21) The diagnosis formerly known as multiple personality disorder is now known as which of the
following?
A.
Dissociative fugue
B.
Dissociative identity disorder
C.
Factitious dissociative identity
disorder
D.
None of the above
22) A major neurocognitive disorder with severe impairment in memory, judgment, orientation, and
cognition is known as which of the following?
A.
Deliriu
m
B.
Dement
ia
C.
Psychos
is
D.
Amnesi
a
23) A patient presents reporting acute amnesia and fugue episodes in addition to recurrent
blackouts, unexplained possessions, and fluctuations in skills, habits, and knowledge. The
ARNP recognizes this is consistent with which of the following?
A.
Systematized Amnesia
B.
Post-traumatic Amnesia
C.
Transient Global Amnesia
D.
Dissociative Identify
Disorder
24) Deficits in language including naming, repetition, reading and comprehension, and writing is
NOT associated with impairment in which of the following regions of the brain?
A.
Broca
B.
Wernicke
C.
Right
parietal
D.
Left
temporal
25) The patient with an illness anxiety disorder is requesting medication only from the ARNP. The
ARNPs response about pharmacotherapy in illness anxiety disorder would include which of
the following?
A.
Pharmacotherapy is never recommended.
B.
Pharmacotherapy provides long term relief from anxiety
C.
Psychotherapy is the most effective treatment of anxiety
illness disorder.
D.
Pharmacotherapy helps alleviating symptoms but cannot
provide la
26) Which of the following is consistent with what is known about kleptomania?
A.
The stealing is well planned.
B.The stealing often involves others.
C.
Risk of consequences of being caught are typically carefully
considered.
D.
The goal for the person with kleptomania is the act of
stealing.
27) A type of delirium characterized by cycling through psychomotor agitation and retardation,
from apathy to hypervigilance is known as which of the following?
A.
Mixed delirium
B.
Bipolar delirium
C.
Hyperactive
delirium
D.
A and B
28) Under hypnosis or during psychotherapy, a patient may recover a memory of a painful
experience that is etiologically significant. This is known as which of the following?
A.
False memory
syndrome
B.
Recalled memory
syndrome
C.
Dissociative trance
disorder
D.
Recovered identity
disorder
29) Which of the following conversion disorder symptoms are associated with a good prognosis?
A.
Tremors and
aphonia
B.
Tremors and
seizures
C.
Paralysis and
seizures
D.
Paralysis and
blindness
30) According to the DSM-5 which of the following symptoms differentiates illness anxiety
disorder from somatic symptom disorder?
A.
In somatic symptom disorder, persons are primarily concerned with the idea they are
ill, with few or no somatic symptoms.
B.
In illness anxiety disorder, persons are primarily concerned with the idea they are ill
with few or no somatic symptoms.
C.
In illness anxiety disorder, the patient may have a medical illness but their anxiety is
out of proportion to their diagnosis.
D.
B and C
31)A recurrent failure to resist impulses to steal objects not needed for personal use or
monetary value is an essential feature of which of the following disorders?
A.
Antisocial personality
disorder
B.
Kleptomania
C.
Conduct disorder
D.
Oppositional defiant
disorder
32) Which of the following would be a cause of concern for the ARNP working with parents of a
0-3 month old?
A.
The parent talks with the baby as if there is a mutual
understanding.
B.
The parent appears to spoil the baby, always holding, cuddling,
comforting.
C.
The parent becomes upset whenever the baby cries.
D.
33)The parent responds promptly whenever the baby cries.
Identifying developmental milestones is an important skill set for ARNPs for which of the
following reasons?
A.
Often developmental milestones go unrecognized until a child is much older.
B.
Knowing when a significant variation in development has occurred improves
diagnostic accuracy.
C The sooner a significant developmental impairment is identified and addressed, the
. better the long-term outcomes could be for patients.
D.
All of the above.
34) Which of the following is true about compulsions?
A.
The person feels compelled to act out their pathological
behavior.
B.
Compulsions are usually ego-dystonic.
C.
Compulsions are acted upon with the expectation of
receiving pleasure.
D.
A and B only
35) The ARNP recognizes which of the following when the 2-month-old opens her mouth when
she sees a bottle.
A.
The 2-month-old must be quite advanced as this is a visual motor skill normally seen
in a 4 month old.
B.
The 2-month-old is demonstrating a normal developmental adaptive skill.
C.
The 2-month-old is demonstrating a normal developmental visual motor skill.
D.
36) The 2-month-old is demonstrating an advanced developmental gross motor skill.
The ARNP notices the 6-month-old does not have a spontaneous smile response and realizes
which of the following?
A.
This is normal for most 6-month-old.
B.
This is a cognitive developmental red-flag delay and triggers further assessment.
C.
This is a social/emotional developmental red-flag delay and triggers further
assessment.
D.
37) This represents a normal delay for a 6-month-old; will need to be assessed further at
the 9-month-old assessment.
Data supports which of the following demographics of persons with conversions disorder?
A.
Conversion disorder is most common among rural people.
B Conversion disorder is most common among persons in higher
. socioeconomic groups
C.
Conversion disorder is most common among persons with higher
education
D.
38) Conversion disorder is most common in civilian populations
Which of the following is consistent with what is known about electroconvulsive therapy
(ECT) use in patients with Dissociative Identity Disorder (DID)?
A.
ECT is helpful in joining various personality identities/altered states.
B.
ECT crosses all personality/altered states equally and typically leads to a full recovery.
C.
ECT is helpful in ameliorating refractory mood disorders and does not worsen
dissociative memory problems.
D.
ECT should not be used in patients with Dissociative Identity Disorder as it can cause
further confusion and refraction.
39) Which of the following conditions associated with childhood are part of the five conditions
which comprise disruptive, impulse-control, and conduct disorders?
A.
Autism spectrum disorder
B.
Reactive attachment disorder
C.
Oppositional defiant disorder
D.
Attention-deficit/hyperactivity
disorder
40) A category of disorders characterized by the inability to resist an intense impulse, drive, or
temptation to perform a particular act that is obviously harmful to self or others or both is
known as which of the following?
A.
Dissociative disorders
B.
Psychosomatic disorders
C.
Trauma and stressor related disorders
D.
Disruptive, impulse-control and conduct
disorders
41) A person reveals to the ARNP that they steal to get the things they want and cannot afford.
The person says they just can’t help themselves, because they have kleptomania. The ARNP
realizes the following:
A.
This presentation is consistent with kleptomania.
B.
This presentation is not consistent with kleptomania because a person with
kleptomania does not realize they have kleptomania.
C.
The person likely does not have kleptomania because a person with kleptomania is
more concerned with the act of stealing rather than the obtaining the object which
has been stolen.
D.
The presentation is consistent with kleptomania because the person is stealing things
they need.
Which

