Which of the following is the main digestible carbohydrate normally consumed in the human diet? A) Amylose B) Cellulose C) Maltose D) Starch ANSWER: D Digestion of which of the following foodstuffs is impaired to the greatest extent in patients with achlorhydria? A) Carbohydrate B) Fat C) Protein ANSWER: C Which of the following is a likely consequence of ileal resection? A) Achalasia B) Atrophic gastritis C) Constipation D) Peptic ulcer E) Vitamin B12 deficiency ANSWER: E All of the following factors can alter the hypothalamic set-point level for core temperature control except A) Skin temperature B) Antipyretics C) Thyroxin D) Pyrogens released from toxic bacteria ANSWER: C Most of the heat loss from an unclothed person at room temperature occurs by which of the following mechanisms? A) Conduction to air B) Conduction to objects C) Convection D) Evaporation E) Radiation ANSWER: E A 57 year old obese woman on hormone replacement therapy develops gallstones. Her gallstones are most likely composed of which of the following substances? A) Bile salts B) Bilirubin C) Calcium salts D) Cholesterol E) Free fatty acids ANSWER: D Most of the energy released from the glucose molecule occurs by which of the following processes? A) Citric acid cycle B) Glycogenesis C) Glycogenolysis D) Glycolysis E) Oxidative phosphorylation ANSWER: E Which of the following is the most abundant source of high energy phosphate bonds in the cells? A) Adenosine triphosphate [ATP] B) Phosphocreatine C) Adenosine diphosphate [ADP] D) Creatine E) Creatinine ANSWER: A Which of the following accounts for the largest component of daily energy expenditure in a sedentary individual? A) Basal metabolic rate B) Maintaining body posture C) Nonshivering thermogenesis D) Thermic effect of food ANSWER: A Most of the energy for strenuous exercise that lasts for more than 5 to 10 seconds but less than 1 to 2 minutes comes from which of the following sources? A) Adenosine triphosphate [ATP] B) Anaerobic glycolysis C) Oxidation of carbohydrates D) Oxidation of lactic acid E) Conversion of lactic acid into pyruvic acid ANSWER: B Which of the following best describes the process by which glucose can be formed from amino acids? A) Gluconeogenesis B) Glycogenesis C) Glycogenolysis D) Glycolysis E) Hydrolysis ANSWER: A The metabolic rate of a person is normally expressed in terms of the rate of heat liberation that results from the chemical reactions of the body. Metabolic rate can be estimated with reasonable accuracy from the oxygen consumption of a person. All of the following factors tends to increase the metabolic rate of a person except A) Growth hormone B) Fever C) Sleep D) Malnutrition ANSWER: C A deficiency of which of the following proteins would be most likely to cause increased appetite? A) Melanin concentrating hormone B) NPY C) Ghrelin D) Orexin A E) Leptin ANSWER: E Deficiency of which of the following would cause "night blindness" in humans? A) Vitamin A B) Vitamin B1 C) Vitamin B6 D) Vitamin B12 E) Vitamin C ANSWER: A Which of the following changes would be expected to stimulate hunger in a person who has not eaten for 24 hours? A) increased neuropeptide Y in hypothalamus B) increased leptin secretion C) increased peptide YY secretion D) decreased ghrelin secretion E) activation of hypothalamic pro-opiomelanocortin [POMC] neurons ANSWER: A Deficiency of which of the following would cause pellagra in humans or black tongue in canines? A) Vitamin A B) Vitamin B1 C) Vitamin B12 D) Vitamin C E) Niacin ANSWER: E Deficiency of which of the following vitamins is the main cause of beriberi? A) Vitamin A B) Thiamine [vitamin B1] C) Riboflavin [vitamin B2] D) Vitamin B12 E) Pyridoxine [vitamin B6] ANSWER: B If bile flow into the duodenum is obstructed, absorption of fat soluble vitamins is reduced. Which of the following complications would you therefore observe for? A) Peripheral neuritis B) Scurvy C) Increased bleeding tendencies D) Macrocytic anemia ANSWER: C Malnutrition will result in the deficiency of the body to produce antibodies because: A) Antibodies are proteins B) Antibodies need amino acids for synthesis C) Antibodies need fats for its energy needs D) Antibodies need CHO to be activated ANSWER: A If a patient undergoes colectomy or the removal of the large intestine, it will result in which of the following? A) Malnutrition B) Dehydration C) Constipation D) Obesity ANSWER: B Even if we go on low fat diet we can still produce fat deposits because fat is synthesized from carbohydrate and protein . Which organ is primarily responsible for this? A) Liver B) Spleen C) Kidneys ANSWER: A A client is admitted to the hospital with exacerbation of his chronic gastritis? What Vitamin deficiency would result from chronic gastritis? A) Vitamin A B) Vitamin B 6 C) Vitamin B 12 D) Vitamin C