1
NURS 611 EXAM 4 PATHO ACTUAL EXAM 2023-2024
COMPLETE 100 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED A+
(MARYVILLE UNIVERSITY)
- Exposure to which substance protects the mucosal barrier of the stomach?
a. Prostaglandins
b. Helicobacter pylori
c. Aspirin
d. Regurgitated bile
Prostaglandins. Prostaglandins and enterogastrones,such as gastric inhibitory
peptide, somatostatin, and secretin, inhibit acid secretion. - Glucose transport enhances the absorption of which electrolyte?
a. Sodium
b. Potassium
c. Phosphate
d. Chloride
Sodium. Sodium passes through the tight junctions and is actively transported
across cell membranes. Sodium and glucose share a common active transport
carrier (sodium-glucose ligand transporter 1 [SGLT1]). - What isthe cause of gastroesophageal reflux disease?
a. Excessive production of hydrochloric acid
b. Zone of low pressure of the lower esophageal sphincter
c. Presence of Helicobacter pylori in the esophagus
d. Reverse muscular peristalsis of the esophagus
Zone of low pressure of the lower esophageal sphincter. Normally, the resting
tone of the lower esophageal sphincter maintains a zone of high pressure that
prevents gastroesophageal reflux. In individuals who develop reflux esophagitis,
this pressure tends to be lower than normal from either transient relaxation or a
weakness of the sphincter. - By what mechanism does intussusception cause an intestinal obstruction?
a. Telescoping of part of the intestine into anothersection of intestine,
usually causing strangulation of the blood supply
b. Twisting the intestine on its mesenteric pedicle, causing occlusion of the
blood supply
c. Loss of peristaltic motor activity in the intestine, causing an adynamic ileus
d. Forming fibrin and scar tissue that attach to the intestinal omentum,
causing obstruction
A. Intussusception is the telescoping of part of the intestine into another section
of intestine, usually causing strangulation of the blood supply.
2
- What isthe most immediate result of a small intestinal obstruction?
a. Vomiting
b. Electrolyte imbalances
c. Dehydration
d. Distention
Distention begins almost immediately, as gases and fluids accumulate proximal
to the obstruction. Within 24 hours, up to 8 L of fluid and electrolytes
enters the lumen in the form of saliva, gastric juice, bile, pancreatic juice, and
intestinal secretions. Copious vomiting or sequestration of fluids in the
intestinal lumen preventstheir reabsorption and produces severe fluid and
electrolyte disturbances. - An intestinal obstruction at the pylorus or high in the small intestine causes metabolic
alkalosis by causing which outcome?
a. Gain of bicarbonate from pancreatic secretions that cannot be absorbed
b. Excessive loss of hydrogen ions normally absorbed from gastric juices
c. Excessive loss of potassium, promoting atony of the intestinal wall
d. Loss of bile acid secretions that cannot be absorbed
Excessive loss of hydrogen ions. If the obstruction is at the pylorus or high in the
small intestine, then metabolic alkalosis initially develops as a result of
excessive loss of hydrogen ionsthat normally would be reabsorbed from the
gastric juices. - What are the cardinal symptoms ofsmall intestinal obstruction?
a. Constant, dull pain in the lower abdomen relieved by defecation
b. Acute, intermittent pain 30 minutesto 2 hours after eating
c. Colicky pain caused by distention, followed by vomiting
d. Excruciating pain in the hypogastric area caused by ischemia
Colicky pain caused by distention followed by vomiting. - What is the primary cause of peptic ulcers?
a. Hypersecretion of gastric acid
b. Helicobacter pylori
c. Hyposecretion of pepsin
d. Escherichia coli
Helicobacter pylori. - A peptic ulcer may occur in all of the following areas except the:
a. Stomach
b. Jejunum
c. Duodenum
d. Esophagus
Jejunum
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- After a partial gastrectomy or pyloroplasty, clinical manifestationsthat include increased
pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which
mechanism?
a. Anaphylactic reaction in which chemical mediators, such as histamine,
prostaglandins, and leukotrienes, relax vascularsmooth muscles, causing
shock.
b. Postoperative hemorrhage during which a large volume of blood is lost,
causing hypotension with compensatory tachycardia.
c. Concentrated bolusthat moves from the stomach into the small intestine,
causing hyperglycemia and resulting in polyuria and eventually
hypovolemic shock.
d. Rapid gastric emptying and the creation of a high osmotic gradient in the
small intestine, causing a sudden shift of fluid from the blood vessels to
the intestinal lumen.
D. Dumping syndrome occurs with varying severity in 5% to 10% of individuals
who have undergone partial gastrectomy or pyloroplasty. Rapid gastric
emptying and the creation of a high osmotic gradient in the small intestine cause a
sudden shift of fluid from the vascular compartment to the intestinal
lumen. Plasma volume decreases, causing vasomotor responses, such as
increased pulse rate, hypotension, weakness, pallor, sweating, and dizziness.
