Exam 4: HESI-A2-Reading

Vaping Electronic cigarettes, or e-cigarettes, are electronic devices that provide users with the same nicotine "fix" that they would receive from a traditional cigarette. However, e-cigarettes do not burn tobacco, and thus do not produce the same toxic chemicals as traditional cigarettes. For this reason, many believe that using e-cigarettes (also known as "vaping") is a safe alternative to smoking tobacco. This perception has turned vaping into a billion-dollar industry and has made vaping extremely popular, especially among adolescents. However, even though e-cigarettes do not produce tobacco smoke, they are still not completely safe. E-cigarette vapor contains a variety of toxic chemicals, including formaldehyde and acetaldehyde. Although they are harmless in small amounts, there have not been any studies of the dangers of long-term exposure to these chemicals. Furthermore, the nicotine in e-cigarettes is just as addictive as the nicotine in traditional cigarettes. Withdrawal symptoms from nicotine deprivation include mood swings, anxiety, and changes in appetite. Exposure to nicotine can also be dangerous for people with cardiovascular problems. While vaping may be better for you than smoking traditional cigarettes, more research needs to be done before e-cigarettes can be considered completely safe. People-especially adolescents-should be wary of getting hooked on these "harmless" cigarettes. Question: What is the primary purpose of the passage?

Trans fats Trans fats are unsaturated fats found in many processed foods. Though their prevalence makes them a part of many people's diet, excessive consumption of trans fats can lead to a variety of serious health problems. Certain trans fats are found naturally in some animal products, such as beef and milk. However, the main source of trans fats for many people is processed foods. Partially hydrogenated vegetable oils are trans fats that are often found in shortening, packaged baked goods, and fried foods. Restaurants and food manufacturers often choose to use partially hydrogenated oils because they are less expensive, have longer shelf lives, and require less refrigeration than non-hydrogenated oils. Although trans fats may be less expensive for food manufacturers to use, and thus cheaper for consumers to purchase, excessive intake of these substances can cause significant health risks. Like saturated fat, trans fat raises the level of LDL ("bad") cholesterol in the body. Unlike saturated fat, however, trans fat also lowers the amount of HDL ("good") cholesterol in the body. Therefore, trans fat has a far more negative overall effect on cholesterol levels in the human body than saturated fat. Studies have also linked the consumption of trans fats to increased risk of heart disease, diabetes, obesity, cancer, liver dysfunction, depression, and memory disorders. According to the text, which is true regarding the relationship between saturated fat and trans fat?

Dissociative Identity Disorder Dissociative Identity Disorder (DID), formerly called multiple personality disorder, is a severe psychological condition in which two or more distinct identities are present in an individual. There has been a dramatic increase in the number of diagnosed cases of  DID in the past 30 years. There has also been an increase in the number of different personalities reported, as well as more unusual personalities. This may be due to an increased awareness of the disease among clinicians. However, it might also be because there have been so many sensational portrayals of DID in popular media. Some believe that people fake the disorder in order to absolve themselves of guilt or gain attention. However, there is a good deal of research that suggests that DID is a legitimate illness. One of the strongest pieces of evidence is the fact that it is found all over the world. There have been cases of DID reported in cities and villages across Turkey, Nigeria, Ethiopia, China, and India, among other places. It is unlikely that people living in rural or remote places have been influenced by portrayals of DID in films or television shows. Others argue that DID is the creation of overzealous clinicians who (unwittingly) induce highly suggestible clients to believe they have multiple personalities. These clinicians encourage clients to "bring out" the other personalities during hypnosis and reward them with praise for doing so, which then makes the clients more likely to believe that the other personalities are real. If this is the case, it may not be a "genuine" illness in that the clinicians have created it, but is this any different than a "genuine" mental illness that is fostered by other people's influences on a client's life?  No matter what has caused the illness, it causes significant distress to the client, and therefore must be treated as a serious and "genuine" problem. Question: What is the author's purpose in writing this passage?

