NR 507 Week 3 Discussion Assignment Papers

NR 507 Week 3 Discussion Assignment Papers

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PART No. 1:

A 17-year-old African American from the inner city complains of severe chest and abdominal pain. Upon examination the attending physician performs and EKG, chest x-ray, and an abdominal and chest clinical examination and finds nothing. Assuming, she is drug seeking he sends her home. She comes back to the ER four hours later and now you see the patient. She explains that she was running track this past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts feeling extensive pain in her chest and abdomen.  She has jaundiced eyes, her blood pressure is 98/50, pulse is 112, T = 99.9 F, R = 28. The pain seems out of proportion to the physical findings.

· What is your list of differential diagnoses in this case and explain how each of these fits with the case patient as described above. Be sure to list at least three (3) pertinent differential diagnoses. Indicate which of these you would select as the most likely diagnosis and explain why.

· Now, as she is in the ER she begins to exhibit stroke like features. ? Does this change your differential?

· How do you treat this patient now? Are they any preventative actions that could have been taken?

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Discussion Assignment Papers

PART No. 2:

Jesse is a 57-year-old male who presents with gradual onset of dyspnea on exertion and fatigue. He also complains of frequent dyspepsia (GERD) with nausea and occasional epigastric pain. He states that at night he has trouble breathing especially while lying on his back (Orthopnea). This is relieved by him sitting up. His vitals are 180/110, P = 88, T = 98.0 F, R = 20.

· Write three (3) differential diagnoses in this case and explain how each item in your differential fits and how it might not fit.

· What tests would you order? What immediate treatment would you consider giving this patient and what treatment when he went home? Assume your first differential is definitive.

· Now, he comes back to your clinic 3 months later and both his ankles are slightly swollen. What possible explanations are there for this observation? CHF now involving right side Must order Echo with EKG and Nuc stress test, labs Pro BNP. NR 507 Week 3 Discussion Assignment Papers.

PART No. 3:

A new patient is brought into the office for their annual evaluation. The child is a 6-year-old and appears a bit small for their age but not so small that any alarm bells are set off.  The vitals are: P = 116, R = 22, T = 98.6 F, BP = 110/50. (The normal vitals in a 6-year-old are P = 75 – 120, R = 16 – 22, T = 98.6 , BP = (85-115)/(48-64).  Examination of the lungs is normal, HEENT is normal, as is the abdominal exam. The heart however, seems laterally displaced and there appears to be only a continuous murmur which can be described as crescendo/decrescendo systolic murmur that extends into diastole. Because, you were trained at Chamberlain College of Nursing you immediately know that this is probably a patent ductus arteriosus.

· Explain the murmur from a mechanistic view of the hearts physiological functioning?

· What is the epidemiology of a patent ductus arteriosus?

· How is a patent ductus arteriosus treated?

NR 507 Week 3 Quiz Answers: NR 507 Week 3 Discussion Assignment Papers

1. The underlying disorder of _____ anemia is defective secretion of intrinsic factor, which is essential for the absorption of vitamin B12.(Points : 2)

2. What is the pathophysiologic process of aplastic anemia? (Points : 2)

3. The body compensates for anemia by (Points : 2)

4. A woman complains of chronic gastritis, fatigue, weight loss, and tingling in her fingers. Laboratory findings show low hemoglobin and hematocrit levels, and a high mean corpuscular volume. These findings are consistent with _____ anemia. (Points : 2)

