NURS 611 EXAM 1 ,2,3 & 4 PATHO ACTUAL EXAM 2023-2024 COMPLETE EACH EXAM CONTAINS 100 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED A+ (MARYVILLE UNIVERSITY)

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NURS 611 EXAM 4 PATHO ACTUAL EXAM 2023-2024
COMPLETE 100 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES|ALREADY GRADED A+
(MARYVILLE UNIVERSITY)

1. 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.
2. 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]).
3. 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.
4. 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.

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5. 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.
6. 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.
7. 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.
8. 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.
9. 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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10. 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
11. 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.
12. 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)

1. 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.
2. 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.
3. 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.
4. 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.
5. Which mineral is needed for thyroid-stimulating hormone (TSH) to stimulate the
   secretion of thyroid hormone (TH)?

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a. Iron
b. Iodide
c. Zinc

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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.

6. 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.
7. 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.
8. 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.
9. 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.
10. 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.

11. 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.
12. 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.
13. 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.
14. 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.
15. 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.
16. 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)

1. Review: the parasympathetic system is all about what?
   Conserving energy, digesting, metabolism, and rest
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.

7. Parkinson and Huntington diseases are associated with defects in which area of the
   brain?
   Basal ganglia
8. 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.
9. What parts of the brain mediate the expression of affect, both emotional and behavioral
   states?
   Limbic system and prefrontal cortex
10. 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.
11. Which area of the brain assumes the responsibility for conscious and unconscious
    muscle synergy and for maintaining balance and posture?
    Cerebellum
12. The brain receives approximately what percentage of the cardiac output?
    20% or 800 to 1000 ml of blood flow per minute
13. 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)

1. 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.
2. 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.
3. 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.
4. 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.
5. 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