NSG5003 South University Final Exam
Question 1
Which component of the cell produces hydrogen peroxide (H2O2) by using oxygen to remove
hydrogen atoms from specific substrates in an oxidative reaction?
a. Lysosomes
b. Peroxisomes
c. Ribosomes
d. Oxyhydrosomes
Answer: b. Peroxisomes
Question 2
What is a consequence of plasma membrane damage to the mitochondria?
a. Enzymatic digestion halts deoxyribonucleic acid (DNA. synthesis.
b. Influx of calcium ions halts adenosine triphosphate (ATP) production.
c. Edema from an influx in sodium causes a reduction in ATP production.
d. Potassium shifts out of the mitochondria, which destroys the infrastructure.
Answer: b. Influx of calcium ions halts adenosine triphosphate (ATP) production.
Question 3
Which statement is a description of one of the characteristics of apoptosis?
a. Apoptosis involves programmed cell death of scattered single cells.
b. Apoptosis is characterized by the swelling of the nucleus and the cytoplasm.
c. Apoptosis involves unpredictable patterns of cell death.
d. Apoptosis results in benign malignancies.
Answer: a. Apoptosis involves programmed cell death of scattered single cells.
Question 4
During cell injury caused by hypoxia, sodium and water move into the cell because:
a. During cell injury caused by hypoxia, sodium and water move into the cell because:
b. The pump that transports sodium out of the cell cannot function because of a decrease in
adenosine triphosphate (ATP) levels.
c. The osmotic pressure is increased, which pulls additional sodium across the cell membrane
d. Oxygen is not available to bind with sodium to maintain it outside of the cell.
Answer: b. The pump that transports sodium out of the cell cannot function because of a
decrease in adenosine triphosphate (ATP) levels.
Question 5
What is an effect of ionizing radiation exposure?
a. Respiratory distress
b. Sun intolerance
c. Deoxyribonucleic acid (DNA. aberrations
d. Death
Answer: c. Deoxyribonucleic acid (DNA. aberrations
Question 6
Obesity creates a greater risk for dehydration in people because:
a. Adipose cells contain little water because fat is water repelling.
b. The metabolic rates of obese adults are slower than those of lean adults.
c. The rates of urine output of obese adults are higher than those of lean adults.
d. The thirst receptors of the hypothalamus do not function effectively.
Answer: a. Adipose cells contain little water because fat is water repelling.
Question 7
In addition to osmosis, what force is involved in the movement of water between the plasma and
interstitial fluid spaces?
a. Oncotic pressure
b. Buffering
c. Net filtration
d. Hydrostatic pressure
Answer: d. Hydrostatic pressure
Question 8
Venous obstruction is a cause of edema because of an increase in which pressure?
a. Capillary hydrostatic
b. Interstitial hydrostatic
c. Capillary oncotic
d. Interstitial oncotic
Answer: a. Capillary hydrostatic
Question 9
At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial
space because:
a. The interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure.
b. The capillary hydrostatic pressure is higher than the capillary oncotic pressure.
c. The interstitial oncotic pressure is higher than the interstitial hydrostatic pressure.
d. The capillary oncotic pressure is lower than the interstitial hydrostatic pressure.
Answer: b. The capillary hydrostatic pressure is higher than the capillary oncotic pressure.
Question 10
It is true that natriuretic peptides:
a. Decrease blood pressure and increase sodium and water excretion.
b. Increase blood pressure and decrease sodium and water excretion.
c. Increase the heart rate and decrease potassium excretion.
d. Decrease the heart rate and increase potassium excretion.
Answer: a. Decrease blood pressure and increase sodium and water excretion.
Question 11
What causes the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and
coma in hypernatremia?
a. High sodium in the blood vessels pulls water out of the brain cells into the blood vessels,
causing brain cells to shrink.
b. High sodium in the brain cells pulls water out of the blood vessels into the brain cells, causing
them to swell.
c. High sodium in the blood vessels pulls potassium out of the brain cells, which slows the
synapses in the brain.
d. High sodium in the blood vessels draws chloride into the brain cells followed by water,
causing the brain cells to swell.
Answer: a. High sodium in the blood vessels pulls water out of the brain cells into the blood
vessels, causing brain cells to shrink.