5. In hemolytic anemia, jaundice occurs only when (Points : 2)

6. Symptoms of polycythemia vera are mainly the result of (Points : 2)

7. Which proinflammatory cytokines are responsible for the development and maintenance of DIC? (Points : 2)

8. Which of the following is a description consistent with acute lymphocytic leukemia (ALL)? (Points : 2)

9. Heparin-induced thrombocytopenia (HIT) is described as a(n) (Points : 2)

10. Which of the following is a description consistent with chronic lymphocytic leukemia (CLL)? (Points : 2)

11. Hemolytic disease of the newborn can occur if the mother is (Points : 2)

12. Polycythemia occurs in a fetus because (Points : 2)

13. The type of anemia that occurs as a result of thalassemia is (Points : 2)

14. The sickle cell trait differs from sickle cell disease in that the child with sickle cell trait (Points : 2)

15. Hemophilia B is caused by clotting factor _____ deficiency. (Points : 2)

16. What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in the brain?(Points : 2)

17. An individual who is demonstrating elevated levels of troponin, creatine kinase (CK), and lactic dehydrogenase (LDH) is exhibiting indicators associated with: (Points : 2)

18. What alteration occurs in injured endothelial cells that contributes to atherosclerosis? (Points : 2)

19. Which of the following is manufactured by the liver and primarily contains cholesterol and protein? (Points : 2)

20. Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes? (Points : 2)

21. When does systemic vascular resistance in infants begin to rise? (Points : 2)

22. An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect? (Points : 2)

23. Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome? (Points : 2)

24. The foramen ovale is covered by a flap that creates a check valve allowing blood to flow unidirectionally from the _____ to the _____.(Points : 2)

25. Which heart defect produces a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border with an occasional ejection click? (Points : 2)

NR 507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam – NR 507 Week 3 Discussion Assignment Papers)

Week 1: Altered Immune System and Altered Inflammatory Response

– Discussion Part One

This week’s graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

6 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Discussion

Discussion Part One (graded)

John is a 19-year-old college football player who presents with sneezing, itchy eyes, and nasal congestion that worsens at night. He states that he has a history of asthma, eczema and allergies

to pollen. There is also one other person on the football team that has similar symptoms. His vitals are BP 110/70, P 84, R 18, T 100 F. Write a differential of at least five (5) possible items from the most likely to less likely. For each disease include information about the epidemiology, pathophysiology and briefly argue why this disease fits the presentation and why it might not fit the presentation.

Week 1: Altered Immune System and Altered Inflammatory Response – Discussion

Part Two

A patient has been admitted into the emergency room that was in the passenger side of a car that collided with another car head on. The patient is pale, barely conscious and has a weak and thready pulse. An IV is started. The vitals are BP 80/50, P 140, T 96.0 and R 26. As the team fights to keep the patient alive they have to remove the spleen. Blood is given but it has been mistyped. A transfusion reaction occurs. Describe the type of hypersensitivity reaction that has occurred and discuss the molecular pathophysiology of the specific type of hypersensitive reaction you have chosen.

In the event that this patient survived the car accident and the transfusion reaction which organs are most likely to be damaged and why?

Week 1: Altered Immune System and Altered Inflammatory

Response – Discussion Part Three

This week’s graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1,

4 Distinguish risk factors associated with selected disease states.(PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Discussion

A 44-year-old patient presents with lump in the chest of approximately 2 cm in diameter. There is a slight dimple over the location of the lump and when the lump is manipulated it seems to be attached to the surrounding tissue. A lumpectomy is performed and the mass is sent to pathology. The pathology report comes back and the mass is confirmed to be an estrogen receptor negative, a progesterone receptor negative and a her2/neu receptor positive breast cancer.

What are some of the risk factors for breast cancer?

What tumor suppressor genes are associated with breast cancer?

What tumor oncogenes are associated with breast cancer?

Compare and contrast tumor suppressor genes from oncogenes?

Week 2: Respiratory Disorders and Alterations in Acid/Base Balance, Fluid and Electrolytes – Discussion Part One

This week’s graded topics relate to the following Course Outcomes (COs).

Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

Distinguish risk factors associated with selected disease states. (PO1)

Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

Distinguish risk factors associated with selected disease states. (PO1)

Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Discussion Part One (graded)

A five-month-old Caucasian female is brought into the clinic as the parent complain that she has been having ongoing foul-smelling , greasy diarrhea. She seems to be small for her age and a bit sickly but, her parent’s state that she has a huge appetite. Upon examination you find that the patient is wheezing and you observe her coughing.

