anchored together through a J-chain and secretory piece. This secretory piece is attached to the IgA antibodies inside the mucosal epithelial cells and may function to protect these immunoglobulin antibodies against degradation by enzymes also found in the secretions, thus decreasing the risk of infections in the mucous membrane. The other options do not accurately identify the immunoglobulin antibody involved in mucous membrane infections.

 

Question 42

2 / 2 pts

Which term is used to identify the movement of gas and air into and out of the lungs?

  

Perfusion

 

Correct!

  

Ventilation

 

  

Respiration

 

  

Diffusion

 

Of the options available, ventilation is the only term used to identify the mechanical movement of gas or air into and out of the lungs.

 

Question 43

2 / 2 pts

What is the first stage in the infectious process?

  

Invasion

 

Correct!

  

Colonization

 

  

Spread

 

  

Multiplication

 

From the perspective of the microorganisms that cause disease, the infectious process undergoes four separate stages of progression: (1) colonization, (2) invasion, (3) multiplication, and (4) spread.

 

Question 44

2 / 2 pts

What process allows the kidney to respond to an increase in workload?

  

Glomerular filtration

 

  

Secretion of 1,25-dihydroxyvitamin D 3

  

Increased heart rate

 

Correct!

  

Compensatory hypertrophy

 

Compensatory hypertrophy allows the kidney to respond to an increase in workload throughout life. The remaining options are not relevant to accommodating an increased workload.

 

Question 45

2 / 2 pts

Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome?

  

Coarctation of the aorta (COA) and pulmonary stenosis (PS)

 

  

Tetralogy of Fallot and persistent truncus arteriosus

 

  

Atrial septal defect (ASD) and dextrocardia

 

Correct!

  

Ventricular septal defect (VSD) and patent ductus arteriosus (PDA)

 

Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18, and Down syndrome include VSD and PDA (see Table 33-2). The other defects are not associated with dysfunction of trisomy 13, trisomy 18, and Down syndrome.

 

Question 46

2 / 2 pts

What is the trigone?

  

A smooth muscle that comprises the orifice of the ureter

 

  

The inner mucosal lining of the kidneys

 

Correct!

 

A smooth triangular area between the openings of the two ureters and the urethra

 

  

One of the three divisions of the loop of Henle

 

The trigone is a smooth triangular area lying between the openings of thetwo ureters and the urethra. The other options do not accurately identify the trigone.

 

Question 47

2 / 2 pts

The coronary ostia are located in the:

  

Left ventricle

 

  

Aortic valve

 

  

Coronary sinus

 

Correct!

  

Aorta

 

Coronary arteries receive blood through openings in the aorta, called the  coronary ostia.

 

Question 48

2 / 2 pts

What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn?

  

Low birth weight

 

  

Alcohol consumption during pregnancy

 

Correct!

  

Premature birth

 

  

Smoking during pregnancy

 

RDS of the newborn, also known as hyaline membrane disease (HMD), is a major cause of morbidity and mortality in premature newborns. None of the other options are considered the chief predisposing factors for RDS.

 

Question 49

2 / 2 pts

The most common site of metastasis for a patient diagnosed with prostate cancer is which location?

Correct!

  

Bones

 

  

Brain

 

  

Bladder

 

  

Kidney

 

The bone, especially the lumbar spine area, is the most common metastasis site for prostate cancer.

 

Question 50

2 / 2 pts

Which of the following is classified as a megaloblastic anemia?

  

Iron deficiency

 

Correct!

  

Pernicious

 

  

Sideroblastic

 

  

Hemolytic

 

Pernicious anemia is the most common type of megaloblastic anemia. The remaining options are not classified as megaloblastic anemias.

 

Question 51

2 / 2 pts

The glomerular filtration rate is directly related to which factor?

Correct!

  

Perfusion pressure in the glomerular capillaries

 

  

Diffusion rate in the renal cortex

 

  

Diffusion rate in the renal medulla

 

  

Glomerular active transport

 

The filtration of the plasma per unit of time is known as the  glomerular filtration rate (GFR), which is directly related to only the perfusion pressure in the glomerular capillaries.

 

Question 52

2 / 2 pts

In a normal, nonmutant state, an oncogene is referred to as a:

  

Basal cell

 

  

Target cell

 

  

Caretaker gene

 

Correct!

  

Proto-oncogene

 

In its normal nonmutant state, an oncogene is referred to as a  proto-oncogene. The other options are not terms used to identify a nonmutant oncogene.

 

Question 53

2 / 2 pts

What is the most common cause of iron deficiency anemia (IDA)?

  

Decreased dietary intake

 

Correct!

  

Chronic blood loss

 

  

Vitamin deficiency

 

  

Autoimmune disease

 

The most common cause of IDA in well-developed countries is pregnancy and chronic blood loss.

 

Question 54

2 / 2 pts

What effect do natriuretic peptides have during heart failure when the heart dilates?

  

Stimulates antidiuretic hormones.

 

  

Inhibits antidiuretic hormones.

 

  

Stimulates renin and aldosterone.

 

Correct!

  

Inhibits renin and aldosterone.

 

Natriuretic peptides inhibit renin and aldosterone during heart failure when the heart dilates. These make up a group of peptide hormones, including atrial natriuretic peptide (ANP), secreted from myocardial cells in the atria and brain natriuretic peptide (BNP) secreted from myocardial cells in the cardiac ventricles. When the heart dilates during volume expansion or heart failure, ANP and BNP inhibit sodium and water absorption by kidney tubules, inhibit the secretion of renin and aldosterone, vasodilate the afferent arterioles, and constrict the efferent arterioles. The result is increased urine formation, leading to decreased blood volume and blood pressure.

 

Question 55

2 / 2 pts

What is the major concern regarding the treatment of gonococci infections?

Correct!

  

Development of antibiotic resistance

 

  

Changes in virulence

 

  

Changes in pathogenicity

 

  

Mutations into different strains

 

Several types of drug-resistant strains have been identified; they are penicillinase-producing  Neisseria gonorrhoeae (PPNG), which is resistant to penicillin; tetracycline-resistant  N. gonorrhoeae (TRNG), which is resistant to tetracycline; chromosomal control of mechanisms of resistance of  N. gonorrhoeae (CMRNG), which is resistant to penicillin and tetracycline; and increasingly a fluoroquinolone-resistant  N. gonorrhoeae (QRNG). The other options are not major concerns.

 

Question 56

2 / 2 pts

Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction?

Correct!

  

I

 

  

II

 

  

III

 

  

IV

 

Hypersensitivity reactions have been divided into four distinct types: type I (IgE-mediated) hypersensitivity reactions, type II (tissue-specific) hypersensitivity reactions, type III (immune complex–mediated) hypersensitivity reactions, and type IV (cell-mediated) hypersensitivity reactions.

 

Question 57

2 / 2 pts

Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?

Correct!

  

IL–1 and IL-6

 

  

IL-2 and TNF-α

 

  

IFN and IL-12

 

  

TNF-ß and IL-4

 

Although a number of stress factors initiate the production of CRH, of the options available, only high levels of IL-1 and IL-6 initiate such a response.

 

Question 58

2 / 2 pts

What is the primary site for uncomplicated local gonococci infections in men?

  

Epididymis

 

  

Lymph nodes

 

Correct!