Rapid distention of the intestine produces a feeling of epigastric fullness,
cramping, nausea, vomiting, and diarrhea - Which statement is consistent with dumping syndrome?
a. Dumping syndrome usually responds well to dietary management.
b. It occurs 1 to 2 hours after eating.
c. Constipation is often a result of the dumping syndrome.
d. It can result in alkaline reflux gastritis.
Usually responds well to dietary management. - Which statement is false regarding the sources of increased ammonia that contribute to
hepatic encephalopathy?
a. End products of intestinal protein digestion are sources of increased
ammonia.
b. Digested blood leaking from ruptured varices is a source of increased
ammonia.
c. Accumulation ofshort-chain fatty acidsthat is attached to ammonia is a
source of increased ammonia.
d. Ammonia-forming bacteria in the colon are sources of increased
ammonia.
The accumulation of short-chain fatty acids, serotonin, tryptophan, and false
neurotransmitters probably contributesto neural derangement and is not
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NURS 611 EXAM 3 PATHO ACTUAL EXAM 2023-2024 COMPLETE 100
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+ (MARYVILLE UNIVERSITY)
- What are clinical manifestations of hypothyroidism?
a. Intolerance to heat, tachycardia, and weight loss
b. Oligomenorrhea, fatigue, and warm skin
c. Restlessness, increased appetite, and metrorrhagia
d. Constipation, decreased heat rate, and lethargy
The lower levels of thyroid hormone result in decreased energy metabolism, resulting
in constipation, bradycardia, and lethargy, thus eliminating the remaining options. - Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone (TH) and is
inhibited when plasma levels of TH are adequate. This is an example of:
a. Positive feedback
b. Neural regulation
c. Negative feedback
d. Physiologic regulation
Negative feedback. Feedback systems provide precise monitoring and control of the
cellular environment. Negative feedback occurs because the changing chemical, neural,
or endocrine response to a stimulus negates the initiating change that triggered the
release of the hormone. Thyrotropin-releasing hormone (TRH) from the hypothalamus
stimulates TSH secretion from the anterior pituitary. Secretion of TSH stimulates the
synthesis and secretion of THs. Increasing levels of T4 and triiodothyronine (T3) then
generate negative feedback on the pituitary and hypothalamus to inhibit TRH and TSH
synthesis. - Lipid-soluble hormone receptors are located:
a. Inside the plasma membrane in the cytoplasm
b. On the outer surface of the plasma membrane
c. Inside the mitochondria
d. On the inner surface of the plasma membrane
Inside the plasma membrane in the cytoplasm. Lipid-soluble hormone receptors are
located inside the plasma membrane and easily diffuse across the plasma membrane to
bind to either cytosolic or nuclear receptors. - The releasing hormones that are made in the hypothalamustravel to the anterior
pituitary via the:
a. Vessels of the zona fasciculata
b. Hypophysealstalk
c. Infundibular stem
d. Portal hypophyseal blood vessels
Portal hypophyseal blood vessels. Releasing and inhibitory hormones are synthesized in
the hypothalamus and are secreted into the portal blood vessels through which they
travel to the anterior pituitary hormones. - Which mineral is needed for thyroid-stimulating hormone (TSH) to stimulate the
secretion of thyroid hormone (TH)?
2
a. Iron
b. Iodide
c. Zinc
3
d. Copper
Iodide. TSH, which is synthesized and stored in the anterior pituitary, stimulates
secretion of TH by activating intracellular processes, including the uptake of iodine
necessary for the synthesis of TH.
- What effect does hyperphosphatemia have on other electrolytes?
a. Increases serum calcium
b. Decreases serum magnesium
c. Decreases serum calcium
d. Increases serum magnesium
Decreases serum calcium. Hyperphosphatemia leadsto hypocalcemia. Remember that
phos and calcium are inversely related. - Insulin transports which electrolyte in the cell?
a. Potassium
b. Sodium
c. Calcium
d. Phosphorus
Potassium. Insulin facilitatesthe intracellular transport of potassium, phosphate, and
magnesium. - Which second messenger is stimulated by epinephrine binding to a β-adrenergic
receptor?
a. Calcium
b. Inositol triphosphate (IP3)
c. Diacylglycerol (DAG)
d. Cyclic adenosine monophosphate (cAMP)
Cyclic adenosine monophosphate (cAMP). Second-messenger molecules are the initial
link between the first signal (hormone) and the inside of the cell. For example, the
binding of epinephrine to a β adrenergic–receptor subtype activates (through a
stimulatory G protein) the enzyme, adenylyl cyclase. Adenylyl cyclase catalyzes the
conversion of adenosine triphosphate (ATP) to the second messenger, 3′, and 5′-cAMP. - Regulation of the release of catecholamines from the adrenal medulla is an example of
which type of regulation?
