Concept Of Illness Dse

SOUTHEAST ASIAN COLLEGE INC DEPARTMENT OF NURSING NCM 202 FIRST LONG EXAM

NAME____________________________________ DATE_________________________

SCORE:_________________ SECTION:_______________

Multiple Choice. Directions: Choose the best answer. Write the letter of your choice on the last page. All answers should be in capital letters STRICTLY NO ERASURES. c. Metaplasia 1. The process of inflammation, involves the d. Hyperplasia following, except: 7. In athletes, the increase in muscle mass is a. Attraction of leukocytes to the site of injury largely due to_______________. b. Inhibition of chemical mediators a. Hypertrophy ] c. Exudation of fluid from vessels d. Restoration of injured tissue to its normal b. metaplasia structure and function c. Atrophy d. anaplasia 2. A nursing student sustained multiple lacerations on her arm, knowing the phases 8. In most instances, metaplasia is the result of cell migration to the site of injury, which of of _____________________ the following inflammatory cells is first to a. chronic irritation appear after injury? b. developmental defect c. somatic mutation a. Neutrophils d. viral infection b. Eosinophils c. Platelets 9. The two primary afferent nociceptors d. macrophages respond maximally to_______________ a. intense painful stimuli 3. Stimuli which are not very severe may lead b. light touch to an altered steady state of the cell in the c. moving stimuli form of; d. vibration a. Chronic inflammation b. Hypersensitivity 10. Which nociceptor is responsible for second c. Acute inflammation pain? d. Cellular adaptation a. A- beta fibers

4. Chronic inflammation may be brought about by the following conditions except one;

a. Autoimmune disease

b. A-delta fibers c. C- fibers d. All of the above

b.

Persistent infection c. Prolonged exposure to toxic agents d. no exception

11. Patients

5. Which of the following cells is considered to be the most important cell/s in chronic inflammation? a. Lymphocytes b. eosinophils c. Neutrophils d. macrophages

a. b. c. d.

6. An increase of tissue volume due to addition of new cells is____________.

a. Anaplasia b.

dysplasia

having non-pharmacologic/ alternative pain interventions for pain (eg. Aromatherapy, reflexology) benefit from this modality mainly because of its__________ proven effectiveness placebo effect both a and b neither of the above

12. Having been recently hired as an emergency room (ER) nurse you came across a patient experiencing bouts of abdominal pain, as a nurse what will be your role in this case? a. Relieve pain by administering pain relieving interventions

b. Monitor adverse effects of the pharmacologic agent administered c. Assess the effectiveness of the treatment d. All of the above

a. b. c. d.

13. A staff nurse was suddenly summoned by

20. Liver macrophages as_____________. a. Kupffer cells b. Osteoclasts c. Langerhan’s cells d. Microglial cells

a. b. c. d.

the attending physician of a patient having cancer-related pain, because the patient exhibited signs of difficulty of breathing. What could be the pharmacologic agent responsible for this effect? NSAIDS Opioids COX inhibitors None of the above

14. Which of the following pharmacologic agents used in pain management, causes gastrointestinal distress? a. Opioids b. NSAIDS c. COX inhibitors d. All of the above 15. A patient in the ER gave a history of periumbilical pain migrating to the right lower abdominal quadrant minutes before coming to the hospital. The pain experienced by the patient is classified as______________ a. acute pain b. chronic pain c. referred pain d. a and c 16. Which of the following is considered to be the neurotransmitter responsible for transmitting pain? a. serotonin b. acetylcholine c. substance P d. GABA

17. The following are causes of cellular injury, a. b. c. d.

except: hypoxia nutritional imbalance infection none of the above

18. __________________ is a study disordered function of the human body. a. Pathophysiology b. Pathology c. Both is correct d. Neither is correct

of

19. A patient was diagnosed to have Hepatitis A infection, which of the following chemical barrier/substance is produced by the body in response to this kind of infection?

Antigen Interferon Lysozyme tears are

also

known

21. Which is correct regarding pain transmission?

a. Prolonged stimuli + injury activation of nociceptors and release of substance P signals enter the ventral root of spinal cordsends fibers via the lateral spinothalamic tract thalamus b. Prolonged stimuli + injury inhibition of nociceptor and neurotransmitter release  signals enter the dorsal root of the spinal cord sends fibers via the lateral spinothalamic tract hypothalamus c. Prolonged stimuli + injury activation of nociceptors and release of substance P signals enter the dorsal root of the spinal cord sends fibers via the lateral spinothalamic tract thalamus d. All is correct 22.Which of the following cells are responsible for the production of immunoglobulins? a. B-cells b. T-cells c. Natural killer cells d. Monocytes 23.A pregnant mother on her last trimester was given Tetanus toxoid injection, which type of immunity is conferred to the baby? a. Active acquired immunity b. Passive acquired immunity c. Natural immunity d. None of the above 24.Which type of immunoglobulin is able to pass through the placenta? a. IgA c. IgG b. IgM d. IgE 25.A nurrse was ordered to do a Tuberculin test, what type of hypersensitivity does a positive reaction to tuberculin fall? a. cell-mediated b. anaphylactic c. Ab mediated d. Immune complex 26.The following are characteristics of pain except one;

a. b. c. d.