ANSWER: C The following is true of protein synthesis except A) During periods of starvation, amino acids are used for producing glucose B) The muscle contains the greatest amount of protein C) The liver produces proteins for its own needs only D) Some of the clotting factors are protein ANSWER: D In advanced cirrhosis of the liver, the patient suffers from ascites which is a result of which of the followingA. A) Increased levels of aldosterone B) Portal hypertension and decreased serum albumin C) Portal hypertension, decreased capillary permeability and obstruction of hepatic duct D) Increased excretion of sodium and increased obstruction of lymphatic channels. ANSWER: B The nurse is caring for an adolescent female who reports amenorrhea, weight loss and depression. Which additional assessment finding would suggest that the woman has eating disorder? A) Wearing light-fitting clothing B) Increased blood disorder C) Oily skin D) Excessive and ritualized exercise ANSWER: D The nurse is assigned to care for a client with anorexia nervosa. Initially, which nursing intervention is most appropriate for the client? A) Providing one on one supervision during meals and for 1 hour afterward. B) Setting the client to eat with other clients to create a normal mealtime atmosphere. C) Trying to persuade the client to eat and thus restore nutritional balances D) Giving the client as much time to eat as desired. ANSWER: A One of the goals for a client with anorexia nervosa is that the client will demonstrate increases individual coping by responding to stress in constructive ways. Which of the following actions is the best indicator that the client is working toward meeting the goal? A) The client drinks 4 L of fluid per day B) The client paces around the unit most of the day C) The client keeps a journal and discusses it with the nurse D) The client talks almost constantly with friends by telephone. ANSWER: C A 15 year old girl with anorexia nervosa has been admitted to a mental health unit. She refuses to eat. Which of the following statements is the best response from the nurse? A) You don't have to eat. It's your choice B) I hope you'll eat your food by mouth. Tube feedings and IV lines can be uncomfortable. C) Why do you think you're fat? You're underweight. Here ___ look in the mirror. D) You really look terrible, at this weight. I hope you'll eat ANSWER: B A client with anorexia nervosa describes herself as a "whale". However, the nurse's assessment reveals the client is 5'8" tall and weighs only 90 lbs.Considering the client's immediate body image, which intervention should be included in the plan of care? A) Asking the client to prepare her figure with magazine photographs of women her age. B) Assigning the client to group therapy in which participants provide realistic feedback about her weight. C) Confronting the client about her actual appearance during one-on –one sessions, scheduled during each shift D) Telling the client of the nurse's concern for her health and desire to help her make decisions to keep her healthy ANSWER: D A client whose husband left her has a recurrence of anorexia nervosa.The nurse caring for her realizes that this exacerbation of anorexia nervosa results from the client's efforts to: A) Manipulate her husband B) Gain control of one part of her life C) Commit suicide D) Live up to her mother's expectation's ANSWER: B During postprandial monitoring, a client with bulimia nervosa tells the nurse, You ca sit with me, but you're just wasting your time. After you sat with me , I was still able to purge. Today my goal is to do it twice. "What is the nurse best response?" A) I trust you not to purge B) How are you purging and when do you do it? C) Don't worry I wont allow you to purge today D) I know its important for you to feel in control, but I ‘ll monitor you for 90 minutes after you eat. ANSWER: D The body is well provided with defenses to protect it against injury. The first line of the body's defense against injury includes biochemical barriers . Which of the following does not include biochemical barriers? A) sebaceous glands which secrete antibacterial and antifungal fatty acids and lactic acid B) Perspiration and tears C) Saliva which contain enzymes [lysozymes] that attacks the cell walls of gram positive bacteria D) Sloughing off with skin ANSWER: D Situation: A patient came to the OPD of the hospital complaining of swelling of his finger a few hours after accidentally pricking it with a needle What in the inflammatory response to tissue injury would have caused this? A) The microorganism invades the tissues B) Basophils release the heparin C) Neutrophils flock to the site of injury D) There is increases capillary permeability ANSWER: D The patient complains of pain. What chemical mediator causes the pain in