Question 8. 8. A 66-year-old female patient has presented to the emergency department because of several months of intermittently bloody stools that has recently become worse. The woman has since been diagnosed with a gastrointestinal bleed secondary to overuse of nonsteroidal anti-inflammatory drugs that she takes for her arthritis. The health care team would realize that which of the following situations is most likely? (Points : 0.4)
The woman has depleted blood volume due to her ongoing blood loss.
She will have iron-deficiency anemia due to depletion of iron stores.
The patient will be at risk for cardiovascular collapse or shock.
She will have delayed reticulocyte release.
Question 9. 9. A nurse practitioner student is familiarizing herself with the overnight admissions to an acute medical unit of a university hospital. Which of the following patients would the student recognize as being least likely to have a diagnosis of antiphospholipid syndrome in his or her medical history? (Points : 0.4)
A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident
A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic attacks
A 30-year-old female with a diagnosis of left leg DVT and a pulmonary embolism
A 21-yer-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use
Question 10. 10. A 60-year-old male patient with an acute viral infection is receiving interferon therapy. The nurse practitioner is teaching the family of the patient about the diverse actions of the treatment and the ways that it differs from other anti-infective therapies. Which of the following teaching points should the nurse practitioner exclude? (Points : 0.4)
“Interferon can help your father’s unaffected cells adjacent to his infected cells produce antiviral proteins that limit the spread of the infection.”
“Interferon can help limit the replication of the virus that’s affecting your father.”
“Interferon helps your father’s body recognize infected cells more effectively.”
“Interferon can bolster your father’s immune system by stimulating natural killer cells that attack viruses.”
Question 11. 11. A nurse practitioner is providing prenatal care and education for a first-time expectant mother, 22 weeks’ gestation, who has a diagnosis of a sexually transmitted infection. Which of the following statements by the expectant mother demonstrates an adequate understanding of vertical disease transmission and congenital infections? (Points : 0.4)
“Gonorrhea and chlamydia pose the greatest risks of transmission from mother to child.”
“I know that my baby will need observation for HIV signs and symptoms in the weeks following my delivery.”
“My baby could become infected either across the placenta or during the birth itself.”
“Prophylactic immunization will reduce my baby’s chance of being born with an illness.”
Question 12. 12. The blood work of a 44-year-old male patient with a diagnosis of liver disease secondary to alcohol abuse indicates low levels of albumin. Which of the following phenomena would a clinician be most justified in anticipating? (Points : 0.4)
Impaired immune function
Question 13. 13. A 30-year-old man has spent 5 hours on a cross-country flight seated next to a passenger who has been sneezing and coughing, and the man has been inhaling viral particles periodically. Which of the following situations would most likely result in the stimulation of the man’s T lymphocytes and adaptive immune system? (Points : 0.4)
Presentation of a foreign antigen by a familiar immunoglobulin
Recognition of a foreign MHC molecule
Recognition of a foreign peptide bound to a self MHC molecule
Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell mediation
Question 14. 14. Which of the following phenomena would be least likely to result in activation of the complement system? (Points : 0.4)
Recognition of an antibody bound to the surface of a microbe
The binding of mannose residues on microbial glycoproteins
Activation of Toll-like receptors (TLRs) on complement proteins
Direct recognition of microbial proteins
Question 15. 15. A tourist presented to a primary care health clinic complaining of malaise, fever, and headache. She has subsequently been diagnosed with Rocky Mountain spotted fever, a pathology caused by Rickettsiaceae. Which of the followed statements best captures a characteristic trait of Rickettsiaceae? (Points : 0.4)
They are eukaryotic.
They have both RNA and DNA.
They have a distinct spiral-shaped morphology.
They are neither gram-negative nor gram-positive.
Question 16. 16. A 40-year-old woman who experiences severe seasonal allergies has been referred by her family physician to an allergist for weekly allergy injections. The woman is confused as to why repeated exposure to substances that set off her allergies would ultimately benefit her. Which of the following phenomena best captures the rationale for allergy desensitization therapy? (Points : 0.4)
Repeated exposure to offending allergens binds the basophils and mast cells that mediate the allergic response.
Exposure to allergens in large, regular quantities overwhelms the IgE antibodies that mediate the allergic response.
Repeated exposure stimulates adrenal production of epinephrine, mitigating the allergic response.
Injections of allergens simulate production of IgG, which blocks antigens from combining with IgE.
Question 17. 17. A 71-year-old male patient with a history of myocardial infarction and peripheral vascular disease has been advised by his nurse practitioner to begin taking 81 mg aspirin once daily. Which of the following statements best captures an aspect of the underlying rationale for the nurse practitioner’s suggestion? (Points : 0.4)
Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin.
Aspirin helps to inhibit adenosine disphosphate (ADP) action and minimizes platelet plug formation.
Aspirin can reduce unwanted platelet adhesion by inhibiting thromboxane A2 (TXA2) synthesis.
Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation.