A nurse practitioner is educating a patient with a recent diagnosis of diabetes about the roles that glucose and insulin play in the disease pathology and the fact that glucose must enter the cell in order to provide energy for the patient.
A nurse practitioner is educating a patient with a recent diagnosis of diabetes about the roles that glucose and insulin play in the disease pathology and the fact that glucose must enter the cell in order to provide energy for the patient. The nurse practitioner knows that which of the following processes allows glucose to enter body cells
Osmosis
Facilitateddiffusion
Activetransport
Diffusion
Question 2.2. As part of an orientation to a genetic counseling practice,a group of medical students is differentiating between autosomal recessive disorders and autosomal dominant disorders. Which of the following statements is true of autosomal recessive disorders?
They can manifest when present in one or both genepairs.
*There is a one in two chance of an affected child in each pregnancy with an affectedmother.
They tend to have a more uniform symptomatology than autosomal dominantdisorders.
The associated disorders are usually attributable toabnormalities in structuralproteins.
Question 3.3. A woman is surprised to read on the Internet that certain infections can cause cancer and has sought clarification from her nurse practitioner during an office visit. How can the NP best respond to the woman’s query?
“Though it’s not particularly common, it’s true that certain bacteria and viruses can lead tocancer.”
“Most cancers that cannot be attributed to family history orlifestyle are in fact associated withviruses.”
“There are many viruses, but only a very few of them have been shown to cause cancer inhumans.”
“This is true; for example, HIV has been shown to cause cancer in somepatients.”
Question 4.4. Which of the following statements most accurately conveys an aspect of cell injury due to impaired calcium homeostasis?
Normal intracellular calcium ion levels are higher than extracellularlevels.
Ischemia and certain toxins cause a decrease in cytosoliccalcium.
Injured cells tend to accumulatecalcium.
Low calcium levels cause an activation of damagingenzymes.
Question 5.5. A 77yearold male patient with a diagnosis of stomachcancer has been found to have metastases in his liver. The patient and his family are surprised at this turn of events, stating that they don’t see how he could have developed cancer in his liver. Which of the following facts would underlie the reply that the careteam provides?
The parenchymal tissue of the liver is particularly susceptible to secondarymalignancies.
The portal circulatory system brings venous blood from thegastrointestinal tract into theliver.
Hepatic stromal tissue shares characteristics with cancerous cells, including lack of anchoragedependence.
*The proximity of the liver to the stomach allows for direct spread of cancerous cells due to a lack of contactinhibition.
Question 6.6. A group of researchers has identified that the prevalence of two particular genetic disorders share a statistical correlation. Which of the following statements best conveys the genetic rationale for this situation?
There is likely a causeandeffect relationship between the two genesresponsible.
The chromosomes containing each gene are likely closelysituated.
The genes causing each disorder are likely in the same section of the samechromosome.
The disorders likely share the samelocus.
Question 7.A nurse practitioner employed in a hospitalist notices that a patient is experiencing muscle atrophy following 2 weeks in traction after a motor vehicle accident. Which of the following factors has most likely contributed to the atrophy of the patient’s muscle cells?
High levels of insulin and IGF1 in the patient’s blood during immobilization
Denervation of the affected muscles during the timeoftraction A reduction of skeletal muscle use secondary to thetraction
treatment
Reduced oxygen consumption and cellular function that ensures muscle cellsurvival
Question 8.8. A researcher is involved in the production of insulinthrough recombinant DNA technology. Which of the following statements could the researcher best provide as a rationale for her work?
The gene fragment responsible for insulin production can beisolated andreproduced.
Particular bacteria are capable of insulinproduction.
It is possible to reproduce the chromosome responsible for insulinproduction.
Recombination of DNA base pairs can result in a gene that will produceinsulin.
Question 9.9. A 7yearold boy is admitted to the hospital with a suspected diagnosis of lead toxicity. Which of the following assessment findings is most congruent with the patient’s diagnosis?
Decreased deeptendonreflexes
Hemoglobin 9.9g/dL
Diffuse musclepain
White blood cells (WBC)11,000/mm3
Question 10.10. The nurse practitioner is seeing a client who has an acute exacerbation of Crohn’s disease. The NP recognizes the fact that the disease involves the inflammation and irritation of the intestinal lining. Which of the following types of tissue is most likely involved in the patient’s pathology?
Simplecolumnarepithelium Glandularepithelium
Simplecuboidalepthelium Stratifiedepithelium
Question 11.11. A child possesses a trait that is the result of the interaction of two different genes, neither of which could have produced the trait independently. Which of the following explanations best captures the genetic explanation for this?
The trait is an expression of multiplealleles.
Epistasis has dictated the phenotypic outcome.
The phenomenon is an example of polygenicinheritance.
The outcome is the result of the interaction between collaborativegenes.
Question 12.12. A new older female patient at a longterm care facility has a diagnosis of type 1 neurofibromatosis (NF1). As part of the intake assessment protocol for the facility, the clinical educator is teaching the care staff about the diagnosis. Which of the following statements most accurately conveys an aspect of neurofibromatosis?
“The neurofibroma lesions are unsightly for the patient, but theyare notpainful.
“Her diagnosis puts her at higher risk of developing a malignant neoplasm.”
“She is living with an example of an autosomal recessive disorder.”
“The patient is likely to be photosensitive as a result of the disease.”