Write a differential diagnosis of at least five (5) disorders and explain why each might be a possibility and any potential weaknesses of each differential.

Why is it that the later in age this disease manifest itself, the less severe the disease is?

What tests would you run to clarify your differential and potentially come to a definitive diagnosis?

If the same child was African in ancestry would this change your initial differential? Why or why not?

Week 2: Respiratory Disorders and Alterations in Acid/Base Balance, Fluid and Electrolytes – Discussion Part Two

This week’s graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

4 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Tammy is a 33-year-old who presents for evaluation of a cough. She reports that about 3 weeks ago she developed a “really bad cold” with rhinorrhea. The cold seemed to go away but then she developed a profound, deep, mucus-producing cough. Now, there is no rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Tammy has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves. NR 507 Week 3 Discussion Assignment Papers

Write a differential of at least five (5) possible diagnosis’s and explain how each may be a possible answer to the clinical presentation above.

Remember, to list the differential in the order of most likely to less likely.

Based upon what you have at the top of the differential how would you treat this patient?

Suppose now, the patient has a fever of 100.4 and complains of foul smelling mucous and breath. Indeed, she complains of producing cups of mucous some days. She has some trouble breathing on moderate exertion but this is only a minor complaint to her. How does this change your differential and why?

Week 2: Respiratory Disorders and Alterations in Acid/Base Balance,

Fluid and Electrolytes – Discussion Part Three

This week’s graded topics relate to the following Course Outcomes (COs).

Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

Distinguish risk factors associated with selected disease states.

Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

Distinguish risk factors associated with selected disease states. (PO

Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

A nursing student comes into your office because they are struggling with the concept of pulmonary function. They know you as an experienced FNP and so they are comfortable asking if you could clarify the terms residual volume (RV), functional reserve capacity (FRC), total lung capacity (TLC) inspiratory reserve volume (IRV), and expiratory reserve volume (ERV).

Give her a definition of each?

List three (3) disorders that can alter the residual volume and explain how they do so?

Week 3: Cardiovascular, Cellular, and Hematologic Disorders – Discussion

Week 3

Part One

This week’s graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1).

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

4 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states

A 17-year-old African American from the inner city complains of severe chest and abdominal pain. Upon examination the attending physician performs and EKG, chest x-ray, and an abdominal and chest clinical examination and finds nothing. Assuming, she is drug seeking he sends her home. She comes back to the ER 4 hours later and now you see the patient. She explains that she was running track this past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts feeling extensive pain in her chest and abdomen. She has jaundiced eyes, her blood pressure is 98/50, pulse is 112, T = 99.9 F, R = 28. The pain seems out of proportion to the physical findings.

What is your list of differential diagnoses in this case and explain how each of these fits with the case patient as described above. Be sure to list at least four (4) pertinent differential diagnoses. Indicate which of these you would select as the most likely diagnosis and explain why.

Now, as she is in the ER she begins to exhibit stroke like features. ? Does this change your differential? How do you treat this patient now? Are they any preventative actions that could have been taken?

Week 3: Cardiovascular, Cellular, and Hematologic Disorders –

Discussion Part Two

This week’s graded topics relate to the following Course Outcomes (COs).

1 Analyze pathophysiologic mechanisms associated with selected disease states. (PO 1)

2 Differentiate the epidemiology, etiology, developmental considerations, pathogenesis, and clinical and laboratory manifestations of specific disease processes. (PO 1)

3 Examine the way in which homeostatic, adaptive, and compensatory physiological mechanisms can be supported and/or altered through specific therapeutic interventions. (PO 1, 7)

4 Distinguish risk factors associated with selected disease states. (PO 1)

5 Describe outcomes of disruptive or alterations in specific physiologic processes. (PO 1)

6 Distinguish risk factors associated with selected disease states. (PO 1)

7 Explore age-specific and developmental alterations in physiologic and disease states. (PO 1, 4)

Jesse is a 57-year-old male who presents with gradual onset of dyspnea on exertion and fatigue. He also complains of frequent dyspepsia with nausea and occasional epigastric pain. He states that at night he has trouble breathing especially while lying on his back. This is relieved by him sitting up. His vitals are 180/110, P = 88, T = 98.0 C, R = 20.

