Session 17

1. The lymphatic system plays a role in maintaining fluid balance within the body by:
a. adding lymph to GI tract secretions. d. carrying excess fluid to the kidneys
b. returning interstitial fluid to the to be excreted.
plasma. e. actively absorbing fluid from the
c. transporting lymph from tissues to blood.
the liver.
Answer: B
The lymphatic system is vital in fluid balance. The extra 3 L of fluid enters the lymphatic capillaries and
becomes lymph. It passes through the lymphatic vessels to return to the blood.

2. Germinal centers are the sites of:

a. increased blood flow to the lymph d. entrance of lymph into lymph nodes.
nodes. e. proliferation of lymphocytes in the
b. fluid production. lymph nodes.
c. increased flow of lymph from
infected tissues.
Answer: E
Lymphatic nodes contain lymphatic nodules are dense aggregations of tissue formed by lymphocytes &
other cells that contain rapidly dividing lymphocytes called germinal centers.

3. Which of the following is the molecule that displays an antigen on the surface of cells?
a. Antigen d. Major histocompatibility complex
b. Antibody molecule
c. Antigen receptor
Answer: D
Major Histocompatibility Complex (MHC) Molecules are glycoproteins that have binding sites specific for
certain antigens. Antigens are substances that stimulate adaptive responses. Antibodies bind to antigen.
Antigen receptors are located in the surfaces of B cells and T cells.

4. What is the nonspecific lymphocyte that kills tumor cells and virus infected cells?
a. Macrophages c. Eosinophils
b. Natural killer cells d. Basophils
Answer: B
Natural Killer (NK) Cells are nonspecific lymphocytes that recognize classes of cells such as tumor cells
or virus infected cells which kill target cells by releasing chemicals that damage cell membranes & cause
cell lysis. Macrophages are large monocytes that leave blood & enter tissues and are responsible for
most phagocytic activity in late stages of infection. Eosinophils participate in inflammation associated with
allergies & asthma. Basophils are motile WBC that can leave blood & enter infected tissues that produce
inflammatory responses to fight against pathogens.

5. Which of the following occur during the inflammation? (Select all that apply)
a. Chemical mediators cause d. Fibrin walls off the infected area
vasodilation e. Complement attracts phagocytes to
b. Blood flow is decreased to the area the area
c. Vascular permeability is decreased
Answer: ADE
All are events that occur during the inflammation, except options B and C. Due to the increased vascular
permeability, the blood flow is increased to the area.

6. Which is the proper order of events in cell-mediated immunity?

(1) Cloning of cytotoxic T cells and memory (3) Activation of T lymphocytes
T cells (4) Cytotoxic T cells attack target cells
(2) Antigen presented to T lymphocyte
a. 2, 3, 4, 1 b. 1, 4, 2, 3
 c. 2, 3, 1, 4 e. 1, 2, 3, 4
d. 3, 2, 4, 1
Answer: C
In cell-mediated immunity, here’s the proper order of events: antigen presented to T lymphocyte 🡪
activation of T lymphocytes 🡪 cloning of cytotoxic T cells and memory T cells 🡪 cytotoxic T cells attack
target cells

7. Which of the following is correctly matched?

a. IgA - found in saliva and tears
b. IgD - can cross the placenta
c. IgG - first to challenge the antigen
d. IgM - antigen-binding receptor on B cells
e. IgE - transfusion reactions
Answer: A
IgA is found in saliva and tears. IgG can cross the placenta. IgM is first to challenge the antigen &
transfusion reactions. IgD is an antigen-binding receptor on B cells. IgE binds to mast cells & basophils to
stimulate inflammatory response.

8. Active natural immunity occurs when:

a. antibodies pass from a pregnant mother to her fetus.
b. antibodies are injected into a host.
c. an individual develops a disease.
d. a person is vaccinated.
e. antibodies are passed in breast milk.
Answer: C
Active natural immunity occurs when an individual develops a disease. Option A & E is for passive natural
immunity. Option B is for passive artificial immunity. Option D is for active artificial.

9. Cytotoxic T cells attack:

a. viruses. d. cells that display normal proteins on
b. bacteria. the surface.
c. cells that display foreign proteins on e. viruses and bacteria
the surface.
Answer: C
Cytotoxic T cells are responsible for immediate immune response by binding to antigen on surfaces of
these cells (viral antigen, tumor antigen, & foreign antigen) & kill them.

