NUR612 Pathophysiology Final Exam McCance & Huether 8th Edition (646 Questions with Answer | Exams Pathophysiology | Docsity (2024)

Download NUR612 Pathophysiology Final Exam McCance & Huether 8th Edition (646 Questions with Answer and more Exams Pathophysiology in PDF only on Docsity! NUR612 Pathophysiology Final Exam McCance & Huether 8th Edition (646 Questions with Answers and Rationales). It is true that a eukaryotic cell A. is smaller than a prokaryotic cell. B. contains structures called organelles. C. lacks a well-defined nucleus. D. does not contain histones. - Verified Answer B. Contains structures called organelles. Eukaryotic cells contain organelles and histones, they have a well-defined nucleus, and are larger than prokaryotic cells. Ch01.1 The function of a histone found in a eukaryote cell focuses on cellular A. division. B. movement. C. activities. D. deoxyribonucleic acid (DNA) folding. - Verified Answer D. deoxyribonucleic acid (DNA) folding. The histones are binding proteins that cause the supercoiling of DNA into chromosomes and do not affect cellular division, movement, or activities. Ch01.2 An organelle that is responsible for the metabolism of cellular energy is referred to as a/an A. Golgi complex. B. mitochondrion. C. endoplasmic reticulum. D. nucleolus. - Verified Answer B. mitochondrion Mitochondria play a role in cellular metabolism, cellular respiration, and energy production. The Golgi complex is responsible for processing and packaging proteins from the endoplasmic reticulum, where they are synthesized. The nucleolus is a small, dense structure that contains the ribonucleic acid (RNA), DNA, and DNA-binding proteins. Ch01.3 Which statement best describes a desmosome? A. A desmosome is a barrier to diffusion. B. Desmosomes hold cells together by continuous bands. C. A desmosome is a communicating tunnel. D. Desmosomes function as a zona occludens. - Verified Answer B. Desmosomes hold cells together by continuous bands. The desmosome is a type of cell junction. The other two types include tight junctions and gap junctions. Desmosomes hold cells together by forming a continuous band of epithelial tissue or belt (or button-like) points of contact. They are also a source of structural stability. Tight junctions serve as barriers to diffusion and prevent the movement of substances through transport proteins. Gap junctions are clusters of communicating tunnels. Ch01.4 Which statement describes the function of a second messenger? A. Binds with membrane-bound receptors via a ligand B. Triggers a cascade of intracellular events C. Opens specific channels in the cell membrane D. Blocks a membrane-bound receptor signal - Verified Answer B. Triggers a cascade of intracellular events The binding of a ligand to a cell surface receptor triggers the activation of intracellular second messengers. Second messengers activate signal transduction pathways in the cell that can initiate different intracellular events. Cyclic adenosine monophosphate (cAMP) and calcium (Ca++) are the two major second-messenger pathways. First messengers are the extracellular ligands that bind to cell surface receptors. Binding of first messengers can result in the opening or closing of specific cell membrane channels or the activation of second messengers. Ch01.5 the signal so that it influences several processes in parallel. The signal can diverge, not converge, and be relayed to several different intracellular targets. Ch01.10 Which are functions of a protein? (Select all that apply.) A. Pores or transport channels B. Enzymes that drive pumps C. Cell surface markers D. Synapses for cells - Verified Answer A. Pores or transport channels B. Enzymes that drive pumps C. Cell surface markers Proteins may act as transport channels, pores, cell surface markers, enzymes that drive pumps, catalysts, and cell adhesion molecules (CAMs), or they may act as the key components of ATP synthesis. Synapses are the connections between two nerve cells Ch01.11 Ribosomes are nucleoproteins that A. are synthesized in the mitochondria and secreted into the cytosol. B. are synthesized in the cytoplasm. C. consist of a network of cisternae. D. synthesize a signal recognition sequence. - Verified Answer D. synthesize a signal recognition sequence. Ch1.1PPT Structure and Function of Cellular Components of Eukaryotic Cell The plasma membrane of a cell is A. permeable to water soluble molecules' movement into the cell. B. composed primarily of amphipathic molecules. C. dimpled because of peripheral membrane proteins. D. impermeable to lipid-soluble molecule - Verified Answer B. composed primarily of amphipathic molecules Ch1.2PPT Structure and Function of Cellular Components of Eukaryotic Cell Which information is correct regarding neurotransmitters? A. Act on the cells that produce and secrete them. B. Act on nearby cells that also take them up and destroy them. C. Are produced by neurosecretory neurons and transmitted via the blood. D. Diffuse across the synaptic cleft and act on postsynaptic target cel - Verified Answer D. Diffuse across the synaptic cleft and act on postsynaptic target cell Ch1.3PPT Cellular Communication A nurse knows that active transport requires A. receptors capable of recognizing and binding with specific molecules. B. a hydrostatic pressure gradient between intracellular and extracellular regions. C. a molecule bound to a ligand that moves the substance down the gradient. D. the presence of pores in the cell membrane with no energy expenditure. - Verified Answer A. receptors capable of recognizing and binding with specific molecules. Ch1.4PPT Membrane Transport: Cellular Intake and Output A nurse recalls depolarization occurs when the A. Cell is more negatively charged and its polarity is negative. B. sodium-potassium (Na+/K+) pump removes sodium from the cell. C. voltage-regulated channels open and Na+ enters the cell. D. Cell decreases by 25-30 millivolts and reaches threshold - Verified Answer C. voltage-regulated channels open and Na+ enters the cell. Ch1.5PPT Movement of Electrical Impulses What is a collection of blood that is located between the skull and the dura is called? A. Epidural hematoma B. Contusion C. Subdural hematoma D. Subarachnoid hemorrhage - Verified Answer A. Epidural hematoma Epidural hematomas are a collection of blood between the inner surface of the skull and the dura. A contusion is a bruise or bleeding into the skin and underlying tissue. A subdural hematoma is a collection of blood between the inner surface of the dura and the surface of the brain. Subarachnoid hemorrhage is a condition in which a cerebral arterial aneurysm ruptures. Ch02.1 The possible diagnosis of shaken baby syndrome is supported when an infant brought to the emergency department is found to have which type of cerebral hematoma? A. Epidural B. Subdural C. Subarachnoid D. Avulsion - Verified Answer B. Subdural A subdural hematoma is associated with blows, falls, or sudden acceleration or deceleration of the head, such as the sudden movements that occur with shaken baby syndrome. Epidural hematomas are the result of a torn artery, often associated with a skull fracture. Subarachnoid hemorrhage is a condition in which a cerebral arterial aneurysm has ruptured. An avulsion is a tear or rip in the skin, resulting when tensile strength of skin or tissue is exceeded. Ch02.2 Which term describes a tear or rip of the skin with a jagged and irregular edge? A. Abrasion B. Incision C. Laceration D. Incised wound - Verified Answer C. Laceration Lacerations occur when the tensile strength of the skin is exceeded, resulting in ragged and irregular abraded edges; an extreme example is A. Antioxidants B. Chemical agents C. Hypoxia D. Mechanical factors - Verified Answer B. Chemical agents C. Hypoxia D. Mechanical factors Injury to cells may be caused by chemical agents, hypoxia, free radicals, infectious agents, physical and mechanical factors, immunologic reactions, genetic factors, and nutritional imbalances. Antioxidants block the synthesis of free radicals. Ch02.8 Which are the most common risks of lead exposure in children? (Select all that apply.) A. Slowed growth B. Psychosis C. Reduced IQ D. Attention-deficit/hyperactivity disorder (ADHD) - Verified Answer A. Slowed growth C. Reduced IQ D. Attention-deficit/hyperactivity disorder (ADHD) Children exposed to lead in the home are at increased risk of damage to the brain and nervous system, slowed growth and development, learning and behavior problems, and hearing and speech problems. Specifically, these risks include reduced IQ, ADHD, juvenile delinquency, and criminal behavior. Psychosis is not a common risk of lead exposure in children. Ch02.9 Which statements are true regarding apoptosis? (Select all that apply.) A. An active process of cellular self-destruction B. A process that deletes cells during embryonic development C. Local cell death after severe and sudden injury D. Causes cell loss in proliferating cell populations - Verified Answer A. An active process of cellular self-destruction B. A process that deletes cells during embryonic development D. Causes cell loss in proliferating cell populations Apoptosis is programmed cell death. It is an active process of cellular self- destruction that is implicated in normal embryonic development, as well as in rapidly proliferating cancer cells. Necrosis is accidental cell death that occurs to local cells after a severe and sudden injury. Ch02.10 Which of the following statements is correct regarding pathologic hyperplasia? A. Produces abnormal proliferation of abnormal cells. B. Is an adaptive mechanism that enables organ regeneration. C. Increases cell size. D. May occur in response to growth factors - Verified Answer D. May occur in response to growth factors Ch2.1PPT Cellular Adaptation A nurse knows that free radicals may be produced by A. protein peroxidation. B. metabolism of exogenous chemicals or drugs. C. spontaneous decay of superoxide. D. vitamins E and C supplements. - Verified Answer B. metabolism of exogenous chemicals or drugs. Ch2.2 Cellular Injury Which of the following is true about alcohol (ethanol)? A. Is metabolized via the microsomal P-450. B. Is primarily metabolized and excreted by the kidneys. C. Increases activation of methionine, an essential amino acid. D. Can produce hypermagnesemia with chronic use - Verified Answer A. Is metabolized via the microsomal P-450 Ch2.3PPT Cellular Injury A nurse remembers that aging is associated with A. reduced cross-linking of collagen. B. reduced degradation of collagen. C. increased cross-linking of collagen. D. increased collagen synthesis. - Verified Answer C. increased cross- linking of collagen. Ch2.4PPT Aging and Altered Cellular and Tissue Biology A person with hypertension and heart failure has edema in the lower legs and sacral area. The nurse suspects this condition