Write a differential in this case and explain how each item in your differential fits and how it might not fit.

What tests would you order? What immediate treatment would you consider giving this patient and what treatment when he went home? Assume your first differential is definitive.

Now, he comes back to your clinic 3 months later and both his ankles are slightly swollen. What possible explanations are there for this observation?

Week 3: Cardiovascular, Cellular, and Hematologic Disorders –

Discussion Part Three

A new patient is brought into the office for their annual evaluation. The child is a 6-year-old and appears a bit small for their age but not so small that any alarm bells are set off. The vitals are: P = 116, R = 22, T = 98.6 ^F, BP = 110/50. (The normal vitals in a 6-year-old are P = 75 – 120, R = 16 – 22, T = 98.6 , BP = (85-115)/(48-64). Examination of the lungs is normal, HEENT is normal, as is the abdominal exam. The heart however, seems laterally displaced and there appears to be only a continuous murmur which can be described as crescendo/decrescendo systolic murmur that extends into diastole. Because, you were trained at Chamberlain College of Nursing you immediately know that this is probably a patent ductus arteriosus.

Week 5: Alterations in Endocrine Function – Discussion Part One

Ms. Blake is an older adult with diabetes and has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. She has a history of Type I diabetes. On admission her laboratory values show:

Sodium (Na+)	156 mEq/L
Potassium (K+)	4.0 mEq/L
Chloride (Cl–)	115 mEq/L
Arterial blood gases (ABGs)	pH- 7.30; Pco2-40; Po2-70; HCO3-20
Normal values
Sodium (Na+)	136-146 mEq/L
Potassium (K+)	3.5-5.1 mEq/L
Chloride (Cl–)	98-106 mEq/L
Arterial blood gases (ABGs)	pH- 7.35-7.45Pco2- 35-45 mmHg Po2-80-100 mmHg HCO3–22-28 mEq/L

• List three (3) reasons on why she may have become bed ridden?
• Based on these reasons what tests would you order?
• Describe the molecular mechanism of the development of ketoacidosis.

13 13 unread replies. 39 39 replies.

A three-month-old baby boy comes into your clinic with the main complaint that he frequently vomits after eating. He often has a swollen upper belly after feeding and acts fussy all the time. The vomiting has become more frequent this past week and he is beginning to lose weight.

• Write three (3) differential diagnoses at this time?
• Is there any genetic component to the top of your differentials?
• What tests would you order?

27 27 unread replies. 38 38 replies.

Write a one (1) paragraph case study of your own for a patient with Ulcerative Colitis?

Week 6: Discussion Part One

You are contacted by an attorney representing a client who has been charged with child abuse and whom faces loss of her child and 15 years in prison. The record indicated that the child was 4 years old and presented to the ER room with a broken arm and a broken leg. There also appeared to be multiple previous fractures. Now, you examine the child and find blue sclera, a sunken chest wall, severe scoliosis, and you observe a triangular face and prominent forehead. You confirm that there have been multiple previous fractures by evaluating the previous X-rays. This is a genetic disorder.

• What is the most likely genetic disease that this presents and why?
• What is the molecular basis of this disease?
• Before, calling the police what should the initial clinician have done?

