NU606 Advanced Pathophysiology
Week 12 Quiz
Question 1Which of the following is not a normal finding on urinalysis? Select all that apply.
Select one or more:
a.pH of 5.0
b.Specific gravity of 1.025
c.Gross hematuria
d.Significant protein
e.pH of 8.5
Question 2Which of the statements about the bladder is true?
a.The bladder wall lacks rugae.
b.Three openings from the urinary bladder form the trigone.
c.It contracts when stimulated by the sympathetic nervous system.
d.Continuous peristalsis in the bladder wall promotes urine flow.
Question 3Which statement accurately describes how blood flows through the kidney?
a.Afferent arteriole to the peritubular capillaries to the cortex
b.Efferent arteriole to the glomerular capillaries to the peritubular capillaries
c.Peritubular arteries to the glomerular capillaries to the venule
d.Afferent arteriole to the glomerular capillaries to the efferent arteriole
Question 4An APRN can expect glomerular filtration rate to increase in a patient that experiences which of the following conditions?
a.Increased plasma osmotic pressure
b.Dilation of the efferent arteriole
c.Increased hydrostatic pressure in the glomerular capillaries
d.Constriction of the afferent arteriole
Question 5If a patient has influenza and high fever, how would the kidney tubules compensate to help maintain normal pH of body fluids?
a.Increase the flow of filtrate and urine.
b.Secrete more acids and reabsorb more bicarbonate ions.
c.Excrete a larger volume of more dilute urine.
d.Retain more chloride ions in exchange for sodium ions.
Question 6Which of the following is the most specific indicator of renal insufficiency?
a.Urine with pH of 5
b.Increased serum urea and creatinine
c.Urine with high specific gravity
d.Decreased blood pressure
Question 7Which of the following signs and/or symptoms indicate a decreased glomerular filtration rate (GFR)?
a.Increased serum urea and decreased serum bicarbonate
b.Urine with low specific gravity and dark color
c.Albuminuria and hematuria
d.Hyponatremia and hypokalemia
Question 8What is the common initial sign of adenocarcinoma of the kidney that should be evaluated promptly?
a.Gross hematuria
b.Microscopic hematuria
c.Sharp flank pain
d.Polyuria
Question 9Which of the following explains why metabolic acidosis develops with bilateral kidney disease?
a.Tubule exchanges are impaired.
b.GFR is increased.
c.Serum urea is increased.
d.More bicarbonate ion is produced.
Question 10Which of the following would be most likely to cause chronic renal failure?
a.Cystitis with pyelonephritis in the right kidney
b.Circulatory shock due to myocardial infarction
c.Diabetes
d.Obstruction of a ureter by a renal calculus
Question 11In acute post-streptococcal glomerulonephritis, the glomerular inflammation causes ________.
a.increased permeability of the glomerular capillaries
b.glomerular congestion and decreased GFR
c.decreased blood pressure and edema
d.a and b
Question 12What causes the glomerular inflammation that occurs in acute post-streptococcal glomerulonephritis?
a.Toxins produced by the bacteria
b.A type III hypersensitivity reaction
c.An ascending infection from the bladder
d.A type IV hypersensitivity reaction
Question 13Involuntary urination by a child after they have achieved urinary control is called ________.
a.enuresis
b.stress incontinence
c.micturition
d.overflow incontinence
Question 14What is the most frequent cause of pyelonephritis secondary to urinary tract infection?
a.An ascending infection by E. coli
b.Abnormal immune response, causing inflammation
c.Dialysis or other invasive procedure
d.Severe pH imbalance of urine
Question 15Urine with a low specific gravity is usually related to which of the following?
a.An infection of the gallbladder and pancreas
b.Renal failure due to tubule damage
c.Lack of sufficient fluid intake
d.Presence of numerous renal calculi in the urethra
Question 16Which of the following statements about spermatogenesis is true?
a.The complete process takes about 18 days.
b.Maturation of sperm takes place in the seminal vesicles.
c.It is controlled by follicle-stimulating hormone (FSH) and testosterone.
d.The process is initiated after each ejaculation.