is due to a(n) A. increase in plasma oncotic pressure. B. decrease in capillary hydrostatic pressure. C. decrease in lymph obstruction pressure. D. increase in capillary hydrostatic pressure - Verified Answer D. increase in capillary hydrostatic pressure Ch2.5 Alterations in Water Movement A person reports severe diarrhea for 2 days. The nurse understands this stimulates a(n) A. reduction in aldosterone secretion. B. reduction in renin secretion. C. increase in antidiuretic hormone secretion. D. increase in natriuretic peptide secretion - Verified Answer C. increase in antidiuretic hormone secretion. Ch2.6PPT Water Balance A person arrives in the emergency department after a loss of consciousness and the development of Kussmaul respirations. The individual has a history of diabetes and 2 days of vomiting and diarrhea. The nurse suspects the person has which of the following primary disorders? A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic alkalosis D. Metabolic acidosis - Verified Answer D. Metabolic acidosis D. Hypernatremia causes cellular swelling. - Verified Answer C. Hypotonic fluid causes cellular swelling. Hypotonic extracellular fluid (ECF) causes intracellular water gain and swelling. When the ECF is hypotonic, water moves from the intravascular space to the interstitial space, across the cell membrane, and into the cell. This action causes the cell to swell. An isotonic solution is equal to the plasma in concentration of solute molecules. Therefore no net water will move because equilibrium exists. The cell size is unchanged. A hypertonic fluid has excessive solute; therefore water will leave the cell and move into the vascular space to help balance this excess. Water leaving the cell results in cell shrinkage. Hypernatremia can occur with an acute gain in sodium or a loss of water, but generally it does not cause cellular swelling. Ch03.1 Which statement is true regarding hyperchloremia? A. Occurs with a deficit of sodium B. Occurs with an excess of bicarbonate C. Has specific symptoms such as thirst D. Requires treatment of the underlying disorder - Verified Answer D. Requires treatment of the underlying disorder. Hyperchloremia (too much chloride) is usually related to an underlying disorder, and therefore treatment is centered on the underlying disorder. Because chloride usually follows sodium, this condition usually occurs with an increase in sodium and a deficit of bicarbonate. Normally, neither specific symptoms are observed nor treatments are available for chloride excess. Ch03.2 Which statement is true regarding hyponatremia? A. Is commonly caused by inadequate sodium intake B. Can occur with a decrease in total body water (TBW) C. Never occurs with burns, vomiting, or diarrhea D. Occurs when sodium drops below 135 mEq/L - Verified Answer D. Occurs when sodium drops below 135 mEq/L Hyponatremia occurs when the serum sodium drops below 135 mEq/L. It is the most common electrolyte disorder in individuals who are hospitalized. Although inadequate sodium intake can cause hyponatremia, it is uncommon. It can also occur with an increase in TBW or as a result of burns, vomiting, diarrhea, or gastrointestinal suctioning. Ch03.3 Which statement is true regarding potassium balance? A. Potassium is the major extracellular electrolyte. B. During acidosis, potassium shifts into the cell. C. Aldosterone is secreted when potassium is decreased. D. Insulin causes the movement of potassium into the cell. - Verified Answer D. Insulin causes the movement of potassium into the cell. Insulin causes movement of potassium into the cell and is one of the treatments for hyperkalemia. Potassium balance is especially significant in the treatment of conditions requiring insulin administration, such as insulin- dependent diabetes mellitus (type 1). Potassium is the major intracellular electrolyte and maintains the osmotic balance of the intracellular fluid (ICF) space. During acidosis, potassium is shifted out of the cell in exchange for hydrogen ions. Aldosterone is secreted when potassium is elevated, resulting in the excretion of potassium by the kidneys. Ch03.4 Which statement is true regarding hypokalemia? A. Hypokalemia occurs when the serum level is below 45 mEq/L. B. One cause of hypokalemia is diabetic ketoacidosis. C. Dietary causes of hypokalemia are common. D. Diuretics do not cause hypokalemia. - Verified Answer B. One cause of hypokalemia is diabetic ketoacidosis. Hypokalemia is low potassium. Therefore hypokalemia is defined as a serum level less than 3.5 mEq/L. It is often caused by diuretics. Diabetic ketoacidosis does cause hypokalemia. Potassium is shifted out of the cell in exchange for hydrogen and then excreted. The serum level may remain within a normal range, but then when insulin is administered, potassium is shifted back into the cells and a deficit occurs. Potassium balance is especially significant in the treatment of conditions requiring insulin administration, such as insulin-dependent diabetes mellitus (type 1). Dietary causes are uncommon. Ch03.5 Hypernatremia is defined as levels above A. 145 mEq/L B. 5.0 mEq/L C. 105 mEq/L D. 9.0 mg/dL - Verified Answer A. 145 mEq/L Hypernatremia is defined as serum levels above 145 mEq/L. Hyperkalemia is defined as serum levels above 5.0 mEq/L, and hyperchloremia is defined as serum levels above 105 mEq/L. Hypocalcemia occurs when serum calcium concentrations are less than 9.0 mg/dL. Ch03.6 Which statement is true regarding magnesium? A. Hypomagnesemia occurs with a concentration greater than 2.5 mEq/L. B. Magnesium is a major extracellular cation. C. Thirty percent is stored in the muscle and bone. D. Symptoms of hypomagnesemia include weakness and depression. - Verified Answer D. Symptoms of hypomagnesemia include weakness and depression. Symptoms of low magnesium include weakness, tetany, increased reflexes, depression, ataxia, convulsions, and irritability. Magnesium level is normal when between 1.5 and 3.0 mEq/L and is a major intracellular cation. Thirty percent is stored in the cells, with 40% to 60% stored in the bones and muscle. Ch03.7 Which statement describes acidemia? A. State in which the pH of arterial blood is greater than 7.45 B. State in which the pH of arterial blood is less than 7.35 C. Systemic decrease in hydrogen ion concentration D. Systemic excess of base - Verified Answer B. State in which the pH of arterial blood is less than 7.35 of DNA that was proposed by Watson-Crick. A codon is a triplet of amino acids. Ch04.1 Which statement is true regarding termination codons? A. Eighty codons are possible. B. Three codons signal the end of a gene. C. Seventy codons specify amino acids. D. Each amino acid has one codon. - Verified Answer B. Three codons signal the end of a gene. Three codons signal the end of a gene, and they are called stop or nonsense codons. Ch04.2 Which statement describes the function of DNA polymerase? A. Synthesizes ribonucleic acid (RNA) from the DNA template B. Synthesizes a polypeptide C. Performs base pairing in replication D. Splits DNA molecules - Verified Answer C. Performs base pairing in replication The function of DNA polymerase is to assist with base pairing when replicating DNA. This enzyme travels along the single DNA strand, adding the correct nucleotides to the free end of the new strand. It also proofreads. Transcription is the synthesis of RNA from DNA. Translation is the formation of a polypeptide from RNA. DNA polymerase does not split DNA molecules. Ch04.3 Which statement is true regarding base pairs? A. Adenine pairs with guanine. B. Guanine pairs with thymine. C. Cytosine pairs with adenine. D. Uracil pairs with adenine. - Verified Answer D. Uracil pairs with adenine. Uracil is structurally similar to thymine. Therefore the correct base pairs are adenine with thymine, guanine with cytosine, and uracil with adenine. Ch04.4 Which term describes the sequence for the beginning of a gene? A. Intron B. Exon C. Promoter site D. Anticodon - Verified Answer C. Promoter site Transcription of a gene begins when an enzyme called RNA polymerase binds to a promoter site on the DNA. A promoter site is a sequence of DNA that specifies the beginning of a gene. Many of the RNA sequences are removed, and the remaining sequences are spliced together to form the functional messenger RNA (mRNA) that will migrate to the cytoplasm. The excised sequences are called introns, and the sequences that are left to code for proteins are called exons. The anticodon is the sequence of three nucleotides that undergo complementary base pairing in translation. Ch04.5 Which statement is true regarding chromosomes? A. There are three cell types. B. The somatic cells contain 46 chromosomes. C. Gametes are diploid cells. D. Diploid cells are formed through meiosis. - Verified Answer B. The somatic cells contain 46 chromosomes. There are two cell types: somatic and gametes. Somatic cells are those that are not gametes (sperm and eggs). They have 46 chromosomes in the nucleus. These are also considered diploid cells. The gametes are haploid cells and have only 23 chromosomes. They are formed from diploid cells through meiosis. Ch04.6 Which term describes a cell that does not contain a multiple of 23 chromosomes? A. Aneuploid B. Monosomy C. Trisomy D. Tetraploidy - Verified Answer A. Aneuploid The term aneuploid means that the cell does not contain a multiple of 23 chromosomes. Monosomy is the presence of only one copy of a given chromosome in a cell. Trisomy is the presence of three copies of a chromosome. Tetraploidy is a cell that contains 92 chromosomes. Ch04.7 Which term describes an allele with an observable effect? A. hom*ozygous B. Heterozygous C. Dominant D. Recessive - Verified Answer C. Dominant Dominant alleles have effects that are observable. hom*ozygous is when two alleles at a locus are identical. Heterozygous is when the two alleles at a locus are different. Recessive alleles may be hidden. Ch04.8 Which statement is true regarding autosomal dominant gene transmission? A. The affected parent transmits the gene to one-half of his or her children. B. The affected gene is found in males only. C. Generations are skipped for transmission. D. Females will transmit the disease more often than males. - Verified Answer A. The affected parent transmits the gene to one-half of his or her children. The affected parent will transmit the trait to (approximately) one-half of his or her children; in each match, a 50% chance exists that either a normal gene or an affected gene will be transmitted to the child. The affected gene is found equally in males and females, bothsexes transmit the trait equally, and no skipping of generations occurs. Ch04.9 Which statement is true regarding autosomal recessive inheritance? D. Turner syndrome - Verified Answer D. Turner syndrome Ch4.3PPT Sex Chromosome Aneuploidy Which information