Question 12
A major determinant of the resting membrane potential necessary for the transmission of nerve
impulses is the ratio between:
a. Intracellular and extracellular Na+
b. Intracellular and extracellular K+
c. Intracellular Na+ and extracellular K+
d. Intracellular K+ and extracellular Na+
Answer: b. Intracellular and extracellular K+
Question 13
In hyperkalemia, what change occurs to the cells’ resting membrane potential?
a. Hypopolarization
b. Hyperexcitability
c. Depolarization
d. Repolarization
Answer: a. Hypopolarization
Question 14
Physiologic pH is maintained at approximately 7.4 because bicarbonate (HCO3) and carbonic
acid (H2CO3) exist in a ratio of:
a. 20:1
b. 1:20
c. 10:2
d. 10:5
Answer: a. 20:1
Question 15
Increased capillary hydrostatic pressure results in edema because of:
a. Losses or diminished production of plasma albumin
b. Inflammation resulting from an immune response
c. Blockage within the lymphatic channel system
d. Sodium and water retention
Answer: d. Sodium and water retention
Question 16
Hypomethylation and the resulting effect on oncogenes result in:
a. A decrease in the activity of the oncogene, thus suppressing cancer development
b. Deactivation of MLH1 to halt deoxyribonucleic acid (DNA. repair
c. An increase in tumor progression from benign to malignant
d. Overexpression of micro-ribonucleic acid (miRNA., resulting in tumorigenesis
Answer: c. An increase in tumor progression from benign to malignant
Question 17
The functions of the major histocompatibility complex (MHC. and CD1 molecules are alike
because both:
a. Are antigen-presenting molecules
b. Bind antigens to antibodies
c. Secrete interleukins (ILs) during the immune process
d. Are capable of activating cytotoxic T lymphocytes
Answer: a. Are antigen-presenting molecules
Question 18
The B-cell receptor (BCR) complex functions uniquely by:
a. Communicating information about the antigen to the helper T (Th) cell
b. Secreting chemical signals to help cells communicate
c. Recognizing the antigen on the surface of the B lymphocyte
d. Communicating information about the antigen to the cell nucleus
Answer: d. Communicating information about the antigen to the cell nucleus
Question 19
The generation of clonal diversity includes a process that:
a. Involves antigens that select lymphocytes with compatible receptors
b. Allows the differentiation of cells into antibody-secreting plasma cells or mature T cells
c. Takes place in the primary (central) lymphoid organs
d. Causes antigens to expand and diversify their populations
Answer: c. Takes place in the primary (central) lymphoid organs
Question 20
Vaccinations are able to provide protection against certain microorganisms because of the:
a. Strong response from immunoglobulin M (IgM)
b. Level of protection provided by immunoglobulin G (IgG)
c. Memory cells for immunoglobulin E (IgE)
d. Rapid response from immunoglobulin A (IgA.
Answer: b. Level of protection provided by immunoglobulin G (IgG)
Question 21
What is the mechanism that results in type II hypersensitivity reactions?
a. Antibodies coat mast cells by binding to receptors that signal its degranulation, followed by a
discharge of preformed mediators.
b. Antibodies bind to soluble antigens that were released into body fluids, and the immune
complexes are then deposited in the tissues.
c. Cytotoxic T (Tc. lymphocytes or lymphokine-producing helper T 1 (Th1) cells directly attack
and destroy cellular targets.
d. Antibodies bind to the antigens on the cell surface.
Answer: d. Antibodies bind to the antigens on the cell surface.
Question 22
When soluble antigens from infectious agents enter circulation, tissue damage is a result of:
a. Complement-mediated cell lysis
b. Phagocytosis by macrophages
c. Phagocytosis in the spleen
d. Neutrophil granules and toxic oxygen products
Answer: d. Neutrophil granules and toxic oxygen products
Question 23
Considering the hypothalamus, a fever is produced by:
a. Endogenous pyrogens acting directly on the hypothalamus
b. Exogenous pyrogens acting directly on the hypothalamus
c. Immune complexes acting indirectly on the hypothalamus
d. Cytokines acting indirectly on the hypothalamus
Answer: b. Exogenous pyrogens acting directly on the hypothalamus
Question 24
Vaccines against viruses are created from:
a. Killed organisms or extracts of antigens
b. Live organisms weakened to produce antigens
c. Purified toxins that have been chemically detoxified
d. Recombinant pathogenic protein
Answer: b. Live organisms weakened to produce antigens
Question 25
Carcinoma in situ is characterized by which changes?
a. Cells have broken through the local basement membrane.
b. Cells have invaded immediate surrounding tissue.
c. Cells remain localized in the glandular or squamous cells
d. Cellular and tissue alterations indicate dysplasia.
Answer: c. Cells remain localized in the glandular or squamous cells
Question 26
Two “hits” are required to inactivate tumor-suppressor genes because:
a. Each allele must be altered and each person has two copies, or alleles, of each gene, one from
each parent.
b. The first hit stops tissue growth and the second hit is needed to cause abnormal tissue growth.
c. Tumor-suppressor genes are larger than proto-oncogenes, requiring two hits to effect
carcinogenesis.
d. The first hit is insufficient to cause enough damage to cause a mutation.