Diabetes There are two types of diabetes: Type 1 and Type 2. Both types of diabetes can cause a variety of serious health risks if left untreated. Some of these health problems include kidney disease, blindness, heart disease, and strokes. About 5-10% of people with diabetes have Type 1 diabetes. Type 1 diabetes most commonly develops in young people. In Type 1 diabetes, the immune system destroys the cells in the pancreas that secrete insulin. Without insulin, the body's cells cannot absorb glucose, and thus cannot produce energy. Symptoms appear after about 90% of the cells have been destroyed. Although most cases of Type 1 diabetes are genetic, some have arisen in people who have had viral infections of the pancreas. Most people who have diabetes (90-95%) have type 2 diabetes, which most commonly develops in people over age 40. Type 2 diabetes results from the inability of tissues to respond to insulin-a condition called insulin resistance. As Type 2 diabetes progresses, the pancreas produces less and less insulin, resulting in a condition called insulin deficiency. There is no cure for either Type 1 or Type 2 diabetes. However, there are ways to manage both types. For Type 1 diabetes, treatment requires receiving regular insulin injections. Type 2 diabetes can also be treated with insulin injections, but can be also be managed with lifestyle changes, such as weight loss, exercise, and reducing intake of carbohydrates. What is the author's purpose in writing the passage?

Basketball Ankle Injury Treatments Basketball players are more likely than any other sports players to injure their ankles. The most common ankle injuries among basketball players are inversion (turning inward) and eversion (turning outward) of the ankle. The sharp twists, frequent running, constant jumping, and sudden stopping associated with basketball put tremendous pressure on a player's ankle joint. The two main ways that players and trainers try to treat and prevent these injuries are taping and bracing. Taping simply involves wrapping special tape snugly around the ankle joint. Although it is simple to apply, there are some drawbacks. Taping is not very expensive when used once, but when used throughout the season, taping is three times more costly than bracing. Taping also loosens with physical activity; after only ten minutes of exercise, the tape will become 50% looser. After one hour of exercise, taping offers no significant support whatsoever. Bracing has proven to be more effective than taping in a number of different studies. It is also much more cost effective  throughout a season. Several types of ankle braces are available for use, ranging from cloth lace-on braces to more rigid plastic braces. Braces decrease the range of motion of the ankle more than taping does, and, therefore, help to prevent future ankle injuries. However, despite the benefits of ankle braces over ankle tape, many players find that braces restrict movement capabilities and also cause discomfort. What can be inferred from the text?

Garlic Breath Anyone who has ever had a delicious piece of garlic bread knows that there is a price to pay for eating it: the dreaded garlic breath. What makes garlic so good at making your breath smell so bad? The main culprit is a compound called allyl methyl sulfide. As your body digests the garlic, the sulfide is released into your bloodstream. From there, it travels through your body until it is eliminated through your digestive system, your urine, or out of your pores. However, some of the allyl methyl sulfide also crosses from the bloodstream into the air that fills your lungs. As you breathe this air out, the garlic smell goes with it. This is why no matter how many pieces of gum you chew, how often you brush your teeth, or how much mouthwash you swish, a garlicky meal can give you stinky breath for days. Recent research shows that the best way to combat the effects of garlic on your breath is to eat a raw apple or some raw mint leaves while you consume garlic. Both apples and mint leaves contain polyphenolic compounds that can neutralize the allyl methyl sulfides in garlic. Question: Which of these is NOT included in the text as a way that the body eliminates sulfide from garlic?

Lactose Intolerance Lactose intolerance is the inability to digest a sugar called lactose in milk and other dairy products. Adults in most of the world are lactose intolerant, although infants are not. This is because many adults lack an enzyme known as lactase. Lactase, which can be found in cells in the intestine, is the enzyme that breaks down lactose. Many individuals lose the ability to synthesize lactase after age six. However, not everyone does. Whether or not the body continues to produce lactase often depends on ethnicity. While only 5-15% of adults of European descent cannot digest lactose, 80-90% of adults of African and Asian descent are lactose intolerant. Research has shown that people of northern European ancestry contain a genetic mutation that allows the secretion of lactase in adulthood. The main symptom of lactose intolerance is gastrointestinal upset. Lactose intolerant people may experience diarrhea, bloating, abdominal pain, gas, and vomiting after consuming lactose-containing foods and beverages. Although there has been some research into gene therapy as a treatment for lactose intolerance, the current best treatment is either ingesting lactase supplements when consuming dairy products or simply avoiding foods containing lactose altogether. Question: Which of the following can be inferred, based on information found in the passage?