inflammation? A) Release of chemotactic factor by mast cells B) Lymphokienes by lymphocytes C) Luekotrienes D) Prostaglandins ANSWER: D What is the most important cell that triggered the inflammation? A) Mast cell B) Plasma cell C) Leukocytes D) Monocytes ANSWER: A Among the following, what inflammatory response is not a vascular response? A) Initial vasodilation B) Increase vessel permeability C) Margination of leukocytes D) Release of histamine by mast cells ANSWER: C A patient came to the emergency room complaining of macular rashes and itchiness all over the body a few minutes after eating crabs. After taking the vital signs, the nurse found out that the patient is hypotensive. The nurse knows that this is caused by generalized vasodilation as a result of the release of the chemical mediator histamine. Which tissue cell is responsible for releasing histamine? A) Basophils B) Eosinophils C) Mast cells D) Neutrophils ANSWER: C A complete blood count is ordered and results shows increased leukocytes. This is because leukocytes are involved in the inflammatory response of the tissues to injury.What is the main function of leukocytes? A) Protect the body from invasion of pathogens B) Release chemicals that constrict blood vessels C) Prevent blood loss during hemorrhage D) None of the above ANSWER: A A patient came in with right lower quadrant pain and the physician had an admitting impression of acute appendicitis. He orders a complete blood count. A rise of what blood cellular component will confirm his suspicion of an acute pathologic process? A) Basophils B) Neutrophils C) Lymphocytes D) Monocytes ANSWER: B In acute inflammation, which white blood cells respond first to the chemotactic factors released by the mast cells? A) Basophils B) Neutrophils C) Lymphocytes D) Monocytes ANSWER: B In acute inflammation, what would be the first cellular response? A) Increased vessel permeability B) Vasoconstriction C) Margination of neutrophils D) Vasodilation ANSWER: D Vascular phase of inflammation includes the following except; A) Vasoconstriction B) Vasodilation C) Initially decreased blood flow D) Directional migration of leukocytes ANSWER: D A patient came into the outpatient department with a chief complaint of cough and afternoon low grade fever of 6 months duration. Aside from chest X-ray, a complete blood count was ordered. What white blood cells are expected to be higher than normal in this patient? A) Mononuclaer leukocytes B) Polymorphonuclear leukocytes C) Mast cells D) Basophils ANSWER: A A ten year old girl was observed to have contacted bacterial infection of the skin. A week later, the patient was brought to the hospital for being oliguric, hypertensive and edematous. Diagnosed as post streptococcal glomerulonephritis. What key plasma protein was activated by the antigen-antibody reactions of the circulating endotoxins? A) Clotting system B) Complement system C) Kinin system D) Inteferon system ANSWER: B Among the following , which is true of fever? A) It is a normal adaptive response to cytokines B) It is a surface temperature C) Endogenous pyrogens from macrophages D) Caused by peripheral vasodilation ANSWER: C In chronic injury , the following occurs except A) Usually infiltrated by mononuclear leukocytes B) Usually infiltrated by polymorphoneuclear leukocytes C) When macrophages are predominant cells, they release chemotactic substances that attract more macrophages D) There is an increased amount of collagen ANSWER: A A housewife tried to do a home repair of her cabinet. She accidentally hit her forefinger with the hammer. A few seconds later. Her forefinger was swollen and red. What vascular phase of the inflammation caused the redness that she observed in her forefinger.? A) Vasoconstriction B) Vasodilation C) Initially decreased blood flow D) Directional migration of leukocytes ANSWER: B Complications in wound healing , no matter how small, can happen. What among the following can delay wound healing? A) Protein deficiency B) Diabetes mellitus C) All of the above D) None of the above A hospital acquired infection is A) familial B) nosocomial C) Genial D) Viral ANSWER: B Disease is a response to A) environmental factors B) specific infective agents C) inherent defects of the body D) All of the above ANSWER: D Which of the following harbors a pathogen for a long period of time? A) Casual carrier B) Chronic carrier ANSWER: B Regarding the natural immune system A) Neutrophils only destroy bacteria circulating in the blood B) Macrophages use nitrous oxide to kill bacteria they have engulfed C) Complement kills bacteria prior to their uptake by phagocytes D) The monocytes of the blood are the precursors of tissue macrophages ANSWER: D Regarding the inflammatory response A) Tissue swelling is the first stage of the inflammatory response B) Mast