  

Urethra

 

  

Prostate

 

Uncomplicated local infections are observed primarily as urethral infections in men.

 

Question 59

2 / 2 pts

Continuous increases in left ventricular filing pressures result in which disorder?

  

Mitral regurgitation

 

  

Mitral stenosis

 

Correct!

  

Pulmonary edema

 

  

Jugular vein distention

 

Pressure changes are important because increased left ventricular filling pressures back up into the pulmonary circulation, where they force plasma out through vessel walls, causing fluid to accumulate in lung tissues (pulmonary edema). This selection is the only option that accurately identifies the disorder described in the question.

 

Question 60

2 / 2 pts

Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge?

  

Trachea

 

  

Left lung

 

Correct!

  

Bronchus

 

  

Bronchioles

 

Approximately 75% of aspirated foreign bodies lodge in a bronchus. The other options are not locations where children aspirate the majority of foreign objects.

 

   

Question 1 Question 1

2 / 2 pts 2 / 2 pts

The lung is innervated by the parasympathetic nervous system via which nerve? The lung is innervated by the parasympathetic nervous system via which nerve?

Correct! Correct!

     

Vagus Vagus

   

     

Phrenic Phrenic

   

     

Brachial Brachial

   

     

Pectoral Pectoral

   

Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel only in the vagus nerve to the lung. Fibers of the parasympathetic division of the autonomic nervous system (ANS) travel only in the vagus nerve to the lung.

   

Question 2 Question 2

2 / 2 pts 2 / 2 pts

What is the action of urodilatin? What is the action of urodilatin?

     

Urodilatin causes vasoconstriction of afferent arterioles. Urodilatin causes vasoconstriction of afferent arterioles.

   

     

It causes vasodilation of the efferent arterioles. It causes vasodilation of the efferent arterioles.

   

     

Urodilatin inhibits antidiuretic hormone secretion. Urodilatin inhibits antidiuretic hormone secretion.

   

Correct! Correct!

     

It inhibits salt and water reabsorption. It inhibits salt and water reabsorption.

   

Urodilatin (a natriuretic peptide) inhibits sodium and water reabsorption from the medullary part of collecting duct, thereby producing diuresis. It is not involved in the actions described by the other options. Urodilatin (a natriuretic peptide) inhibits sodium and water reabsorption from the medullary part of collecting duct, thereby producing diuresis. It is not involved in the actions described by the other options.

   

Question 3 Question 3

2 / 2 pts 2 / 2 pts

What is the direct action of atrial natriuretic hormone? What is the direct action of atrial natriuretic hormone?

     

Sodium retention Sodium retention

   

Correct! Correct!

     

Sodium excretion Sodium excretion

   

     

Water retention Water retention

   

     

Water excretion Water excretion

   

Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) inhibit the secretion of renin, inhibit angiotensin-induced secretion of aldosterone, vasodilate the afferent and constrict the efferent glomerular arterioles, and inhibit sodium and water absorption by kidney tubules. The other actions are not a result of the atrial natriuretic hormone. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) inhibit the secretion of renin, inhibit angiotensin-induced secretion of aldosterone, vasodilate the afferent and constrict the efferent glomerular arterioles, and inhibit sodium and water absorption by kidney tubules. The other actions are not a result of the atrial natriuretic hormone.

   

Question 4 Question 4

2 / 2 pts 2 / 2 pts

Which statement best describes a Schilling test? Which statement best describes a Schilling test?

Correct! Correct!

   

Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B 12  deficiency Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B 12  deficiency Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B 12 12  deficiency

   

Measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia 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 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. Administration of folate and measurement in 2 hours of its level in a blood sample to test for folic acid deficiency anemia.

The Schilling test indirectly evaluates vitamin B 12  absorption by administering radioactive B 12  and measuring excretion in the urine. This selection is the only option that accurately describes a Schilling test. The Schilling test indirectly evaluates vitamin B 12  absorption by administering radioactive B 12  and measuring excretion in the urine. This selection is the only option that accurately describes a Schilling test. The Schilling test indirectly evaluates vitamin B 12 12  absorption by administering radioactive B 12 12  and measuring excretion in the urine. This selection is the only option that accurately describes a Schilling test.

   

Question 5 Question 5

2 / 2 pts 2 / 2 pts

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

     

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

   

Correct! Correct!

     

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

   

     

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

   

     

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

   

HDN can occur only if antigens on fetal erythrocytes differ from antigens on maternal erythrocytes. Maternal-fetal incompatibility exists only if the mother and fetus differ in ABO blood type or if the fetus is Rh-positive and the mother is Rh-negative. This erythrocyte incompatibility does not exist in any of the other options. HDN can occur only if antigens on fetal erythrocytes differ from antigens on maternal erythrocytes. Maternal-fetal incompatibility exists only if the mother and fetus differ in ABO blood type or if the fetus is Rh-positive and the mother is Rh-negative. This erythrocyte incompatibility does not exist in any of the other options.

   

Question 6 Question 6

2 / 2 pts 2 / 2 pts

Which T-lymphocyte phenotype is the key determinant of childhood asthma? Which T-lymphocyte phenotype is the key determinant of childhood asthma?

     

Cluster of differentiation (CD) 4 T-helper Th 1  lymphocytes Cluster of differentiation (CD) 4 T-helper Th 1  lymphocytes Cluster of differentiation (CD) 4 T-helper Th 1 1  lymphocytes

Correct! Correct!

     

CD4 T-helper Th 2  lymphocytes CD4 T-helper Th 2  lymphocytes CD4 T-helper Th 2 2  lymphocytes

     

CD8 cytotoxic T lymphocytes CD8 cytotoxic T lymphocytes

   

     

Memory T lymphocytes Memory T lymphocytes

   

Asthma develops because the Th 2  response (in which CD4 T-helper cells produce specific cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and allergic response in the airways. This selection is the only option that accurately identifies the appropriate T-lymphocyte phenotype. Asthma develops because the Th 2  response (in which CD4 T-helper cells produce specific cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and allergic response in the airways. This selection is the only option that accurately identifies the appropriate T-lymphocyte phenotype. Asthma develops because the Th 2 2  response (in which CD4 T-helper cells produce specific cytokines, such as interleukin [IL]–4, IL-5, and IL-13) promotes an atopic and allergic response in the airways. This selection is the only option that accurately identifies the appropriate T-lymphocyte phenotype.

   

Question 7 Question 7

2 / 2 pts 2 / 2 pts

Perceived stress elicits an emotional, anticipatory response that begins where? Perceived stress elicits an emotional, anticipatory response that begins where?

     

Prefrontal cortex Prefrontal cortex

   

     

Anterior pituitary Anterior pituitary

   

Correct! Correct!

     

Limbic system Limbic system

   

     

Hypothalamus Hypothalamus

   

Perceived stressors elicit an anticipatory response that begins in the limbic system of the brain, the only option responsible for emotions and cognition. Perceived stressors elicit an anticipatory response that begins in the limbic system of the brain, the only option responsible for emotions and cognition.

   

Question 8 Question 8

2 / 2 pts 2 / 2 pts

Hypersensitivity  is best defined as a(an): Hypersensitivity  is best defined as a(an): Hypersensitivity Hypersensitivity  is best defined as a(an):

     

Disturbance in the immunologic tolerance of self-antigens Disturbance in the immunologic tolerance of self-antigens

   

     

Immunologic reaction of one person to the tissue of another person Immunologic reaction of one person to the tissue of another person

   

Correct! Correct!