a. Negative feedback
b. Neural
c. Positive feedback
d. Physiologic
Neural. The release of hormones occurs either in response to an alteration in the cellular
environment or in the process of maintaining a regulated level of certain hormones or certain
substances. Several different mechanisms, one of which is neural control (e.g., stress-induced
release of catecholamines from the adrenal medulla), regulate the release of hormones. - Which hormone doesthe second messenger calcium (Ca++) bind to activate
phospholipase C through a G protein?
a. Angiotensin II
b. Estrogen
c. Thyroxine
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d. Testosterone
Angiotensin II. Ca++ is considered an important second messenger that facilitates the
binding of a hormone (e.g., norepinephrine, angiotensin II) to a surface receptor,
activating the enzyme phospholipase C through a G protein inside the plasma
membrane.
- The control of calcium in cells is important because it:
a. Is controlled by the calcium negative-feedback loop.
b. Is continuously synthesized.
c. Acts as a second messenger.
d. Carries lipid-soluble hormones in the bloodstream.
Acts as a second messenger. In addition to being an important ion that participates in a
multitude of cellular actions, Ca++ is considered an important second messenger. - Where is antidiuretic hormone (ADH) synthesized, and where does it act?
a. Hypothalamus; renal tubular cells
b. Anterior pituitary; posterior pituitary
c. Renal tubules; renal collecting ducts
d. Posterior pituitary; loop of Henle
Hypothalamus; renal tubular cells. Once synthesized in the hypothalamus, ADH acts on
the vasopressin 2 (V2) receptors of the renal duct cells to increase their permeability. - How does a faulty negative-feedback mechanism result in a hormonal imbalance?
a. Hormones are not synthesized in response to cellular and tissue activities.
b. Decreased hormonal secretion is a response to rising hormone levels.
c. Too little hormone production isinitiated.
d. Excessive hormone production results from a failure to turn of the system.
Excessive hormone production results from a failure to turn off the system. Negativefeedback systems are important in maintaining hormones within physiologic ranges. The
lack of negative-feedback inhibition on hormonal release often results in pathologic
conditions. Excessive hormone production, which is the result of the failure to turn of
the system, can cause various hormonal imbalances and related conditions. - A deficiency of which chemical may result in hypothyroidism?
a. Iron
b. Zinc
c. Iodine
d. Magnesium
Zinc. The only cause of hypothyroidism from among the provided options is a deficiency
of endemic iodine. - What imbalance lessensthe rate of secretion of parathyroid hormone
a. Increased serum calcium levels
b. Decreased serum magnesium levels
c. Decreased levels of thyroid-stimulating hormone
d. Increased levels of thyroid-stimulating hormone
The overall effect of parathyroid hormone (PTH)isto increase serum calcium and to
decrease serum phosphate concentration. - Which condition may result from pressure exerted by a pituitary tumor?
NURS 611 EXAM 2 PATHO ACTUAL EXAM 2023-2024 COMPLETE 100
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+ (MARYVILLE UNIVERSITY)
- Review: the parasympathetic system is all about what?
Conserving energy, digesting, metabolism, and rest - The sympathetic nervoussystem primarily servesto protect an individual by doing which
of the following? (select all that apply)
A. Decreasing mucous production
B. Increasing blood sugar levels
C. Increasing body temperature
D. Decreasing sweat excretion
E. Increasing blood pressure
Increases blood sugar levels, increases body temperature, and increases blood pressure
In general, sympathetic stimulation promotes responses that are concerned with the
protection of the individual, which include increasing glucose, body temp, and BP. - Review: the sympathetic system is all about what?
It’s all about mobilizing energy stores, for instance glucose to muscles, decreased
release of insulin, redirects blood supply from the gut to the muscles, heart, and lungs. - Which characteristic isthe most critical index of nervoussystem dysfunction?
Level of consciousness
LOC is the most critical clinical index of nervous system function or dysfunction. An
alteration in consciousnessindicates either improvement or deterioration of a person’s
condition. - Thought and goal-oriented behaviors are functions of which area of the brain?
Prefrontal lobe
The prefrontal area is responsible for goal-oriented behavior such as the ability to
concentrate,short-term or recall memory, and the elaboration of thought and inhibition
on the limbic (emotional) areas of the CNS. - Where isthe region responsible for the motor aspects?
Broca area in the frontal lobe
Broca speech area is the only region responsible for the motor aspects of speech.
- Parkinson and Huntington diseases are associated with defects in which area of the
brain?
