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NURSE EXAMS WITH VERIFIED QUESTIONS AND CORRECT ANSWERS.pdf, Exams of Nursing

Indiana University Purdue University (IUPUI)Nursing
Prof. Timothy Housman

NURSE EXAMS WITH VERIFIED QUESTIONS AND CORRECT ANSWERS.pdf NURSE EXAMS WITH VERIFIED QUESTIONS AND CORRECT ANSWERS.pdf NURSE EXAMS WITH VERIFIED QUESTIONS AND CORRECT ANSWERS.pdf NURSE EXAMS WITH VERIFIED QUESTIONS AND CORRECT ANSWERS.pdf

Typology: Exams

2024/2025

Available from 07/03/2025

lectwiseman
lectwiseman 🇺🇸

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NURSE EXAMS WITH VERIFIED
QUESTIONS AND CORRECT
ANSWERS
-Osis or -philia
- ANSWERS-Elevated count of blood cells
-penia
- ANSWERS-Low count of blood cells
4th generation immunoassay
- ANSWERS-"gold standard"
can test 10 days post exposure
can result negative, positive with HIV antibody, or positive without HIV antibody
Acute Lymphocytic Leukemia (ALL)
- ANSWERS-Marked by >30% lymphoblasts in blood or marrow
Most common in children
Survival rate decreases with age
CM: fever, pallor, bleeding, fatigue, lymphadenopathy, infection, joint pain,
splenomegaly, hepatomegaly, night sweats, weight loss, anemia, thrombocytopenia,
petechiae, ecchymosis
Acute Myelogenous Leukemia (AML)
- ANSWERS-Marked by proliferation of immature myeloid cells, decreased apoptosis,
and lack of cellular differentiation
Most common in adults
Remission is inversely related to age
CM: fever, pallor, bleeding, fatigue, lymphadenopathy, infection, joint pain,
splenomegaly, hepatomegaly, night sweats, weight loss, anemia, thrombocytopenia,
petechiae, ecchymosis
Alloimmunity and example of hypersensitivity
- ANSWERS-When an individuals immune system reacts against antigens on the tissues
of other members of the same species
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NURSE EXAMS WITH VERIFIED

QUESTIONS AND CORRECT

ANSWERS

  • Osis or - philia
  • ANSWERS-Elevated count of blood cells
  • penia
  • ANSWERS-Low count of blood cells 4th generation immunoassay
  • ANSWERS-"gold standard" can test 10 days post exposure can result negative, positive with HIV antibody, or positive without HIV antibody Acute Lymphocytic Leukemia (ALL)
  • ANSWERS-Marked by >30% lymphoblasts in blood or marrow Most common in children Survival rate decreases with age CM: fever, pallor, bleeding, fatigue, lymphadenopathy, infection, joint pain, splenomegaly, hepatomegaly, night sweats, weight loss, anemia, thrombocytopenia, petechiae, ecchymosis Acute Myelogenous Leukemia (AML)
  • ANSWERS-Marked by proliferation of immature myeloid cells, decreased apoptosis, and lack of cellular differentiation Most common in adults Remission is inversely related to age CM: fever, pallor, bleeding, fatigue, lymphadenopathy, infection, joint pain, splenomegaly, hepatomegaly, night sweats, weight loss, anemia, thrombocytopenia, petechiae, ecchymosis Alloimmunity and example of hypersensitivity
  • ANSWERS-When an individuals immune system reacts against antigens on the tissues of other members of the same species

Blood transfusions- causes clumping and lysis of RBC- fever, nausea, chills, low back pain, dark urine, hives, itching, SOB Rh incompatibility- hemolytic disease of newborn with jaundice, give Rhogam within 72 hours of birth (Rh- mother with Rh+ child) Antiretroviral medications