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Case Study-The Pediatric Client with Diabetes
Patient assignment for today is Miguel Ortiz, a 14-year-old Hispanic student who has been newly diagnosed with Type I Diabetes Mellitus. Miguel was admitted with a blood glucose level of 745 mg/dL. At that time, he displayed typical symptoms of diabetic coma. After treatment with IV insulin, Miguel is feeling much better and is in the process of learning to manage his diabetes to prepare for discharge to home.
Physician orders
Monitor blood glucose QID (ac and hs)
Up ad lib / encourage activity
1800 cal diabetic diet
Diabetic teaching
Humulin N 22u / Humulin R 7u in am
Humulin N 16u / Humulin R 5u in pm
Preclinical preparation
As prepare for the clinical day to take care of this young man who has just been diagnosed with Type I diabetes explain the pathophysiology at the cellular level so that will understand how this type of diabetes works will be prepared to answer questions for this client. Discuss the pathophysiology of Type II diabetes as well as compare the two types of diabetes. Because this young man is of Hispanic descent will also need to research how the care of a Hispanic child could vary from a Caucasian child. As research Hispanic beliefs in disease and illness it will be important to understand who makes the decisions in the family regarding healthcare, who will need to be educated regarding his diabetes, and what type of healers do some Hispanic persons utilize other than the medical profession. What are the risk factors associated with diabetes and why is the Hispanic population more at risk for diabetes? (Type responses to all the questions in this paragraph here) (6 points)
Assessment
Enter the room to check the blood glucose before breakfast. As perform initial assessment, look for signs and symptoms of DKA (diabetic ketoacidosis). As progress through the case study and answer the questions please support response with appropriate rationale or support for response. Some of the questions will be a response to the patient so write response to those questions as if were addressing this young patient.
What signs and symptoms are looking for regarding diabetic ketoacidosis? (.5 points)
Miguel asks what normal fasting blood glucose would be, what is the response? (.5 points)
Discuss the onset of Miguel’s illness with him. Miguel describes his symptoms and note they were typical symptoms of most people during the onset of diabetes.
What symptoms would expect patient to describe regarding the onset of Type I Diabetes? How do these symptoms differ from what the symptoms of Type II Diabetes might be? (1 point)
Explain to Miguel that these symptoms were caused by the blood glucose level being higher than normal, and that if his blood glucose level is not controlled, he will experience these symptoms again.
Miguel asks what can cause his blood glucose level to become uncontrolled. What is the response? (1point)
Miguel asks why the body needs insulin. What is your response? (1 point)
Insulin Administration
You prepare to administer Miguel’s morning dose of insulin. Explain everything asprep are the insulin, so Miguel will learn to properly administer his insulin at home.
Miguel asks why are rolling the insulin instead of just shaking it. What is reply? (.5 points)
Explain the process of preparing a mixed dose of insulin. Which insulin do draw up first? Make sure to answer this question as though were providing patient education to this patient. (1point)
When have drawn up both the N and R, how many units of insulin will be in the syringe? (.5 points)
Miguel asks why the insulin is now being given by injection when before it was given IV. How do respond? (1 point)
Miguel asks why the physician has prescribed two types of insulin for him. How do respond? (1 point)
Discuss the differences between the various types of insulin including rapid acting, short acting, intermediate acting, long acting, mixed insulin (example 70/30). Are there any other treatment options for Miguel? (2 points)
Diabetic teaching
When Miguel’s breakfast tray arrives, he looks at the food and says, “I think I’ll just drink the milk and juice. I’ve never been a breakfast eater at least not this kind of food.”
What is best response? (1 point)
Miguel asks what will happen if the CHO intake is less than what is needed to balance the insulin. What is reply? (1 point)
Miguel ponders reply and then asks, “How will I know if this is a problem?” Know that Miguel needs to know the symptoms of hypoglycemia and this is a good opportunity to review this information with him.
What will tell him? (1point)
After breakfast, Miguel takes a shower and takes a long walk around the hospital. When he returns he states, “I feel so nervous, shaky, and weak. My vision is a little blurry.” Note that Miguel’s skin is pale and moist.
What action should you take? (1 point)
After explain the relationship of exercise to the blood glucose level, Miguel states, “I play football, basketball, and baseball at school. I suppose I won’t be able to do that anymore.”
What is the best response? (1point)
When deliver Miguel’s lunch tray, he states, “I’ve been wondering why the doctor won’t just let me take the insulin pills like my uncle does. He’s diabetic and gets by just fine on the pills. I suppose it’s a difference in the doctor’s ideas of treatment.”
How will respond? (1point)
Discuss the action that each of the following antidiabetic agents utilizes and give an example of each; Alpha-glucosidase inhibitors, Biguanide, Insulin Stimulators, and Insulin Enhancing Agents (Thiazolidinediones or Insulin Sensitizers). (2points)
In the early afternoon, sit down with Miguel to discuss the long-term complications which have an increased incidence in those with diabetes.
What complications will discuss? (1 point)
Miguel asks, “How can I avoid these complications?” What information will give him? 1 point)
Miguel sighs and looks unhappy. “What did I do to get this disease?” Now must keep in mind that the Hispanic culture may have different views about disease and illness so keeping those in mind how will you answer his questions?
What information can give Miguel regarding the cause of type I diabetes? (1point)
What other resources can suggest for Miguel’s support once he has been discharged? (1.5 points)
Miguel know that you will be leaving soon. Miguel thanks for all the information have given him today, and has no further needs at this time. Proceed to document the items on which the nurse have done patient teaching.
List those topics (1 point)
Besides working with Miguel to understand his diabetes and all the elements that impact his care who else needs to be involved in his care? Explain how you would facilitate this involvement. Again, you must keep in mind his ethnic background and realize that there are key people that must be integrated into his care if he is to be successful with management of his diabetes. (1.5 points)
This client is 14 based on that what tasks are age appropriate for him regarding his diabetes care? (1point)
Based on other ages in the pediatric group please describe how this scenario would be different if the child were a toddler, preschooler, and elementary aged child. How would your care and education be different and what tasks are appropriate for each age group regarding diabetes care? (3 points)

