MN551 Midterm Exam 2023: Questions
And Answers
Which of the following individuals would be considered to be at risk for the
development of edema? - -An 81-year-old man with right-sided heart failure
and hypothyroidism
-The family of a 68-year-old 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? - -Products of the tumor itself as well as a
hypermetabolic state cause cachexia
-Which of the following statements best conveys an aspect of the respiratory
pressures that govern ventilation?
Question options: - -Negative intrapleural pressure holds the lungs against
the chest wall
-Increased thrombopoietin levels - -Following a course of measles, a 5-year-
old girl developed scattered bruising over numerous body surfaces and was
diagnosed with immune thrombocytopenic purpura (ITP). As part of her
diagnostic workup, blood work was performed. Which of the following results
is most likely to be considered unexpected by the health care team?
-Which of the following situations related to the transition from fetal to
perinatal circulation would be most likely to necessitate medical
intervention? - -Pulmonary vascular resistance, related to muscle regression
in the pulmonary arteries, rises over the course of the infant's first week.
-At which of the following locations in the nephron would a nurse
practitioner first expect blood to be largely free of plasma proteins? - -
Bowman Space
-A 51-year-old female patient who is 2 days postoperative on a surgical unit
of a hospital is at risk for developing atelectasis as a result of being largely
immobile. Which of the following teaching points by her nurse practitioner is
most appropriate?
Question options: - -"You should breathe deeply and cough to help your
lungs expand as much as possible while you're in bed."
-A 66-year-old patient's echocardiogram reveals a hypertrophied left
ventricle, normal chamber volume, and a normal ejection fraction from the
heart. What is this patient's most likely diagnosis? - -Aortic valve stenosis
, -"Stem cells can be used as a source of reserve cells for the entire blood
production system." - -A couple who are expecting their first child have been
advised by friends to consider harvesting umbilical cord blood in order to
have a future source of stem cells. The couple have approached their nurse
practitioner with this request and are seeking clarification of exactly why
stem cells are valuable and what they might expect to gain from harvesting
them. How can the nurse practitioner best respond to the couple's inquiry?
-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 outcome is the result of the interaction between collaborative genes.
-A 55-year-old man has made an appointment to see his nurse practitioner
because he has been awakening three to four times nightly to void and often
has a sudden need to void with little warning during the day. What is the
man's most likely diagnosis and possible underlying pathophysiologic
problem? - -Overactive bladder that may result from both neurogenic and
myogenic sources
-As a result of dehydration, a patient's epithelial cells are producing
insufficient amounts of mucus. Consequently, the patient's mucociliary
blanket is compromised. Which of the following changes would a care
provider most reasonably anticipate as a direct result of this change? - -
Increased amounts of bacteria in the lungs. The primary role of the
mucociliary blanket is to trap foreign particles and bacteria and thus prevent
their entry into the lungs. The impaired ciliary function may result in an
inadequate mucociliary blanket, but the opposite relationship is unlikely.
Decreased oxygen and increased carbon dioxide levels may eventually
result, but not as a direct or immediate consequence.
-An 81-year-old female patient of a long-term care facility has a history of
congestive heart failure. The nurse practitioner caring for the patient has
positioned her sitting up at an angle in bed and is observing her jugular
venous distention. Why is jugular venous distention a useful indicator for the
assessment of the patient's condition? - -Blood backs up into the jugular
vein because there are no valves at the point of entry into the heart.
-Bacterial - -Sputum samples from a patient with pneumonia contain an
infective agent that has a peptidoglycan cell wall, expresses endotoxins,
replicates readily in broth and on agar, grows in clusters, has pili, and does
not stain when exposed to crystal violet. This pneumonia is most likely:
-A 45-year-old patient who experienced exposure to radiation during an
industrial accident several years prior is being assessed. Which of the
following phenomena may underlie the genetic changes that have been
, noted in the patient? - -Base pairs may have been rearranged by the
radiation exposure.
-Splenomegaly and hepatomegaly - -A child has been diagnosed with
thalassemia. Which of the following other health problems is the child at risk
for?
-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 who has herpes simplex and recently recovered from endocarditis
-Which of the following patients would be considered to have a significant
risk of developing the prerenal form of acute renal failure? - -A 22-year-old
male who has lost a large amount of blood following a workplace injury
-As part of the diagnostic workup for a male patient with a complex history
of cardiovascular disease, the care team has identified the need for a record
of the electrical activity of his heart, insight into the metabolism of his
myocardium, and physical measurements, and imaging of his heart. Which of
the following series of tests is most likely to provide the needed data for his
diagnosis and care? - -Echocardiogram, PET scan, ECG
-A female patient is requiring supplementary oxygen by facemask due to
her reduced lung compliance. Which of the following pathophysiologic
processes is most likely to be a contributor to her low lung compliance? - -
Her thoracic cage is less flexible than when she was healthy.
-A 77-year-old female with a diagnosis of chronic obstructive pulmonary
disease is experiencing impaired gas exchange and CO2 retention, despite a
rapid respiratory rate. Which of the following phenomena would her care
team most realistically anticipate? - -Her kidneys will adapt with an increase
in plasma HCO3- and her pH will decrease.
-A nurse practitioner is performing patient teaching about the influenza virus
with each patient who has come to the clinic to receive that year's vaccine.
Which of the following statements by patients best reflects an accurate
understanding of the flu virus? - -"I could come down with viral or bacterial
pneumonia as a result of a bad flu bug."
-A patient is experiencing impaired circulation secondary to increased
systemic arterial pressure. Which of the following statements is the most
relevant phenomenon? - -High afterload because of backpressure against
the left ventricle
-Neutrophils - -A patient presented to the emergency department of the
hospital with a swollen, reddened, painful leg wound and has been diagnosed
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