1.

A 14-year-old male has been admitted to the emergency

room suffering with acute-onset abdominal pain in the
lower right quadrant. Abdominal rebound tenderness is
intense, and he has a fever and leukocytosis. This
individual most likely is suffering from:
a. acute appendicitis
b. diverticulitis
c. ulcerative colitis
d. cholelithiasis
e. cholecystitis: a
2. A 20-year-old man presents with periumbilical pain,
fever, and loss of appetite. Which of the following is the
most likely cause of his abdominal discomfort?
a. Diverticulosis
b. Diverticulitis
c. Appendicitis
d. Mesenteric venous thrombosis: c
Appendicitis is an inflammation of the vermiform appendix and
commonly occurs between the ages of 20 and 30. There is often
periumbilical pain that can be vague. Diverticulosis is
asymptomatic diverticular disease, which is herniation or saclike
outpouching of mucosa through the muscle layers of the colon
wall. Diverticulitis is inflammation of the diverticula in the
colon. Patients are usually older and have a crampy pain, often
in the left lower quadrant. Mesenteric venous thrombosis usually
occurs in older individuals with malignancies, right-sided heart
failure, and deep vein thrombosis.
3. A 23-year-old patient is hit in the temporal portion of his
skull during an altercation. Although he initially loses
consciousness, he soon awakens and is conversant.
Three hours later he is experiencing vomiting,
drowsiness, and confusion. These symptoms are most
likely related to which type of brain injury?
a. Diffuse axonal
b. Intracerebral
c. Subdural
d. Epidural: d
The classic 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.
4. A 55-year-old obese male presents to a sleep clinic
complaining of difficulty sleeping. He reports that he
wakes gasping for air and his wife is ready to divorce
him because his snoring keeps her up at night. Which is
the most likely diagnosis for this patient?
a. Primary hypersomnia
b. Parasomnia
c. Somnambulism
d. Obstructive sleep apnea: d
Obstructive sleep apnea is due to upper airway obstruction and is
accompanied by excessive snoring and episodic apnea. Primary
hypersomnia is excessive daytime sleepiness. Parasomnia is
unusual behavior during sleep. Somnambulism is sleepwalking.
5. Abnormal findings in which of the following evaluations
would indicate possible neurological dysfunction?
Select all that apply.
a. Level of consciousness
b. Pattern of breathing
c. Heart rate
d. Eye position
e. Skeletal muscle motor responses: all except c
6. Acute otitis media (AOM):
a. has no genetic determinants
b. displays a tympanic membrane progressing from
erythema to opaqueness with bulging
c. has breast-feeding as a risk factor
d. is commonly caused by Staphylococcus aureus: b
7. Age-related macular degeneration (AMD):
a. has a higher incidence in hypotensive individuals
b. occurs in individuals before the age of 60 years
c. exhibits retinal detachment and loss of
photoreceptors
d. exhibits loss of accommodation: c
8. Although non-REM and REM sleep are defined by
electrical recordings, they are characterized by
physiologic events. Which does NOT occur?
a. during non-REM sleep, muscle tone decreases
b. Non-REM sleep is initiated by withdrawal of
neurotransmitters from the reticular formation
c. during non-REM, cerebral blood flow to the cortex
decreases
d. during non-REM, levels of corticosteroids increase: d
9. Alzheimer disease:
a. can be caused by increased cerebral levels of
acetylcholine
b. is most prevalent as a late-onset dementia
c. manifests as nerve cell tangles
d. manifests as neuron senile plaques
e. all above: b
McCance Patho Review Qs
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10. The appropriate definition of perceptual dominance is:
a. the duration of time or intensity of pain before overt
pain responses are initiated.
b. pain at one location that may cause an increase in
threshold at another location.
c. repeated exposure to a pain stimulus.
d. the point at which pain is perceived.: b
Perceptual dominance is pain at one location that may cause an
increase in threshold at another location. For example, when a
patient has severe pain in his leg, he may not feel neck pain.
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.
11. The appropriate term for pain that is present in an area
distant from its point of origin is:
a. acute pain.
b. chronic pain.
c. referred pain.
d. somatic pain.: c
Referred pain is pain that is present in an area removed or
distant from its point of origin. Chronic pain is usually
prolonged, lasting at least 3 months. Somatic pain arises from
connective tissue, muscle, bone, and skin. It is may be sharp and
well organized or dull, aching, and poorly localized. Acute pain
arises from cutaneous, deep somatic, or visceral structures and is
a protective mechanism.
12. Autonomic hyperreflexia is characterized by all of the
following except:
a. hypotension
b. slower heart rate
c. stimulation of sensory receptors below the level of the
cord lesion
d. precipitation because of a distended bladder or
rectum: a
13. A basic neural system to cognitive function would
include: Select all that apply.
a. attentional systems.
b. memory systems.
c. affective or emotive systems.
d. sensory systems.
e. language systems.: all except d
14. A benefit of fever to human blood includes:
a. decreased lymphocytic transformation.
b. diminished phagocytosis.
c. increased iron concentration.
d. a switch to lipolysis and proteolysis.: d
Fever has benefits. The higher body temperature decreases serum
levels of iron, zinc, and copper, all of which are need for bacterial
replication. It switches from burning glucose to lipolysis and
proteolysis, thus depriving bacteria of a food source. There is
increased lymphocytic transformation, increasing the immune
response. Increased phagocytosis also occurs.
15. A cause of a cerebral aneurysm includes: Select all that
apply
a. arteriosclerosis.
b. heroin abuse.
c. congenital anomaly.
d. trauma.
e. cocaine abuse.: all except b
16. Causes of acute renal failure include:
a. cholecystitis
b. stones and strictures in kidneys or ureters
c. heart failure leading to poor renal perfusion
d. b and c
e. a, b, and c: d
17. Cerebral death:
a. is death of the cerebellum
b. permits normal internal homeostasis
c. no longer maintains respiratory and cardiovascular
functions
d. is death of the brainstem: b
18. The characteristic lesion of Crohn disease is:
a. found in the ileum
b. precancerous
c. granulomatous
d. malignant
e. a and c: e
19. A characteristic of Alzheimer disease includes: Select all
that apply.
a. rapid onset of symptomology.
b. short-term memory loss.
c. increased irritability and agitation.
d. anxiety and depression.
e. remissions resulting in cognitive clarity.: b, c, and d
20. Chronic constipation may be a result of: Select all that
apply.
a. low-residue diet
b. sedentary lifestyle
c. hyperthyroidism
d. opiates use
e. aging: all except c
21. Chronic renal failure:
a. may result from hypertension
b. is usually the result of chronic inflammation of the
kidney
c. may be treated with dialysis or transplants
d. all above
e. a and c: d
22. The classification of acute pain includes: Select all that
apply.
a. acute visceral.
b. pleuritic.
c. referred.
d. acute somatic.
e. cutaneous.: all except b
23. A client is diagnosed with a Cushing ulcer. What
assessment information related to this client's current
medical condition supports this diagnosis?
a. Third-degree burns over 20% of the body
b. Profound septicemia with high fever
c. Severe head trauma resulting from auto accident
d. Massive internal trauma as a result of a fall: c
Cushing ulcer is a stress ulcer related to severe head trauma or
brain surgery and is caused by overstimulation of the vagus nerve
and decreased mucosal blood flow. Ischemic ulcers develop
within hours of an event such as septicemia, hemorrhage,
multisystem trauma, severe burns, or CHF.