indicates that the nurse has a good understanding of X- linked recessive inheritance? A. The gene is passed from an affected father to all of his daughters. B. The trait is observed significantly more often in females than in males. C. Males are said to be heterozygous for the X chromosome. D. A sex-limited trait is one that occurs significantly more often in one sex than in the other. - Verified Answer A. The gene is passed from an affected father to all of his daughters. Ch4.4PPT X-linked Inheritance Which statement is true regarding the risks of developing a disease? A. Empiric risks are based on assumptions. B. Recurrence risk is higher if more than one family member is affected. C. An individual below the threshold of liability for a disease will have the disease. D. The recurrence risk for disease usually increases rapidly in more remotely related relatives. - Verified Answer B. Recurrence risk is higher if more than one family member is affected. Recurrence risk is higher if more than one family member is affected and usually decreases rapidly in more remotely related relatives. Empiric risks are based on observation. For diseases that have a threshold of liability, an individual usually does not have the disease below the threshold of liability. Ch05.2 Which statement describes a monozygotic twin? A. Twins who share very few traits B. Twins who share all traits C. Twins who form from double ovulation D. Twins whose rates vary among populations - Verified Answer B. Twins who share all traits Monozygotic twins divide from one embryo and actually share traits. They are natural clones. Twins from double ovulation are dizygotic and may not share traits. Monozygotic twins have the same rate across populations. Dizygotic or fraternal rates vary among populations. Ch05.3 Which statement regarding coronary heart disease is true? A. It is the leading killer of Americans. B. Atherosclerosis causes widening of the blood vessels. C. CHD is more common in women. D. The relative risk for CHD does not increase with relatives affected. - Verified Answer A. It is the leading killer of Americans. Coronary heart disease is the leading killer of Americans. Narrowing of blood vessels occurs as a result of atherosclerosis. Men are more commonly affected. Relative risk increases when two or more relatives are affected before the age 55 years. Ch05.4 Which statement regarding hypertension is true? A. Systemic hypertension is observed in less than 5% of populations. B. Environmental factors do not cause hypertension. C. One of the most important factors affecting blood pressure is sodium intake. D. A 100% correlation exists among family members and blood pressure. - Verified Answer C. One of the most important factors affecting blood pressure is sodium intake. Sodium intake, obesity, decreased physical activity, and psychosocial stress are important environmental risk factors for obesity. Systemic hypertension affects approximately 25% to 30% of the population. Only a 20% to 40% correlation exists among family members. Ch05.5 Which gene is linked with breast cancer? A. BRCA1 B. APC C. HLA II D. IDDM - Verified Answer A. BRCA1 BRCA1 is located on chromosome 17, and BRCA2 is located on chromosome 13. If women inherit these genes, then their lifetime risk of getting breast cancer increases by 50% to 80%. The APC gene is associated with colon cancer. Human leukocyte antigen (HLA) II is associated with diabetes. IDDM stands for insulin-dependent diabetes mellitus. Ch05.6 Which statement is true regarding type II diabetes? A. Type II diabetes accounts for fewer than 10% of all cases of diabetes. B. Pancreatic insulin is not produced. C. These individuals experience insulin resistance. D. Type II diabetes is less common among obese persons. - Verified Answer C. These individuals experience insulin resistance. Type II diabetes is responsible for more than 90% of all cases of diabetes. Usually people who develop type II diabetes are older than 40 years of age and are obese. They produce insulin and have insulin resistance. Ch05.7 Which statement is true regarding Alzheimer disease? A. Alzheimer disease affects 40% of the population older than 65 years of age. B. Alzheimer disease is characterized by progressive dementia and memory loss. C. It has one gene locus. D. Antidiuretic hormone is a key factor. - Verified Answer B. Alzheimer disease is characterized by progressive dementia and memory loss. Alzheimer disease affects approximately 5% to 10% of the population, age 65 years and older. It is characterized by progressive dementia and C. "Alterations in the kallikrein-kinin system increases the risk for breast cancer." D. "Women who inherit a mutation in BRCA2 experience a 50% to 80% lifetime risk of developing breast cancer." - Verified Answer D. "Women who inherit a mutation in BRCA2 experience a 50% to 80% lifetime risk of developing breast cancer." Ch5.3PPT Multifactorial Disorders in the Adult Population Type 2 diabetes A. is caused by an absence of insulin. B. usually involves a gene identified as HLA. C. is commonly associated with HLA associations or autoantibodies. D. is often treated with lifestyle modification including diet and exercise. - Verified Answer D. is often treated with lifestyle modification including diet and exercise. Ch5.4PPT Multifactorial Disorders in the Adult Population 5-Azacytidine has been used as a therapeutic drug in the treatment of which disease process? A. Leukemia B. Brain cancer C. Benign neoplasm D. Type II diabetes - Verified Answer A. Leukemia 5-Azacytidine, a demethylating agent, has been used as a therapeutic drug in the treatment of leukemia and myelodysplastic syndrome. 5-Azacytidine is not a therapeutic drug used in the treatment of brain cancer, benign neoplasm, or type II diabetes. Ch06.2 Which characteristic supports the diagnosis of Angelman syndrome? A. Short stature, hypotonia, obesity B. Large size, creases on the earlobe, large tongue C. Growth retardation, leg length discrepancy, small face D. Severe mental retardation, seizures, ataxia - Verified Answer D. Severe mental retardation, seizures, ataxia. Angelman syndrome is characterized by severe mental retardation, seizures, and ataxia. Prader-Willi syndrome is characterized by short stature, hypotonia, and obesity. Beckwith- Wiedemann syndrome is characterized by large size for gestational age, creases on the earlobe, and a large tongue. Russel-Silver syndrome is characterized by growth retardation, leg length discrepancy, and a small, triangular-shaped face. Ch06.3 Children with Beckwith-Wiedemann syndrome are at risk for the development of A. Wilms tumor. B. rectal cancer. C. diabetes. D. pulmonary fibrosis. - Verified Answer A. Wilms tumor. Children with Beckwith-Wiedemann syndrome are at an increased risk for the development of Wilms tumor or hepatoblastoma. Rectal cancer, diabetes, and pulmonary fibrosis are not associated with Beckwith- Wiedemann syndrome. Ch06.4 Which is true regarding epigenetic modifications? A. They alter gene expression by modifying DNA. B. They can modulate behavior later in life. C. They occur only at the time of birth. D. They at best only involve benign processes. - Verified Answer B. They can modulate behavior later in life. Exposure to stress early in life can modulate behavior in adulthood. Epigenetic processes can help store information about the environment, and these relevant epigenetic modifications can modulate behavior later in life. Ch06.5 Which describe epigenetic mechanisms? A. DNA methylation, histone modifications, RNA-based modifications B. RNA methylation, protease modifications, DNA-based modifications C. Genetic disruption, protease modifications, DNA-based modifications D. Histone modification, DNA-based modifications, RNA methylation - Verified Answer A. DNA methylation, histone modifications, RNA-based modifications. DNA methylation, histone modifications, RNA-based modifications are epigenetic mechanisms. RNA methylation and protease modifications are not. Additionally, DNA-based modifications although important are not mechanisms of epigenetics. Ch06.6 Which statement is correct regarding the epigenetic screening of cancer? A. Epigenetic screening is no use to cancer detection. B. Epigenetic screening involves invasive procedures. C. This is a very expensive alternative to current testing. D. It can complement current detection methods. - Verified Answer D. It can complement current detection methods. The common finding of epigenetic alteration in cancerous tissue raises the possibly that epigenetic screening approaches could complement or even replace existing early-detection methods. In some cases, epigenetic screening could be done using bodily fluids, such as urine or sputum, eliminating the need for the more invasive, costly, and risky strategies currently in place. Ch06.7 Which features are associated with Prader-Willi syndrome? (Select all that apply.) A. Short stature B. Small hands and feet D. Hypogonadism E. Mild mental retardation - Verified Answer A. Short stature B. Small hands and feet Ch6.2PPT Epigenetics and Disease - Diseases from Abnormal Imprinting Patterns Which statement by the nurse indicates an accurate understanding of epigenetics and cancer? A."Hypomethylation of the promoter region of the RB1 gene is often observed in retinoblastoma." B."Hypomethylation increases as tumors progress from benign neoplasms to malignancy." C."Hypomethylation of specific subgroups of miRNAs is associated with tumorigenesis." D."Hypomethylation occurs when HDAC inhibitors are administered for cancer." - Verified Answer B."Hypomethylation increases as tumors progress from benign neoplasms to malignancy." Ch6.3PPT Epigenetics and Cancer A 2-month-old infant is admitted to the hospital after several days of vomiting after feedings. The child is diagnosed with pyloric stenosis. This disease does not follow the inheritance patterns of single-gene disease. This type of disease is considered to be A. multifactorial. B. congenital. C. following a bell-shaped distribution model. D. following a liability of threshold model. - Verified Answer D. following a liability of threshold model. Ch6.4PPT Unit II: Genes and Gene-Environment Interaction Case Study 1a A 2-month-old infant is admitted to the hospital after several days of vomiting after feedings. The child is diagnosed with pyloric stenosis. Although the mother is staying with the child after surgical correction, her husband comes to visit and brings their other child. This child has Prader- Willi syndrome. This disease is an example of A. imprinting. B. trisomy. C. hypermethylation. D. nondisjunction - Verified Answer A. imprinting Ch6.4PPT Unit II: Genes and Gene-Environment Interaction Case Study 1b A mother gives birth to an infant diagnosed with Beckwith-Wiedemann syndrome. The mother-baby nurse teaches the new mother and father