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The article and questions to answer/ the format is stated below:
Instructions:
Summarize the article given, Answer the given question under Discussion, cite a specific nursing theory, and discuss how this is related to the journal/article chosen. BASE THE ANSWER TO THE ARTICLE.
REFERENCE: https://www.sciencedaily.com/releases/2021/06/210603171058.htm
Washington University School of Medicine. (2021, June 3). Studies reveal skull as unexpected source of brain immunity: Immune cells from skull bone marrow guard the brain, spinal cord. ScienceDaily. Retrieved January 20, 2022 from www.sciencedaily.com/releases/2021/06/210603171058.htm
ARTICLE: Studies reveal the skull as an unexpected source of brain immunity
Immune cells from skull bone marrow guard the brain, spinal cord
The immune system is the brain’s best frenemy. It protects the brain from infection and helps injured tissues heal, but it also causes autoimmune diseases and creates inflammation that drives neurodegeneration.
Two new studies in mice suggest that the double-edged nature of the relationship between the immune system and the brain may come down to the origins of the immune cells that patrol the meninges, the tissues that surround the brain, and the spinal cord. In complementary studies published June 3 in the journal Science, two teams of researchers at Washington University School of Medicine in St. Louis unexpectedly found that many of the immune cells in the meninges come from bone marrow in the skull and migrate to the brain through special channels without passing through the blood.
These skull-derived immune cells are peacekeepers, dedicated to maintaining a healthy status quo. It’s the other immune cells, the ones that arrive from the bloodstream, that seem to be the troublemakers. They carry genetic signatures that mark them as likely to promote autoimmunity and inflammation, and they become more abundant with aging or under conditions of disease or injury. Taken together, the findings reveal a key aspect of the connection between the brain and the immune system that could inform our understanding of a wide range of brain disorders.
“There has been this gap in our knowledge that applies to almost every neurological disease: neuro-COVID, Alzheimer’s disease, multiple sclerosis, brain injury, you name it,” said Jonathan Kipnis, Ph.D., the Alan A., and Edith L. Wolff Distinguished Professor of Pathology & Immunology and a BJC Investigator. Kipnis is the senior author of one of the papers. “We knew immune cells were involved in neurological conditions, but where were they coming from? What we’ve found is that there’s a new source that hasn’t been described before for these cells.”
Earlier this year, Kipnis showed that immune cells stationed in the meninges keep tabs on the brain. As part of these new studies, Kipnis and Marco Colonna, MD, the Robert Rock Belliveau, MD, Professor of Pathology, and the senior author on the other paper, independently launched projects to find where such cells come from. Kipnis focused on the innate arm of the immune system and Colonna on the adaptive arm. Innate immune cells are responsible for inflammation, which helps defend against infection and heal injuries, but also can damage tissues and contribute to degenerative conditions such as Alzheimer’s and Parkinson’s disease. Adaptive immune cells are capable of specifically targeting undesirables such as viruses and tumors, but they also can mistakenly home in on the body’s healthy tissues, resulting in autoimmune diseases such as multiple sclerosis.
Colonna and colleagues — including co-first authors Simone Brioschi, Ph.D., a postdoctoral researcher, Wei-Le Wang, Ph.D., a postdoctoral researcher, and Vincent Peng, a graduate student — traced the development of B cells, antibody-producing members of the adaptive immune system. They found that most B cells in the meninges arose and matured in the skull bone marrow. As B cells mature, they must be taught to distinguish between normal proteins from the body, which pose no threat, and foreign proteins that signal infection or disease and require a response. For B cells destined for a life patrolling the boundaries of the central nervous system, the skull is a convenient site for this education.
“B cells in the bone marrow of the skull come into contact with the central nervous system and are educated by the central nervous system,” said Colonna, who is also a professor of medicine. “That would not happen if they were released into the blood. Because they are directly in contact with the brain, they learn to be tolerant of brain proteins.”
Along with the tolerant B cells derived from the skull, the researchers also discovered a population of B cells that come into the meninges from the blood. These blood-derived B cells are not trained to ignore normal central nervous system proteins. Some of these cells may wrongly recognize harmless central nervous system proteins as foreign and produce antibodies against them, Colonna said. Moreover, the number of these blood-derived B cells increases with age, providing a clue as to why the risk of neuro-immune conditions is higher in older people.
Meanwhile, Kipnis’ team — led by co-first authors Andrea Cugurra, a graduate student, Tornike Mamuladze, MD, a visiting researcher, and Justin Rustenhoven, Ph.D., a postdoctoral researcher — was searching for the source of meningeal myeloid cells, a group of innate immune cells. They found that myeloid cells arose in the bone marrow of the skull and spinal vertebrae and entered the meninges via direct channels through the bone.
Using mouse models of multiple sclerosis and brain and spinal cord injuries, Kipnis and colleagues found that myeloid cells swarm into the brain and spinal cord in response to injury or disease. Most of the entering cells are drawn from the resident population of myeloid cells in the meninges. These are biased toward regulating and modulating the immune response. But some myeloid cells come in from the blood, and these are more inflammatory, capable of causing damage if not properly controlled.
“Understanding where these cells come from and how they behave is a critical part of understanding the basic mechanisms of neuro-immune interactions, so we can design new therapeutic approaches for neurological conditions associated with inflammation,” said Kipnis, who is also a professor of neurosurgery, of neurology and neuroscience. “The location of these cells in the skull makes them relatively accessible, and opens up the possibility of designing therapies to alter the behavior of these cells and treat neuro-immune conditions.”
FORMAT: Base the answer on the article above:
SUMMARY: Provide 1-2 short paragraphs of what the article/journal is about citing important and salient data.
DISCUSSIONS:
a) What are the advantages of the said updates, trends, management, etc.?
b) What are the disadvantages of the said updates, trends, management, etc.?
c) Is it feasible/adaptable in the Philippines’ local setting? Why? or Why not?
d) Relate it according to the experience/observation in the area (where applicable)?
e) What resolutions to provide to manage problems relative to the issue at hand?
f) What are the implications of these updates, trends, etc. on the nursing profession?
NURSING THEORY: Cite a specific nursing theory and discuss how this is related to the journal/article chosen.