10. Pepper is experiencing difficulty swallowing and inflamed tonsils. Which of the following signs will be
associated with her condition? (Select all that apply)
a. pain c. loss of appetite
b. paleness d. swelling
Answer: AD
The signs associated with local inflammation are pain, heat, swelling, redness, and loss of function.
Session18

1. The site of respiration inside the lungs are _________.

a. Alveoli d. Bronchioles
b. Diaphragm e. Lungs
c. Bronchi
Answer: A
Alveoli is tiny air sacs of lungs which allow for rapid gaseous exchange. It is located at the very end of the
conducting zone and beginning of the respiratory zone in the respiratory system.

2. What is the function of trachea?

a. Filters air we breathe c. Carries air to lungs
b. Releases air out of the body d. Exchange of gas
Answer: A
Trachea is also known as windpipe, a cartilaginous tube that connects the pharynx and larynx to lungs. It
filters the air.

3. Which of the following is the primary function of hyaline cartilage?

a. protect thyroid c. support trachea
b. increase the surface area d. connect conchae
Answer: C
Hyaline cartilage is a glass like but translucent cartilage. It contains no nerves or blood vessels and is
simple in structure. It supports trachea.

4. The result of the process of inspiration is:

a. increased alveolar volume causes increased alveolar pressure.
b. increased alveolar volume causes decreased alveolar pressure.
c. decreased alveolar volume causes increased alveolar pressure.
d. decreased alveolar volume causes decreased alveolar pressure.
e. increased alveolar pressure caused decreased alveolar volume.
Answer: B
In the process of inspiration, the alveolar volume is increased resulting in decreased alveolar pressure for
the air to flow in. On the contrary, during expiration, the alveolar pressure increases caused by decreased
alveolar volume, and air flows out of the alveoli.

5. Arrange the following structures in the order air passes through them during inhalation:
(1) alveolar ducts (3) respiratory bronchiole
(2) alveolus (4) terminal bronchiole

a. 1, 2, 3, 4 c. 4, 3, 1, 2
b. 2, 1, 3, 4 d. 3, 2, 1, 4
 e. 4, 3, 2, 1
Answer: C

6. What is the deep inspiration maximum expiration of lungs is called?

a. Vital capacity c. Inspiratory capacity
b. Total lung capacity d. Functional residual capacity
Answer: A
Vital capacity is the maximum amount of air a person can expel from the lungs after a maximum
inhalation. A person’s vital capacity can be measured by a wet or regular spirometer.

7. Pulmonary ventilation movements are due to __________.

a. Costal muscles and diaphragm c. Wall of lungs
b. Diaphragm d. Costal muscles
Answer: A
Pulmonary ventilation is commonly referred to as breathing. Air flows because of the pressure difference
between the atmosphere and the gases inside the lungs. Costal muscles and diaphragm help pulmonary
ventilation.

8. Expiration during quiet breathing:

a. is an active process.
b. requires more muscle contractions than inspiration.
c. is due to contraction of the diaphragm and elevation of the ribs.
d. occurs when the diaphragm and external intercostal muscles relax.
e. is not affected by the elastic properties of the lungs.
Answer: D
During expiration in quiet breathing, a passive process, the diaphragm and external intercostal muscles
relax. This requires less muscle contractions and the thorax recoils.

9. The vital capacity of the lungs is ____________.

a. the sum of tidal volume, inspiratory reserve volume, and expiratory reserve volume.
b. the sum of tidal volume, inspiratory reserve volume and residual volume.
c. the sum of tidal volume and expiratory reserve volume.
d. the sum of inspiratory reserve volume and expiratory reserve volume.
Answer: A
Vital capacity of the lung is the sum of tidal volume, inspiratory reserve and expiratory reserve volume.
This is the maximum volume of air that a person can expel from the respiratory tract after a maximum
inspiration (about 4,600mL).

10. Pepper has been reviewing the values of respiratory capacities prior to her exposure in the
Respiratory Ward. She knows that the total lung capacity is the sum of the inspiratory and expiratory
reserves and the tidal and residual volumes. Its normal volume is ________.
a. 5000-6000ml c. 4000-5500ml
b. 2500-5000ml d. 3000-6000ml
Answer: A
The average lung capacity of an adult human is about 6L of air. The tidal volume is the volume of air that
is inhaled or exhaled in a single breath. It is about 5,800mL.
Session 19

1. The direction of gas movement is determined by:

a. temperature. d. partial pressure differences.
b. size of the gas molecule. e. pH.
c. solubility of the gas in blood.
Answer: D
The pressure exerted by specific gas in a mixture of gases is known as partial pressure. The movement
of molecules diffuse down their pressure gradient: from areas of higher partial pressure to areas of lower
partial pressure.

