Which of the following statements describes phase 4 of the action potential of cells in the sinoatrial (SA) node?

Question 1

Which of the following statements describes phase 4 of the action potential of cells in the sinoatrial (SA) node? 

Answers: 

A. Potassium permeability is allowing the cell membrane to remain depolarized, and Ca2+ channel opens moving Ca2+ back into the cell.

B. The cells are capable of responding to a greater than normal stimulus before the resting membrane potential is reached.

C. A slow depolarization occurs when Na+ is transported out of the cell and K+ moves back in, resulting in resting membrane potential.

D. The fast sodium channels in the cellular membranes close, causing an abrupt decrease in intracellular positivity.

Question 2

A 31-year-old woman with a congenital heart defect reports episodes of light-headedness and syncope, with occasional palpitations. A resting electrocardiogram reveals sinus bradycardia, and she is suspected to have sick sinus syndrome. Which of the following diagnostic methods is the best choice to investigate the suspicion? 

Answers: 

A. Signal-averaged ECG

B. Holter monitoring

C. Electrophysiologic study

D. Exercise stress testing

Question 3

A patient has been diagnosed with anemia. The physician suspects an immune hemolytic anemia and orders a Coombs test. The patient asks the nurse what this test will tell the doctor. The nurse replies, 

Answers: 

A. “They are looking for the presence of antibody or complement on the surface of the RBC.”

B. “They will wash your RBCs and then mix the cells with a reagent to see if they clump together.”

C. “They will look at your RBCs under a microscope to see if they have an irregular shape (poikilocytosis).”

D. “They will be looking to see if you have enough ferritin in your blood.”

Question 4

Of the following list of patients, who would likely benefit the most from hyperbaric oxygen therapy? 

Answers: 

A. A football player who has torn a meniscus in his knee for the third time this year

B. A patient who developed a fistula between her bowel and vagina following cervical cancer surgery

C. A school-aged child who fell on gravel and has terrible road rash

D. A trauma patient who developed Clostridium spp., an anaerobic bacterial infection in his femur

Question 5

A 71-year-old male patient with a history of myocardial infarction (MI) and peripheral vascular disease (PVD) has been advised by his family physician to begin taking 81 mg aspirin once daily. Which of the following statements best captures an aspect of the underlying rationale for the physician’s suggestion? 

Answers: 

A. Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation.

B. Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin.

C. Aspirin can reduce unwanted platelet adhesion by inhibiting TXA2 synthesis.

D. Aspirin helps to inhibit ADP action and minimizes platelet plug formation.

Question 6

Which of the following assessments and laboratory findings would be most closely associated with acute leukemia? 

Answers: 

A. Increased serum potassium and sodium levels

B. Increased blood urea nitrogen and bone pain

C. High blast cell counts and fever

D. Decreased oxygen partial pressure and weight loss

Question 7

A 55-year-old male who is beginning to take a statin drug for his hypercholesterolemia is discussing cholesterol and its role in health and illness with his physician. Which of the following aspects of hyperlipidemia would the physician most likely take into account when teaching the patient? 

Answers: 

A. Hyperlipidemia is a consequence of diet and lifestyle rather than genetics.

B. The goal of medical treatment is to eliminate cholesterol from the vascular system.

C. Cholesterol is a metabolic waste product that the liver is responsible for clearing.

D. HDL cholesterol is often characterized as being beneficial to health.

Question 8

A 6-year-old girl with a diagnosis of Marfan syndrome is being assessed at a community health clinic. Which of the following assessments would be the health care professional’s lowest priority? 

Answers: 

A. A musculoskeletal assessment

B. A test of the child’s visual acuity

C. Tests of kidney function

D. Cardiovascular assessment

Question 9

In the ICU setting, a patient transported from surgery following open heart bypass grafting will likely have his core temperature measured by a/an 

Answers: 

A. esophageal flexible thermometer monitoring aorta distention.

B. rectal tube inserted to prevent evacuation from bowels while recovering from anesthesia.

C. pulmonary artery catheter being used to measure cardiac output.

D. temperature probe taped behind his ear.

Question 10

The son of an 80-year-old man has noticed that in recent weeks his father has become incontinent of urine for the first time in his life. The man is later diagnosed with transient urinary incontinence, a condition that is most often attributable to 

Answers: 

A. medications.

B. detrusor instability.

C. decrease in bladder and sphincter tone.

D. bladder outlet obstruction.

Question 11

A health educator is teaching a group of colleagues about the physiology of thermoregulation. Which of the following statements is most accurate? 

Answers: 

A. “Prostaglandin E2 (PGE2) exerts a direct fever-producing effect on the hypothalamus.”

B. “Endogenous pyrogens induce host cells to produce exogenous pyrogens.”

C. “PGE2 induces Kupffer cells to initiate a fever response via hepatic sinusoids.”

D. “Arachidonic acid induces cytokines to act on the temperature regulation center.”

Question 12

A patient experiencing immotile cilia syndrome should be frequently assessed by the nurse for which priority complication? 