Intensity Timing Location No exception

27.The following are accepted routes of administration for pharmacologic agents against pain; a. Parenteral b. Enteral c. Transdermal d. All of the above 28.________________ are plasma proteins produced by the body in response to an invading foreign agent. a. Immunoglobulin c. Antibody b. Antigen d. a and c 29.As a staff nurse, before giving pharmacologic agents against pain, what are the necessary premedication assessment: a. A thorough medical history, including history of allergies b. Reassessing the pain status of the patient c. Both is correct d. Neither is correct 30.The primary afferent nociceptors are found in___________________ a. skin b. deep somatic and visceral organs c. both is correct d. none is correct 31.During inflammation DOLOR is due to__________________ a. vascular dilatation and release of chemical mediators b. increased pressure exerted by the accumulation of interstitial fluid and to mediators such as bradykinin c. increased blood flow to the site of inflammation d. all of the above 32. Lesser gastrointestinal tract irritation is an advantage of which pharmacologic agent against pain? a. Cyclooxygenase pathway inhibitors b. Opioids c. NSAIDS d. all of the above 33._________________ is a defensive reaction intended to control, neutralize or even eliminate invading foreign agents and prepare the site of injury for repair. a. Tissue injury b. inflammation c. Hypersensitivity

d. Immunity 34.Which type of Immunoglobulin is predominantly found in body fluids, including colostrums? a. IgA b. IgM c. IgD d. IgE 35. A staff nurse appointed at the out-patient department encountered a patient on follow-up check up for acute parotitis, this kind of infection would lead to what type of immunity? a. Active passive immunity b. Active acquired immunity c. natural immunity d. hypersensitivity 36. The following may cause atrophy, except; a. decrease in use b. Malnutrition c. decrease in blood supply d. no exception 37. Which among the following is considered a natural type of immunity; a. Vaccination with tetanus toxoid b. Acidic environment of vagina c. Immunization with immunoglobulins d. Ab formation after mumps infection 38. Which of the following pain categories and their example is correctly matched? a. Location: post-herpetic neuralgia b. Pain as to onset or duration- osteoarthritis c. Etiology- chest pain d. none is correct 39. Which of the following is not a factor affecting pain response? a. age b. Gender c. Past pain experiences d. all is correct 40. Which of the following is a type of instrument used for assessing pain status of a patient? a. Audio analogue scale b. both is correct c. Faces pain scale d. none is correct 41. Cellular injury can be caused by the following, except; a. 10° C or less b. Excess Vitamin A c. Lye d. No exception

42. Which among the following is correctly matched, except; a. TB: caseous necrosis b. SLE: fibrinoid necrosis c. Breast Cancer: Enzymatic fat necrosis d. All is correct 43. Which among the following cells produce histamine? a. Macrophages b. platelets c. lymphocytes d. Mast cells 44. Which among the following chemical mediators produce, vasoconstriction, and bronchoconstriction? a. Interleukin 1 b. LT C4,D4,E4 c. Prostaglandin d. LTB4 45. Which among the following is the cause of emaciation/inanition in COPD and in patients with cancer? a. TNF b. LTB4 c. PAF d. none is correct 46. Which among the following is a vascular response to injury? a. Illness b. ischemia c. Chronic inflammation d. Inflammation 47. Which among the following substances causes liquefaction of proteins? a. HCl b. Lye c. Mercury d. Lead 48. Which among the following are the major immune cells attacked by HIV? a. plasma cells d. CD8+ T-lymphocytes c. natural killer cells d. CD4+ T-lymphocytes 49. Which among the following is not a cause of hypoxia, except; a. An increase in the blood supply in an organ b. An adequate tidal volume c. Anemia d. none is correct 50. Which among the following is a major cause of death in lightning strike? a. Third degree burns b. neither is correct