2. Which of the following statements about partial pressures of gases is TRUE?

a. PO2 in lung is greater than PO2 in blood; PCO2 in lung is greater than PCO2 in blood
b. PO2 in lung is greater than PO2 in blood; PCO2 in lung is less than PCO2 in blood
c. PO2 in lung is greater than PO2 in blood; PCO2 in lung = PCO2 in blood
d. PO2 in lung is less than PO2 in blood; PCO2 in lung is less than PCO2 in blood
e. PO2 in lung is less than PO2 in blood; PCO2 in lung is greater than PCO2 in blood
Answer: B
The molecules diffuse down their pressure gradient: from areas of higher partial pressure to areas of
lower partial pressure. The partial pressure of gases in blood and lungs is inversely proportional.

3. The maximum amount of oxygen is exchanged from blood in _________.

a. arteries of the body c. left auricle of the heart
b. capillaries surrounding the alveoli d. arteries of the body
Answer: B
The maximum amount of oxygen is exchanged from blood in capillaries surrounding the alveoli.

4. The oxygen is mainly transported in the system as ______________.

a. Hemoglobin c. Oxyhemoglobin
b. Hemo-oxyglobin d. Ferritin
Answer: C
Oxyhemoglobin is a bright red substance formed by the combination of hemoglobin with oxygen present
in oxygenated blood.

5. Which of the following binds stronger to hemoglobin?

a. Carbon Disulphide
b. Carbon Monoxide
c. Carbon Dioxide
d. Oxygen
Answer: B
Carbon monoxide has a high affinity to hemoglobin. It is then followed by carbon dioxide and oxygen.

6. The factors that affect the rate of alveolar diffusion include: (Select all that apply)
a. Solubility of gas c. Thickness of membrane
b. Reactivity of gas d. Concentration gradient
Answer: ACD
In the alveolar capillaries the diffusion of gases occurs. Oxygen diffuses from alveoli into blood and
carbon dioxide from blood to alveoli. Alveolar diffusion does not depend on the reactivity of gas.

7. As humans, our urge to inhale is from __________.

a. rising PCO2 c. rising O2
b. falling PCO2 d. falling PO2
Answer: A
The urge to inhale in humans results from the rise of PCO 2. This refers to the partial pressure of carbon
dioxide.

8. Oxygen diffuses out of blood into tissues because __________.

a. Oxygen concentration of tissue fluid is lower
b. Oxygen concentration of blood is lower
c. Carbon dioxide concentration of tissue fluid is lower
d. Carbon dioxide concentration of tissue fluid is higher
Answer: A
Oxygen diffuses out of the blood into tissues because the concentration of oxygen in tissue fluid is lower.
The principle of osmosis is followed here.

9. The ranking from highest to lowest PO2 in the area of the arterial ends of the tissue capillaries is:
a. capillaries, tissue fluid, cells. d. tissue fluid, capillaries, cells.
b. cells, tissue fluid, capillaries. e. all three are equal.
c. cells, capillaries, tissue fluid.
Answer: A
Gas molecules move randomly from higher to lower concentration. When oxygen is in contact with tissue
fluid, the oxygen dissolves.

10. Pepper has been assigned to the general ward. Upon reviewing the patient’s record, which of the
following body’s responses is a manifestation of lack of oxygen to the brain?
a. Gasping of air c. Sleepy
b. Depressed d. Hyperactive
Answer: C
Reduced supply of oxygen to the brain is called cerebral hypoxia. Prolonged hypoxia induces neurons cell
death via apoptosis.
Session 20

1. Which one of the following represents the correct order through which food passes in the digestive
tract?
a. mouth, pharynx, esophagus, stomach, large intestine, small intestine
b. mouth, esophagus, pharynx, stomach, small intestine, large intestine
c. pharynx, mouth, esophagus, stomach, large intestine, small intestine
d. mouth, pharynx, esophagus, stomach, small intestine, large intestine
e. mouth, pharynx, esophagus, small intestine, stomach, large intestine
Answer: D
As we eat, the food passes through the digestive tract from the entry route to exit as follows: mouth,
pharynx, esophagus, stomach, small intestine, large intestine, & anus.

2. Which of the following is a part of digestion? (Select all that apply)

a. Absorb water, electrolytes and other nutrients
b. Eliminate undigested food through the anus
c. Ingest food
d. Engulf body toxins
e. Break down the macronutrients for usage
Answer: ABCE
All are part of digestion, except option D. This function is primarily done by the lymphatic system.

