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NR507 Week 8 Final Exam
In the pathophysiology of asthma, which of the following processes contributes to airway narrowing and bronchoconstriction?
- ✅ A. Thickening of the bronchial smooth muscle
- B. Inhibition of inflammatory cells
- C. Proliferation of ciliated epithelial cells
- D. Decreased mucus production
A patient with a history of chronic alcohol abuse presents with weakness, fatigue, and difficulty concentrating. Laboratory results show an elevated mean corpuscular volume (MCV) and low vitamin B12 levels. What type of anemia is most likely present?
- A. Hemolytic anemia
- B. Microcytic anemia
- C. Normocytic anemia
- ✅ D. Macrocytic anemia
Which of the following individuals is at increased risk for developing hemolytic anemia?
- A. A middle-aged man with uncontrolled hypertension
- ✅ B. An individual with glucose-6-phosphate dehydrogenase (G6PD) deficiency
- C. A pregnant woman with adequate iron supplementation
- D. A patient with a family history of thalassemia
A patient is newly diagnosed with emphysema. Which treatment strategy is most likely to be ordered by the NP to manage symptoms and improve the patient’s quality of life?
- A. Corticosteroids
- B. Oxygen therapy
- ✅ C. Long-acting bronchodilators
- D. Antibiotics
Which of the following strategies is included in the standard treatment plan for Crohn disease?
- ✅ A. All of the choices are correct
- B. Use of anti–tumor necrosis factor (anti-TNF-α) therapy
- C. Use of corticosteroids
- D. Smoking cessation
Which of the following is the primary site of action of thiazide diuretics in the nephron?
- A. Proximal convoluted tubule
- B. Thick ascending limb of the loop of Henle
- ✅ C. Distal convoluted tubule (early segment)
- D. Collecting duct
Which description best characterizes the appearance of plaque psoriasis?
- A. Honey-colored crusts on an inflamed skin background
- B. Linear erythematous streaks on the skin
- C. Small, fluid-filled blisters on an erythematous base
- ✅ D. Well-demarcated, circular plaques with silvery scale
Which neurotransmitter imbalance is most commonly associated with the pathophysiology of schizophrenia?
- A. Excess serotonin activity in the prefrontal cortex
- B. GABA deficiency in the hippocampus
- C. Acetylcholine depletion in the amygdala
- ✅ D. Dopamine overactivity in the limbic system
Risk factors for ulcerative colitis and Crohn disease are similar except for which factor?
- A. Cancer risk
- ✅ B. Gender
- C. Family history
- D. Age of onset
According to the American Diabetes Association (ADA), which diagnostic criteria are used to diagnose type 2 diabetes mellitus?
- ✅ A. All of the choices are correct
- B. Random plasma glucose ≥200 mg/dL in a patient with classic symptoms of hyperglycemia
- C. HbA1c ≥6.5% using a DCCT-referenced assay
- D. Fasting plasma glucose ≥126 mg/dL (7.0 mmol/L)
In a patient with a healthy heart, what is the physiological response to an increase in preload?
- ✅ A. Increased stroke volume
- B. Decreased stroke volume
- C. Increased afterload
- D. Maintenance of stroke volume at a constant leve
What is the most common cause of cirrhosis of the liver?
- A. Hepatitis C virus
- ✅ B. Nonalcoholic steatohepatitis (NASH)
- C. Hepatitis A virus
- D. Hepatitis B virus
Which of the following represents the most significant difference between emphysema and chronic bronchitis?
- A. A productive cough is an early sign in emphysema, whereas cough appears later in chronic bronchitis
- ✅ B. Emphysema primarily involves damage to the alveoli, while chronic bronchitis involves inflammation of the airways
- C. Cyanosis is more common in emphysema than in chronic bronchitis
- D. Barrel chest is less common in emphysema than in chronic bronchitis
A 55-year-old man with diabetes and hypertension presents with symptoms suggestive of chronic kidney disease. Which laboratory test is most useful for diagnosing and assessing disease severity?
- ✅ A. Serum creatinine and estimated glomerular filtration rate (eGFR)
- B. Urinary pH and specific gravity
- C. Blood glucose levels
- D. Blood urea nitrogen (BUN) levels
During a physical examination, the NP detects a harsh, crescendo–decrescendo systolic murmur at the right upper sternal border that radiates to the carotid arteries. Based on this finding, what is the most likely valve disorder?
- A. Aortic regurgitation
- ✅ B. Aortic stenosis
- C. Mitral stenosis
- D. Mitral regurgitation
A 55-year-old patient presents with aortic regurgitation. Which condition is most likely to contribute to the development of this valvular disorder?
- A. Atherosclerosis of the coronary arteries
- B. Mitral valve prolapse
- ✅ C. Bicuspid aortic valve
- D. Left ventricular hypertrophy
Which of the following is recommended when diagnosing an uncomplicated urinary tract infection (UTI)?