24. A client is diagnosed with hematochezia. Which
assessment finding confirms this diagnosis?
a. Bloody vomitus
b. Bright red rectal bleeding
c. Presence of tarry stools
d. Positive testing for occult blood: b
Hematemesis is blood in the vomitus. Hematochezia is bright red
or burgundy-colored blood from the rectum. Melena is the
description for dark or tarry stools. Occult bleeding is usually
caused by slow, chronic bleeding, and it is not obvious.
25. A client presents with epigastric pain and vomiting. He
is hyperglycemic and tachycardic. Client reports he is
"a heavy drinker but never had problems like this
before." Which disease process is supported by this
client's symptoms?
a. Cholelithiasis
b. Cholecystitis
c. Acute pancreatitis
d. Appendicitis: c
The classic presenting symptom of pancreatitis is midepigastric
pain and vomiting. This patient admits to heavy alcohol
consumption, which can lead to pancreatitis. The history and
assessment do not support the other options.
26. A common cause of both pyelonephritis and cystitis is:
a. urinary calculi
b. invading, ascending microorganisms, such as E. coli
c. allergy reactions
d. heavy metals: b
27. Common manifestation of hiatal hernia is:
a. gastroesophageal reflux
b. diarrhea
c. belching
d. postprandial substernal pain: e
28. Criteria for determining brain death include: Select all
that apply.
a. unresponsive coma.
b. no spontaneous respiration.
c. isoelectric EEG.
d. pupils are reactive but unequal.
e. ocular response to head turning.: a, b, and c
29. Depressed T cell function is associated with:
a. follicular cysts
b. endometrial polyps
c. leiomyomas
d. adenomyosis
e. endometriosis: e
30. A diabetic child with 4.0 grams of protein in her urine
each day is experiencing edema and vitamin D
deficiency. Which is the most likely diagnosis?
a. Nephritic syndrome
b. Nephrotic syndrome
c. Acute renal failure
d. Rapidly progressive glomerulonephritis: b
Nephrotic syndrome is characterized by excretion of 3.5 grams or
more of protein in the urine per day due to glomerular injury.
Nephritic syndrome is characterized by blood in the urine with
red and white cell casts and varying degrees of protein. Acute
renal failure presents with oliguria and a reduction in GFR and
BUN. Rapidly progressive glomerulonephritis usually affects
adults in their 50s and 60s and presents with hematuria.
31. Duodenal ulcers:
a. occur 4 times more often in females than in males
b. may be complicated by hemorrhage
c. are associated with sepsis
d. may cause inflammation and scar tissue formation
around the sphincter of Oddi: b
32. During vomiting, there is:
a. forceful diaphragm and abdominal muscle
contractions, airway closure, esophageal sphincter
relaxation, and deep inspiration
b. deep inspiration, airway closure, forceful diaphragm
and abdominal muscle contractions, and esophageal
sphincter relaxation
c. airway closure, forceful diaphragm and abdominal
muscle contractions, deep inspiration, and esophageal
sphincter relaxation
d. esophageal sphincter relaxation, forceful diaphragm
and abdominal muscle contractions, deep inspiration,
and airway closure.: b
33. Dystonia is:
a. abnormal posture maintained by muscular
contractions
b. flexed posture
c. stooped, hyperflexed posture
d. a spastic gait: a
34. The earliest symptom of chronic renal failure is:
a. pruritus
b. oliguria
c. polyuria
d. decreased BUN: c
35. An elderly alcoholic man falls and experiences a
hematoma that is on the top of his brain. The hematoma
is most likely a:
a. subdural.
b. epidural.
c. extradural.
d. intracerebral.: a
Subdural hematomas are commonly found in the elderly and
persons who abuse alcohol. The remaining options are injuries
not generally observed in this population after experiencing an
alcohol-induced fall.
36. Endogenous opioids include: Select all that apply.
a. enkephalins.
b. endorphins.
c. dynorphins.
d. endomorphins.
e. denkephalins.: all except e
37. Endometriosis:
a. has the ectopic endometrium responding to
hormonal fluctuations of the menstrual cycle
b. occurs primarily in the pleural cavity
c. causes infertility in most women having the disorder
d. does not reoccur after treatment: a
38. Endorphins:
a. increase pain sensations
b. decrease pain sensations
c. may increase or decrease pain sensations
d. have no effect on pain sensations: b
39. Gastric ulcers:
a. may lead to malignancy
b. occur at a younger age than duodenal ulcers
c. always have increased acid production
d. exhibit nocturnal pain
e. both a and c: a
40. Gastroesophageal reflux is:
a. caused by rapid gastric emptying
b. excessive lower esophageal sphincter functioning
c. associated with abdominal surgery
d. caused by spontaneously relaxing lower esophageal
sphincter: d
41. H. pylori is discovered in the GI tract of a client
experiencing an inflammation of the gastric mucosa.
These findings support which diagnosis?
a. Chronic diarrhea
b. Paralytic ileus
c. Chronic gastritis
d. Pyloric obstruction: c
Helicobacter pylori infection is associated with gastritis. The
other options are not related to this organism.
42. Hepatic encephalopathy is manifested by:
a. ascites
b. splenomegaly
c. dark urine
d. oliguria
e. cerebral dysfunction: e
43. In an automobile accident, an individual's forehead
struck the windshield. The coup/contrecoup injury
would be in the:
a. frontal/parietal region
b. frontal/occipital region
c. parietal/occipital region
d. occipital/frontal region: b
44. In bacterial meningitis, the CSF has:
a. normal glucose levels
b. an elevated number of lymphocytes
c. neutrophilic infiltration
d. none above
e. a, b, and c: c
45. In benign prostatic hyperplasia, enlargement of
periurethral tissue of the prostate causes:
a. obstruction of the urethra
b. inflammation of the testis
c. decreased urinary outflow from the bladder
d. abnormal dilation of a vein within the spermatic cord
e. tension of the spermatic cord and testis: a
46. In blunt head trauma:
a. brain tissues are exposed
b. only focal injury occurs
c. the dura is severed
d. the dura remains intact: d
47. In cerebral vasogenic edema:
a. active transport fails
b. there is autodigestion
c. plasma proteins leak into extracellular spaces
d. cerebrospinal fluid leaves the ventricles: c
48. In chronic renal failure, tubulointerstitial disease leads
to:
a. sodium retention
b. sodium wasting
c. no significant changes in sodium levels
d. increased phosphate excretion: d
49. In heatstroke:
a. core temperature usually doesn't exceed 101F
b. sodium loss follows sweating
c. core temperature increases as the regulatory center
fails
d. both b and c: c
50. In hypothermia:
a. the viscosity of blood is decreased
b. acidosis can develop
c. hypothalamic center prevents shivering
d. all above: b
51. In malabsorption syndrome, flatulence and abdominal
distension are likely caused by:
a. protein deficiency and electrolyte imbalance
b. undigested lactose fermentation by bacteria
c. fat irritating the bowel
d. impaired absorption of amino acids and
accompanying edema: b
52. In moderate diffuse axonal injury:
a. coma lasts more than 24 hours
b. coma lasts less than 24 hours
c. disruption of axons occurs in cerebral spheres and
those extending into the diencephalon and brain stem
d. tearing of axons in the cerebral hemisphere
e. a and d: e
53. In pancreatitis:
a. the tissue damage likely results from release of
pancreatic enzymes
b. high cholesterol intake is causative
c. diabetes is uncommon in chronic pancreatitis
d. bacterial infection is the etiologic cause: a
54. In the gate control theory of pain:
a. a "closed gate" increases pain perception
b. stimulation of large A fibers "closes the gate."
c. Both a and b
d. Neither a nor b: b
55. Increased serum levels of epinephrine increase body
temperature by:
a. increasing shivering
b. increasing muscle tone
c. increasing heat production
d. decreasing basal metabolic rate: c
56. An individual has an elevated blood level of urea and
creatinine because of complete calculi blockage of one
ureter. This is referred to as:
a. prerenal disease
b. intrarenal disease
c. postrenal disease
d. preeclampsia
e. hypercalcemia: c
57. An individual shows flexion in upper extremities and
extension in lower extremities. This is:
a. decorticate posturing
b. decerebrate posturing
c. excitation posturing
d. caloric posturing: a
58. An individual with increased intracranial pressure
from a head injury shows small and reactive pupils,
widened pulse pressure, and slowed breathing. Which
stage of ICP exists?