Basal ganglia - Maintenance of a constant internal environment and the implementation of behavioral
patterns are main functions of which area of the brain?
Hypothalamus
Hypothalamic function falls into 2 major areas: 1) maintenance of a constant internal
environment, and 2) implementation of behavioral patterns. - What parts of the brain mediate the expression of affect, both emotional and behavioral
states?
Limbic system and prefrontal cortex - Reflex activities concerned with heart rate, blood pressure, respirations,sneezing,
swallowing, and coughing are controlled by which area of the brain?
Medulla oblongata
The medulla oblongata makes up the myelencephalon and isthe lowest portion of the
brainstem. - Which area of the brain assumes the responsibility for conscious and unconscious
muscle synergy and for maintaining balance and posture?
Cerebellum - The brain receives approximately what percentage of the cardiac output?
20% or 800 to 1000 ml of blood flow per minute - What evidence does the nurse expect to see when a patient experiences trauma to the
hypothalamus? (select all that apply)
A. Uneven expression of mood
B. Unstable blood glucose levels
C. Poor regulation of body temperature
D. Visual disturbances such as blurred vision
E. N/V and symptoms of gastroesophageal reflux disease
Uneven expression of mood, unstable blood glucose levels, and poor temp regulation
NURS 611 EXAM 1 PATHO ACTUAL EXAM 2023-
2024 COMPLETE 100 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+
(MARYVILLE UNIVERSITY)
- It is true that a eukaryotic cell:
○ Is smaller than a prokaryotic cell.
○ Contains structures called organelles.
○ Lacks a well-defined nucleus.
○ Does not contain histones.
Eukaryotes are large, have membrane-bound intracellular compartments called organelles, has
a well defined nucleus, and have histones. - The function of a histone found in a eukaryote cell focuses on cellular:
○ Division
○ Movement
○ Activities
○ Deoxyribonucleic acid (DNA) folding
These proteins bind DNA and are involved in supercoiling of DNA. - An organelle that is responsible for the metabolism of cellular energy is referred to as
a/an:
○ Golgi complex
○ Mitochondrion
○ Endoplasmic reticulum
○ Nucleolus
Organelle found in large numbers and is responsible for cellular respiration and energy
production. Mitochondria contain their own DNA that codes for enzymes needed for oxidative
phosphorylation. - Which statement best describes a desmosome?
○ A desmosome is a barrier to diffusion.
○ Desmosomes hold cells together by continuous bands.
○ A desmosome is a communicating tunnel.
○ Desmosomes function as a zona occludens.
Desmosomes hold cells together by forming either continuous bands or belts of epithelial sheets
or button-like points of contact. Desmosomes also act as a system of braces to maintain
structural stability. - Which statement describes the function of a second messenger?
○ Extracellular ligand that binds with membrane-bound receptors
○ Intracellular enzyme that once will trigger a cascade of intracellular events
○ Chemical messenger that opens specific channels in the cell membrane
○ Chemical messenger that blocks a membrane-bound receptor signal
NURS 611 EXAM 1 PATHO ACTUAL EXAM AND
TEST BANK 2023-2024 COMPLETE 400
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY
GRADED A+ (MARYVILLE UNIVERSITY)
NURS 611 EXAM 1 PATHO ACTUAL EXAM
- It is true that a eukaryotic cell:
○ Is smaller than a prokaryotic cell.
○ Contains structures called organelles.
○ Lacks a well-defined nucleus.
○ Does not contain histones.
Eukaryotes are large, have membrane-bound intracellular compartments called organelles, has
a well defined nucleus, and have histones. - The function of a histone found in a eukaryote cell focuses on cellular:
○ Division
○ Movement
○ Activities
○ Deoxyribonucleic acid (DNA) folding
These proteins bind DNA and are involved in supercoiling of DNA. - An organelle that is responsible for the metabolism of cellular energy is referred to as
a/an:
○ Golgi complex
○ Mitochondrion
○ Endoplasmic reticulum
○ Nucleolus
Organelle found in large numbers and is responsible for cellular respiration and energy
production. Mitochondria contain their own DNA that codes for enzymes needed for oxidative
phosphorylation. - Which statement best describes a desmosome?
○ A desmosome is a barrier to diffusion.
○ Desmosomes hold cells together by continuous bands.
○ A desmosome is a communicating tunnel.
○ Desmosomes function as a zona occludens.
Desmosomes hold cells together by forming either continuous bands or belts of epithelial sheets
or button-like points of contact. Desmosomes also act as a system of braces to maintain
structural stability. - Which statement describes the function of a second messenger?