cells secrete chemotactic agents that attract lymphocytes C) Macrophages secrete vasoactive materials during the inflammatory response D) The inflammatory response can be triggered by antibody binding to the surface of micro-organisms ANSWER: B Regarding the lymphocytes A) The lymphocytes are the most abundant white cells of the blood B) Lymphocytes only leave the blood at sites of inflammation C) B lymphocytes respond to antigens in the extracellular fluid D) All B lymphocytes become plasma cells after they have been stimulated ANSWER: C Regarding the functions of T lymphocytes A) T lymphocytes mature in the thyroid gland B) All T cells secrete cytotoxic materials C) T cells respond to proteins on the surface of host cells D) T cells secrete IgG when they are activated ANSWER: C During an inflammatory response, which is the correct order for cellular events? A) Filtration of monocytes from blood, increased production of neutrophils, activation of tissue macrophages, infiltration of neutrophils from the blood B) Activation of tissue macrophages, infiltration of neutrophils from the blood, infiltration of monocytes from blood, increased production of neutrophils C) Increased production of neutrophils, activation of tissue macrophages, infiltration of neutrophils from the blood, infiltration of monocytes from blood D) Infiltration of neutrophils from the blood, activation of tissue macrophages, infiltration of monocytes from blood, increased production of neutrophils ANSWER: B In a normal healthy person, which of the following blood components has the shortest life span? A) Macrophages B) Memory T cells C) Erythrocytes D) Memory B lymphocytes ANSWER: C A 45 year old man presents to the emergency room with a 2-week history of diarrhea that has gotten progressively worse over the last several days. He has minimal urine output and is admitted to the hospital for dehydration. His stool specimen is positive for parasitic eggs. Which type of WBCs would have an elevated number? A) Eosinophils B) Neutrophils C) T lymphocytes D) B lymphocytes E) Monocytes ANSWER: A An 8 year old male is frequently coming to the clinic for persistent skin infections that do not heal within a normal time frame. He had a normal recovery from the measles. Checking his antibodies following immunizations yielded normal antibody responses. A defect in which of the following cells would most like be the cause of the continual infections? A) B lymphocytes B) Plasma cells C) Neutrophils D) Macrophages E) CD4 T lymphocytes ANSWER: C Where does the transmigration of WBCs occur in response to infectious agents? A) Arterioles B) Lymphatic ducts C) Venules D) Inflamed arteries ANSWER: C A 65 year old alcoholic developed chest pain and cough with an expectoration of sputum. A blood sample revealed that his white blood cell count was `42,000microliter. What is the origin of these WBCs? A) Pulmonary alveoli B) Bronchioles C) Bronchi D) Trachea E) Bone marrow ANSWER: E A 26 year old man received a paper cut. What substance is the major cause of pain of this acute inflammatory response? A) Platelet-activating factor [PAF] B) Bradykinin C) Interleukin-1 D) Tumor necrosis factor [TNF] ANSWER: B A patient visits his dentist, who notices a sore on the patient's lip. The sore was unusual in that there was no pain or drainage from the sore. The patient was subsequently admitted to the hospital with a violent shaking chill. His lab values were Hct [30%], [platelets 400,000microliter], [WBC 4200microliter], [68% lymphocytes, and 20%] neutrophils. What is the diagnosis of this patient? A) A mild, nontreatable, infection B) Agranulocytosis C) Aplastic anemia D) Acute leukemia ANSWER: B What occurs following activation of basophils? A) Decreased diapedesis of neutrophils B) Decreased ameboid motion C) Contraction of blood vessels D) Increased capillary permeability ANSWER: D Fluid exudation into the tissue in the acute inflammatory reaction is due to A) decreased blood pressure B) decreased protein in the interstitium C) obstruction of the lymph vessels D) increased clotting factors E) increased vascular permeability ANSWER: E Which of the following applies to AIDS patients? A) Able to generate a normal antibody response B) Increased helper T cells C) Increased secretion of interleukins D) Decrease in helper T cells ANSWER: D Presentation of antigen on MHC-I by a cell will result in A) generation of antibodies B) activation of cytotoxic T cells C) increase in phagocytosis D) release of histamine by mast cells ANSWER: B What is the term for adhesion of an invading microbe with IgG and complement to facilitate recognition? A) Chemokinesis B) Opsonization C) Phagolysosome fusion D) Signal transduction ANSWER: B Interleukin-2 [IL-2] is an important molecule in the immune response. What is the function of