Johnny is a 5-year-old Asian boy who is brought to a family practice office with a “runny” nose that started about 1 week ago but has not resolved. He has been blowing his nose quite frequently and “sores” have developed around his nose. His mother states, “The sores started as ‘big blisters’ that rupture; sometimes, a scab forms with a crust that looks like “dried maple syrup” but continues to seep and drain.” She is worried because the lesions are now also on his forearm. Johnny’s past medical and family histories are normal. He has been febrile but is otherwise asymptomatic. The physical examination was unremarkable except for moderate, purulent rhinorrhea and 0.5- to 1-cm diameter weeping lesions around the nose and mouth and on the radial surface of the right forearm. There is no regional lymphadenopathy.

• Write a differential of at least three (3) possible diagnoses and explain how each may be a possible answer to the clinical presentation above. Remember, to list the differential in the order of most likely to less likely.
• Based upon what you have at the top of the differentials how would you treat this patient?
• When would you allow the student back to school? Elaborate on your reasoning?

Week 6: Discussion Part Three

Keisha, a 13-year-old female, has come into your urgent care center. She has red conjunctiva, a cough and a fever of about 104 F, She also has a rash on her face a possibly the beginning of a rash on her arms. About 10 days ago she was around another student who had similar symptoms.

• Write three (3) differential diagnoses?
• What are some of the complications of this disease, assume that the top of your differential is the definitive?
• Assume that the second item you place on your differential is the definitive diagnosis. What are some complications of that disease?

Reflect back over the past eight weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #, MSN Essential VIII, and Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

Program Outcome #4: Evaluate the design, implementation, and outcomes of strategies developed to meet healthcare needs (MSN Essentials III, IV, VIII).

MSN Essential VIII: Clinical Prevention and Population Health for Improving Health

•Recognizes that the master’s-prepared nurse applies and integrates broad, organizational, client-centered, and culturally appropriate concepts in the planning, delivery, management, and evaluation of evidence-based clinical prevention and population care and services to individuals, families, and aggregates/identified populations.

Nurse Practitioner Core Competencies # 1 Scientific Foundation Competencies

1. Critically analyzes data and evidence for improving advanced nursing practice.

2. Integrates knowledge from the humanities and sciences within the context of nursing science.

3. Translates research and other forms of knowledge to improve practice processes and outcomes.

4. Develops new practice approaches based on the integration of research, theory, and practice knowledge.

Midterm

Question 1

2 / 2 pts

Examination of the throat in a child demonstrating signs and symptoms of acute epiglottitis may contribute to which life-threatening complication?

Retropharyngeal abscess

Laryngospasms

Rupturing of the tonsils

Gagging induced aspiration

Question 2

2 / 2 pts

Causes of hyperkalemia include:

Hyperparathyroidism and malnutrition

Vomiting and diarrhea

Renal failure and Addison disease

Hyperaldosteronism and Cushing disease

Question 3

2 / 2 pts

What is the life span of an erythrocyte (in days)?

20 to 30

60 to 90

100 to 120

200 to 240

Question 4

2 / 2 pts

Which substance has been shown to increase the risk of cancer when used in combination with tobacco smoking?

Alcohol

Steroids

Antihistamines

Antidepressants

Question 5

0 / 2 pts

Which hepatitis virus is known to be sexually transmitted?

A

B

C

D

Question 6

2 / 2 pts

What is the purpose of the spirometry measurement?

To evaluate the cause of hypoxia

To measure the volume and flow rate during forced expiration

To measures the gas diffusion rate at the alveolocapillary membrane

To determine pH and oxygen and carbon dioxide concentrations. NR 507 Week 3 Discussion Assignment Papers

Question 7

2 / 2 pts

What is the direct action of atrial natriuretic hormone?

Sodium retention

Sodium excretion

Water retention

Water excretion

Question 8

2 / 2 pts

What is the most important negative inotropic agent?

Norepinephrine

Epinephrine

Acetylcholine

Dopamine

Question 9

2 / 2 pts

What is the primary cause of respiratory distress syndrome (RDS) of the newborn?