○ Extracellular ligand that binds with membrane-bound receptors
○ Intracellular enzyme that once will trigger a cascade of intracellular events
○ Chemical messenger that opens specific channels in the cell membrane
○ Chemical messenger that blocks a membrane-bound receptor signal
Transferring signal to an intracellular messenger, which in turn triggers a cascade of
biochemical events within the cell. Second messengers are generated in large numbers when
the membrane-bound enzyme is activated, and they then rapidly diffuse away from their source,
broadcasting the signal throughout the cell.
- Which statement is correct regarding cellular energy?
○ Glycolysis is the building of sugar molecules.
○ Oxidative cellular metabolism is a single reaction making adenosine triphosphate
(ATP).
○ Oxidative phosphorylation occurs in the mitochondria.
○ Anaerobic glycolysis occurs in the presence of oxygen.
Oxidative phosphorylation occurs in the mitochondria and is the mechanism by which the
energy produced from carbohydrates, fats, and proteins is transferred to ATP. - Movement of a solute molecule from an area of high concentration to an area of low
concentration is called:
○ Diffusion
○ Filtration
○ Osmosis
○ Hydrostatic pressure
Diffusion is the movement of a solute molecule from an area of greater solute concentration to
an area of lesser solute concentration. Filtration is the movement of water and solutes through
a membrane because of a greater pushing pressure on one side of the membrane than on the
other side. Hydrostatic pressure is the mechanical force of water against cellular membranes.
Osmosis is the movement of water “down” a concentration gradient, across a semipermeable
membrane from a region of higher water concentration to a region of lower water concentration. - Which of the following is an example of an energy-releasing process?
○ Anabolism
○ Catabolism
○ Substrate-induced reaction
○ Second messenger system
Catabolism is the energy-releasing process of cellular metabolism. Anabolism is the energyusing process of cellular metabolism. - Which of the following describes the term chemotaxis?
○ Uses the second messenger system
○ Cellular signal affecting the cell of origin
○ Movement of cells along a chemical gradient
○ Ligands bind with receptors, triggering a second reaction
NURS 611 EXAM 2 PATHO ACTUAL EXAM TEST BANK 2023-
2024 COMPLETE 200 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED A+
(MARYVILLE UNIVERSITY)
Where is the region responsible for the motor aspects?Broca area in the
frontal lobe. – ANSWER- Broca speech area is the only region
responsible for the motor aspects of speech.
Parkinson and Huntington diseases are associated with defects in which
area of the brain? – ANSWER- Basal ganglia
Maintenance of a constant internal environment and the implementation
of behavioral patterns are main functions of which area of the brain? –
ANSWER- Hypothalamus. Hypothalamic function falls into 2 major
areas: 1) maintenance of a constant internal environment, and 2)
implementation of behavioral patterns.
What parts of the brain mediate the expression of affect, both emotional
and behavioral states? – ANSWER- Limbic system and prefrontal cortex
Reflex activities concerned with heart rate, blood pressure, respirations,
sneezing, swallowing, and coughing are controlled by which area of the
brain? – ANSWER- Medulla oblongata. The medulla oblongata makes
up the myelencephalon and is the lowest portion of the brainstem.
Which area of the brain assumes the responsibility for conscious and
unconscious muscle synergy and for maintaining balance and posture? –
ANSWER- Cerebellum
The brain receives approximately what percentage of the cardiac output?
- ANSWER- 20% or 800 to 1000 ml of blood flow per minute
What evidence does the nurse expect to see when a patient experiences
trauma to the hypothalamus? (select all that apply) A. Uneven
expression of mood B. Unstable blood glucose levels C. Poor regulation
of body temperature D. Visual disturbances such as blurred vision E.
N/V and symptoms of gastroesophageal reflux disease – ANSWERUneven expression of mood, unstable blood glucose levels, and poor
temp regulation. The hypothalamus forms the base of the diencephalon.
Hypothalamic function controls autonomic nervous system function,
regulation of body temp, endocrine function (glucose levels), and
regulation of emotional expression.
What is the first defense of our bodies? – ANSWER- Skin and mucous
membranes
Which action is the purpose of the inflammatory process? – ANSWERTo prevent infection of the injured tissue. If the epithelial barrier is
damaged, then a highly efficient local and system response
(inflammation) is mobilized to limit the extent of damage, to protect
against infection, and to initiate the repair of damaged tissue.
What are the 4 cardinal signs of infection? – ANSWER- Edema (tumor),
warmth (calor), redness (rubor), and pain (dolar). There is a 5th sign
known as loss of function (functio laesa) but Dr. Wunderlich did not
mention this.