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4: c
59. Individuals affected by sleep apnea may experience:
a. polycythemia
b. cyanosis
c. pulmonary hypertension
d. all above: d
60. Injury of the cervical cord may be life threatening
because of:
a. increased intracranial pressure
b. disrupted reflexes
c. spinal shock
d. loss of bladder and rectal control
e. diaphragmatic impairment: e
61. Intellectual function is impaired in the dementing
process. Which intellectual function is NOT impaired?
a. anterograde memory
b. retrograde memory
c. abstraction
d. language deficits
e. all above impaired: e
62. Interleukin-1:
a. raises hypothalmic set point
b. endogenous pyrogen
c. stimulated by exogenous pyrogens
d. none above
e. a, b, and c: e
63. Intervertebral disk herniation:
a. usually occurs at the thoracic level
b. in the lumbosacral area causes pain over the gluteal
region and into the calf or ankle
c. is infrequent in the lumbosacral disks
d. both b and c are correct
e. a, b, and c: b
64. Intestinal obstruction causes:
a. decreased intraluminal tension
b. hyperkalemia
c. decreased nutrient absorption
d. a and b
e. a, b, and c: c
65. Involuntary unilateral or bilateral rhythmic movement
of the eyes is referred to as:
a. nystagmus.
b. amblyopia.
c. glaucoma.
d. strabismus.: a
Nystagmus may be present when at rest or when the eyes move.
Amblyopia is reduced vision in an eye secondary to uncorrected
strabismus. Strabismus is when one eye deviates from the other
when a person is looking at an object. Glaucoma is increased
intraocular pressure.
66. It is correct to assume that a saccular aneurysm:
a. occurs commonly in childhood.
b. grows rapidly.
c. can be due to a combination of congenital and
degenerative changes.
d. occurs in about 10% of the general population.: c
Saccular (berry) aneurysms can be due to a combination of
congenital and degenerative changes. They affect approximately
2% of the general population. They grow slowly over time and are
rare in childhood.
67. It is correct to assume that a subarachnoid hemorrhage
is:
a. a risk for individuals with an intracranial aneurysm.
b. seldom experienced in individuals with
hypertension.
c. not caused by trauma to the head.
d. rarely fatal.: a
Individuals with intracranial aneurysms are at risk for
subarachnoid hemorrhage. Hypertension and trauma are also
risk factors. The mortality is over 50%.
68. It is correct to assume that Cheyne-Stokes respirations
(CSR):
a. involve a pathologically increased ventilatory
response.
b. result in hypocapnia and increased ventilatory
stimulus.
c. cause changes in PaO2 that produce irregular
breathing.
d. increase PaCO2 level when overbreathing occurs.: a
The pathophysiology of CSR includes an increased ventilatory
response to carbon dioxide stimulation. This causes hypercapnia
and diminished ventilatory stimulus. Changes in PaCO2 produce
irregular breathing, not changes in PaO2. The PaCO2 level
decreases to below normal when overbreathing occurs.
69. It is correct to assume that Grade III and Grade IV
astrocytomas are:
a. commonly found in the frontal lobe and cerebral
hemisphere.
b. generally seen more in women than in men.
c. usually neurotic as a result of an absence of
vascularity.
d. bluish gray in color with a hard purplish center.: a
They are commonly found in the frontal lobe and cerebral
hemisphere and are found twice as often in men as in women.
They are often large and well circumscribed with a variegated
pattern. The rim is pinkish gray and solid with a soft, yellow,
necrotic center. There is vascular proliferation.
70. It is TRUE that a hemorrhagic stroke:
a. is the most common cause of CVA.
b. accounts for 50% of all CVA.
c. is commonly caused by hypertension.
d. is often caused by a microinfarct.: c
Chronic, untreated hypertension is generally the cause of
hemorrhagic stroke. Hemorrhagic stroke is the third most
common cause of CVA. It accounts for 10% to 15% of strokes in
whites and 30% in blacks and Asians. An infarct is a type of
occlusive stroke.
71. It is TRUE that Alzheimer disease is:
a. an uncommon neurologic disorder.
b. not believed to have a genetic relationship.
c. a result of neuronal proteins becoming distorted and
tangled.
d. the cause of plaques increasing nerve impulse
transmission.: c
Neurofibrillary tangles occur when the proteins in neurons
become tangled and distorted. There is a genetic relationship in
late-onset familial Alzheimer dementia. It is a common
neurologic disorder; nearly 6 million Americans had the disease
in 2000. With the formation of plaques, there is decreased nerve
impulse transmission.
72. It is true that an acute cerebrovascular accident (CVA)
is:
a. the leading cause of disability in the United States.
b. the fifth most common cause of death in the United
States.
c. likely to be followed by a second stroke within 1 year.
d. experienced by 2 million individuals each year.: a
CVAs are the leading cause of disability and the third leading
cause of death. There are 500,000 stroke victims a year, and 5%
to 14% have a second stroke within 1 year.
73. It is TRUE that an oligodendroglioma:
a. accounts for 20% of all brain tumors.
b. is fast growing.
c. usually is undifferentiated.
d. rarely includes cysts or calcifications.: d
They often have cysts and calcifications but are slow growing,
well-differentiated tumors that comprise 2% of all brain tumors.
74. It is TRUE that encephalitis is:
a. an afebrile illness.
b. caused by bacteria.
c. a result of arthropod borne viruses.
d. caused exclusively by herpes simplex II.: c
It is caused by a virus, often arthropod borne (tick/mosquito
borne). Herpes simplex I can also cause the illness; type I is
more common than type II. Encephalitis is an acute febrile
illness.
75. It is TRUE that spinal shock:
a. is characterized by an incomplete loss of reflex
function.
b. involves all skeletal muscles.
c. causes increased muscle tone below the lesion.
d. results in no disruption of thermal control.: b
Spinal shock does involve function of skeletal muscles resulting
in paralysis and flaccidity. Such an injury is characterized by a
complete loss of reflex function below the level of the lesion, and
impairment of control of thermal regulation is observed.
76. It is TRUE that the specificity theory of pain:
a. focuses on the attention of pain.
b. focuses on previous experience of pain.
c. relates the amount of pain to the amount of soft tissue
injury.
d. relates to the emotions exhibited toward pain.: c
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.
77. Kussmaul respirations can be a result of: Select all that
apply.
a. Pulmonary edema
b. Metabolic alkalosis
c. Metabolic acidosis
d. Dehydration
e. Impaired protein metabolism: a and c
78. Leptin:
a. promotes insulin resistance
b. binds to insulin receptors
c. suppresses hunger/appetite at the hypothalamus
d. a, b, and c
e. none above: c
79. Low-residue diets and chronic constipation play a role
in the pathogenesis of:
a. appendicitis
b. diverticulitis
c. ulcerative colitis
d. Crohn disease
e. cholecystitis: b
80. Manifestations of subarachnoid hemorrhage include
(more than 1 answer may be correct):
a. an explosive headache
b. muscle flaccidity
c. neurologic deficits
d. a delayed age of onset: a, c
81. A means of classifying a seizure includes: Select all that
apply.
a. clinical manifestations.
b. site of origin.
c. response to therapy.
d. length of activity.
e. EEG correlates.: all except d
82. A mechanism that does not result in heat loss is:
a. increased respiration.
b. conduction.
c. convection.
d. vasoconstriction.: d
Vasoconstriction is a mechanism of heat conservation.