Immature immune system

Small alveoli

Surfactant deficiency

Anemia

Question 10

2 / 2 pts

An individual is more susceptible to infections of mucous membranes when he or she has a seriously low level of which immunoglobulin antibody?

NR507 Advanced Pathophysiology – Full Course (all essay discussions+ midterm and final exam)

IgG

IgM

IgA

IgE

Question 11

2 / 2 pts

Low plasma albumin causes edema as a result of a reduction in which pressure?

Capillary hydrostatic

Interstitial hydrostatic

Plasma oncotic

Interstitial oncotic

Question 12

2 / 2 pts

Erythrocyte life span of less than 120 days, ineffective bone marrow response to erythropoietin, and altered iron metabolism describe the pathophysiologic characteristics of which type of anemia?

Aplastic

Sideroblastic

Anemia of chronic disease

Iron deficiency

Question 13

2 / 2 pts

An infant’s hemoglobin must fall below ___ g/dl before signs of pallor, tachycardia, and systolic murmurs occur.

11

9

7

5

Question 14

2 / 2 pts

What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?

Macula densa

Visceral epithelium

Juxtaglomerular apparatus (JGA)

Filtration slits

Question 15

2 / 2 pts

The lung is innervated by the parasympathetic nervous system via which nerve?

Vagus

Phrenic

Brachial

Pectoral

Question 16

2 / 2 pts

Which statement best describes a Schilling test?

Administration of radioactive cobalamin and the measurement of its excretion in the urine to test for vitamin B12 deficiency

Measurement of antigen-antibody immune complexes in the blood to test for hemolytic anemia

Measurement of serum ferritin and total iron-binding capacity in the blood to test for iron deficiency anemia

Administration of folate and measurement in 2 hours of its level in a blood sample to test for folic acid deficiency anemia. NR 507 Week 3 Discussion Assignment Papers

Question 17

2 / 2 pts

Which disorder results in decreased erythrocytes and platelets with changes in leukocytes and has clinical manifestations of pallor, fatigue, petechiae, purpura, bleeding, and fever?

Idiopathic thrombocytopenic purpura (ITP)

Acute lymphocytic leukemia (ALL)

Non-Hodgkin lymphoma (NHL)

Iron deficiency anemia (IDA)

Question 18

2 / 2 pts

Which compensatory mechanism is spontaneously used by children diagnosed with tetralogy of Fallot to relieve hypoxic spells?

Lying on their left side

Performing the Valsalva maneuver

Squatting

Hyperventilating

Question 19

2 / 2 pts

Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct?

Antidiuretic hormone

Aldosterone

Cortisol

Adrenocorticotropin hormone

Question 20

2 / 2 pts

What is the fundamental physiologic manifestation of anemia?

Hypotension

Hyperesthesia

Hypoxia

Ischemia

Question 21

2 / 2 pts

Continuous increases in left ventricular filing pressures result in which disorder?

Mitral regurgitation

Mitral stenosis

Pulmonary edema

Jugular vein distention

Question 22

2 / 2 pts

Which T-lymphocyte phenotype is the key determinant of childhood asthma?

Cluster of differentiation (CD) 4 T-helper Th1 lymphocytes

CD4 T-helper Th2 lymphocytes

CD8 cytotoxic T lymphocytes

Memory T lymphocytes

Question 23

2 / 2 pts

Innervation of the bladder and internal urethral sphincter is supplied by which nerves?

Peripheral nerves

Parasympathetic fibers

Sympathetic nervous system

Tenth thoracic nerve roots

Question 24

2 / 2 pts

Which of the following is classified as a megaloblastic anemia?

Iron deficiency

Pernicious

Sideroblastic

Hemolytic

Question 25

2 / 2 pts

When an individual aspirates food particles, where would the nurse expect to hear decreased or absent breath sounds?

Left lung

Right lung

Trachea

Carina

Question 26

0 / 2 pts

The most common site of metastasis for a patient diagnosed with prostate cancer is which location?