     

Altered immunologic response to an antigen that results in disease Altered immunologic response to an antigen that results in disease

   

     

Undetectable immune response in the presence of antigens Undetectable immune response in the presence of antigens

   

Hypersensitivity  is an altered immunologic response to an antigen that results in disease or damage to the host. The other options are not accurate definitions of hypersensitivity. Hypersensitivity  is an altered immunologic response to an antigen that results in disease or damage to the host. The other options are not accurate definitions of hypersensitivity. Hypersensitivity Hypersensitivity  is an altered immunologic response to an antigen that results in disease or damage to the host. The other options are not accurate definitions of hypersensitivity.

   

Question 9 Question 9

2 / 2 pts 2 / 2 pts

It has been determined that a tumor is in stage 2. What is the meaning of this finding? It has been determined that a tumor is in stage 2. What is the meaning of this finding?

     

Cancer is confined to the organ of origin. Cancer is confined to the organ of origin.

   

     

Cancer has spread to regional structures. Cancer has spread to regional structures.

   

Correct! Correct!

     

Cancer is locally invasive. Cancer is locally invasive.

   

     

Cancer has spread to distant sites Cancer has spread to distant sites

   

Cancer confined to the organ of origin is stage 1; cancer that is locally invasive is stage 2; cancer that has spread to regional structures, such as the lymph nodes, is stage 3; and cancer that has spread to distant sites, such as a liver cancer spreading to the lung or a prostate cancer spreading to bone, is stage 4. Cancer confined to the organ of origin is stage 1; cancer that is locally invasive is stage 2; cancer that has spread to regional structures, such as the lymph nodes, is stage 3; and cancer that has spread to distant sites, such as a liver cancer spreading to the lung or a prostate cancer spreading to bone, is stage 4.

   

Question 10 Question 10

2 / 2 pts 2 / 2 pts

An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect? An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect?

     

Atrial septal defect (ASD) Atrial septal defect (ASD)

   

Correct! Correct!

     

Ventricular septal defect (VSD) Ventricular septal defect (VSD)

   

     

Patent ductus arteriosus (PDA) Patent ductus arteriosus (PDA)

   

     

Atrioventricular canal (AVC) defect Atrioventricular canal (AVC) defect

   

On physical examination, a loud, harsh, holosystolic murmur and systolic thrill can be detected at the left lower sternal border. The intensity of the murmur reflects the pressure gradient across the VSD. An apical diastolic rumble may be present with a moderate-to-large defect, reflecting increased flow across the mitral valve. The presentations of the other congenital heart defects are not consistent with the described symptoms. On physical examination, a loud, harsh, holosystolic murmur and systolic thrill can be detected at the left lower sternal border. The intensity of the murmur reflects the pressure gradient across the VSD. An apical diastolic rumble may be present with a moderate-to-large defect, reflecting increased flow across the mitral valve. The presentations of the other congenital heart defects are not consistent with the described symptoms.

   

Question 11 Question 11

2 / 2 pts 2 / 2 pts

Which statement concerning exotoxins is  true? Which statement concerning exotoxins is  true? true

     

Exotoxins are contained in cell walls of gram-negative bacteria. Exotoxins are contained in cell walls of gram-negative bacteria.

   

     

Exotoxins are released during the lysis of bacteria. Exotoxins are released during the lysis of bacteria.

   

     

Exotoxins are able to initiate the complement and coagulation cascades. Exotoxins are able to initiate the complement and coagulation cascades.

   

Correct! Correct!

     

Exotoxins are released during bacterial growth. Exotoxins are released during bacterial growth.

   

Exotoxins are proteins released during bacterial growth. The other options are not true of exotoxins. Exotoxins are proteins released during bacterial growth. The other options are not true of exotoxins.

   

Question 12 Question 12

2 / 2 pts 2 / 2 pts

The function of the foramen ovale in a fetus allows what to occur? The function of the foramen ovale in a fetus allows what to occur?

Correct! Correct!

     

Right-to-left blood shunting Right-to-left blood shunting

   

     

Left-to-right blood shunting Left-to-right blood shunting

   

     

Blood flow from the umbilical cord Blood flow from the umbilical cord

   

     

Blood flow to the lungs Blood flow to the lungs

   

The nonfused septum secundum and ostium secundum result in the formation of a flapped orifice known as the  foramen ovale, which allows the right-to-left shunting necessary for fetal circulation. The foramen ovale is not involved in the blood flow described by the other options. The nonfused septum secundum and ostium secundum result in the formation of a flapped orifice known as the  foramen ovale, which allows the right-to-left shunting necessary for fetal circulation. The foramen ovale is not involved in the blood flow described by the other options. foramen ovale

   

Question 13 Question 13

2 / 2 pts 2 / 2 pts

Which laboratory test is considered adequate for an accurate and reliable diagnosis of gonococcal urethritis in a symptomatic man? Which laboratory test is considered adequate for an accurate and reliable diagnosis of gonococcal urethritis in a symptomatic man?

     

Ligase chain reaction (LCR) Ligase chain reaction (LCR)

   

Correct! Correct!

     

Gram-stain technique Gram-stain technique

   

     

Polymerase chain reaction (PCR) Polymerase chain reaction (PCR)

   

     

DNA testing DNA testing

   

Microscopic evaluation of Gram-stained slides of clinical specimens is deemed positive for  Neisseria gonorrhoeae if gram-negative diplococci with the typical “kidney bean” morphologic appearance are found inside polymorphonuclear leukocytes. Such a finding is considered adequate for the diagnosis of gonococcal urethritis in a symptomatic man. The other options are not relevant to the diagnosis of this condition. Microscopic evaluation of Gram-stained slides of clinical specimens is deemed positive for  Neisseria gonorrhoeae if gram-negative diplococci with the typical “kidney bean” morphologic appearance are found inside polymorphonuclear leukocytes. Such a finding is considered adequate for the diagnosis of gonococcal urethritis in a symptomatic man. The other options are not relevant to the diagnosis of this condition. Neisseria gonorrhoeae 

   

Question 14 Question 14

2 / 2 pts 2 / 2 pts

Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in infants? Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in infants?

     

Atelectasis and pneumonia Atelectasis and pneumonia

   

Correct! Correct!

     

Edema of the hands and feet Edema of the hands and feet

   

     

Stasis ulcers of the hands, ankles, and feet Stasis ulcers of the hands, ankles, and feet

   

     

Splenomegaly and hepatomegaly Splenomegaly and hepatomegaly

   

Symmetric, painful swelling of the hands and feet (hand-foot syndrome) caused by infarction in the small vessels of the extremities is often the initial manifestation of SCD in infants. This selection is the only option that accurately identifies the manifestations of a vasoocclusive crisis associated with SCD in infancy. Symmetric, painful swelling of the hands and feet (hand-foot syndrome) caused by infarction in the small vessels of the extremities is often the initial manifestation of SCD in infants. This selection is the only option that accurately identifies the manifestations of a vasoocclusive crisis associated with SCD in infancy.

   

Question 15 Question 15

2 / 2 pts 2 / 2 pts

Which statement concerning benign tumors is  true? Which statement concerning benign tumors is  true? true

     

The resulting pain is severe. The resulting pain is severe.