3. Which of the following phases of swallowing involves the epiglottis covering the opening of the
larynx?
a. Voluntary phase
b. Esophageal phase
c. Pharyngeal phase
d. None of these are correct
Answer: C
During the pharyngeal phase, the soft palate closes the nasopharynx, and the epiglottis closes the
opening into the larynx. Pharyngeal muscles elevate the pharynx and larynx and then move the bolus to
the esophagus.

4. Protein digestion begins in the ______________.

a. mouth d. small intestine
b. esophagus e. large intestine
c. stomach
Answer: C
Pepsin, an active enzyme of precursor pepsinogen, starts the protein digestion. This enzyme is primarily
produced by chief cells of gastric glands in the stomach.

5. Which phase of gastric secretion is stimulated by the distention of the stomach?

a. Gastric phase c. Cephalic phase
b. Intestinal phase d. Gastrointestinal phase
Answer: A
During the gastric phase, the food in the stomach is mixed with gastric secretions. Distention of the
stomach stimulates stretch receptors that send action potential and activate the CNS reflexes & local
reflexes. This results in the cascade events that increase secretion.

6. Which of the following hormones does not inhibit gastric gland secretions?
a. secretin
b. gastrin
c. gastric inhibitory peptide
d. cholecystokinin
Answer: B
All of the following hormones inhibit gastric glands secretions, except for option B. Gastrin is a hormone
produced by gastric glands that increases gastric secretion as it stimulates additional secretory activity.

7. Which of the following does not occur during the gastric phase of gastric secretion?
a. Gastrin begins to be secreted by the lower part of the stomach.
b. Hydrochloric acid and pepsin secretion are stimulated in the upper and middle parts of the
stomach.
c. Peptides stimulate the secretion of gastrin.
d. Tactile sensation of food in the mouth sends nervous impulses to the medulla oblongata.
e. All of the choices are correct
Answer: C
All of the choices do not occur during the gastric phase of gastric secretion. Options A, B, and D are
activities that occur during the cephalic phase.

8. The medulla oblongata controls gastric secretion both by the parasympathetic branch of the nervous
system and the endocrine system.
a. The statement is true. b. The statement is false.
Answer: B
The medulla oblongata controls the neural mechanisms that involve the CNS reflexes. Local reflexes,
though, are integrated within the entire enteric plexus in the wall of the digestive tract and do not involve
the CNS for hormonal mechanisms.

9. The anterior chisel-shaped teeth that are adapted for cutting are called:
a. incisors
b. canines
c. premolars
d. molars
e. wisdom teeth
Answer: A
The incisors and canines are primarily cut and tear food, whereas the premolar and molar primarily crush
and grind it. Incisors are located anteriorly.

10. Pepper woke up in the morning with an intense urge to defecate. As she observed her feces, she
noticed leafy green residues and remembered that she ate a lot of cabbages in her dinner. She
realized that there was no need to call for an emergency. She knows that cabbage is not easily
digested because it is rich in:
a. Sucrose
b. Fats
c. Starch
d. Cellulose
e. Protein
Answer: D
Cabbage is one of the vegetables that are rich in cellulose and humans cannot digest cellulose.
Session 21

1. The small intestine extends from the:

a. cardioesophageal sphincter to the c. ileocecal valve to the appendix
pyloric sphincter d. appendix to the sigmoid colon
b. pyloric sphincter to the ileocecal e. cardioesophageal sphincter to
valve ileocecal valve
Answer: B
The small intestine extends from the pyloric sphincter, connecting from stomach, to the ileocecal valve,
connecting ileum to cecum.

2. Which one of the following is the middle section of the small intestine?
a. duodenum d. descending colon
b. ascending colon e. ileum
c. jejunum
Answer: C
The small intestine is composed of duodenum, jejunum, and ileum. The middle section is jejunum.

3. Which statements best describe mechanical digestion?

a. It involves the breaking of covalent chemical bonds in organic molecules by digestive
enzymes.
b. It requires carrier molecules and includes facilitated diffusion, cotransport, and active
transport.
c. It breaks large food particles into smaller ones.
d. It begins in the stomach, where some small, lipid-soluble molecules can diffuse through the
stomach epithelium into the circulation.
Answer: C
Mechanical digestion breaks large food particles down into smaller ones. Chemical digestion involves the
breaking of covalent chemical bonds in organic molecules by digestive enzymes. Absorption begins in the
stomach, where some small, lipid-soluble molecules, such as alcohol and aspirin, can diffuse through the
stomach epithelium into the circulation. Transport requires carrier molecules and includes facilitated
diffusion, cotransport, and active transport.