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Artie is a 21 y/o male who comes to the clinic with a chief complaint of paroxysmal coughing without an apparent cause. He states that this has been going on for about 15 days. He initially had a mild fever and a runny nose. His most likely diagnosis is:
Pertussis
Atypical pneumonia
CAP
Common cold
2. Jeremy is suffering from chronic alcohol abuse. His symptoms include mental confusion, ataxia, stupor, and hypotension. The most likely diagnosis for these symptoms is:
Korsakoff’s syndrome
Insomnia
Anorexia nervosa
Bipolar disorder
3.Susan is a 29 y/o female who comes to the clinic with a 3-day history of fever, chills, nausea, vomiting, and flank pain. During the visit, the NP does a urine dipstick and discover that Susan is positive for nitrites, leukocytes, and >10 WBCs. The physical exam reveals a CVA tenderness. Within 2 weeks, Susan returns to the clinic and a culture of her urine shows she has the same bacteria as when the NP first saw her. This would be referred to as:
Relapsing UTI
Recurring UTI
Persistent UTI
None of the above
4.Archie is a 19 y/o male who comes to the clinic with his significant other because of recent outbursts and then long periods of mood changes that cycle between mania and depression. His most likely diagnosis is:
Major depression
Bipolar depression
Minor depression
None of the above
5.All of the following are characteristics of Kleinfelter syndrome in a male except:
Small testicles
Wide hips
Decreased body and facial hair
Small stature
6.imaging, in relationship to UTIs, should be done in all the following except:
Poor response to antibiotics
H/O of calculi
On initial visit
Recurrent pyelonephritis
7. Zina is a 34 y/o female who comes to the clinic with a chief complaint of 3 years of chronic heartburn. She states that she gets it after eating tacos and bacon. She has tried to self-medicate with OTC antacids with no improvement. In the exam, the NP notices a sour odor on Zina’s breath, thinning tooth enamel, and a chronic red throat. Medications to assist Zina would include all the following except:
Zantac
Pepcid
NSAIDS
Prevacid
8. St. John’s Wart has all the following potential uses except:
Depression
Menopausal symptoms
Wound healing
HIV/AIDSst.
9. The most common side effects of giving SSRIs to depressed patients include:
Diarrhea
Nausea and vomiting
Sexual dysfunction
All of the above
10. Zina is a 34 y/o female who comes to the clinic with a chief complaint of 3 years of chronic heartburn. She states that she gets it after eating tacos and bacon. She has tried to self-medicate with OTC antacids with no improvement. In the exam, the NP notices a sour odor on Zina’s breath, thinning tooth enamel, and a chronic red throat. The most likely diagnosis is:
Halitosis
Peptic ulcer disease
Gastroesophageal reflux disease (GERD)
A or B only
11. Artie is a 21 y/o male who comes to the clinic with a chief complaint of paroxysmal coughing without an apparent cause. He states that this has been going on for about 15 days. He initially had a mild fever and a runny nose. First-line treatment for Artie would include macrolides.
True
False
12. Which of the following can reduce breast cancer risk?
Healthy diet
Limiting ETOH intake
Stop smoking
Maintain normal body weight
All of the above
A, B, & C only
13. What is the earliest age at which one would not give DTap to a child but rather would give Td or Tdap?
1 year old
2 years old
3 years old
7 years old
14. The positive signs of pregnancy include all the following except:
Palpation of uterus by NP
Ultrasound and visualization of fetus
Goodell’s sign (cervical softening at 4 weeks)
Fetal heart tones
15. Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some rhinitis, and low-grade fever. Potential organisms that might have caused Sam’s condition include which of the following:
Mycoplasma pneumoniae
Chlamydia pneumoniae
Legionella pneumonia
All of the above
None of the above
16. All of the following are in the LUQ of the abdomen except
Stomach
Sigmoid colon
Pancreas
Kidney (left)
17. All of the following are presumptive signs of pregnancy except:
Amenorrhea
Chadwick’s sign (blue coloration of the uterus and vagina)
Breast changes
Fatigue
18. At what age should a child be able to speak in full sentences using 3-5 words?
1 y/o
2 y/o
3 y/o
None of the above
19. Zina is a 34 y/o female who comes to the clinic with a chief complaint of 3 years of chronic heartburn. She states that she gets it after eating tacos and bacon. She has tried to self-medicate with OTC antacids with no improvement. In the exam, the NP notices a sour odor on Zina’s breath, thinning tooth enamel, and a chronic red throat. Some lifestyle changes to treat Zina’s condition would include which of the following?
Stop smoking
Avoid ASA
Avoid alcohol
Avoid caffeine
All of the above
A, C, and D only
20. The most common method of contraception is:
IUDs
Sterilization
Condoms
Diaphragms
21. Sam is a 19 y/o male who comes to the clinic with a chief complaint of several weeks of fatigue and non-productive paroxysmal coughing. He initially had a sore throat, some rhinitis, and low-grade fever. Treatment of Sam’s condition includes which of the following:
Doxycycline
Azithromycin
Tessalon Perles
All of the above
A & B only
22. A first-time mother calls the clinic and states that she has sore nipples from breast feeding. The best advice you can give her is:
Stop breast feeding
Supplement with formula
Alternate nipples
It is a common problem but should resolve in 2 weeks.
23. After skin cancer, breast cancer is the most common cancer in women.
True
False
24. Mark is a 2-month-old infant, and he should be able to do all the following tasks except:
Follow objects past midline
Make gurgling sounds
Rolling over
Lift head up 45 degrees
25. Breast cancer in women is characterized by all of the following except:
Mobile mass on palpation
Mass is painless
Mass is typically found in the upper outer quadrant
Skin around breast is dimpled
26. Adam is a 10 y/o male who has Koplik’s spots inside the cheeks by the rear molars. The most likely diagnosis is:
Measles
Hand, foot, and mouth disease
Scarlet fever
Varicella
27. At 12 weeks in a pregnancy the fundal height of the uterus should be:
Above the symphysis pubis
Halfway between symphysis pubis and umbilicus
At level of umbilicus
Below symphysis pubis
28. Susan is a 29 y/o female who comes to the clinic with a 3-day history of fever, chills, nausea, vomiting, and flank pain. During the visit, the NP does a urine dipstick and discover that Susan is positive for nitrites, leukocytes, and >10 WBCs. The physical exam reveals a CVA tenderness. Her most likely diagnosis is:
Lower urinary tract infection
Abdominal virus
Upper urinary tract infection
Sexually transmitted disease
29. Patients with bipolar disorder may have all the following except:
Delusions
Hallucinations
Lower rates of substance abuse
A & B only
30. Lactation mastitis typically occurs in which time frame:
At 3 months after birth
At 6 months after birth
Within the first 2 months after birth
None of the above

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CONCEPT: CELLULAR REGULATION
TOPIC: Cancer – Hematology/Oncologic Emergency

Ms. Y is a 44-year-old woman diagnosed with non-Hodgkin lymphoma (NHL) 3 months ago. She finished receiving her third of six chemotherapy courses 5 days ago. Yesterday morning, she was seen at her oncologist’s office for malaise, muscle weakness, and palpitations. She had splenomegaly on examination. A computed tomography (CT) scan of the abdomen showed metastatic disease in the liver and spleen. She is admitted to the hospital with progressive weakness.
Name 3 risk factors for lymphoma.
A.
B.
C.
Chart View
Comprehensive Metabolic Panel (CMP)

Na 139 mEq/L
K 6.3 mEq/L
Cl 96 mEq/L
CO2 28 mEq/L
Glucose 101 mg/dL
Blood urea nitrogen (BUN) 59 mg/dL
Creatinine 2.5 mg/dL
Ca 6.9 mg/dL
Total protein 5.4 g/dL
Albumin 2.8 g/dL
Phosphorus 4.9 mg/dL
Uric Acid 21 mg/dL
Total bilirubin 0.8 mg/dL
Alkaline phosphatase 172 units/L
Aspartate transaminase (AST) 254 units/L
Alanine transaminase (ALT) 74 units/L
Lactate dehydrogenase (LDH) 214 IU/L

Interpret Ms. Y’s admitting comprehensive metabolic panel results.

Based on the laboratory test results, which common oncologic emergency is Ms. Y experiencing?

Describe the pathophysiology of this condition.

What assessment findings related to this diagnosis would you expect in Ms. Y?

Complete Blood Count (CBC)

White blood cells (WBCs) 1500/mm3
Neutrophils 66%
Lymphocytes 16 %
Monocytes 15%
Eosinophils 5%
Hemoglobin (Hgb) 7.9 g/dL
Hematocrit (Hct) 22.4%
Platelets 21,000/mm3

Interpret the lab values above.

Name 3 additional problems for which Ms. Y is at risk.

What are your nursing priorities right now and why?

