Exam 4: HESI-A2-Reading

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 relatively 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 the women who have sacrificed so much for their country. Question: Which of the following best describes the author's opinion?

Wrinkles Skin wrinkles are caused by a variety of factors. Some of these factors are intrinsic, meaning that you cannot control them because they occur naturally. Others are extrinsic, meaning that they are caused by circumstances outside of the body. One intrinsic factor is aging. As you age, your skin loses collagen, which is the protein responsible for keeping your skin elastic. With less collagen, your skin becomes thinner and more fragile. Aging also reduces the functioning of sweat and oil glands, which work to keep the skin looking smooth. You also lose fat in the deeper layers of your skin as you age. This fat loss causes your skin to sag and develop deeper wrinkles. The two most common extrinsic factors are exposure to ultraviolet radiation (UV rays) and smoking. UV rays in sunlight break down your skin's connective tissue and collagen fibers. To prevent the appearance of wrinkles (as well as protect yourself from skin cancer), you should always use UV-blocking sunscreen. The nicotine in cigarettes is the most likely link between smoking and wrinkles. Nicotine narrows the blood vessels, reducing the blood supply to your skin tissue. This deprives your skin of oxygen and important nutrients, causing damage that contributes to wrinkles. Question: According to the text, what can be inferred from skin that has gone through the aging process?

Dreams The average adult spends almost two full hours every night dreaming. Dreams mainly occur during a period known as REM (Rapid Eye Movement) sleep. While you are in REM sleep, your brain is very active-almost as active as if you were awake. The fact that we dream most often during REM sleep is one of the very few facts about dreams that every scientist agrees on. Scientists do not know exactly which portion of the brain creates dreams or even why we have them in the first place. One theory about their purpose is that dreaming helps the brain to organize and store memories. As your body relaxes, your brain processes all of the information it received during the day. While you sleep, your brain organizes the information into memories; your mind perceives this process as dreaming. Because your mind works differently when you are asleep than it does when you are awake, your dreams may seem confusing, illogical, or just downright silly. Another theory is that dreams allow your mind to work out difficult problems that you encounter while you are awake. The unrealistic, free-flowing nature of dreams allows your mind to consider the problems in creative ways that you would likely never think of during your waking hours. Still, other scientists believe that dreams are random events with no real function. According to this theory, there is no actual reason for dreaming-it is simply what happens when you go to sleep. As you can see, there is no scientific consensus about how or why we dream. There are many different theories, but no proven answers. Until then, you might as well just enjoy the fantastic nighttime adventures you get to go on without ever leaving your bed. What is the author's purpose in writing this passage?

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. What is the author's purpose in writing this passage?

Your Bones At birth, the human body contains over 270 bones. However, as the body grows, some of these bones fuse together. The average adult body contains 206 bones. Together, these bones form the skeleton. The skeleton has many vital functions, including protecting internal organs, providing support, enabling movement, generating blood cells, storing calcium, and helping to regulate the endocrine system. Although we only have one skeleton, it is divided into two major regions: the axial and the appendicular skeletons. The former refers to everything on the body's middle axis, such as the skull, sternum, and vertebrae, while the latter refers to the bones that make up the arms, legs, pelvis, and shoulder girdle. These bones include the femur, the tibia, the ulna, and the radius. Bones are further classified according to their shape and function. The five classifications of bones are: long, short, flat, irregular, and sesamoid bones. Long bones include the fibula and tibia. The carpal bones in the wrist are examples of short bones. Flat bones are thin and curved, and include the ribs, the sternum, and some skull bones. Irregular bones, such as the vertebrae and some facial bones, have complex shapes. Finally, sesamoid bones are small, round bones that form in tendons. There are sesamoid bones in the hands, wrists, and feet, but the most familiar sesamoid bone is the patella, or kneecap. Question: Which of these is NOT a function of the skeleton?