Bones

Brain

Bladder

Kidney

Question 27

2 / 2 pts

Perceived stress elicits an emotional, anticipatory response that begins where?

Prefrontal cortex

Anterior pituitary

Limbic system

Hypothalamus

Question 28

2 / 2 pts

Which manifestations of vasoocclusive crisis are associated with sickle cell disease (SCD) in infants?

Atelectasis and pneumonia

Edema of the hands and feet

Stasis ulcers of the hands, ankles, and feet

Splenomegaly and hepatomegaly

Question 29

2 / 2 pts

Which cytokines initiate the production of corticotropin-releasing hormone (CRH)?

IL–1 and IL-6

IL-2 and TNF-?

IFN and IL-12

TNF-ß and IL-4

Question 30

2 / 2 pts

The generation of clonal diversity occurs primarily during which phase of life?

Fetal

Neonatal

Infancy

Puberty

Question 31

2 / 2 pts

Where in the respiratory tract do the majority of foreign objects aspirated by children finally lodge?

Trachea

Left lung

Bronchus

Bronchioles. NR 507 Week 3 Discussion Assignment Papers

Question 32

2 / 2 pts

Which immunoglobulin (Ig) is present in childhood asthma?

IgM

IgG

IgE

IgA

Question 33

2 / 2 pts

Between which months of age does sudden infant death syndrome (SIDS) most often occur? NR 507 Week 3 Discussion Assignment Papers

0 and 1

2 and 4

5 and 6

6 and 7

Question 34

2 / 2 pts

Which complex (wave) represents the sum of all ventricular muscle cell depolarizations?

PRS

QRS

QT interval

P

Question 35

2 / 2 pts

When a patient has small, vesicular lesions that last between 10 and 20 days, which sexually transmitted infection is suspected?

Genital herpes

Chancroid

Syphilis

Chlamydia

Question 36

2 / 2 pts

What is the chief predisposing factor for respiratory distress syndrome (RDS) of the newborn?

Low birth weight

Alcohol consumption during pregnancy

Premature birth

Smoking during pregnancy

Question 37

2 / 2 pts

Which statement concerning exotoxins is true?

Exotoxins are contained in cell walls of gram-negative bacteria.

Exotoxins are released during the lysis of bacteria.

Exotoxins are able to initiate the complement and coagulation cascades.

Exotoxins are released during bacterial growth.

Question 38

2 / 2 pts

Deficiencies in which element can produce depression of both B- and T-cell function?

Iron

Zinc

Iodine

Magnesium

Question 39

0 / 2 pts

The function of the foramen ovale in a fetus allows what to occur?

Right-to-left blood shunting

Left-to-right blood shunting

Blood flow from the umbilical cord

Blood flow to the lungs

Question 40

2 / 2 pts

Decreased lung compliance means that the lungs are demonstrating which characteristic?

Difficult deflation

Easy inflation

Stiffness

Inability to diffuse oxygen

Question 41

2 / 2 pts

60 to 70

40 to 60

30 to 40

10 to 20

Question 42

2 / 2 pts

Which statement concerning benign tumors is true?

The resulting pain is severe.

Benign tumors are not encapsulated.

Benign tumors are fast growing.

The cells are well-differentiated.

Question 43

2 / 2 pts

How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness?

75 to 100 ml

100 to 150 ml

250 to 300 ml

350 to 400 ml

Question 44

2 / 2 pts

How high does the plasma glucose have to be before the threshold for glucose is achieved?

126 mg/dl

150 mg/dl

180 mg/dl

200 mg/dl

Question 45

0 / 2 pts

Apoptosis is a(an):

Normal mechanism for cells to self-destruct when growth is excessive

Antigrowth signal activated by the tumor-suppressor gene Rb

Mutation of cell growth stimulated by the TP53 gene

Transformation of cells from dysplasia to anaplasia

Question 46

0 / 2 pts

What is the role of collagen in the clotting process?