Increased respiration, conduction, and convection are all
mechanisms of heat loss.
83. Melena is:
a. bloody vomitus
b. gaseous bowel distention
c. blood in the stool
d. loss of appetite
e. black, tarry stools: e
84. The most common cause of TBI is:
a. motor vehicle accidents.
b. falls.
c. sports-related events.
d. violence.: a
Motor vehicle accidents account for 50%. Falls account for 21%.
Sports-related events and violence account for 10% and 12%,
respectively.
85. The most common manifestation of portal hypertension
is:
a. rectal bleeding
b. cirrhosis
c. intestinal bleeding
d. duodenal bleeding
e. vomiting of blood from esophageal bleeding: e
86. Most spinal cord injuries occur in the:
a. cervical and thoracic regions
b. cervical and lumbar regions
c. thoracic and lumbar regions
d. lumbar and sacral regions: b
87. Multiple sclerosis involves:
a. degeneration of dopaminergic receptors
b. activation of the syncytin gene
c. depletion of GABA
d. lower motor neuron muscle wasting: b
88. Nephrotic syndrome is associated with ___ to plasma
___ .
a. increased glomerular permeability; urea
b. decreased glomerular permeability; proteins
c. decreased glomerular permeability; tubular filtrate
d. increased glomerular permeability; proteins: d
89. Nephrotoxins, such as antibiotics, may be responsible
for:
a. acute tubular necrosis
b. acute glomerulonephritis
c. pyelonephritis
d. cystitis: a
90. Osmotic diarrhea is caused by:
a. lactase deficiency
b. bacterial enterotoxins
c. ulcerative colitis
d. crohn disease
e. c and d: a
91. A patient diagnosed with Parkinson disease initially
experiences:
a. difficulty walking.
b. fine tremors.
c. postural instability.
d. rigidity of leg muscles.: b
Tremor is often the first symptom to appear. The symptoms are
often unilateral and then become bilateral, progressing to affect
gait and include postural instability and the inability to walk.
92. A patient experiences a large hematoma from a motor
vehicle accident. The patient develops jaundice due to
increased breakdown (hemolysis) of red blood cells.
Which statement the pathophysiology of hemolysis
regarding this patient's condition is true?
a. There is a decrease in conjugated bilirubin.
b. Increased amounts of unconjugated bilirubin occur.
c. Bilirubin is excreted in the urine.
d. Hemolysis is identical to obstructive jaundice.: b
Hemolysis increases the unconjugated bilirubin, which is not
water soluble so it cannot be excreted in the urine. This does not
affect the conjugated bilirubin, which is increased in obstructive
jaundice.
93. A patient experiences a vertebral fracture in which the
C1 vertebra is fractured into several fragments. This
type of fracture can be described as:
a. simple.
b. compressed.
c. comminuted.
d. dislocation.: c
A comminuted fracture is also called a burst fracture, in which
the vertebral body is shattered into several fragments. A simple
fracture is a single break usually affecting the transverse or
spinous process. A compressed fracture is also called a wedge.
This occurs when there is a crush type of injury and the vertebrae
loses height. A dislocation is when two bones at a joint are no
longer in alignment.
94. A patient experiences abdominal pain that is very
localized and intense. Which type of pain does this
describe?
a. Parietal
b. Visceral
c. Referred
d. Phantom: a
Parietal pain arises from the parietal peritoneum and is more
localized and intense than visceral pain. Visceral pain is often
poorly localized and dull and arises from the organs themselves.
Referred pain is well-localized visceral pain felt at some distance
from a diseased or an affected organ. Phantom pain does not
refer to abdominal pain. It is felt after the loss of a limb.
95. A patient experiences chronic intermittent pain in the
epigastric area when the stomach is empty and in the
middle of the night. This history supports a diagnosis
of:
a. acute gastritis.
b. chronic gastritis.
c. gastric ulcer.
d. duodenal ulcer.: d
These symptoms support a diagnosis of a duodenal ulcer. Acute
gastritis often has vague abdominal discomfort, epigastric
tenderness, and bleeding. Chronic gastritis has symptoms that
include anorexia, fullness, nausea, vomiting, and pain. Gastric
ulcers have symptoms of epigastric pain and may occur
immediately after eating.
96. A patient experiences demyelination of the peripheral
nerves with sparing of the axons. This is characteristic
of:
a. Alzheimer disease.
b. Guillain-Barr.
c. myasthenia gravis.
d. amyotrophic lateral sclerosis (ALS).: b
Guillain-Barr is an idiopathic polyneuritis with acute
inflammatory demyelinating characteristics. There is
demyelination of the peripheral nerves with relative sparing of
the axons. Alzheimer disease is a form of dementia caused by
tangles. Myasthenia gravis is due to anti-acetylcholine-receptor
antibodies. ALS is a degenerative disorder diffusely involving
lower and upper motor neurons, resulting in progressive muscle
weakness.
97. A patient experiences diarrhea, which her physician
contributes to increased mucosal discharge of chloride-
or bicarbonate-rich fluid. Which of the following types
of diarrhea is this?
a. Osmotic
b. Secretory
c. Motility
d. Parasitic: b
Secretory diarrhea is a form of large-volume diarrhea caused by
excessive mucosal secretion of chloride- or bicarbonate-rich fluid
or inhibition of net sodium absorption. Osmotic diarrhea is due
to a nonabsorbable substance in the intestine that draws water
into the lumen by osmosis; an example is lactase deficiency.
Motility diarrhea is caused by resection of the small intestine.
This is often found after bypass surgery (bariatric). Parasitic
diarrhea is caused by parasites in the gastrointenstinal (GI)
tract.
98. A patient experiences no nausea but significant
vomiting with a CNS injury when the trauma:
a. impinges directly on the floor of the third ventricle.
b. causes a decrease in intracranial pressure.
c. involves the vestibular nuclei.
d. also involves the abdominal area.: c
Vomiting associated with CNS injuries involves the vestibular
nuclei. It can also be caused by impingement on the fourth
ventricle or an increase in intracranial pressure. Vomiting with
no associated nausea indicates direct involvement of the central
neural mechanisms regardless of abdominal trauma.
99. A patient experiencing the tonic phase of a seizure
exhibits:
a. muscle contraction with increased muscle tone.
b. alternating contraction and relaxation of muscle.
c. muscle contraction alternating with placidity.
d. complete paralysis.: a
The phase of muscle contraction with increased muscle tone is
the tonic phase. Alternating contraction and muscle relaxation
represents the clonic phase. The postictal phase immediately
follows the seizure. There is no phase that is characterized with
muscle contraction alternating with placidity.
100. A patient has a brain abscess with a decreased necrotic
center and mature collagen. This is most consistent
with which stage?
a. Early cerebritis
b. Late cerebritis
c. Early capsule formation
d. Late capsule formation: c
Early capsule formation occurs on days 10 to 13. The necrotic
center decreases in size and inflammatory infiltrate changes in
character. Mature collagen evolves, forming a capsule. Early
cerebritis occurs on days 1 to 3 and is a localized inflammatory
process. There are marked cerebral edema and a central core of
necrosis. Late cerebritis occurs on days 4 to 9, and there is a
necrotic center surrounded by inflammatory infiltrate of
macrophages and fibroblasts. There is rapid new blood vessel
formation. Late capsule formation occurs on day 14 and later.