DNA analysis Modern forensics-science used in investigating crimes-relies heavily on DNA evidence. Nearly every cell in our bodies contains DNA, the molecule that carries our genetic information. Aside from identical twins, no two human beings have the exact same DNA. Because DNA is present in our hair, blood, skin, and saliva, we leave traces of our DNA just about everywhere we go. Forensic investigators collect and analyze DNA evidence left at crime scenes to identify criminals. On television, this process is quick and conclusive. In real life, however, it is much more complicated. If the material found at the crime scene is too small, too old, or has otherwise been damaged, analyzing the DNA can be difficult. Furthermore, if the sample came from teeth, hair, or bones, it must undergo a different type of analysis called mitochondrial DNA analysis, which uses DNA from a cell's mitochondria instead of the nucleus. Matching mitochondrial DNA is often more difficult than nuclear DNA. Furthermore, forensic experts never suggest that DNA evidence is concrete proof of a suspect's guilt. Forensic science is rooted in probability, not certainty. When the DNA of a suspect is found at a crime scene, it means that the suspect was likely to have been present at the crime scene, but it does not definitively indicate that he or she was guilty of a crime. Question: What is the main idea of the passage?

Hiccups At some point in your life, you have probably had the hiccups. Hiccups are caused by spasms in the diaphragm, a muscle located at the bottom of your chest. As we inhale, the diaphragm contracts, pulling air into the lungs. As we exhale, the diaphragm relaxes, pushing air back out through the mouth and nose. When we hiccup, the diaphragm jerks downward suddenly, pulling a quick burst of air into our lungs. As the air rushes into your body, it hits the voice box. This causes your vocal cords to snap shut, creating the sound we recognize as a hiccup. Hiccups can be triggered by many different things-eating too much, drinking too fast, sudden change of temperature, stress, fatigue, nervousness, and even excessive laughter can all cause the hiccups. While there are many home remedies for hiccups, there is no evidence to suggest that any of them are actually effective. In fact, most cases of the hiccups go away on their own. Although hiccups are usually harmless, they can be a sign of something more serious. Long-term hiccups might be a result of damage to the nerves that serve the diaphragm muscle. Persistent hiccups might also be caused by certain central nervous system disorders, traumatic brain injuries, drug abuse, or kidney disease. Question: What is the best summary of the passage?

PTSD in Female Veterans Post-traumatic stress disorder (PTSD) is a severe anxiety disorder that affects millions of people around the world. Individuals can develop PTSD after experiencing any event that results in psychological trauma. Symptoms of PTSD involve flashbacks to the traumatic event, nightmares, obsessive behavior, anger, insomnia, difficulty concentrating, and hypervigilance. Individuals who suffer from PTSD can experience significant difficulties in social relationships, have lower self-esteem, and have trouble maintaining employment. People with PTSD experience a higher risk of committing suicide and developing a substance abuse disorder. Although PTSD can affect any individual, military veterans are especially susceptible. Furthermore, within this population, women are more than twice as likely as men to develop PTSD. Although studies investigating precisely why women are more likely than men to experience PTSD have not yet been completed, some experts have theorized that low unit cohesion is a major factor. Unit cohesion, defined as the mutual bonds of friendship and support among members of a military unit, is thought to be helpful in reducing the incidence of developing PTSD. Women are more likely than men to experience low unit cohesion for a variety of reasons. One of the most obvious factors is the relative lack of females in the military; currently, women make up only 20% of the armed forces. Pervasive male prejudice against women is another factor that can diminish unit cohesion for female soldiers. Perhaps the biggest impediment to achieving quality treatment for women suffering from wartime PTSD is a shortage of research. While both the VA and independent agencies have completed hundreds of studies researching the prevention of and treatment for PTSD amongst general military populations, there have been no studies completed that solely target women. More must be done to help women who have sacrificed so much for their country. Question: What is the author's purpose in writing this passage?