IL-2? A) Binds to and presents antigen B) Stimulates proliferation of cytotoxic T cells C) Kills virus infected cells D) Is required for replication of helper T cells ANSWER: B CD4 is a marker of A) B cells B) Cytotoxic T cells C) Helper T cells D) An activated macrophage E) A neutrophil precursor ANSWER: C What will occur following presentation of antigen by a macrophage? A) Direct generation of antibodies B) Activation of cytotoxic T cells C) Increase in phagocytosis D) Activation of helper T cells ANSWER: D Activation of the complement system results in which of the following actions? A) Binding of the invading microbe with IgG B) Inactivation of eosinophils C) Decreased tissue levels of complement D) Generation of chemotaxic substances ANSWER: D A 9 year old female has nasal discharge and itching of the eyes in the spring every year. An allergist performs a skin test using a mixture of grass pollens. Within a few minutes she develops a focal redness and a swelling at the test site. This response is most likely due to A) antigen–antibody complexes being formed in blood vessels in the skin B) activation of neutrophils due to injected antigens C) activation of CD4 helper cells and the resultant generation of specific antibodies D) activation of cytotoxic T lymphocytes to destroy antigens ANSWER: A Which of the following applies to cytotoxic T cells? A) Cytotoxic T cells require the presence of a competent B-lymphocyte system B) Cytotoxic T cells require the presence of a competent suppressor T-lymphocyte system C) Cytotoxic T cells are activated by the presentation of antigen by an infected cell D) Cytotoxic T cells destroy bacteria by initiating macrophage phagocytosis ANSWER: C Helper T cells A) are activated by the presentation of antigen by an infected cell B) require the presence of a competent B-cell system C) destroy bacteria by phagocytosis D) are activated by the presentation of antigen by macrophage or dendritic cells ANSWER: D Which of the following transfusions will result in an immediate transfusion reaction? A) O [Rh-] whole blood to an O [Rh+] patient B) A [Rh-] whole blood to a B [Rh-] patient C) AB [Rh-] whole blood to an AB [Rh+] patient D) B [Rh-] whole blood to an B [Rh-] patient ANSWER: B Which of the following is a TRUE statement? A) In a transfusion reaction, there is agglutination of the recipient blood B) Shutdown of the kidneys following a transfusion reaction occurs slowly C) Blood transfusion of [Rh+] blood into any [Rh-] recipient will result in an immediate transfusion reaction D) A person with type AB blood is considered to be a universal recipient ANSWER: D 77.A 21 year old female, blood type B, is undergoing surgery. Her platelet count is [75,000microliter]. She will need platelet infusions before and during surgery. Which of the following blood types would be used to collect platelets that are compatible with the patient? A) Type A only B) Type B only C) Type O only D) Types B and O ANSWER: B Which of the following is TRUE concerning erythroblastosis fetalis [hemolytic disease of the newborn, HDN]? A) This occurs when a Rh+ mother has an Rh- child B) This is prevented by giving the mother a blood transfusion C) A complete blood transfusion after the first birth will prevent HDN D) The father of the child has to be Rh+ ANSWER: D Which of the following will result in a transfusion reaction? Assume that the patient has never had a transfusion. A) Type O Rh- packed cells to an [AB Rh+] patient B) Type A Rh+ packed cells to an [A Rh-] patient C) Type AB Rh+ packed cells to an [AB Rh+] patient D) Type A Rh+ packed cells to an O [Rh+] patient ANSWER: D A mother of blood type A+ who has always been perfectly healthy just delivered her second child. The father is of blood group [O-]. Knowing that the child is of blood group [O-] [O, Rh-], what would you expect to find in this child? A) The child will suffer from erythroblastosis fetalis due to rhesus incompatibility B) The child will suffer from erythroblastosis fetalis due to ABO blood group incompatibility C) The child will suffer from both A and B D) The child has no chance of developing HDN ANSWER: D Which of the following blood units carries the least risks for inducing an immediate transfusion reaction into a B+ [B, rhesus positive] recipient? A) Whole blood A+ B) Whole blood O+ C) Whole blood AB+ D) Packed red cells O+ E) Packed red cells AB- ANSWER: D A pregnant woman comes in for a visit. She is AB Rh- and her husband is A Rh+. This is her first child. What should be done at this time? A) Nothing B) Administer anti-D immunoglobulin to the mother at this time C) Administer anti-D immunoglobulin to the mother after delivery D) Administer anti-D immunoglobulin to the child after delivery E) Administer anti-D immunoglobulin to the child if the child is Rh+ ANSWER: A