about the specifics of this syndrome. Which is a common characteristic of Beckwith-Wiedemann syndrome? A. Omphalocele B. Leg-length discrepancy C. Hyperglycemia D. Obesity - Verified Answer A. Omphalocele Ch6.5PPT Unit II: Genes and Gene-Environment Interaction Case Study 2a A mother gives birth to an infant diagnosed with Beckwith-Wiedemann syndrome. The mother-baby nurse teaches the new mother and father about the specifics of this syndrome. The infant is at an increased risk for which disorder? A. Mental retardation B. Wilms tumor C. Triangular-shaped face D. Hypotonia - Verified Answer B. Wilms tumor Ch6.6PPT Unit II: Genes and Gene-Environment Interaction Case Study 2b Which statement is true regarding the inflammatory response? A. Inflammatory response is the third line of defense. B. Inflammatory response relies on cellular components only. C. Inflammatory response generates a nonspecific response D. Inflammatory response occurs in nonvascular tissue. - Verified Answer C. Inflammatory response generates a nonspecific response. The inflammatory response is the second line of defense. It occurs at the site of tissue injury and generates a nonspecific response that involves cellular and chemical components. The inflammatory response occurs in tissues with a blood supply (vascularized). Ch07.2 Which complement factor is considered an anaphylatoxin? A. C3a B. C1 C. C7 D. C9 - Verified Answer A. C3a C3a, C5a, and C4a are anaphylatoxins. They can induce the rapid degranulation of mast cells and the release of histamine. Ch07.3 Which receptor is expressed on macrophages and facilitates recognition and phagocytosis of bacterial pathogens? A. Complement receptors B. Scavenger receptors C. Toll-like receptors D. Pattern recognition receptors - Verified Answer B. Scavenger receptors The scavenger receptors are primarily expressed on macrophages and facilitate recognition and phagocytosis of bacterial pathogens. Complement receptors recognize a variety of fragments produced through activation of the complement system. Toll-like receptors are expressed on the surface of cells, including epithelial, mast, neutrophils, macrophages, dendritic cells, and lymphocytes. They recognize pathogen-associated molecular patterns or stressed host cells. Pattern recognition receptors recognize patterns of infectious molecules. These receptors are found on cells involved in innate resistance. Ch07.4 Which statement regarding mast cells is true? A. Histamine causes vasoconstriction. B. Mast cells are found only in blood vessels. Resistance is a means by which the body may avoid being infected, but it is not a natural barrier. The natural barriers include physical, biochemical, and mechanical, as well as inflammation at the body's surfaces. Ch07.10 Which characteristics are observable of vascular injury and inflammation? (Select all that apply.) A. Redness B. Coolness to the touch C. Warmth to the touch D. Increased swelling E. Pain - Verified Answer A. Redness C. Warmth to the touch D. Increased swelling E. Pain The four characteristics that are observable for inflammation in vascular tissue are redness, heat, swelling, and pain. Ch07.11 Which pathways activate the complement system? (Select all that apply.) A. Antigen antibody B. Classical C. Lectin D. Alternative - Verified Answer B. Classical C. Lectin D. Alternative The complement system may be activated by the classical, lectin, and alternative pathways. Ch07.12 Which functions of the clotting system are exhibited at the site of injury or inflammation? (Select all that apply.) A. Prevents the spread of infection to adjacent tissues B. Traps microorganisms at the site of inflammation for removal C. Prevents clot formation at the site of injury D. Provides a framework for future repair and healing - Verified Answer A. Prevents the spread of infection to adjacent tissues B. Traps microorganisms at the site of inflammation for removal D. Provides a framework for future repair and healing The clotting system exhibits the following functions: (1) prevents the spread of infection to adjacent tissues; (2) traps microorganisms and foreign bodies at the site of inflammation for removal by infiltrating cells such as neutrophils and macrophages; (3) forms a clot that stops bleeding; and (4) provides a framework for future repair and healing. Ch07.13 Which are systemic effects of inflammation? (Select all that apply.) A. Abscess formation B. Fever C. Leukocytosis D. Increased levels of plasma proteins E. Decreased levels of plasma proteins - Verified Answer B. Fever C. Leukocytosis D. Increased levels of plasma proteins The three primary systemic changes associated with an acute inflammatory response are fever, leukocytosis, and increased levels in circulating plasma proteins. Abscesses are a local manifestation of inflammation and are walled-off lesions filled with purulent exudates. Ch07.14 The characteristic vascular changes at the site of an injury produce A. blood vessel constriction after dilation . B. increased permeability and leakage. C. tightening of the capillary endothelial cell junctions. D. pallor and swelling where the injury occurred. - Verified Answer B. increased permeability and leakage. Ch07.1PPT Innate Immunity: Inflammation and Wound Healing - Second Line of Defense Which statement indicates the nurse has an accurate understanding of mast cells? Mast cells A. "can be activated through an intrinsic or extrinsic pathway." B. "degranulate in response to chemical agents." C. "reduce blood flow after activation." D. "can be blocked by the therapeutic use of aspirin." - Verified Answer B. "degranulate in response to chemical agents." Ch07.2PPT Innate Immunity: Inflammation and Wound Healing - Mast Cells Which information is correct regarding phagocytosis? Phagocytosis involves A. opsonization, engulfment, and formation of a phagosome. B. a reduction in nitric oxide production. C. formation of a phagosome by mast cells. D. a respiratory burst produced by the release of the primary lysosomal granules. - Verified Answer A. opsonization, engulfment, and formation of a phagosome Ch07.3PPT Innate Immunity: Inflammation and Wound Healing - Phagocytosis A person has a large open wound that has formed scar tissue. The nurse knows which type of healing has occurred? A. Primary B. Secondary C. Debridement D. Regeneration - Verified Answer B. Secondary Ch07.4PPT Innate Immunity: Inflammation and Wound Healing A substance that is recognized as foreign or nonself is A. immunoglobulins. B. lymphocytes. C. antibodies. Antibodies are primarily responsible for protection against viruses and bacteria and are part of the humoral arm of the immune system. The antibody can directly invade a microorganism or activate the immune response. T cells undergo differentiation, attack cancerous cells, and are part of cellular immunity. Ch08.3 Which term describes the type of immunity that occurs when preformed antibodies are transferred from a donor to a recipient? A. Passive B. Active C. Memory D. Cellular - Verified Answer A. Passive The two types of adaptive immunity are active and passive. Passive immunity occurs when preformed antibodies are transferred from a donor to a recipient. An example of passive immunity is the passage of maternal antibodies across the placenta to the fetus. Active immunity is produced by an individual after either a natural exposure or an immunization. Memory cells are formed through cellular and humoral immunity; they remember the antigen. Ch08.4 What is the precise portion of the antigen that is configured for recognition and binding of an antibody? A. Paratope B. Epitope C. Self-antigen D. Immunogen - Verified Answer B. Epitope The antigenic determinant or epitope is the precise portion of the antigen that is configured for recognition and binding of an antibody. A paratope is the matching portion on the antibody or lymphocyte receptor. A self-antigen is one that is not foreign to the host. An immunogen is an antigen that induces an immune response. Ch08.5 Which antigen is too small to initiate an immune response? A. Carrier B. Allergen C. Hapten D. Self-antigen - Verified Answer C. Hapten A hapten is a molecule that is foreign but too small to induce an immune response alone. However, when it binds to a larger carrier molecule, it is able to induce an immune response. An allergen is an antigen that can induce an allergic response. A self-antigen is not foreign but has the three other criteria to be an immunogen. Ch08.6 Which statement is true regarding immunoglobulin A (IgA) antibodies? A. IgA-2 is predominantly found in blood. B. IgA-1 is predominantly found in the body's secretions. C. The J chain anchors together the IgA molecules. D. IgA is the most predominant immunoglobulin. - Verified Answer C. The J chain anchors together the IgA molecules. The J chain anchors together the IgA molecules to form dimers and helps them resist degradation from enzymes. IgA-1 is found in the blood, and IgA-2 is found in the secretions of the body. IgG, not IgA, is the most predominant immunoglobulin. Ch08.7 It is true that immunoglobulin E (IgE) is A. designed to protect the host from large viruses. B. the primary cause of common allergies. C. the only inflammatory cell that can damage a virus. D. normally found at high concentrations in the circulation. - Verified Answer B. the primary cause of common allergies. IgE, a mediator of common allergic responses, is an antibody that is designed to protect the host from parasites and is the only inflammatory cell that can damage a parasite. IgE is normally found in low concentrations in the circulation. Ch08.8 Which statement is true regarding aging and the immune system function? A. Older adults have decreased circulating antibodies. B. T-cell function is increased. C. Antibody production to specific antigens is inferior. D. Response to infection is rapid. - Verified Answer C. Antibody production to specific antigens is inferior. T-cell function is decreased, and immune responses are delayed. B-cell production is inferior; however, the cells have increased circulating antibody levels. Ch08.9 Which criteria influence the degree of immunogenicity? (Select all that apply.) A. Foreignness to the host B. Appropriate size C. Appropriate quantity D. Chemical simplicity E. Chemical complexity - Verified Answer A. Foreignness to the host B. Appropriate size C. Appropriate quantity E. Chemical complexity The four criteria that influence the degree of immunogenicity are foreignness to the host, appropriate size, appropriate quantity, and chemical complexity. Ch08.10 Which are molecular classes of immunoglobulins? (Select all that apply.) A. IgC B. IgD C. IgE D. IgM E. IgN - Verified Answer B. IgD C. IgE D. IgM D. Rarely does this type of reaction contribute to autoimmune diseases. - Verified Answer B. Most type I reactions are allergic. Most type I reactions are allergic. They are mediated by IgE. Most type I reactions occur against environmental antigens and can contribute to some autoimmune diseases. Ch09.3 What antibody binds to a mast cell? A. Cytotropic B. Allergen C. Antigen D. Fc - Verified Answer A. Cytotropic A cytotropic antibody (also called a reagin) is the antibody that binds to the mast cell. An allergen is an environmental antigen that induces an allergic response. An antigen stimulates the immune response and antibody to bind to the mast cell. The Fc is the portion of the mast cell where IgE binds. Ch09.4 Which statement is true regarding atopic individuals? A. If one parent has allergies, then a 4% chance exists that the offspring will have similar allergies. B. If two parents have allergies, then a 50% chance exists that their offspring will have similar allergies. C. Atopic individuals tend to produce higher quantities of IgE. D. No genes are associated with an atopic state. - Verified Answer C. Atopic individuals tend to produce higher quantities of IgE. Higher quantities of IgE are present in atopic individuals. If one parent has an allergy, then the individual has a 40% of having allergies; with two parents, the individual has an 80% of having allergies. Multiple genes have been associated with the atopic state. Ch09.5 Which statement is true of serum sickness? A. Immune complexes are formed and deposited in target issues. B. Immune complexes are formed and deposited in the blood vessels. C. It is considered a Type II hypersensivity response. D. Cytotoxic T lymphocytes are responsible for the condition. - Verified Answer A. Immune complexes are formed and deposited in target issues. Serum sickness reactions are caused by the formation of immune complexes in the blood and their deposition in target tissues. An Arthus reaction deposits complexes into the walls of blood vessels. Serum sickness is a Type III hypersensitivity reaction. Type IV mechanisms occur through either cytotoxic T lymphocytes or lymphokine-producing T- helper (Th) 1 cells. Ch09.6 The Arthus reaction is an example of which type of sensitivity reaction? A. I B. II C. III D. IV - Verified Answer C. III The Arthus reaction is a type III hypersensitivity reaction. Ch09.7 Which statement is true regarding a type IV allergic reaction? A. Is immediate in its action B. Is infiltrated with B cells C. Is mediated by antibody production D. Can be transferred by cells - Verified Answer D. Can be transferred by cells Type IV hypersensitivity reactions can be transferred by cells but not by serum. Their actions are delayed because their onset takes from 24 to 72 hours. The site is infiltrated with T lymphocytes and macrophages. A clear hard center surrounds the erythema (redness). Ch09.8 Which is an example of an alloimmune disease? A. Tuberculin reaction B. Graves disease C. Contact dermatitis D. Penicillin allergy - Verified Answer B. Graves disease Graves disease is a classic autoimmune, or alloimmune, disease. Tuberculin reaction is a type IV reaction. Contact dermatitis is a type I reaction. Penicillin is an allergen that induces type I hypersensitivity. Ch09.9 Which statement is true regarding unmatched packed red blood cell (RBC) transfusions? A. Only three different RBC antigens have been identified. B. Approximately 80 major carbohydrate antigens exist. C. People with O type blood have neither A or B antigens. D. A person with type A blood contains anti-O antibodies. - Verified Answer C. People with O type blood have neither A or B antigens. Type O blood does not contain type A or B antigens. However, 80 major different RBC antigens are present. A person with type A blood carries anti- B antibodies and a person with type B blood carries anti-A antibodies. Those with type O blood have anti-A and anti-B antibodies. Ch09.10 Histamine release leads to which of the following? (Select all that apply.) A. Bronchial smooth muscle contraction Correct B. Bronchoconstriction Correct C. Decreased vascular permeability D. Vasoconstriction E. Edema - Verified Answer A. Bronchial smooth muscle contraction B. Bronchoconstriction E. Edema Histamine contracts bronchial smooth muscle, which causes bronchoconstriction. Vascular A. Viruses are less common than bacterial infections. B. Viruses actively produce exotoxins. C. Viruses bypass many defense mechanisms by developing intracellularly. D. Viruses contain all their genetic information in ribonucleic acid (RNA). - Verified Answer C. Viruses bypass many defense mechanisms by developing intracellularly. Viruses enter the cell and may bypass many defense mechanisms. Viruses are the most common form of infection. They contain deoxyribonucleic acid (DNA) and RNA for their genetic information. They do not produce exotoxins or endotoxins. Ch10.3 Which statement regarding fever is true? A. Fever is a failure of the body to regulate temperature. B. An endogenous pyrogen may produce fever. C. The body's central thermostat is the pituitary gland. D. Fever is a failure of the body's defense system. - Verified Answer B. An endogenous pyrogen may produce fever. A pyrogen is a substance that causes fever. Exogenous and endogenous pyrogens exist and affect the regulatory set point in the hypothalamus, which is the body's thermostat. Fever is not a failure of the body's defense system but may actually be beneficial. The body does not fail to regulate temperature; rather, the temperature is regulated at a higher level than normal with a fever. Ch10.4 What contributes to antibiotic-resistant pathogens? A. Inadequate sanitation B. Genetic mutation C. Loss of multidrug transporters D. Limited use of antibiotics - Verified Answer B. Genetic mutation Antibiotic resistance usually results from genetic mutations in the microorganism that can be directly transmitted to neighboring microorganisms. Sanitation and clean drinking water can help control infection. Multidrug transporters on the microorganism's membrane affect the rate of intracellular accumulation of antibiotics by preventing entrance or increasing the efflux of the antibiotic into the cell. Overuse of antibiotics can lead to the destruction of the normal flora and selective overgrowth of antibiotic-resistant strains. Ch10.5 When does secondary vaccine failure occur? A. When toxoids are not administered B. When bacteriophages are administered C. When routine vaccinations are not administered D. When booster immunizations are not administered - Verified Answer D. When booster immunizations are not administered Secondary vaccine failure results if appropriate booster immunizations are not administered. Many adults vaccinated against diseases that are more severe in childhood will not get routine boosters. Although not developing debilitating illness, they may become asymptomatic carriers and infect unvaccinated children. Toxoids are purified toxins that have been chemically detoxified without loss of immunogenicity. Bacteriophages are viruses that specifically infect bacteria; these are used to treat antibiotic resistance. Ch10.6 Which are the stages of pathologic infection? (Select all that apply.) A. Invasion B. Death C. Colonization D. Metastasis E. Multiplication - Verified Answer A. Invasion C. Colonization E. Multiplication The stages of pathologic infection include colonization, invasion, spread, and multiplication. Death and metastasis are not stages of pathologic infection. Ch10.7 Which are mechanisms of antigenic variation? (Select all that apply.) A. Siderophoric switching B. Mutation C. Recombination D. Gene switching - Verified Answer B. Mutation C. Recombination D. Gene switching Mutation, recombination, and gene switching all are forms of antigenic variation. Siderophores are iron receptors on bacteria that assist in replication, and they have nothing to do with antigenic variation. Ch10.8 Which mechanisms are used by viruses to evade the immune response? (Select all that apply.) A. Rapid division B. Antigenic specificity C. Self-protein coat D. Immune suppression E. Lipopolysaccharide - Verified Answer A. Rapid division D. Immune suppression Viruses have developed a number of ways to evade the immune system, including rapid division, the ability to survive inside a host cell, coating the viral capsid with self-antigens from the host cell, antigenic variation, neutralization of immune complexes, complement evasion, immune suppression, and tissue damage. Ch10.9 Which demonstrates how antibiotic resistance may occur? (Select all that apply.) A. Thickened bacterial cell walls trap the antibiotic. B. Modification of the bacterial cell wall prevents antibiotic access. C. Bacterial enzymes destroy the antibiotic. D. Nucleus of the virus is destroyed. - Verified Answer A. Thickened bacterial cell walls trap the antibiotic. B. Modification of the bacterial cell wall prevents antibiotic access. Ch11.2 Which statement is true regarding the effects of circulating epinephrine in the body? A. The heart rate will slow down. B. The heart's contractility will decrease. C. Blood vessels to skeletal muscle will constrict. D. Transient hyperglycemia will result. - Verified Answer D. Transient hyperglycemia will result. Epinephrine dilates blood vessels of the muscles and causes transient hyperglycemia. The epinephrine will increase heart rate and contractility. The venous return to the heart will increase, thus increasing cardiac output and blood pressure. Ch11.3 Which statement is true regarding how cortisol reacts when activated by ACTH? A. Cortisol is plasma bound to corticotropin. B. Gluconeogenesis is halted. C. Cortisol increases blood glucose. D. Cortisol decreases protein synthesis. - Verified Answer C. Cortisol increases blood glucose. Cortisol has many actions. It is bound to a protein called transcortin. It stimulates gluconeogenesis, increases glucose production, and increases protein synthesis. Ch11.4 Which statement is true regarding the immune system in response to stress? A. T-helper 1 (Th1) cells increase. B. A shift in Th1 cells occurs. C. The immune system is not affected. D. Cortisol is released. - Verified Answer D. Cortisol is released. Stress can activate an excessive immune response through cortisol. It can cause the suppression of Th1 cells and a shift in Th2 cells. Ch11.5 Which is a function of norepinephrine? A. Increases contraction of the heart B. Constricts smooth muscle in all blood vessels C. Secretes steroid hormones D. Stimulates adrenal medulla - Verified Answer B. Constricts smooth muscle in all blood vessels. Norepinephrine is released from the adrenal medulla and regulates blood pressure by constricting smooth muscle in all blood vessels. Epinephrine increases myocardial contractility and heart rate. The steroid hormones are stimulated by the hypothalamus, which sets off a chain of events during which steroid hormones are secreted from the adrenal cortex. Cortisol is one of the