   

     

Benign tumors are not encapsulated. Benign tumors are not encapsulated.

   

     

Benign tumors are fast growing. Benign tumors are fast growing.

   

Correct! Correct!

     

The cells are well-differentiated. The cells are well-differentiated.

   

A benign tumor is well-differentiated with its tissue appearing similar to the tissue from which it arose. The other options are characteristic of a malignant tumor. A benign tumor is well-differentiated with its tissue appearing similar to the tissue from which it arose. The other options are characteristic of a malignant tumor.

   

Question 16 Question 16

2 / 2 pts 2 / 2 pts

Which primary characteristic is unique for the immune response? Which primary characteristic is unique for the immune response?

     

The immune response is similar each time it is activated. The immune response is similar each time it is activated.

   

Correct! Correct!

     

The immune response is specific to the antigen that initiates it. The immune response is specific to the antigen that initiates it.

   

     

The response to a specific pathogen is short term. The response to a specific pathogen is short term.

   

     

The response is innate, rather than acquired. The response is innate, rather than acquired.

   

Unlike inflammation, which is nonspecifically activated by cellular damage and pathogenic microorganisms, the immune response is primarily designed to afford long-term specific protection (i.e., immunity) against particular invading microorganisms; that is, it has a  memory function. The other options are not unique characteristics of the immune response. Unlike inflammation, which is nonspecifically activated by cellular damage and pathogenic microorganisms, the immune response is primarily designed to afford long-term specific protection (i.e., immunity) against particular invading microorganisms; that is, it has a  memory function. The other options are not unique characteristics of the immune response. memory

   

Question 17 Question 17

2 / 2 pts 2 / 2 pts

Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child? Which criterion is used to confirm a diagnosis of asthma in an 8-year-old child?

     

Parental history of asthma Parental history of asthma

   

   

Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels Serum testing that confirms increased immunoglobulin E (IgE) and eosinophil levels

Correct! Correct!

     

Reduced expiratory flow rates confirmed by spirometry testing Reduced expiratory flow rates confirmed by spirometry testing

   

     

Improvement on a trial of asthma medication Improvement on a trial of asthma medication

   

Confirmation of the diagnosis of asthma relies on pulmonary function testing using spirometry, which can be accomplished only after the child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities. For younger children, an empiric trial of asthma medications is commonly initiated. The remaining options are major historical and physical factors that contribute but do not confirm the diagnosis of asthma in children. Confirmation of the diagnosis of asthma relies on pulmonary function testing using spirometry, which can be accomplished only after the child is 5 to 6 years of age. Reduced expiratory flow rates that are reversible in response to an inhaled bronchodilator would be characteristic abnormalities. For younger children, an empiric trial of asthma medications is commonly initiated. The remaining options are major historical and physical factors that contribute but do not confirm the diagnosis of asthma in children.

   

Question 18 Question 18

0 / 2 pts 0 / 2 pts

Where are antibodies produced? Where are antibodies produced?

     

Helper T lymphocytes Helper T lymphocytes

   

     

Thymus gland Thymus gland

   

Correct Answer Correct Answer

     

Plasma cells Plasma cells

   

You Answered You Answered

     

Bone marrow Bone marrow

   

An antibody or immunoglobulin is a serum glycoprotein produced only by plasma cells in response to a challenge by an immunogen. An antibody or immunoglobulin is a serum glycoprotein produced only by plasma cells in response to a challenge by an immunogen.

   

Question 19 Question 19

2 / 2 pts 2 / 2 pts

How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness? How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness?

     

75 to 100 ml 75 to 100 ml

   

     

100 to 150 ml 100 to 150 ml

   

Correct! Correct!

     

250 to 300 ml 250 to 300 ml

   

     

350 to 400 ml 350 to 400 ml

   

When the bladder accumulates 250 to 300 ml of urine, it contracts and the internal urethral sphincter relaxes through activation of the spinal reflex arc (known as the  micturition reflex). When the bladder accumulates 250 to 300 ml of urine, it contracts and the internal urethral sphincter relaxes through activation of the spinal reflex arc (known as the  micturition reflex). micturition reflex

   

Question 20 Question 20

2 / 2 pts 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? 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) Idiopathic thrombocytopenic purpura (ITP)

   

Correct! Correct!

     

Acute lymphocytic leukemia (ALL) Acute lymphocytic leukemia (ALL)

   

     

Non-Hodgkin lymphoma (NHL) Non-Hodgkin lymphoma (NHL)

   

     

Iron deficiency anemia (IDA) Iron deficiency anemia (IDA)

   

Pallor, fatigue, petechiae, purpura, bleeding, and fever are generally present with the most common symptoms reflecting the consequence of bone marrow failure, which results in decreased red blood cells and platelets and changes in white blood cells. This selection is the only option that correctly identifies the disease with the symptoms described. Pallor, fatigue, petechiae, purpura, bleeding, and fever are generally present with the most common symptoms reflecting the consequence of bone marrow failure, which results in decreased red blood cells and platelets and changes in white blood cells. This selection is the only option that correctly identifies the disease with the symptoms described.

   

Question 21 Question 21

2 / 2 pts 2 / 2 pts

Carcinoma in situ is characterized by which changes? Carcinoma in situ is characterized by which changes?

     

Cells have broken through the local basement membrane. Cells have broken through the local basement membrane.

   

     

Cells have invaded immediate surrounding tissue. Cells have invaded immediate surrounding tissue.

   

Correct! Correct!

     

Cells remain localized in the glandular or squamous cells. Cells remain localized in the glandular or squamous cells.

   

     

Cellular and tissue alterations indicate dysplasia. Cellular and tissue alterations indicate dysplasia.

   

Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or squamous cell origin. These early stage cancers are localized to the epithelium and have not broken through the local basement membrane or invaded the surrounding tissue. Dysplasia refers to changes in mature cell structure. Carcinoma in situ (CIS) refers to preinvasive epithelial malignant tumors of glandular or squamous cell origin. These early stage cancers are localized to the epithelium and have not broken through the local basement membrane or invaded the surrounding tissue. Dysplasia refers to changes in mature cell structure.

   

Question 22 Question 22

2 / 2 pts 2 / 2 pts

What is the life span of platelets  (in days)? What is the life span of platelets  (in days)? (in days)

Correct! Correct!

     

10 10

   

     

30 30

   

     

90 90

   

     

120 120

   

A platelet circulates for approximately 10 days and ages. Macrophages of the mononuclear phagocyte system, mostly in the spleen, remove platelets. A platelet circulates for approximately 10 days and ages. Macrophages of the mononuclear phagocyte system, mostly in the spleen, remove platelets.

   

Question 23 Question 23

2 / 2 pts 2 / 2 pts

What is the primary cause of respiratory distress syndrome (RDS) of the newborn? What is the primary cause of respiratory distress syndrome (RDS) of the newborn?

     

Immature immune system Immature immune system

   

     

Small alveoli Small alveoli

   

Correct! Correct!

     

Surfactant deficiency Surfactant deficiency

   

     

Anemia Anemia

   

RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange. None of the other options are related to the cause of RDS. RDS is primarily caused by surfactant deficiency and secondarily by a deficiency in alveolar surface area for gas exchange. None of the other options are related to the cause of RDS.