Which type of white blood cell is first to arrive at the site of infection? –
ANSWER- Leukocytes
Parasympathetic nervous system – ANSWER- Body system responsible
for conserving energy and body resources
Sympathetic nervous system (SNS) – ANSWER- Body system that
responds to stress by preparing the body to defend itself
how is blood flow redistributed by the sympathetic nervous system
(SNS) – ANSWER- blood flow to the muscles is increased while blood
flow to GI and integumentary is decreased
how are primary brain injuries classified – ANSWER- Focal or diffuse
(aka multifocal)
focal brain injuries – ANSWER- specific, grossly observable brain
lesions that occur in a precise location
Epidural and subdural hemorrhages
diffuse brain injuries – ANSWER- include brain injury due to hypoxia,
meningitis, encephalitis, and damage to blood vessels
The brain is confined in a limited space so increased pressure can cause
collateral dysfunction: Diabetes Insipidus (ADH not secreted thus
polyuria)
autonomic hyperreflexia – ANSWER- affected at the t5-t6 level or
above; characterized by paroxysmal HTN (up to 300 mmHg systolic), a
pounding headache, blurred vision, sweating above the level of the
lesion with flushing of the skin, nasal congestion, nausea, piloerection
caused by pilomotor spasm, and bradycardia (30-40 beats/min)
location of lesions in cases of autonomic hyperreflexia – ANSWERindividual most likely to be affected have lesions at the T5-T6 level or
above
sequence of events that lead to hyperreflexia induced bradycardia –
ANSWER- bradycardia (30-40bpm) is a sx of hyperreflexia
Stimulation of the carotid sinus –>vagus nerve –>sinoatrial (SA) node.
The intact ANS reflexively responds with an arteriolar spasm that
increases blood pressure. Baroreceptors in the cerebral vessels, the
carotid sinus, and the aorta sense the HTN and stimulate the PNS. The
heart rate decreases, but the visceral and peripheral vessels do not dilate
because efferent impulses cannot pass through the cord
Alzheimer’s disease – ANSWER- leading cause of dementia and one of
the most common causes of severe cognitive dysfunction in older adults
what are the greatest risk factors for Alzheimer’s disease – ANSWERage, family history
NURS 611 EXAM 3 PATHO 2 LATEST VERSIONS ACTUAL
EXAM TEST BANK 2023-2024 COMPLETE 250 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+ (MARYVILLE
UNIVERSITY)
VERSION A
when insulin binds its receptors on muscle cells, an increase in glucose uptake by
the muscle cells is the result. This is an example of what type of effect by a
hormone?
a.Pharmacologic
c.Synergistic
b.Permissive
d.Direct – ANSWER- D
Rationale: Direct effects are the obvious changes in cell function that specifically
result from the stimulation by a particular hormone. The other options are not used
to identify the described effect.
- Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone
(TH) and is inhibited when plasma levels of TH are adequate. This is an example
of:
a.Positive feedback
b.Negative feedback
c.Neural regulation
d.Physiologic regulation – ANSWER- B
Rationale: Feedback systems provide precise monitoring and control of the
cellular environment. Negative feedback occurs because the changing chemical,
neural, or endocrine response to a stimulus negates the initiating change that
triggered the release of the hormone. Thyrotropin-releasing hormone (TRH) from
the hypothalamus stimulates TSH secretion from the anterior pituitary. Secretion of
TSH stimulates the synthesis and secretion of THs. Increasing levels of T4 and
triiodothyronine (T3) then generate negative feedback on the pituitary and
hypothalamus to inhibit TRH and TSH synthesis. The described example is not
accurately identified by any of the other options.
Lipid-soluble hormone receptors are located:
a.Inside the plasma membrane in the cytoplasm
b.On the outer surface of the plasma membrane
c.Inside the mitochondria
d.On the inner surface of the plasma membrane – ANSWER- A
Rationale: Lipid-soluble hormone receptors are located inside the plasma
membrane and easily diffuse across the plasma membrane to bind to either
cytosolic or nuclear receptors. The other options are not true statements.
- Which second messenger is stimulated by epinephrine binding to a βadrenergic receptor?
a.Calcium
b.Inositol triphosphate (IP3)
c.Diacylglycerol (DAG)
d.Cyclic adenosine monophosphate (cAMP) – ANSWER- D
Rationale: Second-messenger molecules are the initial link between the first signal
(hormone) and the inside of the cell (see Table 21-3). For example, the binding of
epinephrine to a β adrenergic-receptor subtype activates (through a stimulatory G
protein) the enzyme, adenylyl cyclase. Adenylyl cyclase catalyzes the conversion
of adenosine triphosphate (ATP) to the second messenger, 3′, and 5′-cAMP. The
remaining messengers are not stimulated by epinephrine to bind as described.
Which hormone does the second messenger calcium (Ca++) bind to activate
phospholipase C through a G protein?
a.
Angiotensin II
c.
Estrogen
b.
Thyroxine
d.