4. Enzymes and bile are carried by the pancreatic duct and bile duct into the:
a. duodenum d. ileum
b. jejunum e. large intestine
c. ileocecal valve
Answer: A
The combined duct of pancreatic and bile empties into the duodenum at the duodenal papilla.

5. The primary function of the small intestine is:

a. absorption of nutrients d. vitamin conversion
b. absorption of water e. mineral secretion
c. waste secretion
Answer: A
The small intestine is responsible for the most absorption which occurs in the duodenum and jejunum.
Options B, C, D, and E are functions of the large intestine.
6. Which one of the following is NOT a modification which is designed to increase surface area within
the small intestine?
a. microvilli c. Peyer’s patches
b. villi d. circular folds
Answer: C
Circular folds, villi, and microvilli greatly increase the surface area of the intestinal lining. Peyer’s patches
are small masses of lymphatic tissue found throughout the ileum region of the small intestine.

7. The sequence of steps by which large food molecules are broken down into their respective building
blocks by catalytic enzymes within hydrolysis reactions is called:
a. ingestion d. chemical digestion
b. propulsion e. absorption
c. mechanical digestion
Answer: B
Once food is placed in the mouth, both mechanical and chemical digestion begin. Mechanical digestion
breaks large food into smaller ones while chemical digestion uses enzymes to break covalent chemical
bonds. Propulsion occurs when peristalsis, the major means of propelling food through the digestive tract,
is initiated. Absorption refers to the movement of nutrients, water & electrolytes from the lumen of the
small intestine into the cell, then into the blood.

8. Transport of digested end products from the lumen GI tract into the bloodstream or lymphatic fluid is
called:
a. ingestion d. absorption
b. propulsion e. defecation
c. digestion
Answer: D
This process refers to absorption, the movement of nutrients, water and electrolytes from the lumen of the
small intestine into the cell, then into the blood. Propulsion occurs when peristalsis, the major means of
propelling food through the digestive tract, is initiated. Digestion can be done through mechanical or
chemical. Defecation is the elimination of indigestible residues from the GI tract via the anus in the form of
feces.

9. Digestion is primarily controlled by the:

a. sympathetic division of the d. enterogastric reflex
autonomic nervous system e. parasympathetic division of the
b. medulla oblongata autonomic nervous system
c. somatic nervous system
Answer: E
The parasympathetic nervous system controls processes in the body such as digestion, repair and
relaxation. When the parasympathetic nervous system is dominant in the body it conserves energy, slows
heart rate, increases digestion and relaxes sphincter muscles in the digestive tract.

10. Pepper is assigned to monitor and assess the patient in Room 1226. Upon auscultation of the
abdomen, 1 or 2 bowel sounds in two minutes is documented. Pepper has interpreted this as which
of the following?
a. Hypoactive c. Normal
b. Hyperactive d. Absent
Answer: A
Hypoactive bowel sound is the description given to auscultation of one to two bowel sounds in 2 minutes.
Normal bowel sounds are heard every 5 to 20 seconds. Hyperactive bowel sounds occur when 5 or 6
sounds are heard in less than 30 seconds. The nurse records that bowel sounds are absent when no
sound is heard in 3 to 5 minutes.
Session 22

1. Which of the following are considered functions of the urinary system? (Select all that apply)
a. Vitamin D synthesis d. Absorption of digested molecules
b. Regulation of white blood cell e. Regulation of blood volume and
synthesis pressure
c. Excretion
Answer: ACE
All are functions of the urinary system, except options B and D. The urinary system regulates red blood
cell synthesis. The option D is a function of the digestive system. The small molecules that result from
digestion are absorbed through the walls of the intestine for use in the body.

2. The urinary system is composed of:

a. Two kidneys, two urethrae, a ureter, and a urinary bladder
b. Two kidneys, a ureter, a urinary bladder, and a urethra
c. Two kidneys, two ureters, a urinary bladder, and a urethra
d. Two kidneys, two ureters, two urethrae, and a urinary bladder
Answer: C
The urinary system consists of two kidneys, two ureters, a urinary bladder, and a urethra. The kidneys are
bean-shaped organs which help the body produce urine to get rid of unwanted waste substances. When
urine is formed, tubes called ureters transport it to the urinary bladder, where it is stored and excreted via
the urethra. The kidneys are also important in controlling our blood pressure and producing red blood
cells.