There is a well-formed necrotic center surrounded by a dense
collagenous capsule.
101. A patient has sustained a traumatic brain injury but is
able to follow simple commands and can manipulate
objects. The term used to describe this state is:
a. coma
b. vegetative
c. minimally conscious
d. locked-in syndrome: c
The term minimally conscious refers to severely altered
consciousness in which the person demonstrates minimal but
defined behavioral evidence of self or environmental awareness.
The clinical features include following simple commands,
manipulation of objects, gestural or verbal yes/no responses,
intelligible verbalization, and stereotypical movements. Locked-
in syndrome describes an individual who has both the content of
thought and the level of arousal intact. The efferent pathways are
disrupted, which means the individual cannot communicate
through speech or body movement. Coma is a state of
neurobehavioral unresponsiveness. Vegetative state is a wakeful
unconscious state.
102. A patient has uncontrolled or premature contractions
of the detrusor muscle. Which condition is associated
with this medical problem?
a. Spinal cord injury
b. Immune system dysfunction
c. Congestive heart failure
d. Renal carcinoma: a
This patient's condition is neurogenic detrusor overactivity.
Spinal cord injury contributes to uncontrolled or premature
contractions of the detrusor muscle associated with a
neurological disorder. This can also be from Guillain-Barr or
transverse myelitis.
103. A patient is brought to the emergency room following a
motor vehicle accident in which he sustained diffuse
brain injury. Which of the following symptoms would be
expected to accompany his injury? Select all that apply.
a. Memory deficits
b. Swallowing disorders
c. Agitation
d. Fatigue
e. Short attention span: all except d
104. A patient is diagnosed with a kidney stone that is
composed of magnesium, ammonium, and phosphate.
What type of urinary calculus is this?
a. Calcium
b. Struvite
c. Uric acid
d. Indinavir: b
Calcium oxalate or calcium phosphate stones account for 70% to
80% of stones. Struvite stones account for about 15% and are
composed of magnesium, ammonium, and phosphate. Uric acid
stones account for about 7% of stones. Less common stone
elements include cystine, 2,8-dihydroxyadeninuria,
triameterene, indinavir, and ammonium acid urate.
105. A patient is diagnosed with a meningioma. The most
likely site of the tumor is the: Select all that apply.
a. sella turcica.
b. olfactory groove.
c. tuberculum sellae.
d. sphenoidal wing.
e. cerebellopontine angle.: all
106. A patient is diagnosed with a peptic ulcer. Which
assessment data confirms this diagnosis? Select all that
apply.
a. Presence of H. pylori in the duodenum
b. Advanced age
c. Follows a strict vegetarian diet
d. History of alcohol abuse
e. Diagnosis of rheumatoid arthritis: all except c
107. A patient is diagnosed with colorectal cancer and is
told that it is limited to the bowel wall. This is
characteristic of which stage of cancer?
a. Stage A
b. Stage B
c. Stage C
d. Stage D: a
Stage A is cancer limited to the bowel wall. Stage B is cancer
extending through the bowel wall. Stage C is nodal metastasis
regardless of extension into the bowel wall. Stage D is distant
metastasis.
108. A patient is diagnosed with hepatitis A. Transmission
of this form of hepatitis occurs via:
a. fecal-oral route.
b. infected blood or body fluids.
c. sexual contact.
d. intravenous drug use.: a
Hepatitis A is transmitted most commonly by the fecal-oral route.
109. A patient is diagnosed with Huntington disease. Which
of the following is a TRUE statement? Huntington's
disease is:
a. a commonly diagnosed neurological disorder.
b. a nonhereditary disease.
c. also known as chorea.
d. asymptomatic until the 2nd decade of life.: c
Huntington disease is also called chorea. It is relatively rare and
is a hereditary degenerative disorder. It most commonly affects
those between the ages of 30 and 50.
110. A patient is diagnosed with portal hypertension due to
liver disease. Which assessment observation supports
this diagnosis?
a. Hematemesis
b. Abdominal pain from splenomegaly
c. Ascites
d. Altered mental status: a
The most common clinical manifestation of portal hypertension
is vomiting of blood (hematemesis) from bleeding esophageal
varices. The other options are not associated with this disorder.
111. A patient is experiencing pain that courses over the
buttocks and into the calf and ankle. This is suggestive
of a herniated disc at which vertebral level?
a. Cervical
b. Thoracic
c. Lumbar
d. Coccyx: c
A herniated disc in the lumbosacral area is associated with pain
that radiates along the sciatic nerve and courses over the buttock
and into the calf and ankle. Both a cervical and thoracic injury
would indicate pain that originated higher on the body. A
herniated coccyx vertebrate would result in pain beginning a
point lower than that described.
112. A patient presents with a wide-based gait in which the
feet were turned outward. She staggers when walking
and holds her pelvis stiff. These characteristics are
representative of:
a. cerebellar gait.
b. basal ganglion gait.
c. decorticate posture.
d. apraxia.: a
Cerebellar dysfunction results in a wide-based gait in which the
feet are turned inward or outward. Basal ganglion gait is a wide-
based gait in which the person walks with small steps and
decreased arm swing. Decorticate posture occurs when the upper
extremities are flexed at the elbows and held close to the body
while the lower extremities are externally rotated and extended.
Apraxia is the inability to perform purposeful or skilled motor
acts in the absence of paralysis, sensory loss, abnormal posture,
or tone.
113. A patient who exhibits involuntary twisting movements
caused by slow muscle contraction on the right side of
the body is experiencing:
a. hypertonia.
b. spasticity.
c. hemidystonia.
d. paratonia.: c
Injury to the putamen or its outflow tracts would result in
hemidystonia. Hypertonia is increased muscle tone. Spasticity
results from hyperexcitability of the stretch reflexes. Paratonia is
resistance to passive movement that is proportional to the force
applied.
114. A patient who fell and hit his head 2 days ago is now
restless and irritable. This scenario is characteristic of:
a. Alzheimer disease.
b. dementia.
c. delirium.
d. coma.: c
Delirium is an acute state of confusion. It is abrupt in its onset.
The patient may have difficulty in concentration, restlessness,
irritability, tremulousness, insomnia, and poor appetite.
Dementia is a more chronic problem in which there is
progressive failure of many cerebral functions. Alzheimer disease
is a type of dementia. A coma is a loss of consciousness.
115. A patient who is experiencing a loss of comprehension
or the production of language is described as having:
a. dysphasia.
b. aphasia.
c. expressive dysphasia.
d. transcortical dysphasia.: a
Aphasia is complete inability to speak. Dysphasia is impairment
in comprehension or production of language. Expressive
dysphasia is characterized primarily by deficits in expression, but
comprehension may be present. Transcortical dysphasia involves
the ability to repeat and to recite.
116. A patient who is experiencing difficulty in recognizing
a pattern's form and the nature of objects is exhibiting
characteristics of:
a. agnosia.
b. aphasia.
c. dysphasia.
d. Alzheimer disease.: a
Agnosia is a defect of pattern recognition. Aphasia is the
complete absence of speech. Dysphasia is impairment of
comprehension or production of language. Alzheimer disease is
a disease of dementia.
117. A patient who reports a loss of childhood memories is
describing a characteristic of:
a. selective attention deficit.
b. retrograde amnesia.
c. anterograde amnesia.
d. executive attention deficits.: b
Retrograde amnesia is the loss of past memories, whereas
anterograde amnesia is the inability to form new memories.