  • ANSWERS-Used to impede viral replication of HIV virus, come in 6 classes
  1. Nucleoside reverse transcriptase inhibitors
  2. Non-nucleoside reverse transcriptase inhibitors
  3. Protease inhibitors
  4. CCR5 inhibitors- inhibits binding to CCR
  5. Fusion inhibitor- inhibits fusion between HIV and cell membrane
  6. Integrate inhibitor- inhibits viral integrate enzyme Arachidonic pathway purpose
  • ANSWERS-Synthesis of prostaglandins ASA
  • ANSWERS-Blocks COX1 and COX2, also inhibits Thromboxane A2 and prostaglandins Atopic disorders
  • ANSWERS-Genetic Type 1 hypersensitivity, asthma, hay fever, eczema, urticaria Autoimmunity and example of hypersensitivity
  • ANSWERS-A breakdown of tolerance in which the bodies immune system begins to recognize self-antigens as foreign. Graves Disease- autoantibodies form against thyroid cells- bind to thyroid cells and mimic action of TSH, increases secretion of thyroxine Myasthenia Gravis- autoantibodies against acetylcholine bind to the post synaptic receptors and inhibit synaptic transmission of acetylcholine. Leads to muscle weakness and paralysis (mind to ground) Guillain-Barre' syndrome- antibodies bind with myelin sheath of the peripheral nervous system, triggering the immune response. Causes demyelination of the peripheral nerves and a rapidly progressive, ascending paralysis (ground to brain) Basophilia- definition and causes
  • ANSWERS-Increased # of basophils From allergic reactions causes of thrombus
  • ANSWERS-Triad of Virchow- injury to blood vessels, abnormality in blood flow, hypercoagulability some medications increase risks Chemotactic factors
  • ANSWERS-Biochemical substance that attracts leukocyte to the site of inflammation Chronic leukemia
  • ANSWERS-Gradual onset, cells appear normal but do not function appropriately and accumulate

CM- fever, myalgia, cervical lymphadenopathy, mild hepatitis, retinal detachment, vision loss, blindness Tx- resistant to medications, no prevention Coagulation cascade

  • ANSWERS-Factor XII activates kinin. Function is to form fibrin mesh to stop bleeding and trap micro organisms. Complement
  • ANSWERS-Functions include bacterial lysis, vasodilation and increased vascular permeability, triggers mast cell degranulation, chemotaxis, and opsonization. Corticosteroids
  • ANSWERS-Inhibit phospholipase A2, preventing formation of prostaglandins, thromboxane A2, prostacyclin, and leukotrines COX
  • ANSWERS-Prostaglandin of arachidonic pathway. Provides gastroprotection, platelet aggregation, fluid/electrolyte balance COX
  • ANSWERS-Prostaglandin of arachidonic pathway. Responsible for pain, fever, renal protection, tissue repair, reproduction development. COX2 inhibitors- clinical implications
  • ANSWERS-Protect gastric mucosa- prevent ulcers and bleeding. Removed from market r/t cardiac events except for Celebrex. Can impair renal function , monitor labs. Cytokine growth factor function
  • ANSWERS-Promotes production and maturation of neutrophils Cytokine IL1 function
  • ANSWERS-Causes fever, activates phagocytes & lymphocytes and also increases the release of IL6a Cytokine IL6 function
  • ANSWERS-Stimulates production of acute phase reactants and promotes growth and stimulation of RBCs Cytokine TNF function
  • ANSWERS-Causes fever, increases synthesis of proinflammatory proteins by liver, causes muscle wasting, induces thrombosis Cytokines
  • ANSWERS-Soluble factors that contribute to the regulation of innate or adaptive resistance by affecting other neighboring cells. Can be pro-inflammatory or anti- inflammatory. Can react quickly or be more delayed. Define acute leukemia
  • ANSWERS-Rapid onset- aggressive accumulation of immature cells, causes overproduction of leukocytes by the bone marrow, causes overcrowding, prevents formation of normal blood cells Describe the difference between HIV and AIDS, and clinical implications
  • ANSWERS-CD4 count >200 is HIV, If the CD4 count drops below 200 and an AIDS

defining illness occurs then the patient is said to have AIDS. Once they have progressed, they will always have AIDS, even if CD4 count goes up. AIDS defining illnesses: PCP, toxoplasmosis, progressive multi focal leukoencephalopathy, disseminated MAC, Kaposki's sarcoma, lymphoma, TB, esophageal or tracheal candida infection, invasive cervical cancer, CMV infection, and histoplasmosis Describe the role of HLA in solid organ rejections

  • ANSWERS-HLA is typed and matched on donor and recipient to decrease risk of rejection HLA is targeted response for rejection discuss DIC
  • ANSWERS-activation of the coagulation system causes widespread intravascular fibrin deposition, fibrinolytic products attempt to break down fibrin- adhere to platelets to prevent adhesion. coagulation products are eventually consumed and bleeding occurs. may cause organ failure r/t micro-thrombi triggers: malignancy, sepsis, infection, ob complications, trauma, Sx, ARDS, rhabdo, venomous snake bites CM: oozing, bleeding from all puncture sites, bleeds from all body cavities, prolonged PT/PTT, elevated d-dimer, platelet count <100, discuss hemophilia A
  • ANSWERS-affects 1 in 5-10K males sex linked recessive disease, deficient in factor VIII normal platelets and PT, prolonged PTT, decreased factor VIII CM: knee, elbow, and ankle bleeds, GI bleeds discuss hemophilia B
  • ANSWERS-affects 1 in 20-30K males Christmas disease- deficient in factor IX normal platelets and PT, prolonged PTT, decreased factor IX CM: knee, elbow, and ankle bleeds, GI bleeds discuss liver disease
  • ANSWERS-all factors of clotting can be affected discuss macrocytic, microcytic, and normocytic anemias
  • ANSWERS-classified by size of RBC macrolytic- MCV >100, includes pernicious and folic acid anemias, can be caused by ETOH microlytic- MCV <80, folic acid anemia normolytic- MCV 80-100 (normal range), sickle cell is an example Discuss some clinical implications of solid organ transplant rejection
  • ANSWERS-rejection is an immune response, mostly T-cell mediated. Slow process, Type 4 hypersensitivity Patients are highly susceptible to infections r/t use of immunosuppressants