Question 17Testicular cancer usually spreads first to the ________.
a.lungs
b.bone
c.pelvic lymph nodes
d.prostate
Question 18The most common solid tumor found in young men is ________ and can be detected early through ________.
a.prostatic cancer; digital rectal exam
b.testicular cancer; self-testicular exam
c.bladder cancer; screening urinalysis
d.penile cancer; yearly annual exams
Question 19Which best describes the classic presentation of testicular tumors and cancer?
a.Soft, tender mass
b.Multiple firm nodules, usually painful and bilateral
c.Hard, painless unilateral mass
d.Small, fluid-filled cyst just under the scrotal skin
Question 20A hard nodule in the peripheral area of the prostate gland felt on digital rectal exam is worrisome for ________.
a.prostate cancer
b.benign prostatic hypertrophy
c.acute prostatitis
d.chronic prostatitis
Question 21Which of the following is an early sign of endometrial carcinoma?
a.Positive Pap test
b.Minor vaginal bleeding or spotting
c.Urinary tract infection resistant to treatment
d.Painful intercourse
Question 22Which of the following terms describes painful menstruation?
a.Polymenorrhea
b.Premenstrual syndrome
c.Dysmenorrhea
d.Endometriosis
Question 23In women who have endometriosis, what causes the typical severe pain that can occur with each menstrual cycle?
a.Obstruction in the fallopian tubes
Inflammation due to blood irritating the endometrial tissue causes the typical severe pain that can occur with endometriosis.
b.Inflammation due to blood irritating the endometrial tissue
c.Hormonal imbalance causing uterine contractions
d.Fibrous tissue responding to hormonal changes in the menstrual cycle
Question 24Viable sperm may not be able to access an ovum when _______.
a.cervical mucus is highly viscous
b.vaginal pH is abnormal
c.structural abnormalities are present
d.All of the above
Question 25Which pathogen is the most common cause of pelvic inflammatory disease (PID) and subsequent infertility?
a.Chlamydia
b.Syphilis
c.Trichomoniasis
d.Herpes simplex
Question 26Which type of microbe is responsible for syphilis infection?
a.A gram-negative diplococcus
b.An anaerobic protozoa
c.A virus
d.An anaerobic spirochete
Question 27Which of the following STIs can develop into a systemic infection with significant multisystem sequalae?
a.Gonorrhea
b.Chlamydia
c.Syphilis
d.None of the above
Question 28In which of the following organs is it necessary for oxygenated blood (arterial) to mix with unoxygenated blood (venous) for the organ to function properly?
a.Pancreas
b.Liver
c.Small intestine
d.Spleen
Question 29Increased peristalsis and secretions in the digestive tract are triggered by which of the following?
a.Sympathetic nervous system
b.Vagus nerve
c.Increased saliva
d.Absence of food in the system
Question 30Which of the following statements is true regarding the visceral peritoneum?
a.It lines the stomach wall.
b.It hangs from the stomach over the loops of small intestine.
c.It contains many pain receptors.
d.It forms the outer covering of the stomach.
Question 31Which of the following statements best describes dysphagia?
a.A herniation of the gastric mucosa through a segment of weakened muscle
b.Recurrent reflux of acid into the esophagus
c.Swelling in the throat
d.Difficulty in swallowing
Question 32Which of the following occurs in congenital pyloric stenosis?
a.Lack of peristalsis in the lower section of the stomach and duodenum
b.Failure of an opening to develop between the stomach and duodenum
c.Hypertrophy of smooth muscle in the pylorus
d.Thickening of the gastric wall due to chronic inflammation associated with age
Question 33Which of the following individuals is at highest risk for the development of acute gastritis?
a.A long-term, heavy cigarette smoker
b.Patient with arthritis taking enteric-coated aspirin on a daily basis
c.A person with an autoimmune reaction in the gastric mucosa
d.An individual with an allergy to shellfish who mistakenly eats shellfish
Question 34Which of the following can develop secondary to chronic bleeding from gastric carcinoma?