Balance Everyone knows that your ears are responsible for your sense of hearing. But did you also know that your ears are also partially responsible for your sense of balance? Your inner ear contains something called the vestibular system, which is a key component in your body's ability to establish and maintain balance. The vestibular system mainly consists of three semicircular canals. Each semicircular canal has a different orientation, allowing them to detect a variety of movements. The canals are filled with a fluid called endolymph. When you move your head, the fluid in the canals also moves; this movement sends signals to the brain about the position of your head. Your brain uses this information to help your body stay balanced. Damage to the vestibular system caused by disease or injury can severely affect a person's balance. Consuming too much alcohol can also temporarily affect the vestibular system. Because alcohol thins the blood, it also changes the viscosity of the endolymph. The thinned-out endolymph sends signals to your brain that your body is rotating even though it is not. This is why many people feel like the room is spinning when they are drunk. According to the text, which of these is true regarding the semicircular canals?

Father of Surgery Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi, also known as Albucasis, is considered by many people to be the "Father of Modern Surgery." Al-Zahrawi was born in Spain in 936 CE, a time when Spain was part of the Islamic empire. One of Al-Zahrawi's greatest contributions was the Kitab al-Tasrif, a 30-volume encyclopedia of medical information. The Kitab al-Tasrif took Al-Zahrawi over 50 years to complete. It contains information about a wide variety of illnesses, injuries, medical conditions, treatments, and surgical procedures. His book includes discussions of dentistry, obstetrics, ophthalmology, urology, and cranial surgery, among many others. He even provides illustrations for over 200 different surgical instruments. In the Kitab, Al-Zahrawi presents the first description of ectopic pregnancy and provides the first evidence that hemophilia is a genetic condition. Surgeons continued to use the information in the Kitab al-Tasrif well into the 1700s. In fact, some of Al-Zahrawi's practices are still being used to this very day. For example, Al-Zahrawi developed a technique to treat gynecomastia (enlarged breast tissue) in men that is still in practice today. Finally, the Kitab also includes something vital for all modern practitioners to keep in mind: a reminder that patients are human beings who must be treated regardless of their wealth or social status. Question: Which supporting detail is an example of an opinion, rather than factual information?

Autism and Vaccines Autism spectrum disorders (ASD) are a range of psychological conditions characterized by challenges with social interaction, behavior, speech, and nonverbal communication. While there is no general consensus among medical professionals about the underlying causes of ASD, theories range from genetic inheritance to environmental factors. One of the most controversial theories to have emerged in recent times is that ASD could be caused by the MMR [mumps, measles, rubella] vaccine that was first developed in the 1960s. The vaccine is a mixture of three live viruses and is administered via injection to children when they are one year old. By the late 1990s, this vaccination had led to the near-eradication of measles in countries that employed widespread inoculation. However, a combination of spurious scientific data and alarmist media attention led to an entirely preventable resurgence in measles cases in the early 21^st century. The first claims of a connection between the MMR vaccine and autism were made in 1998, when an article in The Lancet, a respected British medical journal, reported on eight cases of autism that could possibly be traced back to the administration of an MMR vaccine. An onslaught of media coverage followed the publication of this article. The popular press quickly seized upon this story; in 2002, over 1200 articles were written about the link between MMR vaccines and ASD. Less than 30% of these articles, however, mentioned that an overwhelming amount of scientific evidence suggested that these vaccinations were completely safe. Question: Which of the following is NOT true about ASD according to the passage?