Selective attention deficit is the ability to select specific
information to be processed from environmental and internal
stimuli. Executive attention deficit is the inability to maintain
sustained attention, inability to set goals and recognize when an
object meets a goal, and a deficit in working memory.
118. A patient who reports abdominal and back pain has
been diagnosed with bacteria in the urine. What is the
appropriate term for involvement of the upper urinary
tract that is likely to cause such symptoms?
a. Cystitis
b. Pyelonephritis
c. Urinary tract infection
d. Asymptomatic bacteriuria: b
Cystitis is inflammation of the bladder. A urinary tract infection
is inflammation of the urinary epithelium, followed by invasion
and colonization by some pathogen. Pyelonephritis indicates
involvement of the upper tracts. Asymptomatic bacteriuria is
urine with bacteria that do not provoke infection.
119. A patient who reports that 'everything tastes
unpleasant' is exhibiting symptoms of:
a. hyposmia.
b. anosmia.
c. hypogeusia.
d. dysgeusia.: d
Dysgeusia is a perversion of taste in which everything has an
unpleasant flavor. Hyposmia is an impaired sense of smell.
Anosmia is a complete loss of smell. Hypogeusia is a decrease in
taste sensation.
120. A patient who was outside on a summer day and is now
experiencing increased sweating and thirst, weakness,
and dizziness is exhibiting signs of:
a. heat cramps.
b. heat exhaustion.
c. hyperthermic stroke.
d. malignant hyperthermia.: b
Heat exhaustion is the result of prolonged high core
temperatures. There is often dehydration, feelings of weakness,
dizziness, nausea, and fainting. Heat cramps are severe,
spasmodic cramps in the abdomen and the extremities that
follow prolonged sweating and associated sodium loss. Heat
stroke may be lethal and is caused by exposure to excessive heat
and loss of the body's protective mechanisms for cooling.
Malignant hyperthermia is a lethal complication of a rare
inherited muscle disorder.
121. Peptic ulcers may be located in the:
a. stomach
b. esophagus
c. duodenum
d. colon
e. a, b, and c: e
122. The person at highest risk for traumatic brain injury
(TBI) is:
a. African American and economically disadvantaged.
b. male and disabled.
c. female and 20 years of age.
d. an economically advantaged young adult.: a
Those at highest risk for TBI are children 0 to 4 years of age,
older adolescents aged 15 to 19 years, and adults aged 65 years
and older. Males have the highest incidence in every age group.
TBI is highest among African Americans and in lower- and
median-income families.
123. Pinhole-sized pupils can be a result of an overdose of:
a. atropine.
b. scopolamine.
c. opiates.
d. amphetamines.: c
Opiates (heroin and morphine) cause pinhole or constricted
pupils. The other choices cause large dilated pupils.
124. The poor absorption of vitamin A will result in:
a. osteoporosis.
b. neurological deficiencies.
c. night blindness.
d. petechiae.: c
A deficiency in vitamin A can result in night blindness. Vitamin
D is involved in osteoporosis, vitamin E in neurological
development, and vitamin K in petechiae formation.
125. Postical sleeping can be seen in ____ seizures.
a. partial
b. unilateral
c. grand mal
d. psychomotor: d
126. Precipitating causes of seizure include all of the
following except:
a. meningitis
b. stroke
c. hyperglycemia
d. hyperthermia
e. all above: c
127. Predisposing factors in the development of colon
cancer include all of the following EXCEPT:
a. familial polyposis
b. ulcerative colitis
c. low-fiber/high-fat diet
d. high-fiber diet
e. high refined CHO diet: d
128. The presence of albumin in the urine would indicate
probable damage to:
a. glomeruli
b. renal columns
c. collecting tubules
d. pyramids
e. none above: a
129. Pyelonephritis is: (More than 1 answer may be correct.)
a. an inflammation and infection of the urinary bladder
b. characterized by fever, chills, and flank pain
c. characterized by pyuria, bacteriuria, and hematuria
d. more common in young women than in young men:
b,c,d
130. Referred pain from upper abdominal diseases
involves:
a. sacral region
b. L2 to L4
c. T8, L1, and L2
d. gluteal regions, posterior thighs, calves: c
131. Renal calculi may be composed of:
a. calcium oxalate
b. uric acid
c. cholesterol
d. all above
e. a and b: e
132. Renal function tests include:
a. the urinalysis
b. BUN and serum creatinine
c. SGOT/SGPT
d. a and b
e. a, b, and c: d
133. Risk factors for a CVA includes: Select all that apply.
a. obesity.
b. smoking.
c. diabetes.
d. arterial hypertension.
e. atrial fibrillation.: all except a
134. Risk factors for esophageal carcinoma would include:
Select all that apply.
a. alcohol abuse.
b. tobacco use.
c. thin body habitus.
d. zinc deficiency.
e. sliding hiatal hernia.: all except c
135. Ruptured aneurysms are most likely in ___
cerebrovascular accidents.
a. TIA
b. thrombotic
c. embolic
d. hemorrhagic: d
136. Short-term starvation involves:
a. glycogenolysis
b. gluconeogenesis
c. proteolysis
d. a and b
e. a, b, and c: d
137. Sleep apnea:
a. is lack of breathing during sleep
b. can result from airway obstruction during sleep
c. is associated with jet-lag syndrome
d. all above
e. both a and b: e
138. Supratentorial processes reduce arousal by:
a. destroying the reticular activating system
b. displacement of the brainstem
c. destroying the brainstem
d. both a and c
e. none of the above: b
139. Symptoms of cholelithiasis include all of the following
EXCEPT:
a. nausea and vomiting
b. right upper quadrant tenderness
c. jaundice
d. decreased serum bilirubin levels
e. abdominal distress: d
140. The term used to describe a patient who sustains a
cerebrovascular accident and is paralyzed on the left
side is:
a. hemiplegia.
b. paraplegia.
c. diplegia.
d. quadriplegia.: a
Hemiplegia means loss of motor function on one side of the
body. Paraplegia refers to loss of motor function of the lower
extremities. Diplegia is the paralysis of both upper or both lower
extremities as a result of cerebral hemisphere injuries.
Quadriplegia refers to paralysis of all four extremities.
141. Transient ischemic attacks (TIAs) are:
a. unilateral neurologic deficits that slowly resolve
b. generalized neurologic deficits that occur a few
seconds every hour
c. focal neurologic deficits that develop suddenly, last
for several minutes, and clear in 24 hours
d. neurologic deficits that slowly evolve or develop: c
142. A trauma patient diagnosed with a brain contusion
experiences changes in attention, memory, affect, and
emotion. In which region of the brain is the contusion
most likely located?
a. Cerebral
b. Frontal
c. Cerebellum
d. Midbrain: b
Contusions are most commonly found in the frontal lobes,
particularly at the poles and along the inferior orbital surfaces.
They result in changes in attention, memory, and executive
attentional functioning.
143. Uremia exhibits:
a. polycythemia
b. retention of metabolic acids
c. low plasma calcium levels
d. increased erythropoiesis
e. a and d: b
144. Uremia, as seen in chronic renal failure, would
include:
a. metabolic acidosis
b. elevated BUN and creatinine
c. cardiovascular disturbances
d. all above: d
145. Vestibular nystagmus:
a. is the constant, involuntary movement of the eyeball
caused by ear disturbances
b. is the sensation of spinning
c. may be caused by alterations in nervous system from
receptor to the cerebral cortex
d. causes a diminished sense of the position of body
parts: a
146. When a client reports jaundice, fatigue, anorexia,
nausea and vomiting, a diagnosis of hepatitis is made.