HIV EIA

  • ANSWERS-3rd generation immunoassay, can use urine, saliva, or serum (best), >99% accuracy test at 12 weeks post-exposure HIV EIA (3rd generation immunoassay)
  • ANSWERS-can use urine, saliva, or serum (most accurate), need to wait until 12 weeks post exposure to see antibodies, >99% accurate 4th generation immunoassay- "gold standard" measures P24 antigen can test 10 days post exposure how do direct thrombin inhibitors alter coagulation cascade
  • ANSWERS-prevent activation of fibrinogen and XIII how does low molecular weight heparin affect coagulation cascade
  • ANSWERS-inhibits factor Xa and prevents formation of prothrombinase complex and consequently thrombin how is coagulation cascade altered by warfarin
  • ANSWERS-blocks Proteins S and C blocks Vit K enzyme to prevent carboxylation, decreasing amount of functional K to be used in Vit K dependent coagulation factors Kinin
  • ANSWERS-Converted to bradykinin which is responsible for pain and chemotaxis, and it increases vascular permeability and vasodilation. Leukocytosis
  • ANSWERS-Increase in number of total WBC Leukopenia
  • ANSWERS-Decrease in number of total WBC Leukotrines
  • ANSWERS-Released when mast cells degranulate, prolong the inflammatory process. Cause vasodilation, attract neutrophils, monocytes, and eosinophils.target of inhibition for singular. Lymphocytic leukemia
  • ANSWERS-Excessive production of lymphocytes Lymphocytopenia- definition and causes
  • ANSWERS-Decreased # of lymphocytes From AIDS, chemotherapy, or steroid use Lymphocytosis- definition and causes
  • ANSWERS-Increased # of lymphocytes From viral infections, lymphoma, or leukemia MAC- mycobacterium avium complex
  • ANSWERS-AFB- leads to systemic infection, grows slow- thick cell wall hard to penetrate CM- fever, night sweats, anorexia, weight loss, lymphadenopathy Tx- clarithromycin and ethambutol for 6-12 months

Mast cell

  • ANSWERS-Cellular bags of granules located in loose connective tisssue close to blood vessels. Activation initiates inflammatory process. Monocytes
  • ANSWERS-Become macrophages when entering the tissue, responsible for presenting antigens to the CD4 cell which triggers T-cell immunity and B-cell immunity. Releases additional cytokines IL1, IL6, TNF. Monocytopenia- definition and causes
  • ANSWERS-Decreased # of monocytes From steroid use of HIV infection Monocytosis- definition and causes
  • ANSWERS-Increased # of monocytes From TB infection or during recovery from an infection Multiple myeloma pathophysiology and CM
  • ANSWERS-Chromosomal abnormality that leads to production of malignant plasma cells, cells secrete antibodies which are deposited in organs (mostly bones) and grow malignant tumors, 3 yr life span Vertebrae, skull, ribs and pelvis most frequently affected CM: hypercalcemia, recurrent infections, renal failure Myelogenous leukemia
  • ANSWERS-Excessive production of granulocytes Neutropenia- definition and causes
  • ANSWERS-Decreased # of neutrophils From liver disease, viral infections, drugs Neutrophilia- definition and causes
  • ANSWERS-Elevated neutrophil count From bacterial infections, inflammation, and necrotic tissue Neutrophils
  • ANSWERS-Predominant leukocyte at work during the early stages of acute inflammation Non-selective NSAIDS
  • ANSWERS-Inhibit COX1 and COX2, risk for gastric ulceration, GI bleeds, edema, renal impairment Pathophysiology and clinical implications of folate deficient anemia
  • ANSWERS-Folic acid is required for RBC synthesis, when lacking, cell continues to grow- but not mature, will get large and be destroyed in the bone marrow Monitor nutritional status of patients, elderly are easily malnourished ETOH dependent may need supplementation Pathophysiology and clinical implications of iron deficient anemia
  • ANSWERS-Microcytic Iron is necessary for production of hgb. Iron stores are depleted and less hgb is produced, results in small RBCs