Medication Record

IV 0.9% normal saline at 150 mL/hr
100 mEq sodium bicarbonate (NaHCO3) in the first liter of the IV fluid
rasburicase 6 mg IV now
allopurinol 500 mg twice a day orally
furosemide 40 mg IVP now then every 6 hours
sodium polystyrene sulfonate (Kayexalate) 15 g orally every 6 hours
aluminum hydroxide 2 caps orally with meals

What is the expected outcome associated with each medication Ms. Y is receiving?
normal saline
NaHCO3
rasburicase
allopurinol
furosemide
Kayexalate

What are your nursing responsibilities when administering Kayexalate?

Discuss 2 major complications that could happen if Ms. Y’s abnormal laboratory test results (CMP results) will not be resolve?
A.
B.

Name 3 signs and symptoms for each of the following problems.
A. anemia
B. neutropenia
C. thrombocytopenia

List at least 7 independent nursing interventions that you would include based on the client’s abnormal laboratory test results.
A.
B.
C.
D.
E.
F.
G.
Comprehensive Metabolic Panel (CMP) day 2

Na 136 mEq/L
K 4.7 mEq/L
Cl 104 mEq/L
CO2 26 mEq/L
Glucose 110 mg/dL
Blood urea nitrogen (BUN) 36 mg/dL
Creatinine 2.1 mg/dL
Ca 7.9 units/L
Total protein 5.4 g/dL
Albumin 2.8 g/dL
Phosphorus 4.1 mg/dL
Uric Acid 2.0 mg/dL
Total bilirubin 1.0 mg/dL
Alkaline phosphatase 94 units/L
Aspartate transaminase (AST) 46 units/L
Alanine transaminase (ALT) 44 units/L
Lactate dehydrogenase (LDH) 222 IU/L

Interpret Ms. Y’s latest lab results by comparing it with the previous laboratory test results 24 hours ago.

If you think that the client’s condition is resolving, what other interventions would you include in her plan of care?

List at least 5 other oncologic emergencies and give at least two nursing interventions for each.
A.
B.
C.
D.

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A nurse in an outpatient infusion clinic discusses with a friend the admission of a woman community leader who is receiving treatment for cancer. The nurse’s friend then talks to others, who talk to still others, until there is widespread knowledge of the patient’s cancer in the community. The woman’s daughter hears about her mother’s cancer diagnosis at school and is very upset. (3 points)
What recent act was violated in the initial conversation?
Discuss at least 2 ethical principles that are involved in this situation.
What are the ramifications for this case?
Who is at fault?
Mrs. Cole is admitted with uncontrolled diabetes mellitus. She has a saline lock in place in her left wrist area. A symptomatic drop in blood sugar to 38 requires she receive 50 ml of 50% dextrose infused at 3 mL/min via the peripheral infusion site. She responds well, but the next day needs another dose of dextrose via the same infusion site for a second drop in blood sugar. At discharge, she complains of burning and pain at the site. The nurse documents that the catheter is intact on discontinuation of the peripheral catheter, but no assessment data or subjective patient complaints are recorded. The patient is admitted three days later with purulent drainage form the left wrist infusion site, temperature of 101 degrees F, and pulse rate of 100. (2 points)
What is the probable reason for the second admission?
What are the legal ramifications of this case?
Describe 3 areas of concern in IV therapy that can put a nurse at risk for litigation. (1 point)
Missy, an LPN, has been asked to administer a drug by IV push. She is uncertain whether or not this task falls within her scope of practice. Which are the proper resources to refer to for information related to her scope of practice? Select all that apply. (1 point)
Hospital and unit policies and procedures
The ordering physician
The CNA working with her
The hospital pharmacist
Nurse Practice Act
State Board of Nursing
A pediatric client is admitted to the unit with pneumonia. A peripheral IV is ordered. (2 points)
What equipment would you choose for this infusion and why?
What education would you provide the parents?
The nurse is inserting a peripheral IV catheter into Mr. Twinkle’s right arm. The client suddenly says, “That feels like there is an electrical shock going down my arm and into my fingers!” What should the nurse do first? (2 points)
Explain to the client that is a common response to having an IV inserted
Instruct the client to relax and take deep breaths
Pull the needle out slightly and then advance it again
Remove the needle from the client’s arm
Give rationale for your answer:
Explain at least 2 things that the RN could delegate to a CNA in the preparation of the venipuncture procedure for an elderly client. (1 point)
The nurse is caring for Mrs. Fellow on a medical unit. She was admitted with deep vein thrombosis (DVT). Admission orders include IV heparin 2,000 units per hour continually. (1 point)
If the heparin is available as 25,000 units in 500 ml of 5% dextrose in water, at what rate will the nurse set the infusion pump?
What med should available as an antidote?
How will the nurse know if the treatment for DVT is successful?
Give 2 therapeutic communication statements that the RN could use to ease the worry of the pediatric client whom must undergo venipuncture. (1 point)
Describe the consequences to a client if a nurse unintentionally punctures an artery for infusion therapy instead of venipuncture. (1 point)
Describe the rationale for using the smallest cannula possible for venipuncture. (1 point)
The use of laminar flow hoods in the pharmacy when preparing IV solutions: (Select all that apply-1 point)
May decrease airborne contaminants entering the IV solution
Will protect the pharmacist from exposure to all chemicals
Provides a constant, one-directional flow of filtered area on the work space
Should especially be used when preparing cytotoxic medications
Mr. Cummings, a client with delirium, is admitted to the hospital. His lab results were: Na 155, Cl 101, K 3.9, HCO3 21, BUN 88, glucose 99. Based on these results, which of the following nursing diagnoses are the most appropriate for this client? (1 point)
Imbalanced nutrition, less than body requirements
Impaired urinary elimination
Fluid volume deficit
Fluid volume excess
Self-care deficit: feeding
What are the two main different types of IV replacement fluid and describe the difference between the two different types of fluid? Give an example of both kinds of solutions. (2 points)
List three ways to prevent complications from occurring with IV therapy. (1 point)
An increased amount of circulating antidiuretic hormone will cause (increased/decreased) water retention. (1 point)
What is the normal serum level for potassium? ____________ and list 3 symptoms of hypokalemia. (1 point)
List 5 nursing interventions which would be effective with treatment of fluid volume deficit. (1 point)
Joseph, a young adult client, has been admitted to a medical unit with complaints of fever, vomiting and diarrhea. The nurse documents the nursing diagnosis of Fluid Volume Deficit on his care plan. Which of the following lab results would demonstrate an improvement in Joseph’s condition? (1 point)
Urine specific gravity 1.025, Hematocrit 44%, Sodium 140
Urine specific gravity 1.000, Hematocrit 37%, Sodium 133
Urine specific gravity 1.040, Hematocrit 55%, Sodium 156
When giving potassium infusions, the medication must be _____________, the concentration should not exceed ____________and should not be given at a rate that exceeds __________. _________monitoring should be done during potassium infusions. The most common client complaint during potassium infusion is _______________. If this occurs, the nurse should __________________________
What is biofilm and what are the implications of it in IV therapy?
List signs and symptoms that could be present in the following body systems during fluid volume excess and fluid volume deficit.
Fluid Volume Excess
Fluid Volume Deficit
Cardiovascular
Urinary
Gastrointestinal
Musculoskeletal
Neurosensory
Integumentary
Respiratory
What are the dangers of using D5W for hydration?
Describe 4 specialized nursing considerations related to safety for each of the following categories of clients regarding IV therapy:
Pediatric clients
Geriatric clients
If children require 20ml/kg/hr of IV fluid replacement for the first hour of initial management of fluid loss, how many ml/hr will the nurse set the pump at for a child weighing 14 pounds? Calculate ml/hr for the first hour, rounding to the nearest whole number.
Using scholarly resources and/or a state board of nursing website, please discuss the scope of practice for IV therapy for the LPN and the RN.
True or False Scalp veins do not contain valves, which allows for two-way flow of the blood.
True or False When inserting an IV into a scalp vein, aim the needle upward toward the top of the head.
True or False In the geriatric client, the veins in the hands are not the best choice at times for infusion therapy due to thinning of the skin and loss of subcutaneous tissue.
True or False Stabilization of the vein is a very important technique in successful IV insertion in the geriatric client.