Answer: a. Each allele must be altered and each person has two copies, or alleles, of each gene,
one from each parent.
Question 27
What is the skin-related health risk induced by some types of chemotherapy?
a. Infection
b. Ultraviolet damage
c. Pain
d. Erythema
Answer: a. Infection
Question 28
When a child is diagnosed with cancer, which intervention has the greatest influence on the
child’s mortality rate?
a. Age at the time of diagnosis
b. Participation in clinical trials
c. Proximity to a major cancer treatment center
d. Parental involvement in the treatment planning
Answer: b. Participation in clinical trials
Question 29
Reflex activities concerned with the heart rate, blood pressure, respirations, sneezing,
swallowing, and coughing are controlled by which area of the brain?
a. Pons
b. Midbrain
c. Cerebellum
d. Medulla oblongata
Answer: d. Medulla oblongata
Question 30
The edema of the upper cervical cord after a spinal cord injury is considered life threatening
because of which possible outcome?
a. Hypovolemic shock from blood lost during the injury
b. Breathing difficulties from an impairment to the diaphragm
c. Head injury that likely occurred during the injury
d. Spinal shock immediately after the injury
Answer: b. Breathing difficulties from an impairment to the diaphragm
Question 31
What term is used to describe the complication that can result from a spinal cord injury above T6
that is producing paroxysmal hypertension, as well as piloerection and sweating above the spinal
cord lesion?
a. Craniosacral dysreflexia
b. Parasympathetic dysreflexia
c. Autonomic hyperreflexia
d. Retrograde hyperreflexia
Answer: c. Autonomic hyperreflexia
Question 32
Atheromatous plaques are most commonly found:
a. In larger veins
b. Near capillary sphincters
c. At branches of arteries
d. On the venous sinuses
Answer: c. At branches of arteries
Question 33
Multiple sclerosis is best described as:
a. A CNS demyelination, possibly from an immunogenetic virus
b. Inadequate supply of acetylcholine at the neurotransmitter junction as a result of an
autoimmune disorder
c. The depletion of dopamine in the CNS as a result of a virus
d. A degenerative disorder of lower and upper motor neurons caused by viral-immune factors
Answer: a. A CNS demyelination, possibly from an immunogenetic virus
Question 34
Graves disease develops from:
a. A viral infection of the thyroid gland that causes overproduction of thyroid hormone
b. An autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue
c. Thyroid-stimulating immunoglobulin, which causes overproduction of thyroid hormones
d. Ingestion of goitrogens, which inhibits the synthesis of the thyroid hormones, causing goiter
Answer: c. Thyroid-stimulating immunoglobulin, which causes overproduction of thyroid
hormones
Question 35
Pathologic changes associated with Graves disease include:
a. High levels of circulating thyroid-stimulating immunoglobulins
b. Diminished levels of TRH
c. High levels of TSH
d. Diminished levels of thyroid-binding globulin
Answer: a. High levels of circulating thyroid-stimulating immunoglobulins
Question 36
A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values:
arterial pH 7.20, serum glucose 500 mg/dl, positive urine glucose and ketones, serum potassium
(K+) 2 mEq/L, and serum sodium (Na+) 130 mEq/L. The patient reports that he has been sick
with the “flu” for a week. What relationship do these values have to his insulin deficiency?
a. Increased glucose use causes the shift of fluid from the intravascular to the intracellular space.
b. Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic
diuresi
c. Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic
alkalosis.
d. Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and
electrolyte loss.
Answer: c. Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and
metabolic alkalosis.
Question 37
Type 2 diabetes mellitus is best described as:
a. Resistance to insulin by insulin-sensitive tissues
b. The need for lispro instead of regular insulin
c. An increase in glucagon secretion from α cells of the pancreas
d. The presence of insulin autoantibodies that destroy β cells in the pancreas
Answer: a. Resistance to insulin by insulin-sensitive tissues
Question 38
The common hay fever allergy is expressed through a reaction that is mediated by which class of
immunoglobulins?
a. Immunoglobulin E (IgE)
b. Immunoglobulin G (IgG)
c. Immunoglobulin M (IgM)
d. T cells
Answer: a. Immunoglobulin E (IgE)
Question 39
A person diagnosed with type 1 diabetes experiences hunger, light headedness, tachycardia,
pallor, headache, and confusion. The most probable cause of these symptoms is:
a. Hyperglycemia caused by incorrect insulin administration
b. The dawn phenomenon from eating a snack before bedtime
c. Hypoglycemia caused by increased exercise
d. Somogyi effect from insulin sensitivity
Answer: c. Hypoglycemia caused by increased exercise
Question 40
Hypoglycemia, followed by rebound hyperglycemia, is observed in those with:
a. The Somogyi effect
b. The dawn phenomenon
c. Diabetic ketoacidosis (DKA.