Testosterone – ANSWER- A
Rationale: Ca++ is considered an important second messenger that facilitates the
binding of a hormone (e.g., norepinephrine, angiotensin II) to a surface receptor,
activating the enzyme phospholipase C through a G protein inside the plasma
membrane. None of the other options acts on its target cell via a second messenger.
The control of calcium in cells is important because it:
a.
Is controlled by the calcium negative-feedback loop.
b.
Is continuously synthesized.
c.
Acts as a second messenger.
d.
Carries lipid-soluble hormones in the bloodstream. – ANSWER- C
Rationale: In addition to being an important ion that participates in a multitude of
cellular actions, Ca++ is considered an important second messenger. The other
options are not true statements related to the control of calcium within the cells.
The portion of the pituitary that secretes oxytocin is:
a.
Posterior
c.
Anterior
b.
Inferior
d.
Superior – ANSWER- A
Rationale: Only the posterior pituitary secretes oxytocin.
Antidiuretic hormone acts to cause vasoconstriction when:
a.
Urine output is less than 20 ml/hr.
b.
Serum osmolality is increased.
c.
Osmotic and oncotic pressures are increased.
d.
Vasopressin is pharmacologically administered. – ANSWER- D
Rationale: ADH was originally named vasopressin because, in extremely high
doses, it causes vasoconstriction and a resulting increase in arterial blood pressure.
However, significant vasoconstriction may only be achieved pharmacologically.
Antidiuretic hormone induced vasoconstriction is not a result of the other options.
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NURS 611 EXAM 4 PATHO ACTUAL EXAM AND REAL EXAM
TEST BANK 2023-2024 COMPLETE 300 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+ (MARYVILLE
UNIVERSITY)
- Exposure to which substance protectsthe mucosal barrier of the stomach?
a. Prostaglandins
b. Helicobacter pylori
c. Aspirin
d. Regurgitated bile
Prostaglandins. Prostaglandins and enterogastrones,such as gastric inhibitory
peptide, somatostatin, and secretin, inhibit acid secretion. - Glucose transport enhancesthe absorption of which electrolyte?
a. Sodium
b. Potassium
c. Phosphate
d. Chloride
Sodium. Sodium passes through the tight junctions and is actively transported
across cell membranes. Sodium and glucose share a common active transport
carrier (sodium-glucose ligand transporter 1 [SGLT1]). - What isthe cause of gastroesophageal reflux disease?
a. Excessive production of hydrochloric acid
b. Zone of low pressure of the lower esophageal sphincter
c. Presence of Helicobacter pylori in the esophagus
d. Reverse muscular peristalsis of the esophagus
Zone of low pressure of the lower esophageal sphincter. Normally, the resting
tone of the lower esophageal sphincter maintains a zone of high pressure that
prevents gastroesophageal reflux. In individuals who develop reflux esophagitis,
this pressure tendsto be lower than normal from either transient relaxation or a
weakness of the sphincter. - By what mechanism doesintussusception cause an intestinal obstruction?
a. Telescoping of part of the intestine into anothersection of intestine,
usually causing strangulation of the blood supply
b. Twisting the intestine on its mesenteric pedicle, causing occlusion of the
blood supply
c. Loss of peristaltic motor activity in the intestine, causing an adynamic ileus
d. Forming fibrin and scartissue that attach to the intestinal omentum,
causing obstruction
A. Intussusception is the telescoping of part of the intestine into another section
of intestine, usually causing strangulation of the blood supply.
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- What isthe most immediate result of a small intestinal obstruction?
a. Vomiting
b. Electrolyte imbalances
c. Dehydration
d. Distention
Distention begins almost immediately, as gases and fluids accumulate proximal
to the obstruction. Within 24 hours, up to 8 L of fluid and electrolytes
enters the lumen in the form of saliva, gastric juice, bile, pancreatic juice, and
intestinal secretions. Copious vomiting or sequestration of fluids in the
intestinal lumen preventstheir reabsorption and producessevere fluid and
electrolyte disturbances. - An intestinal obstruction at the pylorus or high in the small intestine causes metabolic
alkalosis by causing which outcome?
a. Gain of bicarbonate from pancreatic secretionsthat cannot be absorbed
b. Excessive loss of hydrogen ions normally absorbed from gastric juices
c. Excessive loss of potassium, promoting atony of the intestinal wall
d. Loss of bile acid secretions that cannot be absorbed
Excessive loss of hydrogen ions. If the obstruction is at the pylorus or high in the
small intestine, then metabolic alkalosisinitially develops as a result of
excessive loss of hydrogen ionsthat normally would be reabsorbed from the
gastric juices. - What are the cardinalsymptoms ofsmall intestinal obstruction?