primary steroid hormones. Ch11.6 Which statement regarding corticotropin-releasing hormone (CRH) and its influence on the immune system is true? A. CRH is also released from peripheral inflammatory sites. B. CRH causes vasoconstriction. C. CRH causes decreased vascular permeability. D. Red blood cells are the peripheral targets. - Verified Answer A. CRH is also released from peripheral inflammatory sites. CRH is released from the hypothalamus and from peripheral inflammatory sites. Because this hormone is proinflammatory, it causes vasodilation and increased vascular permeability. The primary target of peripheral CRH is the mast cell. Ch11.7 Which statement is true regarding stress and the immune system? A. Seasonal allergies are related to stress. B. Cardiovascular disease is one condition that is related to stress. C. The level of proinflammatory cytokines is decreased. D. Negative emotions cause few alterations in cytokine production. - Verified Answer B. Cardiovascular disease is one condition that is related to stress. Cardiovascular disease, aging, cancer, osteoporosis, arthritis, type II diabetes mellitus, and chronic obstructive pulmonary disease (COPD) are associated with the prolonged presence of proinflammatory cytokines. These proinflammatory cytokines increase during stress. Negative emotions are directly associated with the increased level of these proinflammatory cytokines. Ch11.8 Where does the perception of stress initiate? (Select all that apply.) A. Peripheral nervous system Correct B. Exocrine system C. Parasympathetic nervous system D. Central nervous system - Verified Answer A. Peripheral nervous system D. Central nervous system The perception of stress is initiated in the central nervous and peripheral nervous systems. Ch11.9 Which are stages in the development of the general adaptation syndrome? (Select all that apply.) A. Alarm B. Exposure C. Resistance D. Exhaustion - Verified Answer A. Alarm C. Resistance D. Exhaustion The three successive stages in the development of the general adaptation syndrome are alarm, resistance, and exhaustion. Ch11.10 blood-forming cells are called leukemias. Carcinoma is a cancer of epithelial tissue. Ch12.3 Which marker is used to evaluate a tumor of the adrenal gland? A. Prostate-specific antigen (PSA) B. Alpha-fetoprotein (AFP) C. Catecholamines D. Adrenocorticotropic hormone (ACTH) - Verified Answer C. Catecholamines Catecholamines are secreted by the adrenal medulla and are found in excess if a tumor exists. PSA levels are used to detect prostate cancer. AFP is used to detect liver and germ cell cancers. ACTH is the marker used to detect pituitary adenomas. Ch12.4 When in its normal state, which gene negatively regulates proliferation? A. Oncogenes B. Tumor-suppressor genes C. Proto-oncogenes D. Telomeres - Verified Answer B. Tumor-suppressor genes Tumor-suppressor genes encode proteins that, when in their normal state, negatively regulate proliferation. Oncogenes are mutant genes that, when in their normal nonmutant state, direct the synthesis of protein that positively accelerate proliferation. A proto-oncogene is an oncogene in its nonmutant state. Telemeres are protective ends or caps on each chromosome. Ch12.5 Which statement is true regarding the staging of cancer? A. Localized cancer is considered a high stage. B. Benign tumors are stage 4. C. Cancers that have spread regionally are stage 3. D. Stage 1 has the poorest prognosis. - Verified Answer C. Cancers that have spread regionally are stage 3. 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 lymph nodes, is stage 3; and cancer that has spread to distant sites, such as a liver cancer spreading to the lung or prostate cancer spreading to bone, is stage 4. The prognosis generally worsens with increasing tumor size, lymph node involvement, and metastasis. Benign tumors do not spread to distant regions. Ch12.6 Which statement is true regarding metastasis? A. Metastasis is a highly efficient process. B. Metastasis occurs through the vascular and lymphatic systems. C. Metastatic cancer cells suppress proteases. D. Most cancer cells are able to metastasize to new areas. - Verified Answer B. Metastasis occurs through the vascular and lymphatic systems. Two distinct mechanisms give rise to patterns of distant spread. First, cancer cells spread through vascular and lymphatic pathways, as well as natural tissue planes. Metastatic cells are very heterogeneous, and some of these cells have new abilities that can facilitate metastasis. Metastasis is highly inefficient; to metastasize, a cancer cell must surmount multiple physical and physiologic barriers. Many metastatic cells secrete proteases and protease activators to digest the extracellular matrix and basem*nt membrane, enabling cells to move. Only rare cells in a cancer are able to metastasize. Ch12.7 Which statement characterizes radiation therapy? A. Radiation is used to kill cancer cells while minimizing damage to normal structures. B. Effective killing of cancer cells using radiation requires poor local delivery of oxygen. C. Radiation blocks the normal growth pathways in cells. D. Radiation can cause reversible changes in normal tissues. - Verified Answer A. Radiation is used to kill cancer cells while minimizing damage to normal structures. Radiation is used to kill cancer cells while minimizing damage to normal structures. Effective cell killing using radiation also requires good local delivery of oxygen. Radiation produces slow changes in most cancers and irreversible changes in normal tissues as well. Antimetabolite chemotherapy blocks normal growth pathways in cells. Ch12.8 Which virus is linked to the development of cancer? (Select all that apply.) A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Epstein-Barr virus E. Human papillomavirus - Verified Answer B. Hepatitis B C. Hepatitis C D. Epstein-Barr virus E. Human papillomavirus Hepatitis B and C have been linked to the development of liver cancer, which is usually caused by chronic inflammation. Epstein-Barr virus can lead to B-cell lymphomas in those individuals who are immunosuppressed. Human papillomavirus has been linked to cervical, anogenital, oral- pharyngeal, and penile cancers. Hepatitis A has not been linked to the development of cancer. Ch12.9 Which statement is true regarding caretaker genes? (Select all that apply.) A. Caretaker genes encode proteins that repair damaged deoxyribonucleic acid (DNA). B. Loss of function results in increased mutation rates. C. Loss of function can cause increased rates of cancer. D. Mutations that disrupt caretaker genes are not inherited. E. Loss of function causes chromosome instability. - Verified Answer A. Caretaker genes encode proteins that repair damaged deoxyribonucleic acid (DNA). D. accounts for 4000-5000 deaths a year worldwide. - Verified Answer B. is more prevalent in men than women. Men are more likely to smoke (18.8%) than women (14.8%). Current cigarette smoking is higher among persons aged 18-24 years, 25-44 years, and 45-64 years than among those 65 years and older. Smoking also causes damage to blood vessels and contributes to a number of other diseases. Tobacco use accounts for one out of every five deaths each year in the United States—many more than 4000-5000 in the United States alone. Ch13.1 A man has worked with asbestos in his career for longer than 40 years. Which cancer is the most likely to develop? A. Bladder B. Leukemia C. Stomach D. Lung - Verified Answer D. Lung Asbestos may cause mesothelioma or lung cancer. Benzol inhalation is linked to leukemia in shoemakers and in workers in the rubber cement, explosives, and dye industries. According to the International Agency for Research on Cancer (IARC), strong evidence indicates an increased risk of bladder, skin, and lung cancers after consumption of water with high levels of arsenic. Bacterial infection from Helicobacter pylori has been associated with stomach cancer. Ch13.2 Which statement is not true regarding the body's defense mechanisms against cell damage? A. The phase I activation enzyme is represented by cytochrome P-450. B. The enzymes that protect against cell damage are predominantly found in the liver. C. The two primary defense mechanisms are xenobiotics and the antioxidant system. D. Most xenobiotics are transported in the blood by lipoproteins. - Verified Answer C. The two primary defense mechanisms are xenobiotics and the antioxidant system. Xenobiotics are a variety of compounds that can cause cellular damage and are transported by lipoproteins in the blood. The body has two primary defense systems to protect against xenobiotics that cause cell damage: (1) detoxification enzymes and (2) antioxidant systems. The enzymes are primarily found in the liver, and the phase I activation enzymes are represented by the P-450 system. Ch13.3 Which statement is true regarding ultraviolet (UV) light? A. UV light causes basal cell carcinoma and squamous cell carcinoma. B. The degree of damage is not affected by wavelength. C. UV light can cause the formation of sarcomas. D. The principal source of ultraviolet radiation (UVR) is tanning beds. - Verified Answer A. UV light causes basal cell carcinoma and squamous cell carcinoma. Skin exposure to UVR and to ionizing radiation (IR) produces reactive oxygen species (ROS) in large quantities, which can lead to oxidative stress, tissue injury, and direct deoxyribonucleic acid (DNA) damage. The duration, intensity, and wavelength content affect exposure. UV light can cause the formation of basal cell and squamous cell carcinomas. The principal source of UVR is sunlight. Ch13.4 Which statement is true regarding basal cell carcinoma (BCC)? A. BCC is most commonly found on the trunk of the body. B. BCC is commonly found on those with a dark complexion. C. Individuals with these tumors usually have a history of tanning, not burning. D. BCC is most commonly found on the head and neck. - Verified Answer D. BCC is most commonly found on the head and neck. BCC commonly occurs on the head and neck. Individuals with these tumors generally have light complexions, light eyes, and fair hair. They tend to sunburn rather than tan and live in areas of high sunlight exposure. Usually these cancers arise on areas of the body that receive the greatest sun exposure, although they are not necessarily restricted to these skin sites. Ch13.5 Which statement is true regarding obesity? (Select all that apply.) A. It has been increasing rapidly over the past 20 years. B. BMI is one of several globally accepted criteria for overweightness. C. Obesity is linked to an increased risk of developing many cancers. D. Childhood obesity occurs only in low socioeconomic groups. - Verified Answer A. It has been increasing rapidly over the past 20 years. C. Obesity is linked to an increased risk of developing many cancers. Obesity in most developed