d. Hyperosmolar hyperglycemic nonketotic syndrome
Answer: a. The Somogyi effect
Question 41
Which structure is lined with columnar epithelial cells
a. Perimetrium
b. Endocervical canal
c. Myometrium
d. Vagina
Answer: b. Endocervical canal
Question 42
Where is the usual site of cervical dysplasia or cancer in situ?
a. Where the squamous epithelium of the cervix meets the cuboidal epithelium of the vagina
b. Where the columnar epithelium of the cervix meets the squamous epithelium of the uterus
c. Where the squamous epithelium of the cervix meets the columnar epithelium of the uterus
d. Where the columnar epithelium of the cervix meets the squamous epithelium of the vagina
Answer: d. Where the columnar epithelium of the cervix meets the squamous epithelium of the
vagina
Question 43
Which statement best describes a Schilling test?
a. Administration of radioactive cobalamin and the measurement of its excretion in the urine to
test for vitamin B12 deficiency
b. Measurement of antigen-antibody immune complexes in the blood to test for hemolytic
anemia
c. Measurement of serum ferritin and total iron-binding capacity in the blood to test for iron
deficiency anemia
d. Administration of folate and measurement in two hours of its level in a blood sample to test
for folic acid deficiency anemia
Answer: a. Administration of radioactive cobalamin and the measurement of its excretion in the
urine to test for vitamin B12 deficiency
Question 44
In aplastic anemia (AA), pancytopenia develops as a result of which of the following?
a. Suppression of erythropoietin to produce adequate amounts of erythrocytes
b. Suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and
thrombocytes
c. Lack of deoxyribonucleic acid (DNA) to form sufficient quantities of erythrocytes, leukocytes,
and thrombocytes
d. Lack of stem cells to form sufficient quantities of leukocytes
Answer: b. Suppression of the bone marrow to produce adequate amounts of erythrocytes,
leukocytes, and thrombocytes
Question 45
Which statement is true regarding warm autoimmune hemolytic anemia?
a. Warm autoimmune hemolytic anemia occurs primarily in men.
b. It is self-limiting and rarely produces hemolysis.
c. Erythrocytes are bound to macrophages and sequestered in the spleen.
d. Immunoglobulin M (IgM) coats erythrocytes and binds them to receptors on monocytes.
Answer: d. Immunoglobulin M (IgM) coats erythrocytes and binds them to receptors on
monocytes.
Question 46
Hemolytic disease of the newborn (HDN) can occur if the mother:
a. Is Rh-positive and the fetus is Rh-negative
b. Is Rh-negative and the fetus is Rh-positive
c. Has type A blood and the fetus has type O blood
d. Has type AB blood and the fetus has type B blood
Answer: b. Is Rh-negative and the fetus is Rh-positive
Question 47
When diagnosed with hemolytic disease of the newborn (HDN), why does the newborn develop
hyperbilirubinemia after birth but not in utero?
a. Excretion of unconjugated bilirubin through the placenta into the mother’s circulation is no
longer possible.
b. Hemoglobin does not break down into bilirubin in the intrauterine environment.
c. The liver of the fetus is too immature to conjugate bilirubin from a lipid-soluble form to a
watersoluble form.
d. The destruction of erythrocytes producing bilirubin is greater after birth.
Answer: a. Excretion of unconjugated bilirubin through the placenta into the mother’s
circulation is no longer possible.
Question 48
How does angiotensin II increase the workload of the heart after a myocardial infarction (MI)?
a. By increasing the peripheral vasoconstriction
b. By causing dysrhythmias as a result of hyperkalemia
c. By reducing the contractility of the myocardium
Answer: a. By increasing the peripheral vasoconstriction
Question 49
What event is a characteristic of the function in Zone I of the lung?
a. Blood flow through the pulmonary capillary bed increases in regular increments.
b. Alveolar pressure is greater than venous pressure but not greater than arterial pressure.
c. The capillary bed collapses, and normal blood flow ceases.
d. Blood flows through Zone I, but it is impeded to a certain extent by alveolar pressure.
Answer: b. Alveolar pressure is greater than venous pressure but not greater than arterial
pressure.
Question 50
What factor associated with gluten-sensitive enteropathy (celiac sprue) causes an infant to bruise
and bleed easily?
a. Vitamin K deficiency from fat malabsorption
b. Bone marrow function depression
c. Iron, folate, and B12 deficiency anemias
Answer: a. Vitamin K deficiency from fat malabsorption