c. electrolyte imbalance d. both are correct 51. Which among the following is not a granulocyte? a. Monocyte b. Eosinophils c. Neutrophils d. Basophils 52. Which among the following WBC increases during allergic and parasitic infections? a. Mast cells b. lymphocytes c. Eosinophils d. none is correct 53. Which among the following is not a pain mediator, except; a. Serotonin b. Bradykinin c. Leukotriene d. Histamine 54. Which among the following is not a process in WBC emigration? a. Margination b. rolling c. aggregation d. pavementing 55. Which among the following diseases causes granulomatous inflammation? a. Miliary tuberculosis b. Treponemal infection c. both are correct d. neither is correct 56. Payers patches are numerous in what portion of the GIT? a. stomach b. colon c. duodenum d. ileum 57. ________ is the body’s specific protection against an invading foreign agent. a. inflammation b. antibody c. antigen d. immunity 58. The organ where T-cell lymphocytes differentiates/matures is _____. a. liver b. bone marrow c. spleen d. Thymus 59. Which among the following WBC is found in delayed hypersensitivity reaction? a. Mast cells

b. basophils c. macrophages d. none is correct 60. IgA can be found/produced in the following, except; a. Breast milk b. saliva c. placenta d. all is correct

61. In a patient already in the ER with signs of inflammation what should you do? a. Go to your CI and inform him or her then eat b. Assist the patient and start getting the history c. give epinephrine d. none is correct 62. Which among the following is algogenic? a. trauma b. inflammation c. neither is correct d. both are correct 63. This is a behavioral pattern of substances use characterized by a compulsion to take the drug primarily to experience its effects; a. dependence b. addiction c. nociception d. analgesia 64. Pain is interpreted in which portion of the brain? a. cerebrum b. hypothalamus c. thalamus b. spinal cord 65. A patient was complaining of muscle pain even after medication was given. Your senior opened the T.V. and asked the patient to watch. This is a non-pharmacologic management, this is called_____. a. hypnosis b. therapeutic touch c. aromatherapy d. distraction

66. Which among the following conditions produces inappropriate or exaggerated responses to an antigen? a. Autoimmunity b. Immunity c. Hypersensitivity d. All is correct.

67. A drug for pain that can be given thru the transdermal route; a. morphine b. ketorolac c. fentanyl d. none is correct 68. Which among the following is the precursor of prostaglandins? a. linolenic acid b. alpha hydroxyacid c. arachidonic acid d. none is correct 69. What is the first manifestation of Aspirin toxicity? a. tinnitus b. bone marrow depression c. gastritis d. fever 70. Which among the following is correctly matched (routes of administration)? a. IM- Intramuscular b. PO: per ovary c. PR: pro renal d. none is correct

II. IDENTIFICATION: No erasures, incorrect spelling will be invalidated. _______________1. Substance inhibited by Aspirin in platelets that lead to bleeding. _______________2. OPOIDS are derived from this plant. _______________3. A major cause of death in opioid overdose. _______________4. A surgical intervention for pain where sensory nerves are destroyed where they enter the spinal cord. _______________5. } Give two examples of chemicals that produce pain. _______________6. _______________7. These drugs are also called narcotic analgesics. _______________8. The most painful route of administration is____. _______________9. The nerve tract where the signals from the nociceptors enter going to the brain. _______________10. These are morphine-like substances produced by the body that naturally reduces pain. _______________11.} 3 categories of pain _______________12. _______________13. _______________14. Breakthrough pain is seen in patients given this type of medication. _______________15. The antibody with no definite function. _______________16. The immune system’s third line of defense is___ _______________17. Macrophages in the brain are called ____. _______________18. Type of necrosis in acute hemorrhagic pancreatitis _______________19.} 2 types of necrosis seen in wet gangrene _______________20. _______________21. Another name for cachectin is___. _______________22. A process that enhances phagocytosis _______________23. Calor in inflammation is primarily due to ___. _______________24. 4 infectious agents that cause cellular injury _______________25.} _______________26. _______________27. _______________28. Primary function of Vitamin C _______________29. A disorder in steady state regulation _______________30. Tumor in inflammation is due to ___. I. Answers: MULTIPLE CHOICE 1.____ 21.___ 2.____ 22.___ 3.____ 23.___ 4.____ 24.___ 5.____ 25.___ 6.____ 26.___ 7.____ 27.___ 8.____ 28.___ 9.____ 29.___ 10.___ 30.___ 11.___ 31.___ 12.___ 32.___ 13.___ 33.___ 14.___ 34.___ 15.___ 35.___ 16.___ 36.___ 17.___ 37.___ 18.___ 38.___ 19.___ 39.___ 20.___ 40.___

41.___ 42.___ 43.___ 44.___ 45.___ 46.___ 47.___ 48.___ 49.___ 50.___ 51.___ 52.___ 53.___ 54.___ 55.___ 56.___ 57.___ 58.___ 59.___ 60.___

61.___ 62.___ 63.___ 64.___ 65.___ 66.___ 67.___ 68.___ 69.___ 70.___

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