Basketball Ankle Injury Treatments Basketball players are more likely than any other sports players to injure their ankles. The most common ankle injuries among basketball players are inversion (turning inward) and eversion (turning outward) of the ankle. The sharp twists, frequent running, constant jumping, and sudden stopping associated with basketball put tremendous pressure on a player's ankle joint. The two main ways that players and trainers try to treat and prevent these injuries are taping and bracing. Taping simply involves wrapping special tape snugly around the ankle joint. Although it is simple to apply, there are some drawbacks. Taping is not very expensive when used once, but when used throughout the season, taping is three times more costly than bracing. Taping also loosens with physical activity; after only ten minutes of exercise, the tape will become 50% looser. After one hour of exercise, taping offers no significant support whatsoever. Bracing has proven to be more effective than taping in a number of different studies. It is also much more cost effective throughout a season. Several types of ankle braces are available for use, ranging from cloth lace-on braces to more rigid plastic braces. Braces decrease the range of motion of the ankle more than taping does, and, therefore, help to prevent future ankle injuries. However, despite the benefits of ankle braces over ankle tape, many players find that braces restrict movement capabilities and also cause discomfort. Based on information in the text, what is NOT described as a drawback to taping?

Lactose Intolerance Lactose intolerance is the inability to digest a sugar called lactose in milk and other dairy products. Adults in most of the world are lactose intolerant, although infants are not. This is because many adults lack an enzyme known as lactase. Lactase, which can be found in cells in the intestine, is the enzyme that breaks down lactose. Many individuals lose the ability to synthesize lactase after age six. However, not everyone does. Whether or not the body continues to produce lactase often depends on ethnicity. While only 5-15% of adults of European descent cannot digest lactose, 80-90% of adults of African and Asian descent are lactose intolerant. Research has shown that people of northern European ancestry contain a genetic mutation that allows the secretion of lactase in adulthood. The main symptom of lactose intolerance is gastrointestinal upset. Lactose intolerant people may experience diarrhea, bloating, abdominal pain, gas, and vomiting after consuming lactose-containing foods and beverages. Although there has been some research into gene therapy as a treatment for lactose intolerance, the current best treatment is either ingesting lactase supplements when consuming dairy products or simply avoiding foods containing lactose altogether. Question: Which of the following is true about lactose intolerance?

Lyme Disease Lyme disease is caused by ticks. More specifically, Lyme disease is caused by Borrelia bacteria, which are carried by ticks. When ticks infected with this bacteria bite humans, the bacteria can be transmitted into the bloodstream, causing an illness known as Lyme disease. The symptoms of Lyme disease include fever, headache, fatigue, and joint and muscle pain. One of the most noticeable signs is a rash that looks like a series of red rings radiating out from the bite. This usually appears a week after the tick bite. However, not everyone with Lyme disease gets this rash. The good news is that Lyme disease can be treated with antibiotics. Most people recover quickly and fully. However, if Lyme disease is not treated properly, patients can suffer from debilitating symptoms weeks, months, and even years after the bite. This condition is known as post-treatment Lyme disease (PTLD) or chronic Lyme disease (CLD). To protect yourself from Lyme disease, always cover your skin with clothing or insect repellent when hiking or camping. If you get bitten by a tick, remove the tick right away; most cases of Lyme disease require the tick to be attached for 36 to 48 hours. If red rings appear, see a doctor right away. Lyme disease can be harmful, but it is preventable and treatable with early intervention. Question: Which detail supports the idea that most people recover quickly from Lyme disease?

Concussions Concussions are brain injuries that occur when a person receives a blow to the head, face, or neck. Although most people who suffer a concussion experience initial bouts of dizziness, nausea, and drowsiness, these symptoms often disappear after a few days. The long-term effects of concussions, however, are less understood and far more severe. Recent studies suggest that people who suffer multiple concussions are at significant risk for developing chronic traumatic encephalopathy (CTE), a degenerative brain disorder that causes a variety of dangerous mental and emotional problems to arise weeks, months, or even years after the initial injury. These psychological problems can include depression, anxiety, memory loss, inability to concentrate, and aggression. In extreme cases, people suffering from CTE have even committed suicide or homicide. The majority of people who develop these issues are athletes who participate in popular high-impact sports, especially football. Improvements in diagnostic technology have provided substantial evidence to link severe-and often fatal-psychological disorders to the head injuries players receive while on the field. Recent autopsies performed on the brains of football players who have committed suicide have shown advanced cases of CTE in every single victim. In response to the growing understanding of this danger, the National Football League (NFL) has revised its safety regulations. There is hope that these new regulations, coupled with advances in helmet design, will reduce the number of concussions player endure, and thus curb the number of CTE cases. Efforts by the NFL and other professional sports leagues are certainly laudable. However, new regulations at the professional level cannot protect amateur players, especially young people. Fatal cases of CTE have been reported in victims as young as 21. With appropriate equipment and form, tackling need not be dangerous. Proper tackling form-using the arms and shoulders to aim for a player's midsection rather than leading with the top of the head-should be taught at an early age. Youth, high school, and college leagues should also adopt safety rules even more stringent than the NFL's. Question: Which best explains the author's opinion regarding the National Football League's (NFL) response to concussion dangers?