Initiates the clotting cascade.

Activates platelets.

Stimulates fibrin.

Deactivates fibrinogen.

Question 47

0 / 2 pts

Infants are most susceptible to significant losses in total body water because of an infant’s:

High body surface–to–body size ratio

Slow metabolic rate

Kidneys are not mature enough to counter fluid losses

Inability to communicate adequately when he or she is thirsty

Question 48

0 / 2 pts

What is the action of urodilatin?

Urodilatin causes vasoconstriction of afferent arterioles.

It causes vasodilation of the efferent arterioles.

Urodilatin inhibits antidiuretic hormone secretion.

It inhibits salt and water reabsorption.

Question 49

0 / 2 pts

Which cardiac chamber has the thinnest wall and why?

The right and left atria; they are low-pressure chambers that serve as storage units and conduits for blood.

The right and left atria; they are not directly involved in the preload, contractility, or afterload of the heart.

The left ventricle; the mean pressure of blood coming into this ventricle is from the lung, which has a low pressure.

The right ventricle; it pumps blood into the pulmonary capillaries, which have a lower pressure compared with the systemic circulation. NR 507 Week 3 Discussion Assignment Papers

Question 50

0 / 2 pts

Research supports the premise that exercise has a probable impact on reducing the risk of which cancer?

Liver

Endometrial

Stomach

Colon

Question 51

0 / 2 pts

What is the trigone?

A smooth muscle that comprises the orifice of the ureter

The inner mucosal lining of the kidneys

A smooth triangular area between the openings of the two ureters and the urethra

One of the three divisions of the loop of Henle

Question 52

2 / 2 pts

What is the most abundant class of plasma protein?

Globulin

Albumin

Clotting factors

Complement proteins

Question 53

2 / 2 pts

The glomerular filtration rate is directly related to which factor?

Perfusion pressure in the glomerular capillaries

Diffusion rate in the renal cortex

Diffusion rate in the renal medulla

Glomerular active transport

Question 54

0 / 2 pts

Which cells have phagocytic properties similar to monocytes and contract like smooth muscles cells, thereby influencing the glomerular filtration rate? NR 507 Week 3 Discussion Assignment Papers

Principle cells

Podocin cells

Mesangial cells

Intercalated cells

Question 55

0 / 2 pts

Why is nasal congestion a serious threat to young infants?

Infants are obligatory nose breathers.

Their noses are small in diameter.

Infants become dehydrated when mouth breathing.

Their epiglottis is proportionally greater than the epiglottis of an adult’s.

Question 56

2 / 2 pts

The risk for respiratory distress syndrome (RDS) decreases for premature infants when they are born between how many weeks of gestation?

16 and 20

20 and 24

24 and 30

30 and 36

Question 57

2 / 2 pts

What is the ratio of coronary capillaries to cardiac muscle cells?

1:1 (one capillary per one muscle cell)

1:2 (one capillary per two muscle cells)

1:4 (one capillary per four muscle cells)

1:10 (one capillary per ten muscle cells)

Question 58

2 / 2 pts

A person with type O blood is considered to be the universal blood donor because type O blood contains which of the following?

NR 507 Week 3 Discussion Assignment Papers

No antigens

No antibodies

Both A and B antigens

Both A and B antibodies

Question 59

2 / 2 pts

The drug heparin acts in hemostasis by which processes?

Inhibiting thrombin and antithrombin III (AT-III)

Preventing the conversion of prothrombin to thrombin

Shortening the fibrin strands to retract the blood clot

Degrading the fibrin within blood clots

Question 60

2 / 2 pts

What effects do exercise and body position have on renal blood flow?

Exercise and body position activate renal parasympathetic neurons and cause mild vasoconstriction.

They activate renal sympathetic neurons and cause mild vasoconstriction.

Both activate renal parasympathetic neurons and cause mild vasodilation.

They activate renal sympathetic neurons and cause mild vasodilation.

Final exam