- A. Urinalysis to identify red blood cells (RBCs)
- B. Urine culture to identify specific bacteria
- C. Renal ultrasound
- ✅ D. Urine dipstick to identify leukocyte esterase or nitrites
In the diagnosis and management of asthma, how can peak flow measurements be used to assess the severity of airflow limitation?
- ✅ A. Monitoring peak flow before and after bronchodilator administration
- B. Using peak flow as a substitute for pulmonary function tests
- C. Using peak flow as the sole diagnostic tool for asthma
- D. Using peak flow to measure oxygen saturation levels
Which of the following is considered a borderline total cholesterol level?
- A. 150–199 mg/dL
- B. 100–129 mg/dL
- C. ≥240 mg/dL
- ✅ D. 200–239 mg/dL
Which of the following symptoms are typically seen in Stage 1 chronic kidney disease?
- A. Anemia
- ✅ B. Usually no symptoms are seen at this stage
- C. Mild hypertension
- D. Hyperphosphatemia
What is the primary pathophysiological mechanism underlying benign prostatic hyperplasia (BPH)?
- A. Formation of prostatic cysts
- B. Increased production of androgens
- ✅ C. Progressive enlargement of the prostate gland
- D. Inflammation and infection of the prostate gland
A 50-year-old patient with dyslipidemia is evaluated for secondary causes contributing to abnormal lipid levels. Which of the following medical conditions is most likely to be a secondary cause of dyslipidemia?
- A. Essential hypertension
- ✅ B. Hypothyroidism
- C. Adrenal insufficiency
- D. Familial hypercholesterolemia
Untreated Stage 5 chronic kidney disease (CKD) will result in which of the following symptoms?
- A. Hyperphosphatemia
- B. Anemia
- C. Severe hypertension
- ✅ D. All the choices are correct
Which statement best differentiates between high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol?
- ✅ A. HDL cholesterol is considered “good” cholesterol and helps remove excess cholesterol from the bloodstream, while LDL cholesterol is considered “bad” cholesterol and contributes to plaque buildup in the arteries
- B. HDL cholesterol is synthesized by the liver and is essential for hormone production, while LDL cholesterol is a byproduct of cellular metabolism
- C. HDL cholesterol carries cholesterol to cells for energy, while LDL cholesterol transports excess cholesterol to the liver for excretion
- D. HDL cholesterol increases atherosclerosis risk, while LDL cholesterol is protective
What is the primary pathophysiological process underlying pre-renal failure?
- A. Inflammation and infection of the renal tubules
- ✅ B. Inadequate blood flow to the kidneys
- C. Obstruction of the urinary tract
- D. Direct damage to the renal parenchyma
What is the primary role of angiotensin-converting enzyme inhibitors (ACEIs) in the management of chronic kidney disease (CKD)?
- A. Providing symptomatic relief of kidney pain
- ✅ B. Slowing the progression of kidney damage
- C. Reducing blood pressure only
- D. Enhancing diuresis and kidney damage
A 40-year-old patient presents with severe colicky flank pain, hematuria, and nausea. The provider suspects renal calculi. Which sign or symptom is most indicative of renal calculi?
- A. Urgency and frequency of urination
- B. Suprapubic tenderness
- ✅ C. Severe flank pain that radiates to the groin
- D. Fever and chills
What is the primary cause of polyuria in individuals with type 1 diabetes mellitus?
- A. Decreased glomerular filtration rate
- B. Hyperactivation of the renin–angiotensin–aldosterone system
- C. Increased secretion of antidiuretic hormone
- ✅ D. Osmotic diuresis caused by elevated glucose levels
The nurse practitioner is reviewing the chest X-ray of a patient with chronic obstructive pulmonary disease (COPD). Which finding is most likely present?
- A. Bulging diaphragm
- ✅ B. Flattened diaphragm
- C. Elongated diaphragm
- D. Enlarged heart
What is the underlying pathophysiology of primary hyperparathyroidism?
- A. Excessive production of parathyroid hormone (PTH) due to a tumor in the thyroid gland
- B. Insufficient secretion of calcium by the parathyroid glands
- C. Autoimmune destruction of the parathyroid glands
- ✅ D. Overproduction of parathyroid hormone by one or more parathyroid glands
In chronic kidney disease (CKD), the presence of proteinuria is primarily attributed to which mechanism?
- A. Decreased filtration of proteins in the renal tubules
- ✅ B. Glomerular hyperfiltration and increased glomerular capillary permeability
- C. Increased glomerular filtration rate (GFR)
- D. Impaired reabsorption of proteins in the renal tubules
Which of the following patients is most at risk for urge incontinence?
- A. A 47-year-old male with benign prostatic hyperplasia
- ✅ B. A 60-year-old postmenopausal woman
- C. A 40-year-old pregnant woman
- D. A 30-year-old male with a history of regular exercise
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