countries (and in urban areas of many developing countries) has been increasing rapidly over the past 20 years. Being overweight or obese, measured using the body mass index (BMI), is linked to an increased risk of developing 11 cancers: liver, advanced prostate, ovarian, gallbladder, kidney, colorectal, esophageal (adenocarcinoma), postmenopausal breast, pancreatic, endometrial, and stomach (cardia). The only globally accepted criteria for overweightness and obesity are based on body mass index (BMI). Childhood obesity occurs in all income and religious groups. Ch13.6 A person drinks alcohol in excessive quantities. Which areas are likely to develop cancer related to alcohol consumption? (Select all that apply.) A. Oral cavity B. Larynx C. Pharynx D. Spleen E. Liver - Verified Answer A. Oral cavity B. Larynx C. Pharynx E. Liver to oral, esophageal, and liver cancers. Ch13.11 Which statement indicates the nurse has an accurate understanding about the association between tobacco and cancers? "Tobacco use is associated with cancer of the A. prostate. B. endometrium. C. esophagus. D. breast. - Verified Answer C. esophagus. Ch13.1PPT Cancer Epidemiology - Environmental/Lifestyle Factors A nurse recalls that in women, obesity is associated with A. small intestinal cancer. B. prostate cancer. C. lung cancer. D. endometrial cancer - Verified Answer D. endometrial cancer Ch13.2PPT Cancer Epidemiology - Environmental/Lifestyle Factors Which information is correct regarding ultraviolet light? Ultraviolet light causes A. multiple myeloma. B. basal cell carcinoma. C. cervical cancer. D. glioma. - Verified Answer B. basal cell carcinoma Ch13.3PPT Cancer Epidemiology - Environmental/Lifestyle Factors Which structure is part of the central nervous system (CNS)? A. Brain B. Somatic nervous system C. Peripheral nerve pathways D. Cranial nerves - Verified Answer A. Brain The brain is part of the CNS. The peripheral nervous system (PNS) consists of the cranial nerves and the spinal nerves. The PNS can be divided into the somatic nervous system and the autonomic nervous system. Ch15.1 Which is an insulating substance for the neuron? A. Schwann sheath B. Myelin C. Neurilemma D. Node of Ranvier - Verified Answer B. Myelin Myelin is an insulating substance. The neurilemma is the same as a Schwann sheath; it is the delicate tissue that surrounds each axon. The nodes of Ranvier are interruptions at regular intervals that occur in the myelin. Ch15.2 Which neurons transmit impulses from neuron to neuron? A. Unipolar neurons B. Sensory neurons C. Motor neurons D. Interneurons - Verified Answer D. Interneurons Interneurons, or associational neurons, transmit impulses from neuron to neuron. Motor neurons transmit impulses away from the CNS. Sensory neurons carry impulses from the peripheral sensory receptors to the CNS. Unipolar neurons have one process that branches shortly after leaving the cell body. Ch15.3 Which term describes successive, rapid impulses received from a single neuron on the same synapse? A. Temporal summation B. Spatial summation C. Convergence D. Facilitation - Verified Answer A. Temporal summation Temporal summation refers to the effects of successive, rapid impulses received from a single neuron on the same synapse. Spatial summation refers to the combined effect of impulses from a number of neurons on a single synapse at the same time. Facilitation refers to the effects of excitatory postsynaptic potential (EPSP) on the plasma membrane potential. Convergence refers to a number of neurons firing and converging Ch15.4 Which is a component of the midbrain? A. Cerebral hemisphere B. Tegmentum C. Cerebellum D. Medulla oblongata - Verified Answer B. Tegmentum The tegmentum, corpora quadrigemina, and cerebral peduncles are parts of the midbrain. The cerebral hemispheres make up the forebrain. The brainstem is composed of the midbrain, medulla oblongata, and pons. Ch15.5 Which part of the brain contains all cell bodies and dendrites of the neurons? A. Gyri B. Sulci C. White matter D. Gray matter - Verified Answer D. Gray matter The gray matter contains the cell bodies and dendrites of the neurons. The gyri are the convolutions of the cerebrum. The sulci are the grooves between adjacent gyri. The white matter contains myelinated nerve fibers. Ch15.6 Which statement is true regarding Broca's area? A. Is responsible for receptive speech B. Is responsible for motor speech C. Results in the inability to hear Dopamine is the precursor of both epinephrine and norepinephrine. Epinephrine induces general vasodilation because of the predominance of β-adrenergic receptors in the muscle vasculature. Preganglionic sympathetic fibers release epinephrine. Epinephrine varies with the type of neuroreceptor stimulated. Ch15.12 Which information is correct regarding associational neurons? Associational neurons A. carry impulses between two distinct processes arising from the cell body. B. carry impulses from peripheral receptors to the CNS. C. transmit impulses to an effector organ. D. transmit impulses from neuron to neuron - Verified Answer D. transmit impulses from neuron to neuron Ch15.1PPT - Neurons A nurse knows that the premotor area (Brodmann area 6) is A. responsible for goal-oriented behavior. B. involved in eye movements. C. responsible for the motor aspects of speech. D. involved in programming motor movements - Verified Answer D. involved in programming motor movements Ch15.2PPT - Central Nervous System Which information is most accurate regarding the subarachnoid space?The subarachnoid space A. contains CSF. B. lies above the dura mater. C. lies below the pia mater. D. adheres to the brain and spinal cord - Verified Answer A. contains CSF Ch15.3PPT - Protective Neural Structures The neurotransmitter released by preganglionic parasympathetic fibers is B. dopamine B. epinephrine C. acetylcholine D. norepinephrine - Verified Answer C. acetylcholine Ch15.4PPT - Neurotransmitters and Neurorecetors Which statement is true regarding the specificity theory of pain? A. Focuses on the attention of pain B. Focuses on the previous experience of pain C. Relates the amount of pain to the amount of soft tissue injury D. Is related to the emotions exhibited toward pain - Verified Answer C. Relates the amount of pain to the amount of soft tissue injury. The specificity theory of pain postulates that the intensity of pain is directly related to the amount of associated tissue injury. It does not take into account previous experience, emotions, or attention to pain. Ch16.1 Which two systems regulate the complex emotional responses to pain? A. Frontal and cerebellar lobes B. Limbic and reticular systems C. Thalamus and brainstem D. Midbrain and nuclei of thalamus - Verified Answer B. Limbic and reticular systems The reticular and limbic systems regulate how an individual emotionally responds to pain. Ch16.2 Which is an excitatory neurotransmitter? A. Glutamate B. Gamma-aminobutyric acid (GABA) C. Glycine D. Substance P - Verified Answer A. Glutamate Glutamate and aspartate are the most common excitatory neurotransmitters in the brain and spinal cord. GABA and glycine are inhibitory. Substance P is contained in the neurons that synapse with GABA and glycine, and they inhibit pain. Ch16.3 What is the definition of perceptual dominance? A. Duration of time or intensity before overt pain responses is regulated. B. Pain at one location may mask pain at another location. C. Repeated exposure to pain. D. The point at which pain is perceived. - Verified Answer B. Pain at one location may mask pain at another location. Perceptual dominance is pain at one location that may cause an increase in the threshold of pain at another location. For example, when a person has severe pain in the leg, neck pain might not be felt. Pain tolerance is the duration of time or intensity of pain before overt pain responses are initiated. Repeated exposure to pain usually decreases pain tolerance. The pain threshold is the point at which pain is perceived. Ch16.4 Which is classified as a myofascial pain syndrome? A. Muscle strain B. Mastectomy C. Neck dissection D. Surgical amputation - Verified Answer A. Muscle strain Myofascial pain syndrome (MPS) is a regional pain syndrome associated with injury to muscle, fascia, and tendons and includes myositis, fibrositis, myofibrositis, myalgia, and muscle strain. These conditions involve myofascial trigger points within a taut band of skeletal muscle. The pain may be the result of low-threshold mechanosensitive afferents projecting to sensitized dorsal horn neurons and the development of peripheral and central sensitization. Ch16.5 A. visceral pain. B. referred pain. C. chronic pain. D. peripheral neuropathic pain. - Verified Answer A. visceral pain. Visceral pain refers to pain in internal organs and the lining of body cavities. It may be an aching, gnawing, throbbing, or intermittent cramping sensation. Referred pain is pain felt in an area removed or distant from its point of origin. Chronic or persistent pain is usually defined as lasting for more than 3-6 months and is pain lasting well beyond the expected normal healing time. Peripheral neuropathic pain is caused by peripheral nerve lesions and an increase in the sensitivity and excitability of primary sensory neurons and cells in the dorsal root ganglion (peripheral sensitization). Ch16.11 The temporary resetting of the hypothalamic thermostat to a higher level in response to endogenous or exogenous pyrogens is known as A. fever. B. thermoregulation. C. shivering. D. thermogenesis. - Verified Answer A. fever. Fever is a normal adaptive response to endogenous and exogenous pyrogens. It is a temporary resetting of the hypothalamic thermostat in response to these pyrogens. During fever, the core body temperature is maintained at a new higher set point, resulting in increased body temperature. Thermoregulation is the same as temperature regulation. Shivering is rapid muscle oscillations. Thermogenesis is heat production. Ch16.12 Which term describes the elevation of the body temperature without an increase in the hypothalamic set point? A. Hyperthermia B. Hypothermia C. Convection D. Conduction - Verified Answer A. Hyperthermia Hyperthermia is the elevation of the body temperature without an increase in the hypothalamic set point. The hypothalamic set point is elevated in a fever. Hypothermia is the core body temperature less than 35°C (95°F). Convection is the transfer of heat through currents of gases or liquids. Conduction refers to heat loss by direct molecule-to-molecule transfer from one surface to another. Ch16.13 Which statements are true regarding sleep patterns in older adults? (Select all that apply.) A. Sleep time is decreased. B. Sleep takes longer to initiate. C. Sleep is maintained much easier. D. Sleep is deeper. - Verified Answer A. Sleep time is decreased. B. Sleep