Question 13.13. A male patient of a nurse practitioner has an autosomal dominant disorder. The patient and his partner are considering starting a family. Which of the patient’s following statements indicates the patient has an adequate understanding of the genetic basis of this health problem?
“I know there’s no way of accurately determining the chance that my child will inherit thedisease.”
“My children who don’t have the disease still run the risk of passing it on to theirchildren.”
“I know that new genetic mutations won’t occur between generations.”
“I know that a single mutant allele is to blame for the healthproblem.”
Question 14.14. Which of the following patients of a primary care nurse practitioner would not require extra screening for cancer?
A 51yearold woman whose grandmother died of breastcancer
A 48yearold man who takes immunosuppressant drugs following akidneytransplant
A 50yearold male who is obese and has a lowfiber,highfat diet
A 38yearold female with Down syndrome and congenitalscoliosis
*Question 15.15. The nurse practitioner is providing care for a patient with a diagnosis of cirrhosis, and he notes that the patient’s sclerae are jaundiced. The nurse practitioner recalls that jaundice is caused by excess accumulation of bilirubin, a pigment that can accumulate in which part of the cell?
Nucleus
Cytoplasm
Golgiapparatus
Rough endoplasmic reticulum(ER)
Question 16.16. The family of a 68yearold man who is in the end stages of small cell lung cancer is distraught at his visible body wasting that has worsened in recent weeks. Which of the following phenomena best accounts for the patient’s anorexia and cachexia?
Inadequate cellular metabolism of glucose results from tumor factors
High fat losses coupled with preservation of muscle massexaggerate the appearance ofwasting
Products of the tumor itself as well as a hypermetabolic state causecachexia
Inadequate food intake due to symptoms and treatment results in loss of both muscle andfat
Question 17.17. A 6yearold girl with a diagnosis of Marfan syndrome is being assessed at a community health clinic. Which of the following assessments would be the health care professional’s lowest
priority?
A test of the child’s visualacuity
*Amusculoskeletalassessment Tests of kidneyfunction
Cardiovascularassessment
Question 18.18. The NP is providing care for a 21yearold female patient with gas gangrene of a compound fracture in her arm. Which of the following assessment findings would the nurse most reasonably expect to find when caring for a patient with a diagnosis of gas gangrene?
Inflammation of the affectedtissue
A positive culture for Staphylococcus
Spreading edema
Impaired alveolar gasexchange
Question 19.19. A student nurse practitioner asks her preceptor about the origins of different tissues, and their cellular origins during the process of development. Which of the following statements by the preceptor best describes the process of cell differentiation?
“Cells of the hematopoietic system produce the appropriate body cells that are required at each stage ofdevelopment.”
“A single stem cell differentiates into approximately 200different types ofcells.”
“A fertilized ovum undergoes a series of divisions, yielding many different celltypes.”
“Cells differentiate into necessary body cells, peaking after conception, and ceasing near the time ofbirth.”
Question 20.20. The nurse practitioner working in occupational health has been asked to speak to a group of factory workers about the importance of wearing gloves when working with strong chemicals such as turpentine and paint thinner. Which of the following characteristics of cell membranes underlies the nurse’s teaching?
Cell membranes are impermeable to all but lipidsolublesubstances.
Cell membranes have lipids that have a hydrophilic head and a hydrophobictail.
Cell membranes contain receptors for hormones and biologicallyactivesubstances.
Transmembrane proteins can pass through the cell membrane into the intracellularenvironment.
Question 21.21. Which of the following pregnant women has most likely encountered the greatest increase in the risk that her child will have a fetal anomaly?
A woman with diagnoses of syphilis and cirrhosis oftheliver
A woman who has herpes simplex and recently recoveredfrom endocarditis
A woman with chronic obstructive pulmonary syndrome and tuberculosis
A woman with diagnoses of insulindependent diabetes mellitusand
peripheral neuropathy
Question 22.22. Which target of both chemotherapy and radiation treatment accounts for adverse as well as therapeutic effects?
Cellsurfacereceptors
Circulating hormone levels Bloodvessels
Rapidly proliferatingcells
Question 23.23. An infant who is four days postpartum has been diagnosed with a singlegene disorder. The parents of the child have a number of questions about the etiology of the health problem, which the physician is attempting to address in detail. Which of the following teaching points most accurately captures an aspect of singlegene congenital disorders?
Affected genes are present on autosomal chromosomes rather than sexchromosomes.
The majority of singlegene disorders manifest near the time of puberty.
A particular defect can be caused by mutations at one of several differentloci.
Singlegene disorders are associated with existing rather thannewmutations.
Question 24.24. Following a biopsy, a 54yearold man has been diagnosedas having a benign neoplastic tumor. Which of the following characteristics most likely applies to his tumor?
The tumor is poorly approximated and has the potential to break loose.
The tumor may secrete hormones or cytokines.
The welldifferentiated neoplastic cells are clustered together in a single mass.
It has a rapid rate of growth and can induceischemia.
Question 25.25. A nurse practitioner employed in the emergency department admits a patient who has experienced severe frostbite to his hands and toes after becoming lost on a ski trail. The NP recognizes that which of the following phenomena has caused the tissue damage?
Decreased blood viscosity has resulted ininterstitialbleeding.
Reactive vasodilation has compromisedperfusion.
Autonomic nervous stimulation has resulted in injury.
Decreased blood flow has inducedhypoxia.
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