3. Which of the following is a connective tissue that surrounds the kidneys?

a. Hilum c. Calyx
b. Renal capsule d. Renal pyramid
Answer: B
Hilum is on the medial side of the kidney where the renal artery and nerves enter and where the renal
vein and ureter exit the kidney. Calyx is a funnel-shaped that surrounds the tip of each renal pyramid.
Renal pyramid, any of the triangular sections of tissue that constitute the medulla, or inner substance, of
the kidney.

4. This is known to be the functional units of the kidneys:

a. Renal papilla c. Juxtaglomerular apparatus
b. Glomerulus d. Nephrons
Answer: D
Nephron is the basic structural and functional unit of the kidney. Its chief function is to regulate the
concentration of water and soluble substances like sodium salts by filtering the blood, reabsorbing what is
needed and excreting the rest as urine.

5. Which of the following statements is true?

a. Filtration is the movement of materials across the wall of the nephron into Bowman’s capsule
to form a filtrate.
b. In reabsorption, the solutes are reabsorbed across the filtration membrane into the interstitial
fluid by transport processes, such as active transport and cotransport.
c. In secretion, solutes are secreted across the wall of the nephron into the filtrate.
d. All statements need further evaluation.
Answer: C
All are falsely stated, except for option C. Filtration is the movement of materials across the filtration
membrane into Bowman’s capsule to form a filtrate. In reabsorption, the solutes are reabsorbed across
the wall of the nephron into the interstitial fluid by transport processes, such as active transport and
cotransport.

6. The ascending limb of the loop of Henle functions to:

a. dilute the filtrate by removing solutes.
b. remove water and additional solutes.
c. help regulate aldosterone secretion.
d. increase the rate of active transport of Na+ in the distal tubules and collecting ducts.
Answer: A
The ascending limb of the loop of Henle functions to dilute the filtrate by removing solutes. The thin
segment of the ascending limb is not permeable to water, but it is permeable to solutes.

7. Approximately _____ L of filtrate enters the nephrons each day; of that volume _____% is reabsorbed
in the proximal tubule.
a. 80 L and 35% c. 240 L and 85%
b. 180 L and 65% d. 280 L and 99%
Answer: B
Approximately 180 L of filtrate enters the nephrons each day; of that volume, 65% is reabsorbed in the
proximal tubule. In the proximal tubule, solute molecules move by active transport and cotransport from
the lumen of the tubule into the interstitial fluid. Water moves by osmosis because the cells of the tubule
wall are permeable to water.

8. Antidiuretic hormone (ADH) regulates the amount of water reabsorbed by the distal tubules and
collecting ducts. When ADH levels increase, the permeability of the distal tubules and collecting ducts
to water decreases, and less water is reabsorbed from the filtrate. This statement is:
a. Definitely true c. Partially true
b. Definitely false d. Partially false
Answer: B
Approximately 180 L of filtrate enters the nephrons each day; of that volume, 65% is reabsorbed in the
proximal tubule. In the proximal tubule, solute molecules move by active transport and cotransport from
the lumen of the tubule into the interstitial fluid. Water moves by osmosis because the cells of the tubule
wall are permeable to water.
9. Starting from the glomerular capsule, the correct order of the renal tubule regions is:
a. proximal convoluted tubule, distal convoluted tubule, loop of Henle
b. distal convoluted tubule, loop of Henle, proximal convoluted tubule
c. loop of Henle, proximal convoluted tubule, distal convoluted tubule
d. proximal convoluted tubule, loop of Henle, distal convoluted tubule
e. distal convoluted tubule, proximal convoluted tubule, loop of Henle.
Answer: D
The renal tubule regions start from renal corpuscle, proximal convoluted tubule, loop of Henle, and to
distal convoluted tubule.

10. Pepper, who is drinking beer at a party, falls and hits her head on the ground. Her friend Orah dials
“911” because Pepper is unconscious, depressed ventilation (shallow and slow respirations), rapid
heart rate, and is profusely bleeding from both ears. Which primary acid-base imbalance is Pepper at
risk for if medical attention is not provided?
a. Metabolic Acidosis c. Respiratory Acidosis
b. Metabolic Alkalosis d. Respiratory Alkalosis
Answer: C
One of the risk factors of having respiratory acidosis is hypoventilation which may be due to brain trauma,
coma, and hypothyroidism or myxedema. Other risk factors include COPD, respiratory conditions such as
pneumothorax, pneumonia and status asthmaticus. Drugs such as morphine and MgSO 4 toxicity are also
risk factors of respiratory acidosis.