Which stage of the disease process is supported by
these symptoms?
a. Prodromal phase
b. Icteric phase
c. Recovery phase
d. Chronic active hepatitis: a
The prodromal phase begins about 2 weeks after exposure and
includes the symptoms described. The icteric phase begins 1 to 2
weeks after the prodromal phase and includes jaundice, dark
urine, clay-colored stools, and hepatomegaly. The recovery phase
begins with resolution of jaundice and other symptoms. Chronic
active hepatitis is persistence of clinical manifestations and liver
inflammation after acute infection.
147. Which activity has been documented to increase the
levels of circulating endogenous endorphins?
a. Cough
b. Stress
c. Sleep
d. Pain: b
Stress, sexual intercourse, acupuncture, and excessive physical
exertion have all been linked to increased levels of circulating
endorphins. Drinking behavior and cough are actually
moderated by endorphins. Sleep and pain are not linked with
excessive amounts of endorphins.
148. Which are characteristics of anorexia nervosa? Select
all that apply.
a. Fear of becoming obese
b. Distorted body image
c. Body weight 25% less than normal
d. Absence of three consecutive menstrual periods
e. Diagnosed chronic depression: a, b, d
149. Which are frequent sites for distant metastasis for
prostate cancer? Select all that apply.
a. Brain
b. Lymph nodes
c. Liver
d. Bones
e. Lungs: all except a
150. Which are possible causes of prostate cancer? Select all
that apply.
a. Elevated androgen levels
b. Reduced levels of 5-dihydrotestosterone
c. High exposure to ultraviolet light rays
d. Chronic prostatic inflammation
e. Genetic predisposition: all except c
151. Which are predisposing factors for acute urinary tract
infections? (More than 1 answer may be correct.)
a. congenital deformities of urinary tract
b. the sex of the patient
c. decreased urine flow
d. increased urine flow
e. increased fluid intake: a,b,c
152. Which assessment question demonstrates an
understanding of a possible cause of achalasia?
a. "Are you chronically constipated?"
b. "What types of high fiber foods do you eat?"
c. "Do you become 'gassy' after meals?"
d. "Have you been under a lot of stress lately?": d
Psychosocial achalasia has been documented and may be the
result of life stressors. The other options are not associated with
this disorder.
153. Which can be characteristic of urethral stones?
a. severe pain in the back
b. severe pain in abdomen
c. nausea and vomiting
d. all above
e. a and c: d
154. Which condition may cause obstructed urine flow?
Select all that apply.
a. Prostate enlargement
b. Pelvic organ prolapse
c. Low bladder wall compliance
d. Detrusor areflexia
e. Detrusor hyperflexia: all except d
155. Which describe a patient in acute renal failure? (More
than 1 answer may be correct)
a. elevated serum creatinine
b. leukocystitis
c. low BUN
d. fever
e. oliguria: a,e
156. Which does NOT cause constipation?
a. opiates
b. megacolon
c. sedentary lifestyle
d. hyperthyroidism
e. emotional depression: d
157. Which extraintestinal manifestations are found in
ulcerative colitis? Select all that apply.
a. Gallstones
b. Uveitis
c. Polyarthritis
d. Cutaneous lesions
e. Liver disorders: c, d, e
158. Which is a determinant of severity for obstructive
uropathy? Select all that apply.
a. Location of the blockage
b. Degree of completeness of the blockage
c. Type of blockage
d. Duration of the blockage
e. Cause of the lesion: all except c
159. Which is a factor that is required before a stone is
formed? Select all that apply.
a. Supersaturation of one of the salts
b. Precipitation from a liquid to a solid
c. Aggregation
d. Low concentration of salt
e. Presence or absence of Tamm-Horsfall protein: all
except d
160. Which is a risk factor for the development of CVAs?
a. polycythemic vera
b. hypertension
c. diabetes mellitus
d. hyperhomocysteinemia
e. all above: e
161. Which is involved in fever?
a. tumor necrosis factor
b. endotoxins
c. elevation of the set point in the hypothalamus
d. both a and b
e. a, b, and c: e
162. Which is NOT a characteristic of chronic renal failure?
a. hyperkalemia
b. anuria
c. anemia
d. pruritus
e. acidosis: b
163. Which is not a neuromodulator of pain?
a. prostaglandins
b. 5-hydroxytryptamine
c. norepinephrine
d. lymphokines
e. heparin: e
164. Which is NOT a primary intracerebral neoplasm?
a. astrocytoma
b. meningioma
c. oligodendroglioma
d. ependymoma: b
165. Which is the most important difference between
proliferative and non-proliferative breast tissue
changes?
a. Genetic aberrations are more common in non-
proliferative lesions.
b. Cancer prognosis is better for non-proliferative
breast tissue changes.
c. Non-proliferative breast lesions do not increase the
risk of breast cancer.
d. Cancer resulting from non-proliferative breast
lesions has a higher cure rate.: c
Non-proliferative breast lesions do not increase the risk of breast
cancer. The remaining statements are not true of this type of
breast tissue change.
166. Which is TRUE regarding meningitis?
a. Bacterial meningitis is a primary infection of the gray
matter.
b. Aseptic meningitis is most commonly caused by a
fungus.
c. Fungal meningitis is very common.
d. Tubercular meningitis has a 90% recovery rate, if
diagnosed early.: d
Tubercular meningitis has a 90% recovery rate with early
diagnosis and treatment. Fungal meningitis is uncommon.
Aseptic meningitis is most commonly caused by a virus. Bacterial
meningitis is caused by primary infection of the pia mater and
arachnoid.
167. Which is TRUE regarding metastatic tumors that are
located in the brain?
a. Carcinomas are disseminated to the brain from the
circulation.
b. One-third of metastatic tumors are located within the
brain.
c. Two-thirds of metastatic tumors are located in the
extradural spaces.
d. Tumors of the pelvis tend to involve the frontal lobe.: a
Carcinomas disseminate to the brain from the circulation. Two-
thirds of metastatic tumors are located within the brain, and one-
third are located in the extradural spaces. Tumors of the pelvis
tend to metastasize to the cerebellum and pons.
168. Which most often causes biliary cirrhosis?
a. malnutrition
b. alcoholism
c. Hep A or C
d. autoimmunity
e. biliary obstruction: e
169. Which most typically characterizes the victims of a
cerebral embolic stroke?
a. individuals older than 65 years of age with a history
of hypertension
b. individuals with a long history of TIAs
c. middle-aged individuals with a history of heart
disease
d. individuals with gradually occuring symptoms that
then rapidly disappear: c
170. Which of the following genes have been linked with the
development of breast cancer? Select all that apply.
a. BRCA1
b. BRCA2
c. p53
d. PSA
e. Her-2/neu: all except d
171. Which of the following is a TRUE statement regarding
Crohn disease?
a. It involves the mucosa only.
b. Skip lesions are common.
c. It affects only the rectum.
d. The most common site is the rectum.: b
Crohn disease affects the entire GI tract and can affect all layers
of the mucosa and serosa. Skip lesions are common, meaning
the disease is not continuous; it skips parts of the colon. The
most common area for the disease is the ileocolon
172. Which of the following is a TRUE statement regarding
ulcerative colitis?
a. It extends throughout the entire GI tract.
b. It generally appears in childhood.
c. African-Americans are more commonly affected.
d. Bloody, purulent diarrhea is a common symptom.: d
Frequent diarrhea, with passage of small amounts of blood and
purulent mucus, is common. Ulcerative colitis is a chronic
inflammatory condition that is common in those of Jewish or
European descent. The lesions usually begin appearing between
20 and 40 years of age and are located from the rectum to the
colon proximally.