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Ms. Y is a 44-year-old woman diagnosed with non-Hodgkin lymphoma (NHL) 3 months ago. She finished receiving her third of six chemotherapy courses 5 days ago. Yesterday morning, she was seen at her oncologist’s office for malaise, muscle weakness, and palpitations. She had splenomegaly on examination. A computed tomography (CT) scan of the abdomen showed metastatic disease in the liver and spleen. She is admitted to the hospital with progressive weakness.
Name 3 risk factors for lymphoma.
A.
B.
C.
Chart View
Comprehensive Metabolic Panel (CMP)
Na 139 mEq/L
K 6.3 mEq/L
Cl 96 mEq/L
CO2 28 mEq/L
Glucose 101 mg/dL
Blood urea nitrogen (BUN) 59 mg/dL
Creatinine 2.5 mg/dL
Ca 6.9 mg/dL
Total protein 5.4 g/dL
Albumin 2.8 g/dL
Phosphorus 4.9 mg/dL
Uric Acid 21 mg/dL
Total bilirubin 0.8 mg/dL
Alkaline phosphatase 172 units/L
Aspartate transaminase (AST) 254 units/L
Alanine transaminase (ALT) 74 units/L
Lactate dehydrogenase (LDH) 214 IU/L
Interpret Ms. Y’s admitting comprehensive metabolic panel results.
Based on the laboratory test results, which common oncologic emergency is Ms. Y experiencing?
Describe the pathophysiology of this condition.
What assessment findings related to this diagnosis would you expect in Ms. Y?
Complete Blood Count (CBC)
White blood cells (WBCs) 1500/mm3
Neutrophils 66%
Lymphocytes 16 %
Monocytes 15%
Eosinophils 5%
Hemoglobin (Hgb) 7.9 g/dL
Hematocrit (Hct) 22.4%
Platelets 21,000/mm3
Interpret the lab values above.
Name 3 additional problems for which Ms. Y is at risk.
What are your nursing priorities right now and why?
Medication Record
IV 0.9% normal saline at 150 mL/hr
100 mEq sodium bicarbonate (NaHCO3) in the first liter of the IV fluid
rasburicase 6 mg IV now
allopurinol 500 mg twice a day orally
furosemide 40 mg IVP now then every 6 hours
sodium polystyrene sulfonate (Kayexalate) 15 g orally every 6 hours
aluminum hydroxide 2 caps orally with meals
What is the expected outcome associated with each medication Ms. Y is receiving?
normal saline
NaHCO3
rasburicase
allopurinol
furosemide
Kayexalate
What are your nursing responsibilities when administering Kayexalate?
Discuss 2 major complications that could happen if Ms. Y’s abnormal laboratory test results (CMP results) will not be resolve?
A.
B.
Name 3 signs and symptoms for each of the following problems.
A. anemia
B. neutropenia
C. thrombocytopenia
List at least 7 independent nursing interventions that you would include based on the client’s abnormal laboratory test results.
A.
B.
C.
D.
E.
F.
G.
Comprehensive Metabolic Panel (CMP) day 2
Na 136 mEq/L
K 4.7 mEq/L
Cl 104 mEq/L
CO2 26 mEq/L
Glucose 110 mg/dL
Blood urea nitrogen (BUN) 36 mg/dL
Creatinine 2.1 mg/dL
Ca 7.9 units/L
Total protein 5.4 g/dL
Albumin 2.8 g/dL
Phosphorus 4.1 mg/dL
Uric Acid 2.0 mg/dL
Total bilirubin 1.0 mg/dL
Alkaline phosphatase 94 units/L
Aspartate transaminase (AST) 46 units/L
Alanine transaminase (ALT) 44 units/L
Lactate dehydrogenase (LDH) 222 IU/L
Interpret Ms. Y’s latest lab results by comparing it with the previous laboratory test results 24 hours ago.
If you think that the client’s condition is resolving, what other interventions would you include in her plan of care?
List at least 5 other oncologic emergencies and give at least two nursing interventions for each.
A.
B.
C.
D.
E.