   

Question 24 Question 24

2 / 2 pts 2 / 2 pts

What is the life span of an erythrocyte  (in days)? What is the life span of an erythrocyte  (in days)? (in days)

     

20 to 30 20 to 30

   

     

60 to 90 60 to 90

   

Correct! Correct!

     

100 to 120 100 to 120

   

     

200 to 240 200 to 240

   

Because it cannot undergo mitotic division, the erythrocyte has a limited life span of approximately 120 days. Because it cannot undergo mitotic division, the erythrocyte has a limited life span of approximately 120 days.

   

Question 25 Question 25

2 / 2 pts 2 / 2 pts

Low plasma albumin causes edema as a result of a reduction in which pressure? Low plasma albumin causes edema as a result of a reduction in which pressure?

     

Capillary hydrostatic Capillary hydrostatic

   

     

Interstitial hydrostatic Interstitial hydrostatic

   

Correct! Correct!

     

Plasma oncotic Plasma oncotic

   

     

Interstitial oncotic Interstitial oncotic

   

Losses or diminished production of plasma albumin is the only option that  contributes to a decrease in plasma oncotic pressure. Losses or diminished production of plasma albumin is the only option that  contributes to a decrease in plasma oncotic pressure. Losses or diminished production of plasma albumin is the only option that  Losses or diminished production of plasma albumin is the only option that  contributes to a decrease in plasma oncotic pressure.

   

Question 26 Question 26

2 / 2 pts 2 / 2 pts

Which blood cell type is elevated at birth but decreases to adult levels during the first year of life? Which blood cell type is elevated at birth but decreases to adult levels during the first year of life?

Correct! Correct!

     

Monocytes Monocytes

   

     

Platelets Platelets

   

     

Neutrophils Neutrophils

   

     

Lymphocytes Lymphocytes

   

Only monocyte counts are high in the first year of life and then decrease to adult levels. Only monocyte counts are high in the first year of life and then decrease to adult levels.

   

Question 27 Question 27

2 / 2 pts 2 / 2 pts

Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)? Which organ is stimulated during the alarm phase of the general adaptation syndrome (GAS)?

     

Adrenal cortex Adrenal cortex

   

Correct! Correct!

     

Hypothalamus Hypothalamus

   

     

Anterior pituitary Anterior pituitary

   

     

Limbic system Limbic system

   

The alarm phase of the GAS begins when a stressor triggers the actions of the hypothalamus and the sympathetic nervous system (SNS) (see Figure 11-1). The other organs are not stimulated by the alarm phase of GAS. The alarm phase of the GAS begins when a stressor triggers the actions of the hypothalamus and the sympathetic nervous system (SNS) (see Figure 11-1). The other organs are not stimulated by the alarm phase of GAS.

   

Question 28 Question 28

2 / 2 pts 2 / 2 pts

Phagocytosis involves neutrophils actively attacking, engulfing, and destroying which microorganisms? Phagocytosis involves neutrophils actively attacking, engulfing, and destroying which microorganisms?

Correct! Correct!

     

Bacteria Bacteria

   

     

Fungi Fungi

   

     

Viruses Viruses

   

     

Yeasts Yeasts

   

Invasion is the direct confrontation with an individual’s primary defense mechanisms against only bacteria, which include the complement system, antibodies, and phagocytes, such as neutrophils and macrophages. Invasion is the direct confrontation with an individual’s primary defense mechanisms against only bacteria, which include the complement system, antibodies, and phagocytes, such as neutrophils and macrophages.

   

Question 29 Question 29

2 / 2 pts 2 / 2 pts

What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion? What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?

     

Macula densa Macula densa

   

     

Visceral epithelium Visceral epithelium

   

Correct! Correct!

     

Juxtaglomerular apparatus (JGA) Juxtaglomerular apparatus (JGA)

   

     

Filtration slits Filtration slits

   

Control of renal blood flow, glomerular filtration, and renin secretion occur at the JGA. Together, the juxtaglomerular cells and macula densa cells form the JGA. The control of renal blood flow, glomerular filtration, and renin secretion is not directed by any of the other options. Control of renal blood flow, glomerular filtration, and renin secretion occur at the JGA. Together, the juxtaglomerular cells and macula densa cells form the JGA. The control of renal blood flow, glomerular filtration, and renin secretion is not directed by any of the other options.

   

Question 30 Question 30

2 / 2 pts 2 / 2 pts

The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born between how many weeks of gestation? The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born between how many weeks of gestation?

     

16 and 20 16 and 20

   

     

20 and 24 20 and 24

   

     

24 and 30 24 and 30

   

Correct! Correct!

     

30 and 36 30 and 36

   

Surfactant is secreted into fetal airways between 30 and 36 weeks. The other options are not true regarding the timeframe when the risk for RDS decreases. Surfactant is secreted into fetal airways between 30 and 36 weeks. The other options are not true regarding the timeframe when the risk for RDS decreases.

   

Question 31 Question 31

2 / 2 pts 2 / 2 pts

What is the functional unit of the kidney called? What is the functional unit of the kidney called?

     

Glomerulus Glomerulus

   

Correct! Correct!

     

Nephron Nephron

   

     

Collecting duct Collecting duct

   

     

Pyramid Pyramid

   

The nephron is the functional unit of the kidney. Although the other options are also located in the kidney, they are not its functional units. The nephron is the functional unit of the kidney. Although the other options are also located in the kidney, they are not its functional units.

   

Question 32 Question 32

2 / 2 pts 2 / 2 pts

Which hepatitis virus is known to be sexually transmitted? Which hepatitis virus is known to be sexually transmitted?

     

A A

   

Correct! Correct!

     

B B

   

     

C C

   

     

D D

   

Only hepatitis B virus (HBV) is known to be sexually transmitted. Only hepatitis B virus (HBV) is known to be sexually transmitted.

   

Question 33 Question 33

2 / 2 pts 2 / 2 pts

Which statement is  true concerning the IgM? Which statement is  true concerning the IgM?  true

Correct! Correct!

     

IgM is the first antibody produced during the initial response to an antigen. IgM is the first antibody produced during the initial response to an antigen.

   

     

IgM mediates many common allergic responses. IgM mediates many common allergic responses.

   

     

IgM is the most abundant class of immunoglobulins. IgM is the most abundant class of immunoglobulins.

   

     

IgM is capable of crossing the human placenta. IgM is capable of crossing the human placenta.

   

Typically, IgM is produced first (primary immune response), followed by IgG against the same antigen. The other options are not true statements regarding IgM. Typically, IgM is produced first (primary immune response), followed by IgG against the same antigen. The other options are not true statements regarding IgM.

   

Question 34 Question 34

2 / 2 pts 2 / 2 pts

Apoptosis is a(an): Apoptosis is a(an):

Correct! Correct!