a.Occult blood in the stool and anemia
b.Hematemesis and shock
c.Severe abdominal pain and distention
d.Red blood on the surface of the stool
Question 35Which of the following is the most common cause of gastroenteritis secondary to Salmonella infection?
a.Unrefrigerated custards or salad dressings
b.Poorly canned foods
c.Raw or undercooked poultry or eggs
d.Contaminated water
Question 36Which of the following describes what occurs in a patient with congenital esophageal atresia?
a.Direct passage of saliva and food from the mouth into the trachea and lungs
b.Periodic reflux of gastric secretions into the esophagus
c.No fluid or food entering the stomach
d.Gastric distention and cramps
Question 37Which of the following refers to inflammation usually related to infection of the bile ducts?
a.Cholelithiasis
b.Cholecystitis
c.Cholangitis
d.Choledocholithiasis
Question 38Which pathologic change occurs first in alcoholic liver disease?
a.Formation of nodules with shrinkage of the liver
b.Inflammation with necrosis
c.Development of fibrous bands of tissue
d.Accumulation of fat in hepatocytes with concurrent hepatomegaly
Question 39Which of the following refers to obstruction by gallstones of the biliary tract?
a.Cholangitis
b.Cholelithiasis
c.Cholecystitis
d.Choledocholithiasis
Question 40You have just diagnosed a patient with alcoholic liver disease, and he asks if his condition is reversible. As you answer him, you remember that the damage from alcoholic liver disease can be reversed at which stage of disease progression?
a.It can never be reversed.
b.Initial stage only
c.Alcoholic hepatitis/cirrhosis stage
d.It can be reversed at any stage.
Question 41Which of the following statements is true regarding hepatitis B? Select all that apply.
Select one or more:
a.The liver is inflamed and enlarged.
b.Blood clotting delays are apparent at later stages of the disease.
c.Hepatocytes cannot regenerate when the virus is present.
d.Infection is self-limiting.
Question 42Buildup of which substance may lead to encephalopathy in a patient with cirrhosis?
a.Serum urea
b.Conjugated bilirubin
c.Serum ammonia
d.Serum bicarbonate
Question 43What signs and symptoms are most commonly elicited when a gallstone obstructs the cystic duct?
a.Left upper quadrant pain that gradually worsens
b.Acute pancreatitis
c.Severe colicky pain in upper right quadrant
d.Inflammation and infection in the gallbladder
Question 44Which of the following conditions is characterized by stools that are mostly liquid and contain mucus and frank blood?
a.Diverticulitis
b.Ulcerative colitis
c.Crohn’s disease
d.Appendicitis
Question 45Small, hidden amounts of blood in stool that do not cause visible changes are referred to as ________.
a.melena
b.occult blood
c.frank blood
d.hematochezia
Question 46A congenital condition in which parasympathetic innervation is missing from a section of the colon, impairing motility, is referred to as ________.
a.diverticulitis
b.Crohn’s disease
c.Intussusception
d.Hirschsprung disease
Question 47Which of the following descriptions is most consistent with steatorrhea?
a.A light gray-colored stool
b.A tarry black stool
c.Bulky, fatty, foul-smelling stools
d.White stools streaked with blood
Question 48Which of the following does the defecation reflex require?
a.Stimulation by the sympathetic nervous system
b.Contraction of the internal anal sphincter
c.Coordination through the sacral spinal cord
d.None of the above
Question 49Chemical peritonitis that occurs secondary to a perforated gallbladder is likely to lead to what outcome?
a.Leakage of intestinal bacteria into blood and the peritoneal cavity
b.Massive hemorrhage and shock
c.Breakdown of the gallstones
d.Development of gallstones
Question 50Which of the following statement(s) about jaundice is/are true?
1. It is often the first manifestation of hepatitis.
2. Jaundice indicates permanent liver damage.
3. Individuals with hepatitis are always jaundiced.
4. Jaundice usually develops with hepatocellular carcinoma.
a.1, 4
b.4 only
c.1, 3
d.2, 4