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Question 25
The type of therapy typically indicated for individuals with chronic and significant suicidality and self-harm is known as which of the following?
Cognitive behavioral therapy (CBT) .
Trauma-focused CBT
.
Motivational interviewing
.
Dialectical-behavioral therapy
.
Question 26
The average time from the start of child mental health symptoms until a young person enters mental health treatment is which of the following?
A 4weeks-6 .
B 3months-6 .
C 1-2 years
.
D 8-10
years
Question 27
A general term for programs that teach and encourage skillful parent and caregiver responses to challenging child behaviors.
Motivational interviewing
.
Dialectical-behavioral therapy
.
Cognitive behavioral therapy (CBT) .
Behavioral management training .
Question 28
Nightmares and night terrors are associated with disorganization and arousal during which stage of sleep?
Stage1
.
Stage2
.
Stage3
.
Stage4
.
Question 29
The right to assent of dissent from treatment for a child or adolescent is reflected in which of the following American Academy of Child and Adolescent Psychiatry ethical issues?
Fidelity
.
Autonomy
.
Beneficence
.
Nonmaleficence
.
Question 30
In the event of a crisis in which the child is threatening to hurt himself, the first steps should include which of the following?
Address any acute safety concerns
.
Obtain any necessary professional assistance .
Develop a prevention plan for future crises .
A and B
.
Question 31
A 10-year-old child presents with developmentally inappropriate and persistent difficulty with inattention with symptoms which are interfering with academic goals and in social settings. This is consistent with which of the following diagnoses?
Conduct disorder
.
Autism spectrum disorder
.
Generalized anxiety disorder
.
Attention-deficit/hyperactivity disorder .
Question 32
A patient presents endorsing persistent low-grade (sub-acute) depression for the last several years, uncertain of when it started, thinks he has always been depressed but still goes through the motions. These symptoms are consistent with which of the following diagnoses?
Dysthymia
.
Cyclothymia
.
Major Depression, subacute, recurrent .
Bipolar II disorder
.
Question 33
Examples of atypical features in a patient with Major Depressive Episode include which of the following?
A Overeating and
oversleeping
Loss of appetite
.
Insomnia
.
Sleep walking
.
Question 34
Somnambulism is characterized by which of the following?
Waking from sleep/naps with vivid recall of intensely frightening dreams
.
A sleep-wake pattern out of synchrony with the desired sleep-wake schedule
.
Excessive daytime sleepiness or sleep attacks
. D Repeated episodes of rising from bed and walking about for between several minutesto a half hour during nocturnal sleep .
Question 35
A 15-year-old girl presents with symptoms that include restrictive eating and food avoidance, with a desire to avoid obesity, which persists despite negative consequences. This presentation is consistent with which of the following diagnoses?
Bulimia nervosa
.
Anorexia nervosa
.
Encopresis
. D Autism spectrum disorder .
Question 36
Which of the following antidepressants are approved by the FDA for treating depression in children ages 8-17?
Sertraline
.
Fluoxetine
.
Duloxetine
.
Fluvoxamine
.
Question 37
When assessing for substance abuse in an adolescent, the clinician should initially assess for which of the following?
Safety
.
Self medication
.
Substance tolerance .
Substance use disorder .
Question 38
Which of the following is consistent with what is known about prevalence of Bipolar I disorder?
Bipolar I Disorder is more prevalent in men
.
Bipolar I Disorder is more prevalent in women
.
Manic episodes are more prevalent in women.
.
Bipolar I Disorder has equal prevalence among men and women. .
Question 39
Which of the following is NOT consistent with the code of ethics for the nursing profession?
A code of ethics for the nursing profession informs every aspect of the nurse’s life. .
A code of ethics makes explicit the primary obligations of the nursingprofession.
.
A code of ethics addresses the values and ideals of the nursing profession. .
B and C only
.
Question 40
Which of the following is NOT consistent with what is known about anorexia nervosa?

Anorexia nervosa is more prevalent in males.
.
Anorexia nervosa is most frequent in developed countries
.
Anorexia nervosa is equally prevalent in males and females
. D Roughly half of patients with anorexia nervosa will not only diet but will also regularlyengage in binge and purge behaviors .
Question 41
The mental health practitioner realizes the following about using a behavioral health rating scale?
Rating scare are inherently imperfect.
.
Rating scales should never be the sole basis for making a diagnosis.
.
Behavioral health rating scales are an efficient tool to quickly diagnosis a patient. .
A and B
.
Question 42
When responding to a family member about the genetic factors related to mood disorders the APRN would share which of the following?
There is no evidence that genetics plays a role in mood disorders.
.
If one parent has a mood disorder the child has a 50% risk of developing a mood disorder. .
Bipolar I Disorder is typically the most common form of mood disorder in families of bipolar probands. .
Evidence from twin studies provides the most compelling data for the role of genetic factors in mood disorders. .
Question 43
Which of the following medications are approved by the FDA for treating OCD in children ages 6-17?
A
. Sertraline
B
. Fluoxetine
C
. Fluvoxamine
D
. Clomipramine
Question 44
Universal sleep hygiene would NOT include which of the following?
Getting adequate exercise
.
Avoid heavy meals before bedtime
.
Consistent bedtime and arousal time
. D Only go to bed when you are actually feeling sleepy .
Question 45
Which of the following is NOT consistent with pseudodementia seen in major depressive disorder?
Sudden onset
.
Diurnal variation
.
Confabulation
.
Can be coached and encouraged into remembering .
Question 46
When evaluating a child due to disruptive or aggressive behavior, which diagnostic category should be considered first?
Abuse
.
Conduct disorder
.
Communication disorder
.
Attention deficit/hyperactivity disorder .
Question 47
Which of the following may be symptoms of depression in children?
School phobia
.
Excessive clinging to parents
.
Preferring to spend time with friends fromschool .
A and B
.
Question 48
Which of the following would be consistent with ethical principles regarding relationships with patients in the ANA’s Code of Ethics for Nurses (Provision 1.2)?
The nurse must respect patient’s decisions. .
The nurse must support all patient choices. .
The nurse must agree with all patient choices. .
A and B only
.
Question 49
The domain of ethics concerning the nature of ethics and moral reasoning is known as which of the following?
A Metaethics
. B Normative ethics .
Applied ethics
.
Moral ethics
.
Question 50
A dissociation between the patient’s experience of sleeping and the objective polygraphy measures of sleep is known as which of the following?
A Sleep state misperception .
B Psychophysiological
.
insomnia
Persistent insomnia
.
Non-organic insomnia
.

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Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 5th Edition
Thyroiditis
Case Studies
The patient, a 23-year-old woman, has had a bout of flulike symptoms over the past few weeks. Most recently, she has become increasingly tired. She is taking birth control pills to control her menses. Her anterior neck became painful during the past few weeks. The physical examination results reveal that her thyroid is diffusely enlarged and mildly tender.
Studies Results
Routine laboratory tests Within normal limits (WNL)
Total thyroxine (T4), p. 497 8 mcg/dL (normal: 5-12 mcg /dL)
Free T4 0.5 ng/dL (normal: 0.8-2.7 ng/dL)
Free T4 index 0.4 ng/dL (normal: 0.8-2.4 ng/dL)
Triiodothyronine (T3), p. 506 52 ng/dL (normal: 70-205 ng/dL)
Thyroxine-binding globulin (TBG), p. 495 12 mg/dL (normal: 1.7-3.6 mg/dL)
Thyroid stimulating hormone (TSH), p. 486 32 microunits/mL (normal: 2-10 microunits/mL)
Thyroid scanning, p. 839 Enlarged gland; normal shape, position, and function of the thyroid gland. No areas of decreased or increased uptake
Thyroid ultrasound, p. 895 Enlarged gland; normal shape and position of the thyroid gland
Thyroid antibodies
Antithyroglobulin antibody, p. 102 1:250 (normal: titer <1:100) Antithyroid peroxidase antibody, p. 104 1:500 (normal: titer <1:100) Thyroid-stimulating immunoglobulins, p. 491 Negative Diagnostic Analysis Total T4 measures protein-bound and unbound T4. Because the patient was taking birth control pills, her TBG was elevated; therefore, her total T4 was normal. Free T4 and FT4 index tests measure unbound T4. When the free T4 and the FT4 index were measured, they were found to be low, indicating that the patient had hypothyroidism. The TSH level was elevated because of primary failure of the thyroid. The thyroid antibodies were elevated, indicating that the patient had Hashimoto thyroiditis. Her long-acting thyroid stimulator (LATS) levels were normal, discounting Graves disease as a cause of her diffusely enlarged thyroid. Her thyroid ultrasound and scan failed to show any localized, defined tumor. The patient was started on thyroid replacement therapy, and her TSH level returned to normal. Over the next few weeks, she felt markedly better. Her thyroid pain and tiredness disappeared. Critical Thinking Questions Why were the thyroid antibodies important in this patient's diagnosis? What symptoms might she experience if too much thyroid replacement medication were administered?