     

Normal mechanism for cells to self-destruct when growth is excessive Normal mechanism for cells to self-destruct when growth is excessive

   

     

Antigrowth signal activated by the tumor-suppressor gene  Rb Antigrowth signal activated by the tumor-suppressor gene  Rb Rb

     

Mutation of cell growth stimulated by the  TP53 gene Mutation of cell growth stimulated by the  TP53 gene TP53 gene

     

Transformation of cells from dysplasia to anaplasia Transformation of cells from dysplasia to anaplasia

   

Normal cells have a mechanism that causes them to self-destruct when growth is excessive and cell cycle checkpoints have been ignored. Diverse stimuli, including normal development and excessive growth, trigger this self-destruct mechanism, called  apoptosis. The remaining options do not describe apoptosis. Normal cells have a mechanism that causes them to self-destruct when growth is excessive and cell cycle checkpoints have been ignored. Diverse stimuli, including normal development and excessive growth, trigger this self-destruct mechanism, called  apoptosis. The remaining options do not describe apoptosis. apoptosis

   

Question 35 Question 35

2 / 2 pts 2 / 2 pts

What are the abnormalities in cytokines found in children with cystic fibrosis (CF)? What are the abnormalities in cytokines found in children with cystic fibrosis (CF)?

   

Deficit of interleukin (IL)–1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-α) Deficit of interleukin (IL)–1 and an excess of IL-4, IL-12, and interferon-alpha (IFN-α)

   

Deficit of IL-6 and an excess of IL-2, IL-8, and granulocyte colony-stimulating factor (G-CSF) Deficit of IL-6 and an excess of IL-2, IL-8, and granulocyte colony-stimulating factor (G-CSF)

Correct! Correct!

     

Deficit of IL-10 and an excess of IL-1, IL-8, and TNF-α Deficit of IL-10 and an excess of IL-1, IL-8, and TNF-α

   

   

Deficit of IL-3 and an excess of IL-14, IL-24, and colony-stimulating factor (CSF) Deficit of IL-3 and an excess of IL-14, IL-24, and colony-stimulating factor (CSF)

   

Abnormal cytokine profiles have been documented in CF airway fluids, including deficient IL-10 and excessive IL-1, IL-8, and TNF-α, all changes conducive to promoting inflammation. This selection is the only option that accurately identifies the abnormalities in cytokines observed in children with CF. Abnormal cytokine profiles have been documented in CF airway fluids, including deficient IL-10 and excessive IL-1, IL-8, and TNF-α, all changes conducive to promoting inflammation. This selection is the only option that accurately identifies the abnormalities in cytokines observed in children with CF.

   

Question 36 Question 36

2 / 2 pts 2 / 2 pts

Research supports the premise that exercise has a probable impact on reducing the risk of which cancer? Research supports the premise that exercise has a probable impact on reducing the risk of which cancer?

     

Liver Liver

   

     

Endometrial Endometrial

   

     

Stomach Stomach

   

Correct! Correct!

     

Colon Colon

   

The World Cancer Research Fund summarizes the effects as  convincingfor cancers of the colon and  probable for postmenopausal breast cancer and endometrial cancer. The relationship is not supported for the remaining options. The World Cancer Research Fund summarizes the effects as  convincingfor cancers of the colon and  probable for postmenopausal breast cancer and endometrial cancer. The relationship is not supported for the remaining options. convincing probable

   

Question 37 Question 37

2 / 2 pts 2 / 2 pts

Why is nasal congestion a serious threat to young infants? Why is nasal congestion a serious threat to young infants?

Correct! Correct!

     

Infants are obligatory nose breathers. Infants are obligatory nose breathers.

   

     

Their noses are small in diameter. Their noses are small in diameter.

   

     

Infants become dehydrated when mouth breathing. Infants become dehydrated when mouth breathing.

   

     

Their epiglottis is proportionally greater than the epiglottis of an adult’s. Their epiglottis is proportionally greater than the epiglottis of an adult’s.

   

Infants up to 2 to 3 months of age are obligatory nose breathers and are unable to breathe in through their mouths. Nasal congestion is therefore a serious threat to a young infant. This selection is the only option that accurately describes why nasal congestion is a serious threat to young infants. Infants up to 2 to 3 months of age are obligatory nose breathers and are unable to breathe in through their mouths. Nasal congestion is therefore a serious threat to a young infant. This selection is the only option that accurately describes why nasal congestion is a serious threat to young infants.

   

Question 38 Question 38

2 / 2 pts 2 / 2 pts

Between which months of age does sudden infant death syndrome (SIDS) most often occur? Between which months of age does sudden infant death syndrome (SIDS) most often occur?

     

0 and 1 0 and 1

   

Correct! Correct!

     

2 and 4 2 and 4

   

     

5 and 6 5 and 6

   

     

6 and 7 6 and 7

   

The incidence of SIDS is low during the first month of life but sharply increases in the second month of life, peaking at 2 to 4 months and is unusual after 6 months of age. The incidence of SIDS is low during the first month of life but sharply increases in the second month of life, peaking at 2 to 4 months and is unusual after 6 months of age.

   

Question 39 Question 39

2 / 2 pts 2 / 2 pts

In which primary immune deficiency is there a partial-to-complete absence of T-cell immunity? In which primary immune deficiency is there a partial-to-complete absence of T-cell immunity?

     

Bruton disease Bruton disease

   

Correct! Correct!

     

DiGeorge syndrome DiGeorge syndrome

   

     

Reticular dysgenesis Reticular dysgenesis

   

     

Adenosine deaminase deficiency Adenosine deaminase deficiency

   

The principal immunologic defect in DiGeorge syndrome is the partial or complete absence of T-cell immunity. The other options are not the result of either a partial or complete absence of T-cell immunity. The principal immunologic defect in DiGeorge syndrome is the partial or complete absence of T-cell immunity. The other options are not the result of either a partial or complete absence of T-cell immunity.

   

Question 40 Question 40

2 / 2 pts 2 / 2 pts

Blood vessels of the kidneys are innervated by the: Blood vessels of the kidneys are innervated by the:

     

Vagus nerve Vagus nerve

   

Correct! Correct!

     

Sympathetic nervous system Sympathetic nervous system

   

     

Somatic nervous system Somatic nervous system

   

     

Parasympathetic nervous system Parasympathetic nervous system

   

The blood vessels of the kidney are innervated by the sympathetic noradrenergic fibers that cause arteriolar vasoconstriction and reduce renal blood flow. The other options are not involved in this process. The blood vessels of the kidney are innervated by the sympathetic noradrenergic fibers that cause arteriolar vasoconstriction and reduce renal blood flow. The other options are not involved in this process.

   

Question 41 Question 41

2 / 2 pts 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? An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody?

     

IgG IgG

   

     

IgM IgM

   

Correct! Correct!

     

IgA IgA

   

     

IgE IgE

   

The IgA molecules found in bodily secretions are dimers anchored together through a J-chain and secretory piece. This secretory piece is attached to the IgA antibodies inside the mucosal epithelial cells and may function to protect these immunoglobulin antibodies against degradation by enzymes also found in the secretions, thus decreasing the risk of infections in the mucous membrane. The other options do not accurately identify the immunoglobulin antibody involved in mucous membrane infections. The IgA molecules found in bodily secretions are dimers anchored together through a J-chain and secretory piece. This secretory piece is attached to the IgA antibodies inside the mucosal epithelial cells and may function to protect these immunoglobulin antibodies against degradation by enzymes also found in the secretions, thus decreasing the risk of infections in the mucous membrane. The other options do not accurately identify the immunoglobulin antibody involved in mucous membrane infections.

   

Question 42 Question 42

2 / 2 pts 2 / 2 pts

Which term is used to identify the movement of gas and air into and out of the lungs? Which term is used to identify the movement of gas and air into and out of the lungs?

     

Perfusion Perfusion

   

Correct! Correct!