Preventing Heart Disease Heart disease is a life-threatening condition that kills millions of people every year. In fact, heart disease is the number one killer of human beings worldwide; over thirty percent of deaths every year are due to some form of cardiovascular disease. Although there are many different types of medications and surgical procedures that can treat heart disease, prevention is the most important factor in reducing the number of deaths. Proper nutrition is important in preventing heart disease. The recommended diet for a healthy heart is low in saturated fats, cholesterol, salt, and refined sugar. The diet should be high in fiber, whole grains, fruits, and vegetables. Smoking and excessive alcohol consumption should be avoided. Smoking increases the risk for heart disease at least ten-fold, and drinking too much alcohol can raise the levels of some fats in the blood and lead to high blood pressure and increase the risk of cardiovascular damage. Lack of physical exercise can also make a person more likely to suffer from heart disease. Participating regularly in aerobic exercise, which can include walking, jogging, dancing, or swimming significantly reduces the risk of heart disease. Another contributor to heart disease is stress. Constant stress can expose your body to persistently elevated levels of the stress hormones cortisol and adrenaline. High levels of these hormones can increase blood pressure and damage artery walls. Engaging in yoga, meditation, or other relaxation techniques can be helpful in reducing stress and lowering the risk of heart disease. Question: What is the best summary of the passage?

Sports Drinks When you sweat heavily, your body loses electrolytes and water. The most important electrolytes are potassium and sodium-these substances keep your body's cells working properly. Commercials for sports drinks claim that their products will replenish the electrolytes lost during exercise. However, sports drinks are not really necessary for most people. Eating a normal diet that contains healthy amounts of sodium and potassium will maintain the electrolyte balance in your body. Unless you are exercising very intensely for more than 60 minutes, you do not need to use a sports drink to replace lost electrolytes. Most people believe that sports drinks are healthy beverages-after all, if athletes drink them, they must be good for you. On the contrary, sports drinks are filled with artificial ingredients and sugar. One 20-ounce bottle of an average sports drink contains 34 grams of sugar and 130 calories. These empty calories can actually cause you to gain weight instead of helping to keep you fit. One study presented at the 2012 Obesity Society's annual scientific meeting revealed that teenagers gained an average of 3.5 pounds every two years just by consuming a bottle of sports drink every day. The best beverage for you to drink before, during, or after a workout is water. Water has no sugar, no salt, no calories, and no artificial flavors or colors. Water will rehydrate your body and quench your thirst better than any other drink. Unless you are a serious athlete who regularly exercises for more than 60 minutes at a time, sports drinks ultimately do more harm than good. Question: What does the author suggest as a reason why most people believe that sports drinks are healthy?

Lyme Disease Lyme disease is caused by ticks. More specifically, Lyme disease is caused by Borrellia 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 of the following is NOT true regarding protection from Lyme disease?

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 author's purpose in writing this passage?

GMOs GMOs, or genetically modified organisms, are organisms whose genes have been altered in laboratories. Scientists modify the genetic codes of plants or animals by inserting copies of desirable genes into the organism's DNA. While modifying organisms in a laboratory is a relatively new scientific development, people have been experimenting with genetics on plants and animals for centuries. For example, cattle ranchers have selectively bred their animals to produce cows that give more milk. Although some people fear the "Frankenstein" nature of GMOs, there is no scientific evidence to suggest that GMO-based foods are harmful for human consumption. In fact, there are several reasons to believe that GMOs actually quite beneficial. Through genetic modification, scientists can breed species of plants or animals that yield hardier, more abundant, or even more nutritious food. Geneticists have been able to produce rice plants that can survive droughts and wheat plants that are naturally pest-resistant. Some genetically modified foods have been engineered to have higher levels of specific nutrients, such as protein or calcium. Proponents of GMOs argue that these kinds of advances might one day help to end world hunger. Furthermore, genetically modified crops and animals can be bred to require fewer natural resources and produce less waste. This means that GMOs might also be better for the environment. Question: Which of the following can be inferred about GMOs?

Running vs. Walking Running is one of the best ways to get exercise. You do not need to join a gym or buy expensive equipment to go for a run. But you might be surprised to learn that walking can be just as good for you as running. In fact, going for a walk might be even better for you than going for a run. Running can help lower your blood pressure and reduce your risk for heart disease. However, recent research by the American Heart Association shows that walking is just as good for your heart as running. A brisk walk can lower the risk for heart disease, high blood pressure, and high cholesterol just as much as running does. The only catch? You have to walk for twice as long as you would run. In order to get the benefits of a 15-minute run, you need to walk for 30 minutes. Walking is just as good as running when it comes to cardiac health, but there are other ways in which walking can actually be better for you than running. Running can be tough on your body, especially your joints. In fact, a recent study published by the American College of Sports Medicine shows that as many as 40 to 50 percent of runners suffer a running-related injury every year. Walking does have some advantages over running. However, one thing is for sure: either one is better for you than sitting on a couch! Question: What is the best summary of the passage?

