Clearly explain whether the following responses are normal, or not.

A. HR response to rising exercise intensity (hint look at MET and HR increases together)

B. Peak HR reached

C. HR recovery after the test

71

Once a neoplasm has been established, all of the following are required for progression to metastatic disease EXCEPT:

Select one:

A. Apoptosis.

B. Angiogenesis.

C. Detachment and invasion.

D. Spread via lymphatic and blood vessels.

Discussion Questions (Choose Three)

1. People consume many liquids besides water: tea, soda, sports drinks, coffee. There is often debate about whether these beverages are good hydration, or if they only dehydrate? What does the book have to say on this issue? What factors must be considered when drinking non-water hydrating beverages?

2.Sodium is overabundant in the typical American diet because salt is often added in excessive quantities to processed foods. Find a food label that has an outrageous amount of sodium per serving. Then find a low sodium substitute food and post that label as well. Make sure the foods are essentially equal in calories & Serving size. What is the most shocking value of sodium we can find as a class?

3. The book states “there is no miracle food or supplement”. This is so true. Find 3 foods or supplements that are generally touted as “good”, then provide at least one nutritional, cultural, or environmental problem with that food or supplement. For example, eggs are a great source the vitamin choline, but eggs are also one of the foods most likely to cause a food allergy. (you must do this for 3 foods).

4. The book points out that less than 10% of Americans get the recommended number of fruit and vegetable servings per day. And that potato (French fries and hash browns) was the most reported veggie. Why is American vegetable intake so low? What can be done to increase veggie consumption in your diet, your family’s diet, and in those around you? (see the tools for change section in chapter 8) Many people choose to take a supplemental multi-vitamin instead of eating a healthy well-balanced diet. Can taking a multivitamin replace veggies in the diet?

5. Do veggies and multi-vitamins have the same health benefits? Are vitamin supplements and veggies equally safe? Explain your answer?

79

A viral infection will trigger ________, which is important to destroy ________.

Select one:

A. humoral immunity only; intracellular viral pools

B. cell mediated immunity only; viruses in any location.

C. humoral and cell mediated immunity; intracellular and extracellular viral pools.

D. cell mediated immunity only; intracellular viral pools

82

Mary is an 8 year old girl who fell off her skateboard and has grazed her knee and hand. The epithelium of the skin is broken and bleeding. This case study will be used to contextualise and highlight the linkages between the early non-specific defences and later specific defences.

Non-specific defence mechanisms that would be important at the time of Mary’s injury:

Select one:

A. Include barriers to invasion, phagocytosis, inflammation, fever, interferon and complement proteins.

B. Include barriers to invasion, phagocytosis, B and T cells, inflammation and complement.

C. Require recognition of specific antigen sites on invading pathogens.

D. Require a long lead up time before they become effective.

85

Which of the following are types of non-living vaccines?

1. Sub-unit
2. Live attenuated
3. Toxoid
4. Whole killed

Select one:

A. I, III, IV

B. II, IV

C. IV

D. I, III

What is the most effective way to culture Halobacterium noricense that colonize The Great Salt Lake in Utah? Explain how the conditions and culture media you choose will meet the nutritional and environmental needs of the microorganism. (Is there a particular temperature you should use? Is CO2 needed? What medium would be best?)

Research a major (note the word major) security/ privacy breach that occurred in the healthcare or public health domain in the last 5 years. Answer the following questions. What was the impact on patients?

What could have been done to prevent it?

What was the penalty / fine awarded to the healthcare organization?

YH presents to the clinic with a chief complaint of severe pain, redness, and swelling in his joints. Upon further assessment, he has been diagnosed with gout.

a. Explain what is causing YH’s severe joint pain on a biochemical level. Which specific degradation pathway does it relate to?

b. You suspect the patient’s diet might be the primary cause of his gout. What type of diet could contribute to gout? What is another potential cause of gout unrelated to his diet?

c. Allopurinol is the drug of choice to prevent next gout episode. What is its target substrate and how does inhibiting it help to prevent gout? Explain its mechanism of action and how it can help to decrease the patient’s uric acid formation. (hint: there are 2 ways)

95

Which of the following will require sterilised equipment for a patient with no special sterility requirements?

1. Indwelling catheter
2. Bed sheet
3. Urinary catheter
4. Wound dressings
5. Blood pressure cuff
6. Urine bottle

Select one:

A. I, II, IV, VI

B. I, III, IV

C. I, II, II, IV

D. I, IV, VI

1. A physician is called to the intensive care unit at the local hospital to care for Joe West, a patient in coronary crisis. The physician spends an hour at the patient's bedside, stabilizing him.

CPT code    __________

2. The physician is preparing to leave the hospital after seeing Joe West but is called back into the intensive care unit to see and stabilize another patient, Ted Keel. The service to the patient takes 1 1/2 hours

CPT code      ____________________

3. An established patient, Harriet Turner, comes to the office for a follow up visit. She has been prescribed medication for her recent onset of depression, but since her last visit, when the dosage was increased, she has felt that the medication is making her sleepy and lethargic. Considering the other factors such as other medical problems and drug interactions, the physician spends 25 minutes with the patient performing a detailed history and physical examination. After reviewing the details as well as the recent laboratory work, the physician concludes that a different medication should be prescribed. The physician’s decision-making has moderate complexity, given the possible medical complications that could arise.

CPT code    __________

While discussing the increased use of technology to gather, store, and access healthcare information, senior nursing students discuss the importance of preventing data security breaches and the implication of such breaches on nurses professionally. The class is divided into groups to research and prepare information on various relevant topics to present to the entire class.

1. A group is assigned to create a summary of information related to the ethical aspects of electronic data collection to the profession of nursing. What information will be included?
2. A group of students is assigned to research information regarding a healthcare organizational risk assessment. What will that group focus upon?