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1 Antigone represents those who:
a. They forgive the enemy.
b believe by unconditional faith.
c they don’t commit.
d take positions in life.
e they fear the state.
2 A trait of Cretan culture was:
a. his extreme pacifism.
b. ignorance of religion.
c. livestock issues.
d. seminomadism.
e live in small villages.
3. A trait of the Paleolithic era was:
a the appearance of the currency.
b semi-nomadic life.
c the development of pottery.
d the invention of the alphabet.
e advancement in jug painting.

4. A legacy of Rome was:
a. heliocentric science.
b. totemism.
c. the Pythagorean system.
d. satirical literature.
e. the sexagimal system.

5. A point of Greek culture was:
a. strict sexual morality.
b. abusive religious fanaticism.
c. ritual cannibalism.
d. social polygamy.
e. critical reflection.

6. A contribution of Greek culture to posterity was:
a. metallurgy.
b the bas-relief.
c. the drama.
d. zoolatry.
e. the goldsmith

7. How is the origin of evil, punishment and knowledge explained in the first three chapters of Genesis?

8. The Neolithic is a prehistoric period characterized by being an era:
a. industrial.
b. philosophical
c. villager
d. scientific.
e. pre-agricultural

9. What in your opinion are the principles of Socrates that we human beings of the 21st century should consider? Answer in light of the reading “Socrates and Greek philosophy”.

10. The reading “There are no stupid questions” by Carl Sagan begins by talking about:
a. primitive society.
b. Eskimo religion.
c. the discovery of Troy and Pompeii.
d. the inhabitants of the Renaissance.
e. the world wars.

11. Carl Sagan says that young people at his institute (University) are afraid to ask questions due to, among other things:
a. their religious fears.
b. who do not know the story.
c. the ignorance.
d. peer pressure.
e. They are only interested in music.

12. In the studies presented by Sagan, US students:
a. they were the best in all the sciences.
b. They showed that they knew more about the technology.
c. they lost in almost every order.
d. they won in science and mathematics.
e. they only won in art and music.

13. For Sagan, adult Americans:
a. they are the best in philosophy.
b. They have educational deficiencies.
c. dominate the field of astronomy.
d. They know a lot about physics.
e. everyone accepts Darwinism.

14. Carl Sagan highlights in the article:
a. the wisdom of spirit guides.
b. faith, tradition and authority.
c. the scientific method and experimentation.
d. the educational value of obedience.
e. religious culture based on inspired books.

15. We must improve, according to Sagan, through:

a. More budget for education.
b. support for banks and entrepreneurs.
c. strengthen military spending.
d. entertainment and festivals.
e. religious television programs.

16 Sagan says that ordinary people in the US:
a. They think science is hard.
b. They enjoy good knowledge of history.
c. They know a lot about other cultures.
d. they know quite a bit about the literature of Asia and Africa.
e. consider the paleontological field useless.

17 Sagan considers that it is necessary to stimulate:
a. more acknowledgment of the paranormal.
b. critical and skeptical thinking.
c. respect and observance of the Bible and the Koran.
d. the values of the nation’s founders.
e. reverence and submission to educators.

18 Sagan states that a good resource for better educational training is:
a. ask questions.
b. rigid and disciplined schools.
c. go to the wise men of the past.
d. memorization.
e. pressure the student.

19. During the Neolithic era it developed:
a. the patriarchy.
b. irreligiousness.
c. the matriarchy.
d. Gender equality.
e. the foundling

20. Oedipus deciphered the question from:
a. the Sphinx.
b. the jellyfish.
c. the Minotaur.
d. the Oracle.
e. the cyclops
21 Oedipus was a
a. abusive husband.
b. good question solver.
c. bad fighter.
d. mediocre son.
e. unjust king.

22 Oedipus was sentenced to:
a. exile.
b. torture.
c. hell.
d. leprosarium.
e. corporal punishment.

23 Oedipus finished:
a. devoured by a monster.
b. sacrificed to the gods.
c. in exile
d. committing suicide
e. killed in combat.

24 In the mythological story of Oedipus it was understood that human beings:
a. They ruled the gods.
b. they exercised free will and freedom.
c. they traced and determined their own lives.
d. They were controlled by fate.
e. They were despised by the divinities.

25I n the Oedipus legend it is understood that:
a. military revenge is legitimate.
b. the Oracle of Delphi is wrong.
c. incest is acceptable.
d. fate is inescapable.
e. the death of defenseless in understandable.

26. The Middle Ages emphasized the:
a. bestiality.
b. rationalism.
c. scientism.
d. animism.
e. theocentrism.

27. As a result of the Reformation and Counter-Reformation there were:
a. help of religions to new scientific ideas.
b. fanaticism and intolerance among Christians.
c. recognition and respect for so-called witches.
d. rise of medieval pagan ideas.
e. dialogue and understanding in Europe.

28 A characteristic of the Renaissance was:
a. the development of the sciences.
b. take the Middle Ages as a model.
c. rejection of antiquity.
d. the cult of reason.
e. the rise of the reliquary.

29.One cause of the religious crisis of the 16th century or Protestant Reformation was:
a. the interpretation of the Bible.
b. religious fanaticism.
c. theocentrism.
d. the conquest of the New World.
e. Nicolaus Copernicus thesis.

30 An idea of Martin Luther regarding religious doctrine was:
a. devotion to relics.
b. priestly celibacy.
c. the reduction of the sacraments.
d. works help salvation.
e. believe in all Catholicism.

31 During the Renaissance there were:
a. Few technical advances.
b. setback in inventions and travel.
c. peace and peaceful religious coexistence.
d. advance of feudalism, but commercial retreat.
e. intellectual and literary development.

32 During the Middle Ages it was believed in:
a. The science.
b. the technological.
c. The authorities.
d. zoolatry.
e. the animism.

33 The so-called Counter-Reformation saw the development of the Council of Trent where the Catholic Church established:
a. eliminate the catechism.
b. medieval theocentrism.
c. the Holy Office of the Inquisition.
d. the reduction of the sacraments to two.
e. acceptance of Lutheran ideas.

34 The Renaissance humanist Thomas More believed in:
a. Displace God from our life.
b. religious fanaticism.
c. the domination of one social class over another.
d. married life forever.
e. male dominance over female.

35 Theologian John Calvin posited:
a. devotion to science.
b. human predestination.
c. that God created the world and left.
d. the free will of the believer.
e. respect the opinion of others.

36 The order of the Society of Jesus was noted for emphasizing that its members, the Jesuits, stand out:
a. go back to the past and prevent the progress of knowledge.
b. to receive a careful intellectual formation.
c. for his combats against medieval heretics.
d. to dialogue and reach a consensus with the reformists.
e. in preventing science education from progressing.

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