     

Ventilation Ventilation

   

     

Respiration Respiration

   

     

Diffusion Diffusion

   

Of the options available, ventilation is the only term used to identify the mechanical movement of gas or air into and out of the lungs. Of the options available, ventilation is the only term used to identify the mechanical movement of gas or air into and out of the lungs.

   

Question 43 Question 43

2 / 2 pts 2 / 2 pts

What is the first stage in the infectious process? What is the first stage in the infectious process?

     

Invasion Invasion

   

Correct! Correct!

     

Colonization Colonization

   

     

Spread Spread

   

     

Multiplication Multiplication

   

From the perspective of the microorganisms that cause disease, the infectious process undergoes four separate stages of progression: (1) colonization, (2) invasion, (3) multiplication, and (4) spread. From the perspective of the microorganisms that cause disease, the infectious process undergoes four separate stages of progression: (1) colonization, (2) invasion, (3) multiplication, and (4) spread.

   

Question 44 Question 44

2 / 2 pts 2 / 2 pts

What process allows the kidney to respond to an increase in workload? What process allows the kidney to respond to an increase in workload?

     

Glomerular filtration Glomerular filtration

   

     

Secretion of 1,25-dihydroxyvitamin D 3 Secretion of 1,25-dihydroxyvitamin D 3 Secretion of 1,25-dihydroxyvitamin D 3 3

     

Increased heart rate Increased heart rate

   

Correct! Correct!

     

Compensatory hypertrophy Compensatory hypertrophy

   

Compensatory hypertrophy allows the kidney to respond to an increase in workload throughout life. The remaining options are not relevant to accommodating an increased workload. Compensatory hypertrophy allows the kidney to respond to an increase in workload throughout life. The remaining options are not relevant to accommodating an increased workload.

   

Question 45 Question 45

2 / 2 pts 2 / 2 pts

Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome? Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome?

     

Coarctation of the aorta (COA) and pulmonary stenosis (PS) Coarctation of the aorta (COA) and pulmonary stenosis (PS)

   

     

Tetralogy of Fallot and persistent truncus arteriosus Tetralogy of Fallot and persistent truncus arteriosus

   

     

Atrial septal defect (ASD) and dextrocardia Atrial septal defect (ASD) and dextrocardia

   

Correct! Correct!

     

Ventricular septal defect (VSD) and patent ductus arteriosus (PDA) Ventricular septal defect (VSD) and patent ductus arteriosus (PDA)

   

Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18, and Down syndrome include VSD and PDA (see Table 33-2). The other defects are not associated with dysfunction of trisomy 13, trisomy 18, and Down syndrome. Congenital heart defects that are related to dysfunction of trisomy 13, trisomy 18, and Down syndrome include VSD and PDA (see Table 33-2). The other defects are not associated with dysfunction of trisomy 13, trisomy 18, and Down syndrome.

   

Question 46 Question 46

2 / 2 pts 2 / 2 pts

What is the trigone? What is the trigone?

     

A smooth muscle that comprises the orifice of the ureter A smooth muscle that comprises the orifice of the ureter

   

     

The inner mucosal lining of the kidneys The inner mucosal lining of the kidneys

   

Correct! Correct!

   

A smooth triangular area between the openings of the two ureters and the urethra A smooth triangular area between the openings of the two ureters and the urethra

   

     

One of the three divisions of the loop of Henle One of the three divisions of the loop of Henle

   

The trigone is a smooth triangular area lying between the openings of thetwo ureters and the urethra. The other options do not accurately identify the trigone. The trigone is a smooth triangular area lying between the openings of thetwo ureters and the urethra. The other options do not accurately identify the trigone.

   

Question 47 Question 47

2 / 2 pts 2 / 2 pts

The coronary ostia are located in the: The coronary ostia are located in the:

     

Left ventricle Left ventricle

   

     

Aortic valve Aortic valve

   

     

Coronary sinus Coronary sinus

   

Correct! Correct!

     

Aorta Aorta

   

Coronary arteries receive blood through openings in the aorta, called the  coronary ostia. Coronary arteries receive blood through openings in the aorta, called the  coronary ostia. coronary ostia

   

Question 48 Question 48

2 / 2 pts 2 / 2 pts

What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn? What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn?

     

Low birth weight Low birth weight

   

     

Alcohol consumption during pregnancy Alcohol consumption during pregnancy

   

Correct! Correct!

     

Premature birth Premature birth

   

     

Smoking during pregnancy Smoking during pregnancy

   

RDS of the newborn, also known as hyaline membrane disease (HMD), is a major cause of morbidity and mortality in premature newborns. None of the other options are considered the chief predisposing factors for RDS. RDS of the newborn, also known as hyaline membrane disease (HMD), is a major cause of morbidity and mortality in premature newborns. None of the other options are considered the chief predisposing factors for RDS.

   

Question 49 Question 49

2 / 2 pts 2 / 2 pts

The most common site of metastasis for a patient diagnosed with prostate cancer is which location? The most common site of metastasis for a patient diagnosed with prostate cancer is which location?

Correct! Correct!

     

Bones Bones

   

     

Brain Brain

   

     

Bladder Bladder

   

     

Kidney Kidney

   

The bone, especially the lumbar spine area, is the most common metastasis site for prostate cancer. The bone, especially the lumbar spine area, is the most common metastasis site for prostate cancer.

   

Question 50 Question 50

2 / 2 pts 2 / 2 pts

Which of the following is classified as a megaloblastic anemia? Which of the following is classified as a megaloblastic anemia?

     

Iron deficiency Iron deficiency

   

Correct! Correct!

     

Pernicious Pernicious

   

     

Sideroblastic Sideroblastic

   

     

Hemolytic Hemolytic

   

Pernicious anemia is the most common type of megaloblastic anemia. The remaining options are not classified as megaloblastic anemias. Pernicious anemia is the most common type of megaloblastic anemia. The remaining options are not classified as megaloblastic anemias.

   

Question 51 Question 51

2 / 2 pts 2 / 2 pts

The glomerular filtration rate is directly related to which factor? The glomerular filtration rate is directly related to which factor?

Correct! Correct!

     

Perfusion pressure in the glomerular capillaries Perfusion pressure in the glomerular capillaries

   

     

Diffusion rate in the renal cortex Diffusion rate in the renal cortex

   

     

Diffusion rate in the renal medulla Diffusion rate in the renal medulla

   

     

Glomerular active transport Glomerular active transport

   

The filtration of the plasma per unit of time is known as the  glomerular filtration rate (GFR), which is directly related to only the perfusion pressure in the glomerular capillaries. The filtration of the plasma per unit of time is known as the  glomerular filtration rate (GFR), which is directly related to only the perfusion pressure in the glomerular capillaries. glomerular filtration rate

   

Question 52 Question 52

2 / 2 pts 2 / 2 pts

In a normal, nonmutant state, an oncogene is referred to as a: In a normal, nonmutant state, an oncogene is referred to as a:

     

Basal cell Basal cell

   

     

Target cell Target cell

   

     

Caretaker gene Caretaker gene

   

Correct! Correct!

     

Proto-oncogene Proto-oncogene

   

In its normal nonmutant state, an oncogene is referred to as a  proto-oncogene. The other options are not terms used to identify a nonmutant oncogene. In its normal nonmutant state, an oncogene is referred to as a  proto-oncogene. The other options are not terms used to identify a nonmutant oncogene. proto-oncogene

   

Question 53 Question 53

2 / 2 pts 2 / 2 pts

What is the most common cause of iron deficiency anemia (IDA)? What is the most common cause of iron deficiency anemia (IDA)?