Risk factors and CM of pernicious anemia

  • ANSWERS-Risk: vegan, gastrectomy, atrophy of gastric mucosa r/t autoimmune disease CM: beefy red tongue, weakness, fatigue, loss of appetite, weight loss, neurological symptoms- parenthesis of hands/feet, loss of sense of position and vibration Risk factors and CM of sickle cell anemia
  • ANSWERS-African descent, Mediterranean, middle eastern, or Indian descent, familial history Pain during crisis Risk factors for multiple myeloma
  • ANSWERS-African descent Males more common Around 6th decade of life Systemic Lupus Erythematosus
  • ANSWERS-E. Primarily women aged 20-40, Type III hypersensitivity. Antibodies are formed against DNA Genetic, leads to tissue damage. Exacerbated by infections, UV light, estrogen, meds, stress Diagnosed by serum ANA C.M. Butterfly rash (cheeks), photosensitivity, nonerosive arthritis of at least 2 peripheral joints, inflammation of serous sacs, proteinuria, seizures, anemia, leukopenia, thrombocytopenia Thromboxane
  • ANSWERS-Vasoconstriction, platelet aggregation Type 1 hypersensitivity
  • ANSWERS-E. Immediate response to allergen, food, meds, pollen, asthma, allergic reactions P. IgE binds with antigen at 1st exposure. Antigen binds with this complex at 2nd exposure. Inflammatory cascade initiates. C.M. Urticaria, rhinitis, conjunctivitis, angioedema, anaphylaxis Type 2 hypersensitivity
  • ANSWERS-E. Antibodies directed against fixed antigens on the plasma membrane of cells C.M. Varies depending on alloimmune or autoimmune Type III hypersensitivity
  • ANSWERS-Widespread immune and inflammatory response not specified for any cell or tissue. SLE, RA Antibodies are formed against and bind to circulating antigens, antigen-antibody complex deposits in vessel walls or tissue. Causes cellular and tissue damage. IgG and IgM response, spread via circulation- not specific to a cell or tissue- widespread damage.

Type IV hypersensitivity

  • ANSWERS-T-cell lymphocyte mediated reaction that does not require antibody activation. Delayed response- 24 - 72 hours. Contact dermatitis- poison ivy, topical drugs, chemicals such as nickel or formaldehyde. Antigens too small to cause a reaction bind to proteins, response includes rash, red bumps, itching, and blisters. Reactive tuberculin test- PPD cause and induration in 24-72 if person was previously exposed to tuberculin antigen Solid organ transplant rejection- 11 - 14 days after 1st exposure, 5-6 days after 2nd exposure, results in mononuclear infiltration, decreased circulation, and tissue necrosis. what are causes of thrombocytopenia
  • ANSWERS-post-op hemodilution (nadir 2-4 days), splenomegaly, HIV, bone marrow failure, hemolysis, multiple medications What are CM that indicate a compromised immune system in a person with HIV
  • ANSWERS-Thrush, cervical dysphasia, cervical carcinoma in situ, fever of 38.5 (101.3) or greater X 1 month, oral hairy leukoplakia, herpes zoster, immune thrombocytopenia purpura (ITP), PID, peripheral neuropathy, vaginal yeast infections, Kaposi sarcoma, presence of any opportunistic infections. Should be treated with prophylactic antibiotics What is the etiology, incubation, and mode of transmission for HIV
  • ANSWERS-Virus enters bloodstream and begins seeking out the CD4 (T-helper cells). The virus fuses to CD4 cells and integrates with host's DNA. More CD4 cells become infected, and eventually rupture. Overall CD4 count is reduced, leaving patient susceptible to opportunist infections. Transmitted via bodily fluids-blood borne. Incubates as long as 10 years in untreated individuals. What is the etiology, incubation, and mode of transmission for influenza
  • ANSWERS-Comes from one of three types- A, B, C Transmitted via aerosol Incubation is 1-4 days (usually 2) What is the etiology, incubation, and mode of transmission for measles
  • ANSWERS-Initial infection and viral replication occur locally in tracheal and bronchial epithelial cells. After 2-4 days, local lymphatic tissues are infected. Virus is disseminated to various organs, and rash appears. Transmitted by respiratory droplets, either airborne or on surfaces up to 2 hours Incubated 7-14 days (average 10-12 days) Which antibodies and antigens do each blood type have
  • ANSWERS-A has A antigen and B antibodies B has B antigen and A antibodies AB has AB antigens, and no antibodies O has no antigens, but A and B antibodies