a. Constant, dull pain in the lower abdomen relieved by defecation
b. Acute, intermittent pain 30 minutesto 2 hours after eating
c. Colicky pain caused by distention, followed by vomiting
d. Excruciating pain in the hypogastric area caused by ischemia
Colicky pain caused by distention followed by vomiting. - What isthe primary cause of peptic ulcers?
a. Hypersecretion of gastric acid
b. Helicobacter pylori
c. Hyposecretion of pepsin
d. Escherichia coli
Helicobacter pylori. - A peptic ulcer may occur in all of the following areas except the:
a. Stomach
b. Jejunum
c. Duodenum
d. Esophagus
Jejunum
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- After a partial gastrectomy or pyloroplasty, clinical manifestationsthat include increased
pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which
mechanism?
a. Anaphylactic reaction in which chemical mediators, such as histamine,
prostaglandins, and leukotrienes, relax vascularsmooth muscles, causing
shock.
b. Postoperative hemorrhage during which a large volume of blood is lost,
causing hypotension with compensatory tachycardia.
c. Concentrated bolusthat movesfrom the stomach into the small intestine,
causing hyperglycemia and resulting in polyuria and eventually
hypovolemic shock.
d. Rapid gastric emptying and the creation of a high osmotic gradient in the
small intestine, causing a sudden shift of fluid from the blood vessels to
the intestinal lumen.
D. Dumping syndrome occurs with varying severity in 5% to 10% of individuals
who have undergone partial gastrectomy or pyloroplasty. Rapid gastric
emptying and the creation of a high osmotic gradient in the small intestine cause a
sudden shift of fluid from the vascular compartment to the intestinal
lumen. Plasma volume decreases, causing vasomotor responses, such as
increased pulse rate, hypotension, weakness, pallor, sweating, and dizziness.
Rapid distention of the intestine produces a feeling of epigastric fullness,
cramping, nausea, vomiting, and diarrhea - Which statement is consistent with dumping syndrome?
a. Dumping syndrome usually responds well to dietary management.
b. It occurs 1 to 2 hours after eating.
c. Constipation is often a result of the dumping syndrome.
d. It can result in alkaline reflux gastritis.
Usually responds well to dietary management. - Which statement isfalse regarding the sources of increased ammonia that contribute to
hepatic encephalopathy?
a. End products of intestinal protein digestion are sources of increased
ammonia.
b. Digested blood leaking from ruptured varicesis a source of increased
ammonia.
c. Accumulation ofshort-chain fatty acidsthat is attached to ammonia is a
source of increased ammonia.
d. Ammonia-forming bacteria in the colon are sources of increased
ammonia.
The accumulation of short-chain fatty acids, serotonin, tryptophan, and false
neurotransmitters probably contributesto neural derangement and is not
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associated with ammonia levels. The other options provide accurate
information regarding how the sources of ammonia contribute to hepatic
encephalopathy.
- Which statement isfalse regarding the pathophysiologic process of acute pancreatitis?
a. Bile duct or pancreatic duct obstruction blocksthe outflow of pancreatic
digestive enzymes.
b. Acute pancreatitis can also result from direct cellular injury from drugs or
viral infection.
c. Acute pancreatitisis an autoimmune disease in which immunoglobulin G
(IgG) coats the pancreatic acinar cells; consequently, the pancreatic
enzymes destroy the cells.
d. Acute pancreatitisis usually mild and spontaneously resolves.
The false answer is C. The backup of pancreatic secretions and the activation and
release of enzymes (activated trypsin activates chymotrypsin, lipase, and
elastase) within the pancreatic acinar cells cause acute pancreatitis, an
obstructive disease. The activated enzymes cause autodigestion
(e.g., proteolysis, lipolysis) of the pancreatic cells and tissues, resulting
in inflammation. Acute pancreatitis is usually a mild disease and
spontaneously resolves; however, approximately 20% of those with the
disease develop a severe acute pancreatitis that requires hospitalization.
Pancreatitis develops because of a blockage to the outflow of pancreatic
digestive enzymes caused by bile duct or pancreatic duct obstruction (e.g.,
gallstones). Acute pancreatitis can also result from direct cellular injury from
drugs or viral infection. - Obesity is defined as a body mass index (BMI) greater than what measurement?
a. 22
b. 28
c. 25
d. 30
Obesity is an energy imbalance, with caloric intake exceeding energy
expenditure, and is defined as a BMI greater than 30. - Which are the early (prodromal) clinical manifestations of hepatitis? (Select all that
apply.)
a. Fatigue
b. Vomiting
c. Itching
d. Splenomegaly
e. Hyperalgia
A, B, E. The prodromal (preicteric) phase of hepatitis begins approximately 2
weeks after exposure and ends with the appearance of jaundice. Fatigue,