     

Decreased dietary intake Decreased dietary intake

   

Correct! Correct!

     

Chronic blood loss Chronic blood loss

   

     

Vitamin deficiency Vitamin deficiency

   

     

Autoimmune disease Autoimmune disease

   

The most common cause of IDA in well-developed countries is pregnancy and chronic blood loss. The most common cause of IDA in well-developed countries is pregnancy and chronic blood loss.

   

Question 54 Question 54

2 / 2 pts 2 / 2 pts

What effect do natriuretic peptides have during heart failure when the heart dilates? What effect do natriuretic peptides have during heart failure when the heart dilates?

     

Stimulates antidiuretic hormones. Stimulates antidiuretic hormones.

   

     

Inhibits antidiuretic hormones. Inhibits antidiuretic hormones.

   

     

Stimulates renin and aldosterone. Stimulates renin and aldosterone.

   

Correct! Correct!

     

Inhibits renin and aldosterone. Inhibits renin and aldosterone.

   

Natriuretic peptides inhibit renin and aldosterone during heart failure when the heart dilates. These make up a group of peptide hormones, including atrial natriuretic peptide (ANP), secreted from myocardial cells in the atria and brain natriuretic peptide (BNP) secreted from myocardial cells in the cardiac ventricles. When the heart dilates during volume expansion or heart failure, ANP and BNP inhibit sodium and water absorption by kidney tubules, inhibit the secretion of renin and aldosterone, vasodilate the afferent arterioles, and constrict the efferent arterioles. The result is increased urine formation, leading to decreased blood volume and blood pressure. Natriuretic peptides inhibit renin and aldosterone during heart failure when the heart dilates. These make up a group of peptide hormones, including atrial natriuretic peptide (ANP), secreted from myocardial cells in the atria and brain natriuretic peptide (BNP) secreted from myocardial cells in the cardiac ventricles. When the heart dilates during volume expansion or heart failure, ANP and BNP inhibit sodium and water absorption by kidney tubules, inhibit the secretion of renin and aldosterone, vasodilate the afferent arterioles, and constrict the efferent arterioles. The result is increased urine formation, leading to decreased blood volume and blood pressure.

   

Question 55 Question 55

2 / 2 pts 2 / 2 pts

What is the major concern regarding the treatment of gonococci infections? What is the major concern regarding the treatment of gonococci infections?

Correct! Correct!

     

Development of antibiotic resistance Development of antibiotic resistance

   

     

Changes in virulence Changes in virulence

   

     

Changes in pathogenicity Changes in pathogenicity

   

     

Mutations into different strains Mutations into different strains

   

Several types of drug-resistant strains have been identified; they are penicillinase-producing  Neisseria gonorrhoeae (PPNG), which is resistant to penicillin; tetracycline-resistant  N. gonorrhoeae (TRNG), which is resistant to tetracycline; chromosomal control of mechanisms of resistance of  N. gonorrhoeae (CMRNG), which is resistant to penicillin and tetracycline; and increasingly a fluoroquinolone-resistant  N. gonorrhoeae (QRNG). The other options are not major concerns. Several types of drug-resistant strains have been identified; they are penicillinase-producing  Neisseria gonorrhoeae (PPNG), which is resistant to penicillin; tetracycline-resistant  N. gonorrhoeae (TRNG), which is resistant to tetracycline; chromosomal control of mechanisms of resistance of  N. gonorrhoeae (CMRNG), which is resistant to penicillin and tetracycline; and increasingly a fluoroquinolone-resistant  N. gonorrhoeae (QRNG). The other options are not major concerns. Neisseria gonorrhoeae N. gonorrhoeae  N. gonorrhoeae  N. gonorrhoeae 

   

Question 56 Question 56

2 / 2 pts 2 / 2 pts

Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction? Immunoglobulin E (IgE) is associated with which type of hypersensitivity reaction?

Correct! Correct!

     

I I

   

     

II II

   

     

III III

   

     

IV IV

   

Hypersensitivity reactions have been divided into four distinct types: type I (IgE-mediated) hypersensitivity reactions, type II (tissue-specific) hypersensitivity reactions, type III (immune complex–mediated) hypersensitivity reactions, and type IV (cell-mediated) hypersensitivity reactions. Hypersensitivity reactions have been divided into four distinct types: type I (IgE-mediated) hypersensitivity reactions, type II (tissue-specific) hypersensitivity reactions, type III (immune complex–mediated) hypersensitivity reactions, and type IV (cell-mediated) hypersensitivity reactions.

   

Question 57 Question 57

2 / 2 pts 2 / 2 pts

Which cytokines initiate the production of corticotropin-releasing hormone (CRH)? Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?

Correct! Correct!

     

IL–1 and IL-6 IL–1 and IL-6

   

     

IL-2 and TNF-α IL-2 and TNF-α

   

     

IFN and IL-12 IFN and IL-12

   

     

TNF-ß and IL-4 TNF-ß and IL-4

   

Although a number of stress factors initiate the production of CRH, of the options available, only high levels of IL-1 and IL-6 initiate such a response. Although a number of stress factors initiate the production of CRH, of the options available, only high levels of IL-1 and IL-6 initiate such a response.

   

Question 58 Question 58

2 / 2 pts 2 / 2 pts

What is the primary site for uncomplicated local gonococci infections in men? What is the primary site for uncomplicated local gonococci infections in men?

     

Epididymis Epididymis

   

     

Lymph nodes Lymph nodes

   

Correct! Correct!

     

Urethra Urethra

   

     

Prostate Prostate

   

Uncomplicated local infections are observed primarily as urethral infections in men. Uncomplicated local infections are observed primarily as urethral infections in men.

   

Question 59 Question 59

2 / 2 pts 2 / 2 pts

Continuous increases in left ventricular filing pressures result in which disorder? Continuous increases in left ventricular filing pressures result in which disorder?

     

Mitral regurgitation Mitral regurgitation

   

     

Mitral stenosis Mitral stenosis

   

Correct! Correct!

     

Pulmonary edema Pulmonary edema

   

     

Jugular vein distention Jugular vein distention

   

Pressure changes are important because increased left ventricular filling pressures back up into the pulmonary circulation, where they force plasma out through vessel walls, causing fluid to accumulate in lung tissues (pulmonary edema). This selection is the only option that accurately identifies the disorder described in the question. Pressure changes are important because increased left ventricular filling pressures back up into the pulmonary circulation, where they force plasma out through vessel walls, causing fluid to accumulate in lung tissues (pulmonary edema). This selection is the only option that accurately identifies the disorder described in the question.

   

Question 60 Question 60

2 / 2 pts 2 / 2 pts

Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge? Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge?

     

Trachea Trachea

   

     

Left lung Left lung

   

Correct! Correct!

     

Bronchus Bronchus

   

     

Bronchioles Bronchioles

   

Approximately 75% of aspirated foreign bodies lodge in a bronchus. The other options are not locations where children aspirate the majority of foreign objects. Approximately 75% of aspirated foreign bodies lodge in a bronchus. The other options are not locations where children aspirate the majority of foreign objects.

   

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