takes longer to initiate. The sleep patterns of the older adult differ from that of the younger adult or child. The total sleep time is decreased, and the older adult takes longer to initiate and maintain sleep. Ch16.14 A nurse recalls the reflex withdrawal of an affected body part from painful stimuli before the pain is perceived is controlled by A.myelinated A-beta fibers. B. unmyelinated C fibers. C. unmyelinated C-alpha fibers. D. myelinated A fibers - Verified Answer D. myelinated A-delta fibers Primary order neurons: nociceptors - stimulated by severe mechanical deformation, mechanical deformation, and/or temperature extremes - Myelinated A-delta fibers: transmission is fast and causes reflex withdrawal of affected body part from stimulus before pain sensation is perceived - Unmyelinated C polymodal fibers: stimulated by mechanical, thermal, and chemical nociceptors (transmission is slower and conveys dull, aching, or burning sensations - A-beta fibers: large myelinated fibeers that transmit touch and vibration sensations Ch16.1PPT - Neuroanatomy of pain Which finding would the nurse expect to recognize during the assessment of a person with chronic pain? The person is A. experiencing tachycardia. B. probably malingering (faking). C. depressed. D. hypertensive - Verified Answer A. experiencing tachycardia. https://www.mayoclinic.org/medical-professionals/endocrinology/news/ postural-orthostatic-tachycardia-syndrome-and-chronic-fatigue-in- adolescents/mac-20430815 Ch16.2PPT - Chronic Pain Fever is stimulated by A. arginine vasopressin. B. endogenous pyrogens (endotoxins). C. metabolism of brown fat. D. tumor necrosis factor-α - Verified Answer B. endogenous pyrogens (endotoxins). Ch16.3PPT - Pathogenesis of Fever A nurse recalls the majority of the sleep cycle is spent in stage A. N1. B. N2. C. N3. D. REM - Verified Answer B. N2 N1: Light sleep, 3%−8% of sleep time The term minimally conscious applies to a severely altered consciousness during which the person demonstrates minimal but defined behavioral evidence of self or environmental awareness. The clinical features include following simple commands, manipulating objects, gestural or verbal yes and no responses, intelligible verbalization, and stereotypical movements. Coma is a state of unarousable neurobehavioral unresponsiveness. A vegetative state is the complete unawareness of self or the surrounding environment and a complete loss of cognitive function. Locked-in syndrome describes an individual who has the content of thought and the level of arousal intact. However, the efferent pathways are disrupted, which means the individual cannot communicate through speech or body movement. Ch17.3 A person experiences a unilateral, partial seizure and maintains consciousness. Which term is appropriate to describe this type of seizure? A. Generalized B. Focal C. Febrile D. Status epilepticus - Verified Answer B. Focal Focal (partial) seizures only involve neurons unilaterally. They often have a local (focal) onset. Consciousness may be maintained. In generalized seizures, consciousness is almost always impaired or lost. Febrile seizure occurs in children younger than 6 years who experience a high fever. Status epilepticus is the experience of recurring seizure activity in which recovery is incomplete. Seizure activity can last 30 minutes or more. Ch17.4 A person experiencing difficulty in recognizing a pattern cannot recognize the form and nature of objects. Which term describes this condition? A. Agnosia B. Aphasia C. Dysphasia D. Alzheimer - Verified Answer A. Agnosia Agnosia is a defect of pattern recognition that involves the loss of recognition through one sense, although the object or person may still be recognized by other senses. Agnosia can be tactile, visual, or auditory. Aphasia is the complete loss of the comprehension or production of language. Dysphasia is an impairment of comprehension or production of language. Alzheimer is a disease of dementia. Ch17.5 An individual having difficulty concentrating is restless and irritable and briefly confused. These changes have developed over 2-3 days. Which describes this condition? A. Alzheimer disease B. Dementia C. Delirium D. Coma - Verified Answer C. Delirium Delirium is an acute state of confusion and is abrupt in its onset (over 2-3 days). The person may have difficulty concentrating, is restlessness and irritable, exhibits tremulousness and insomnia, and has a poor appetite. Alzheimer disease is a type of dementia. Dementia is a more chronic problem during which progressive failure of many cerebral functions occurs. Coma is a loss of consciousness. Ch17.6 An individual sustains a cerebral vascular accident (CVA) that results in left-sided paralysis. Which describes this condition? A. Hemiplegia B. Paraplegia C. Diplegia D. Quadriplegia - Verified Answer A. Hemiplegia Hemiplegia means the loss of motor function (paresis or paralysis) of the upper and lower extremities on one side of the body. Paraplegia refers to the loss of motor function of the lower extremities. Diplegia is the paralysis of either upper or lower extremities as a result of cerebral hemisphere injuries. Quadriplegia refers to paralysis of all four extremities. Ch17.7 Which are basic neural systems that are essential for the cognitive sphere? (Select all that apply.) A. Attentional systems B. Memory and language systems C. Affective or emotive systems D. Sensory systems - Verified Answer A. Attentional systems B. Memory and language systems C. Affective or emotive systems The three basic (core) neural systems to the cognitive sphere include attentional systems that provide arousal and maintenance of attention over time, memory and language systems through which information is communicated, and affective or emotive systems that mediate mood, emotion, and intention. Ch17.8 Which are categories of neurologic function that are classified as critical for evaluation? (Select all that apply.) A. Level of consciousness (LOC) Correct B. Pattern of breathing Correct C. Heart rate D. Eye position - Verified Answer A. Level of consciousness (LOC) B. Pattern of breathing D. Eye position The five categories that are critical to the evaluation process for neurologic functioning include: (1) LOC, (2) pattern of breathing, (3) size and reactivity of pupils, (4) eye position and reflexive response, and (5) skeletal muscle motor responses. Although heart rate is a vital sign, it is not always indicative of neurologic status. Ch17.9 An individual arrives in the emergency department in a coma with a possible drug overdose. Which drugs would cause the pupils to be dilated and fixed? (Select all that apply.) - Group of neurons that appear chronically hyperexcitable; fire more frequently and with greater amplitude - Cortical excitation spreads Ch17.3PPT - Seizure Disorders A nurse recalls that increased intracranial pressure can occur because of A. loss of cerebrospinal fluid. B. increased cerebral activity. C. loss of cerebral function. D. cerebral edema - Verified Answer D. cerebral edema - Normal is 5−15 mmHg/60−180 mm/H2O - Is caused by increased intracranial content - Tumor growth - Is also caused by - Edema - Excessive cerebrospinal fluid - Hemorrhage Ch17.4PPT - Increased Intracranial Pressure - slide 56 During the morning report, a nurse is assigned to care for a person who is areflexic. The nurse understands this means the person has A. no tendon reflexes. B. muscle rigidity. C. paratonia. D. cogwheel phenomenon - Verified Answer A. no tendon reflexes Paratonia - Paratonia is the inability to relax muscles during muscle tone assessment. There are two types of paratonia: oppositional and facilitatory. Oppositional paratonia ("gegenhalten") occurs when subjects involuntarily resist to passive movements, [1] while facilitatory paratonia ("mitgehen") occurs when subjects involuntary assist passive movement. Cogwheel phenomenon - cogwheel rigidity or cogwheeling, is a type of rigidity seen in people with Parkinson's disease. It's often an early symptom of Parkinson's, and it can be used to make a diagnosis Ch17.5PPT - Upper and Lower Motor Neuron Syndromes The person at highest risk for traumatic brain injury (TBI) is A. black and economically disadvantaged. B. male and disabled. C. female and over 20 years of age. D. an economically advantaged young adult. - Verified Answer A. black and economically disadvantaged. Those at highest risk for TBI are children 0-4 years of age, older adolescents aged 15-19 years, and adults aged 65 years and older. Males have the highest incidence in every age group. TBI is highest among black and in lower- and median-income families. Ch18.1 Age and the admission of the Glasgow Coma Scale (GCS) are important diagnostic factors in TBI. Which GCS score describes a severe TBI? A. 13-15 B. 12-13 C. 9-12 D. 3-8 - Verified Answer D. 3-8 The hallmark of a severe TBI is a loss of consciousness for more than 24 hours. A severe TBI is a GCS score of 8 or less associated with cognitive and/or physical disability or death. Ch18.2 An older adult who abuses alcohol has fallen and is diagnosed with a hematoma that is located on the top of the brain. Which type of hematoma fits this description? A. Subdural B. Epidural C. Extradural D. Intracerebral - Verified Answer A. Subdural Acute subdural hematomas rapidly develop (within hours) and are usually located at the top of the skull. Subacute subdural hematomas develop more slowly, often over 48 hours to 2 weeks. Falls, especially in older adults or in those with long-term alcohol abuse, are associated with chronic subdural hematomas. Chronic subdural hematomas develop over weeks to months. Extradural or epidural hemorrhages occur between the dura and the skull and are most likely caused by a temporal fracture. Intracerebral hematomas occur in 2% to 3% of head injuries and are not located on top of the brain. Ch18.3 A patient is hit in the temporal portion of his skull. Although initial loss of consciousness occurs, the patient soon awakens and is conversant. Three hours later vomiting, drowsiness, and confusion are noted. These symptoms are most likely related to which type of brain injury? A. Diffuse axonal B. Intracerebral C. Subdural D. Epidural - Verified Answer D. Epidural The classical presentation of an epidural hematoma is a person hit in the temporal area with damage to the middle meningeal artery. The patient will lose consciousness at the time of injury, but there may be a period where consciousness is regained. The patient will then become more confused and drowsy. This scenario is not typical with the other types of brain injury. Ch18.4 A person experiences a vertebral fracture in which the C1 vertebra is fractured into several fragments. This type of fracture can be described as which of the following? A. Simple B. Compressed C. Comminuted D. Wedge - Verified Answer C. Comminuted