Session 23

1. The male gonads have both sperm-producing and testosterone-producing functions and are called
_________.
a. testes d. ovum
b. sperm e. gametes
c. ovaries
Answer: A
Testes are divided into lobules containing the seminiferous tubules that consist of interstitial cells that
secrete testosterone, germ cells where the sperm cells begin, & sustentacular cells that nourish the germ
cells and produce a number of hormones.

2. The actual "sperm-forming factories" of male reproductive system that empty sperm into the rete
testes are called the:
a. interstitial cells d. bulbourethral glands
b. epididymis e. seminiferous tubules
c. ductus deferens
Answer: E
Seminiferous Tubules contain within lobules which serve as a site of sperm cell development. This is the
actual ‘sperm-forming factories’ of male reproductive system that empty sperm into the rete testis.

3. Androgens such as testosterone are produced by the:

a. seminiferous tubules c. epididymis
b. interstitial cells d. bulbourethral glands
Answer: B
Interstitial Cells or also known as Leydig Cells secrete testosterone.

4. The correct descending order of the male duct system (from inside to outside) is:
a. epididymis, ductus deferens, urethra, ejaculatory duct
b. ejaculatory duct, epididymis, ductus deferens, urethra
c. ductus deferens, epididymis, ejaculatory duct, urethra
d. epididymis, ductus deferens, ejaculatory duct, urethra
e. ejaculatory duct, ductus deferens, epididymis, urethra
Answer: D
The descending order of the male duct system: starting from seminiferous tubules, rete testis, efferent
ductules, epididymis, ductus deferens, ampulla of ductus deferens, ejaculatory duct, prostatic urethra,
membranous urethra, spongy urethra, exiting to external urethral orifice.

5. Which of the following is true regarding the spermatic cord? (Select all that apply)
a. it is a connective tissue sheath d. it contains nerves
b. it encloses the ductus deferens e. it contains blood vessels
c. it encloses the epididymis
Answer: ABDE
All are true statements pertaining to spermatic cord, except option C. The epididymis is enclosed by a two
layered pseudostratified epithelium. The epithelium is separated by a basement membrane from the
connective tissue wall which has smooth muscle cells.

6. The middle part of the male urethra that extends from the prostate to the penis is called the:
a. prostatic urethra d. penile urethra
b. membranous urethra e. bulbourethral
c. spongy urethra
Answer: B
The urethra is divided into three parts: first part is prostatic urethra which passes through the prostate
gland, middle part is the membranous urethra which passes through the floor of pelvis & surrounded by
external urinary sphincter and the end part is the spongy urethra which extends the length of penis &
opens at its end.

7. All are considered components of semen: (Select all that apply)

a. sperm d. bulbourethral fluid
b. seminal fluid e. epididymal fluid
c. prostatic fluid
Answer: ABCD
Semen is a mixture of sperm cells, seminal vesicles secretions, prostatic fluid, and the mucus from
bulbourethral glands.

8. The milky-colored fluid secreted from the prostate glands is intended to:
a. nourish sperm d. neutralize urine
b. activate sperm e. are endocrine only
c. cleanse the urethra
Answer: B
The prostatic fluid has several functions: regulation of pH and liquefy the coagulated semen through
proteolytic enzymes for the sperm cells to be released and be able to swim to the oocyte.

9. Pregnancy is generally improbable with a sperm count:

a. under 20,000 per milliliter d. under 20 million per milliliter
b. under 1 million per milliliter e. under 100 million per milliliter
c. under 5 million per milliliter
Answer: D
The most common cause of infertility in males is a low sperm cell count. If the sperm cell count drops to
below 20 million sperm cells per mL, the male is usually sterile.