The Liver The liver is one of the largest and most vital organs in the body. It is located on the right side of the body and is protected by the rib cage. The liver performs many important jobs, including breaking down nutrients, removing toxins, and destroying damaged blood cells. The liver's main function is to filter blood. Blood travels to the liver from the digestive tract. The liver processes this blood, removing toxins and metabolizing nutrients. The liver also secretes bile during this process. Bile is stored in the gallbladder and released into the large intestine. Bile aids in the digestion of fats. The liver also makes proteins necessary for blood clotting, removes worn-out blood cells, helps to regulate blood sugar levels, and stores vitamins A, D, E, K, and B12. There are several diseases that can affect the liver. Because the liver performs so many important functions in the body, liver problems can be life-threatening. Hepatitis is a disease characterized by inflammation of the liver. Left untreated, certain types of hepatitis can be fatal. Cirrhosis is another dangerous liver condition. Cirrhosis develops when healthy liver tissue is replaced by scar tissue. This is most often caused by long-term alcohol abuse. Cirrhosis can cause swelling, internal bleeding, and eventually, liver failure. The only cure for cirrhosis is a full liver transplant. What can be inferred from a situation in which the liver is not functioning properly?

Wrinkles Skin wrinkles are caused by a variety of factors. Some of these factors are intrinsic, meaning that you cannot control them because they occur naturally. Others are extrinsic, meaning that they are caused by circumstances outside of the body. One intrinsic factor is aging. As you age, your skin loses collagen, which is the protein responsible for keeping your skin elastic. With less collagen, your skin becomes thinner and more fragile. Aging also reduces the functioning of sweat and oil glands, which work to keep the skin looking smooth. You also lose fat in the deeper layers of your skin as you age. This fat loss causes your skin to sag and develop deeper wrinkles. The two most common extrinsic factors are exposure to ultraviolet radiation (UV rays) and smoking. UV rays in sunlight break down your skin's connective tissue and collagen fibers. To prevent the appearance of wrinkles (as well as protect yourself from skin cancer), you should always use UV-blocking sunscreen. The nicotine in cigarettes is the most likely link between smoking and wrinkles. Nicotine narrows the blood vessels, reducing the blood supply to your skin tissue. This deprives your skin of oxygen and important nutrients, causing damage that contributes to wrinkles. Question: According to the text, what is the relationship between oil glands and the skin's appearance?

Synaesthesia Does the number five smell like lemons? Is the sound of a flute purple? Does the letter "R" taste like cinnamon? These questions might seem strange, but to people with synaesthesia, they make perfect sense. Synaesthesia is a neurological phenomenon where the senses get crossed. People with synaesthesia (also called "synaesthetes") experience this phenomenon in different ways. The most common form of synaesthesia is called color-graphemic synaesthesia. People who experience this form of synaesthesia associate letters and numbers with certain colors. For example, the letter "A" might always appear to be red and the number eight might always look blue. Another common form of synaesthesia is chromesthesia: the association of sounds with colors. Some people who experience this phenomenon see bursts of color when they hear everyday sounds, such as dogs barking or water dripping. Others associate specific colors with different musical notes. Although scientists do not yet understand what causes some people to experience synaesthesia, some researchers argue for something called the cross-activation theory. This theory suggests that the regions of the brain responsible for interpreting information from the different senses have become "crossed," that is, the neurons from one sense inadvertently activate the neurons from another sense. There is also evidence to suggest that synaesthesia is a genetic trait. While there is no treatment for synaesthesia, there is also not much demand for a treatment; most synaesthetes report that they find their condition rather pleasant. Question:  What is the main idea of the passage?

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: What is the author's purpose in writing this passage?