Answers: 

A. Epistaxis resulting from loss of cilia in the nasal passageway

B. Sterility caused by inability of the sperm to swim downstream

C. Bronchiectasis due to interferences with clearance of inhaled bacteria along the respiratory tract

D. Inability to hear soft sounds related to kinocilium on the hair cells in the inner ear

Question 13

The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which of the following assessment questions posed to the parents is likely to be most useful in the differential diagnosis? 

Answers: 

A. “Is there any mold in your home that you know of?”

B. “Is there any family history of neuromuscular diseases?”

C. “Has your baby ever been directly exposed to any chemical cleaning products?”

D. “Have you ever given your child any honey or honey-containing products?”

Question 14

In the context of a workshop on rheumatoid arthritis, a clinical educator is teaching a group of nurses about autoimmune diseases. Which of the following statements by an attendee would the educator most likely want to follow up with further teaching? 

Answers: 

A. “Often the problem can be traced to antigens that sensitize T cells without the need for presentation.”

B. “In some cases, the body attacks its own cells that are chemically similar to those of infectious organisms.”

C. “Introduction of a foreign antigen can sometimes induce a cascade of immune response that is not self-limiting”

D. “Sometimes when the body’s own cells are released after a long time, they are interpreted as being foreign.”

Question 15

Which of the following pregnant women has most likely encountered the greatest increase in the risk that her child will have a fetal anomaly? 

Answers: 

A. A woman with diagnoses of syphilis and cirrhosis of the liver

B. A woman who has herpes simplex and who has recently recovered from endocarditis

C. A woman with chronic obstructive pulmonary syndrome and tuberculosis

D. A woman with diagnoses of insulin-dependent diabetes mellitus and peripheral neuropathy

Question 16

In which of the following individuals would a clinician most suspect multiple myeloma as a diagnosis? 

Answers: 

A. A 70-year-old woman whose blood work reveals large numbers of immature granulocytes

B. A 68-year-old former coal miner who has white cell levels exponentially higher than normal ranges

C. A 40-year-old man who has had three broken bones over the past 6 months and whose serum calcium and creatinine levels are elevated

D. An 81-year-old male resident of a long-term care home who has an uncommon bacterial pneumonia and who is unable to produce a fever

Question 17

A group of novice nursing students are learning how to manually measure a client’s blood pressure using a stethoscope and sphygmomanometer. Which of the following statements by students would the instructor most likely need to correct? 

Answers: 

A. “If my client’s arm is too big for the cuff, I’m going to get a BP reading that’s artificially low.”

B. “I’ll inflate the cuff around 30 mm Hg above the point at which I can’t palpate the client’s pulse.”

C. “The accuracy of the whole process depends on my ability to clearly hear the Korotkoff sounds with the bell of my stethoscope.”

D. “With practice, my measurement of clients’ blood pressures with this method will be more accurate than with automated machines.”

Question 18

A physician is explaining to a 40-year-old male patient the importance of completing his course of antibiotics for the treatment of tuberculosis. The physician explains the damage that could occur to lung tissue by Mycobacterium tuberculosis. Which of the following phenomena would underlie the physician’s explanation? 

Answers: 

A. Tissue destruction results from neutrophil deactivation.

B. Macrophages form a capsule around the Mycobacterium tuberculosis bacteria, resulting in immune granulomas.

C. Neutrophils are ineffective against the Mycobacterium tuberculosis antigens.

D. Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis.

Question 19

0 out of 1 points

A student makes the statement to a colleague, “Blood plasma is essentially just a carrier for the formed elements like red blood cells and white blood cells.”What would be the most accurate response to this statement? 

Answers: 

A. “Not really. Plasma also contributes to the processes of protein synthesis and hematopoiesis.”

B. “Actually, plasma is integral to the proper function of the liver and maintenance of acid–base balance.”

C. “Actually, plasma plays a significant role in nutrient and waste transport.”

D. “That’s not really true. Plasma is crucial in the immune and inflammatory responses.”

Question 20

A number of clients have presented to the emergency department in the last 32 hours with complaints that are preliminarily indicative of myocardial infarction. Which of the following clients is least likely to have an ST-segment myocardial infarction (STEMI)? 

Answers: 

A. A 70-year-old woman who is complaining of shortness of breath and vague chest discomfort

B. A 66-year-old man who has presented with fatigue, nausea and vomiting, and cool, moist skin

C. A 71-year-old man who has moist skin, fever, and chest pain that is excruciating when he moves but relieved when at rest

D. A 43-year-old man who woke up with substernal pain that is radiating to his neck and jaw

 

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