173. Which of the following is considered a risk factor for
vaginal cancer?
a. Human papillomavirus (HPV)
b. Endometriosis
c. Concurrent breast cancer
d. Birth control pills: a
HPV infection and prior carcinoma of the cervix place a woman
at higher risk for developing vaginal cancer. Research has not
linked the other options to this form of cancer
174. Which of the following regarding chronic gastritis is
true?
a. There are four types.
b. Type A, or fundal gastritis, is the most severe.
c. Type B, or antral gastritis, is the most rare.
d. It tends to occur in young individuals.: b
Chronic gastritis is classified as type A (fundal) or type B
(antral). Fundal is the more rare and severe of the two types. It
occurs most frequently in the elderly.
175. Which of the following statements is TRUE regarding
grading of the astrocytoma?
a. Grade I is not treated.
b. Grade II is treated with radiation only.
c. Grades III and IV are treated with surgery.
d. Grade III is not well circumscribed.: c
Grade I is treated with surgery and then follow-up CT scans for
recurrence. Grade II is treated surgically if accessible and then
with radiation. Grade III and IV are treated with surgery. Grade
III is well circumscribed.
176. Which pair of structures regulates the complex
emotional responses to pain?
a. Frontal and cerebellar lobes
b. Limbic and reticular system
c. Thalamus and brainstem
d. Midbrain and nuclei of thalamus: b
The reticular and limbic systems regulate what we feel about
pain. The remaining structures are not involved.
177. Which renal condition usually has a history of recent
infection with beta-hemolytic streptococci?
a. pyelonephritis
b. chronic renal failure
c. nephrosis
d. glomerulonephritis
e. calculi: d
178. Which statement is NOT true concerning
glomerulonephritis?
a. Significant damage to kidneys occurs during the
body's response to an infection
b. Fever and flank pain occur
c. Complement activation attracts neutrophils
d. It is characterized by hematuria, proteinuria, and
the presence of casts
e. Approximately 90% of individuals develop chronic
disease: e
179. Which statement is NOT true concerning urinary tract
infections?
a. Once cystitis develops, pyelonephritis will certainly
occur
b. They are usually caused by coliforms, especially E.
coli
c. Organisms probably enter the bladder by way of the
urethra
d. The patient may be asymptomatic: a
180. Which statement is NOT true regarding increasing
intracranial pressure?
a. accumulating CO2 causes vasoconstriction
b. the brain volume increases
c. the blood volume in the vessels increases
d. brain tissue shifts from the compartment of greater
pressure to one of lesser pressure
e. both b and c: a
181. Which statement is TRUE regarding breast cancer?
a. The older the age at a woman's first childbirth, the
lower the risk.
b. It is the second most common cause of cancer in
women.
c. The incidence has been declining since 1955.
d. African-American women have the highest mortality
rate.: d
African-American women in all age groups experience the
highest mortality rate. It has been on the rise since 1955. It is the
most common cause of cancer in women. Early childbirth lowers
the risk of having cancer.
182. Which statement is TRUE regarding cancer of the
colon?
a. It is the most frequent cause of cancer death.
b. It accounts for 25% of all cancer deaths.
c. It tends to occur in young individuals less than 40
years of age.
d. Treatment will include surgical resection of the
colon.: d
Treatment for cancer of the colon is always surgical. Colorectal
cancer is the second most frequent cause of cancer death in the
United States; it accounts for 10% to 15% of all cancer deaths. It
also occurs in individuals older than 50 years.
183. Which statement is true regarding hiatal hernia?
a. There are three common types of such a hernia.
b. The most common type is paraesophageal.
c. Paraesophageal is herniation of the greater curvature
of the stomach.
d. Sliding hernia is triggered by standing.: c
There are two types of hiatal hernia: sliding and paraesophageal.
Sliding is the most common and reverses with standing. It moves
into the thoracic cavity with sitting, bending, tight clothing,
ascites, and obesity. Paraesophageal is caused by herniation of
the greater curvature of the stomach through a second opening in
the diaphragm.
184. Which statement is TRUE regarding the act of retching?
a. It begins with a shallow respiration.
b. Hypersalivation and tachycardia are common.
c. The esophagus becomes distended.
d. Reverse peristalsis seldom occurs.: c
Retching begins with a deep inspiration, followed by distention
of the esophagus, contraction and spasm of abdominal muscles,
lower esophageal relaxation, and reverse peristalsis.
Hypersalivation and tachycardia are common during nausea.
185. Which statement regarding benign prostatic
hyperplasia (BPH) is TRUE?
a. Ten percent of men will have it by age 80 years.
b. It is an uncommon condition.
c. The prostate is largest at birth and continues to
shrink.
d. It may be problematic if urethral compression
occurs.: d
BPH is a common condition. It may be a problem if there is
compression of the urethra. Eighty percent of men will have it
before age 80. The prostate increases in size throughout life and
is the smallest at birth.
186. Which statement regarding cirrhosis is true? Select all
that apply.
a. Cirrhosis develops rapidly.
b. The causes are not clearly understood.
c. Portal hypertension is a complication.
d. Severity is determined by amount of the toxin.
e. Prognosis is poor even when contaminant is
removed.: b, c, d
187. Which statement regarding renal cell carcinoma is
correct?
a. It is associated with p53.
b. Symptoms include hematuria.
c. Early stages produce a large abdominal mass.
d. Granular cell tumors have better prognosis.: b
Symptoms include hematuria, flank pan, and flank/abdominal
mass. Early stages are often silent, and clear cell tumors have a
better prognosis. Overexpression of p53 is demonstrated in
bladder tumors.
188. Which substance is an abnormal constituent of urine?
a. urea
b. glucose
c. sodium chloride
d. creatinine: b
189. Which type of hearing loss is a result of foreign body
obstruction of the inner ear?
a. Conductive
b. Sensorineural
c. Functional
d. Presbycusis: a
Conductive hearing loss occurs when a change in the outer or
middle ear, such as a foreign body lodged in the ear canal,
impairs conduction of the sound from the outer to inner ear.
Sensorineural hearing loss is caused by impairment of the organ
of Corti or its central connections. Presbycusis is a form of
sensorineural hearing loss usually seen in elderly people.
Functional hearing loss is believed to be caused by emotional or
psychologic factors.
190. Which type of jaundice is caused by the increased
destruction of erythrocytes?
a. obstructive
b. hemolytic
c. hepatocellular
d. b and c: b
191. Which viral hepatitis is NOT associated with a chronic
state or carrier state?
a. Hep A
b. Hep B
c. Hep C
d. serum hepatitis
e. Hep D: a
192. Which would be consistent with a diagnosis of viral
hepatitis? (More than 1 answer may be correct)
a. elevated aspartate transaminase (AST) serum
enzymes
b. decreased serum albumin levels
c. prolonged coagulation times
d. increased serum bilirubin levels
e. decreased alanine transaminase (ALT) serum
enzymes: a, b,c, d
193. With which bacteria is acute glomerulonephritis
associated?
a. E. coli
b. Staphylococcus
c. Group A streptococcus
d. Klebsiella: c
Glomerulonephritis is an inflammation of the glomeruli and is
often caused by a streptococcal infection. It usually occurs 7 to 10
days after the infection.
194. A young child presents with redness of the eyes. The
parents indicate that this condition seems to be 'going
around' the daycare. Which is the most likely
diagnosis?
a. Blepharitis
b. Keratitis
c. Trachoma
d. Conjunctivitis: d
Acute bacterial conjunctivitis, or pinkeye, is a highly contagious
bacterial infection. Blepharitis is inflammation of the eyelids.
Keratitis is an infection of the cornea. Trachoma is a bacterial
infection caused by poor hygiene and is the leading cause of
preventable blindness.