Hangovers Veisalgia, more commonly known as a hangover, is the name for the range of unpleasant physical effects that occur following the excessive consumption of alcoholic beverages. The most commonly experienced effects include nausea, vomiting, sensitivity to light and sound, headache, thirst, and lethargy. The degree of the hangover's severity is determined by factors occurring both before and after the alcohol is metabolized. The main pre-metabolic cause of veisalgia is the quantity of alcohol consumed. Binge drinking is one of the most notorious contributors to hangovers. Empirical research suggests that even an increase in consumption from four to six beers can result in twice the susceptibility to end up with a hangover. Another pre-consumption factor that contributes to hangovers is the number of congeners present in alcohol. Congeners are chemical substances produced during the fermentation process that gives the alcohol color, taste, and aroma. Recent studies have shown that alcohol with a high congener content, such as bourbon (which is brown), is three times as likely to cause a hangover as the same amount of low-congener alcohol, such as vodka (which is clear). Post-metabolic causes of veisalgia have less to do with the amount or kind of alcohol consumed and more to do with genetics. One of the major post-metabolic causes of veisalgia is the production of acetaldehyde. During the initial stages of metabolization, the liver produces an enzyme known as alcohol dehydrogenase. This enzyme works to convert the ethanol present in alcohol into the compound acetaldehyde. Studies have shown that individuals who lack this enzyme-and thus also lack the ability to break down ethanol in the liver-have a much higher rate of hangover occurrence, and experience more immediate and more severe hangover symptoms. Question: What is the main idea of 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 meaning of the word probability in the last paragraph?

Synaesthesia Does the number five smell like lemons? Is the sound of a flute purple? Does the letter "R" taste like cinnamon? These questions might seem strange, but to people with synaesthesia, they make perfect sense. Synaesthesia is a neurological phenomenon where the senses get crossed. People with synaesthesia (also called "synaesthetes") experience this phenomenon in different ways. The most common form of synaesthesia is called color-graphemic synaesthesia. People who experience this form of synaesthesia associate letters and numbers with certain colors. For example, the letter "A" might always appear to be red and the number eight might always look blue. Another common form of synaesthesia is chromesthesia: the association of sounds with colors. Some people who experience this phenomenon see bursts of color when they hear everyday sounds, such as dogs barking or water dripping. Others associate specific colors with different musical notes. Although scientists do not yet understand what causes some people to experience synaesthesia, some researchers argue for something called the cross-activation theory. This theory suggests that the regions of the brain responsible for interpreting information from the different senses have become "crossed," that is, the neurons from one sense inadvertently activate the neurons from another sense. There is also evidence to suggest that synaesthesia is a genetic trait. While there is no treatment for synaesthesia, there is also not much demand for a treatment; most synaesthetes report that they find their condition rather pleasant. Question: What can be inferred about a person with chromesthesia who hears a train whistle blow?

Women in Clinical Trials When new drugs or medical procedures are ready to be tested on human subjects, researchers find volunteers for clinical trials. However, far more men than women are used as subjects during these trials. It was widely assumed for many years that women and men would respond to medication in the same way. Therefore, it did not seem to matter whether men or women were participating in clinical trials. Because of this, researchers mostly drew from pools of male volunteers because they were perceived to be more low-risk (and accordingly, less expensive to include in a trial). Women who are pregnant, nursing, post-menopausal or even simply of childbearing age are considered too "risky" to participate in clinical trials. These parameters essentially eliminate all women. However, it is difficult to determine whether this decision to eliminate women was made out of beneficence or paternalism. The main problem with this gender discrepancy is that men and women are physiologically different. Their bodies process medications and respond to treatments differently. The over representation of men in clinical trials has impeded the progress of understanding how new medications will affect women. Question: Which of the following statements represents the opinion of the author and is not a statement of fact?

Fibromyalgia Fibromyalgia is a chronic condition that affects an estimated 3-6% of the world's population. The disorder is characterized by both physiological and psychological symptoms, including nerve pain, fatigue, sleep and mood disturbances, headaches, bowel problems, and incontinence. The exact cause of fibromyalgia is unknown. For some people, fibromyalgia symptoms begin after some sort of physical or psychological stress. However, for others, the onset of symptoms is gradual. Research has shown that genetics may play a part, but there is also evidence that environmental factors can contribute. The wide variety of symptoms made it difficult to diagnose and treat for many years, though recent research has made some promising advances. Although a cure for fibromyalgia has not yet been developed, research has shown that some of the symptoms can be treated with pharmaceuticals, such as tricyclics or gabapentinoids, or non-pharmacological methods, such as meditation, mindfulness, and cognitive behavior therapy. The most successful pharmacological treatment for fibromyalgia has been tricyclic antidepressants, such as amitriptyline and nortriptyline. These drugs increase the levels of the neurotransmitters serotonin and norepinephrine, which are often found at decreased levels in the brains of people who suffer from chronic pain. By boosting endorphins and relaxing muscles, tricyclics can ease some of the musculoskeletal pain felt by people with fibromyalgia. Question: What is the main idea of the passage?