10. Pepper has been reviewing the process of spermatogenesis for their upcoming examinations. As a
student nurse, which of the following is not true regarding this phase in male reproductive system?
a. Spermatogenesis is sperm production that begins at birth and continues through puberty.
b. The process is begun by primitive stem cells called spermatogonia.
c. During puberty, FSH causes each division of spermatogonia into one stem cell (type A cell)
and one type B cell that becomes a primary spermatocyte.
d. The primary spermatocytes undergo meiosis to secondary spermatocytes, which then form
four spermatids.
e. The spermatids streamline and a tail is formed during spermiogenesis, after which they are
mature enough to fertilize an ovum and are called sperm.
Answer: A
Spermatogenesis is sperm production that begins during puberty and continues throughout life. The
process is begun by primitive stem cells called spermatogonia. From birth until puberty, spermatogonia
undergo mitotic division to increase the number of stem cells. During puberty, FSH causes each division
of spermatogonia into one stem cell (type A cell) and one type B cell that becomes a primary
spermatocyte. The primary spermatocytes then undergo meiosis to secondary spermatocytes, which then
form four spermatids. The spermatids streamline and a tail is formed during spermiogenesis, after which
they are mature enough to fertilize an ovum and are called sperm.

11. The hormone responsible for ovulation is _________.

a. test estrogen d. luteinizing hormone
b. progesterone e. adrenocorticotropic hormone
c. follicle-stimulating hormone
Answer: D
During ovulation, the oocyte is released due to follicle-stimulating hormone (FSH).

12. The menstrual cycle is:

a. 7 days long c. 28 days long
b. 14 days long d. 40 days long
Answer: C
The average menstrual cycle is 28 days (short as 18 days & long as 40 days) and results from cyclical
changes that occur in endometrium.

13. Which of the following are events that occur during the proliferative state of menstrual cycle? (Select
all that apply)
a. it is stimulated by rising estrogen levels
b. the basal layer of the endometrium regenerates
 c. glands are formed in the endometrium
d. endometrial blood supply is increased
e. the endometrium becomes thin and shiny in appearance
Answer: ABCD
All are correct events that occur during the proliferative state of menstrual cycle, except for option E. The
endometrium of this event is thickened, in preparation for the ovulation.

14. Which one of the following is NOT one of the secondary sex characteristics in young women?
a. enlargement of the accessory d. decreased fat deposits beneath the
organs of reproduction skin
b. breast development e. widening and lightening of the pelvis
c. appearance of axillary and pubic
hair
Answer: D
All are secondary sex characteristics in young women, except option D. Adipose tissue is deposited in the
breasts and around the hips, causing them to enlarge and assume adult form.

15. The corpus luteum is a special glandular structure of the ovaries that primarily produces:
a. estrogen d. interstitial cell-stimulating hormone
b. progesterone e. luteinizing hormone
c. testosterone
Answer: B
Following ovulation, the granulosa cells divide rapidly and enlarge to form the corpus luteum that releases
progesterone.

16. The release of estrogen from the ovaries stimulates the release of GnRH from:
a. the ovaries. d. the hypothalamus.
b. the corpus luteum. e. the anterior pituitary and the
c. the anterior pituitary. hypothalamus
Answer: B
Gonadotropin-Releasing Hormone (GnRH) is a hormone released by hypothalamus to trigger the anterior
pituitary gland to secrete LH and FSH.

17. When a primary follicle enlarges, and there are several layers of granulosa cells, it is called a:
a. primordial follicle. c. secondary follicle.
b. primary follicle. d. mature follicle.
Answer: C
A secondary follicle forms when fluid-filled vesicles develop and theca cells arise on the outside of the
follicle. This is produced just before the ovulation, when the primary oocyte completes the first meiotic
division.

18. The ovary is attached to the superior margin of the uterus by the:
a. mesovarium. c. ovarian ligament.
b. broad ligament. d. suspensory ligament.
Answer: C
Suspensory ligament extends from each ovary to lateral body. Ovarian ligament attaches the ovary to the
superior margin of the uterus. Broad ligament spreads out on both sides of the uterus and attaches to the
ovaries and uterine tubes. Mesovarium folds in the peritoneum where the ovaries are attached.

19. Trace the pathway of an egg as it passes through the uterine tube.
(1) ampulla (3) infundibulum
(2) fimbriae (4) isthmus
a. 1, 2, 3, 4 c. 3, 4, 1, 2
b. 2, 4, 1, 3 d. 2, 3, 1, 4
Answer: D
A mature egg travels from the fimbriae, to infundibulum, to ampulla, and finally to the isthmus of the
uterine tube.

20. Pepper has been trying to recognize the events occurring in female sex act. Which of the following
are included? (Select all that apply)
a. The labia become smaller
b. Steroids such as progesterone are converted to androgens
c. Mucus-like fluid is secreted into the vagina
d. Motor action potentials are conducted from the spinal cord to the reproductive organs by both
sympathetic and parasympathetic fibers
Answer: BCD
All events are happening during the sexual act, except for option A. The labia becomes larger from the
engorgement of blood.

11