Placebos A placebo is any kind of drug, procedure, or treatment that does not have legitimate medicinal properties. Placebos do not contain any sort of active ingredient meant to treat an illness or injury. Placebo pills, for example, might be made out of sugar or corn starch. However, even though placebos contain no medicine whatsoever, people who take them often experience reactions that cannot possibly be triggered by the substances in the pills themselves. This is known as the placebo effect. In one study of the placebo effect, volunteers were given a starch pill and told that it was a stimulant similar to caffeine. These volunteers reported feeling more alert and slightly jittery. They also showed an increased heart rate and a spike in blood pressure. Researchers then gave the exact same placebo pill to a different group of people, this time telling them that it was a depressant. The second group of participants reported feeling drowsy and sluggish, and showed a reduced heart rate and lowered blood pressure. Researchers use placebos to evaluate the effectiveness and possible side effects of new drugs. For example, during a study for a drug to treat depression, half of the participants might be given the actual drug while the other half are given a placebo. None of the participants know whether or not they are taking the real drug or the placebo. Researchers can then compare the results between the two groups to determine whether or not the drug produces the desired results and examine the side effects. Question: Based on the passage, which of these is true?

Garlic Breath Anyone who has ever had a delicious piece of garlic bread knows that there is a price to pay for eating it: the dreaded garlic breath. What makes garlic so good at making your breath smell so bad? The main culprit is a compound called allyl methyl sulfide. As your body digests the garlic, the sulfide is released into your bloodstream. From there, it travels through your body until it is eliminated through your digestive system, your urine, or out of your pores. However, some of the allyl methyl sulfide also crosses from the bloodstream into the air that fills your lungs. As you breathe this air out, the garlic smell goes with it. This is why no matter how many pieces of gum you chew, how often you brush your teeth, or how much mouthwash you swish, a garlicky meal can give you stinky breath for days. Recent research shows that the best way to combat the effects of garlic on your breath is to eat a raw apple or some raw mint leaves while you consume garlic. Both apples and mint leaves contain polyphenolic compounds that can neutralize the allyl methyl sulfides in garlic. Question: Based on the text, which is true regarding the relationship between polyphenolic compounds and allyl methyl sulfides?

DNA analysis Modern forensics-science used in investigating crimes-relies heavily on DNA evidence. Nearly every cell in our bodies contains DNA, the molecule that carries our genetic information. Aside from identical twins, no two human beings have the exact same DNA. Because DNA is present in our hair, blood, skin, and saliva, we leave traces of our DNA just about everywhere we go. Forensic investigators collect and analyze DNA evidence left at crime scenes to identify criminals. On television, this process is quick and conclusive. In real life, however, it is much more complicated. If the material found at the crime scene is too small, too old, or has otherwise been damaged, analyzing the DNA can be difficult. Furthermore, if the sample came from teeth, hair, or bones, it must undergo a different type of analysis called mitochondrial DNA analysis, which uses DNA from a cell's mitochondria instead of the nucleus. Matching mitochondrial DNA is often more difficult than nuclear DNA. Furthermore, forensic experts never suggest that DNA evidence is concrete proof of a suspect's guilt. Forensic science is rooted in probability, not certainty. When the DNA of a suspect is found at a crime scene, it means that the suspect was likely to have been present at the crime scene, but it does not definitively indicate that he or she was guilty of a crime. Question: Which of the following best reflects the author's opinion of DNA forensics?