Patho Exam 1

Which of the following disorders represents excessive activation of the immune system? a. Immunodeficiency b. Hypersensitivity c. Autoimmunity d. Hyposensitivity

b. Hypersensitivity

Which white blood cell malignancy is characterized by a 'honeycomb' like appearance in the bones? a. AML b. Multiple myeloma c. CML d. Hodgkin's Lymphoma

b. Multiple myeloma

Transfusion reactions involve RBC destruction caused by a. donor antigens. b. recipient antibodies. c. donor T cells. d. recipient T cells.

b. recipient antibodies.

Which of the following is the most abundant leukocyte? a. Eosinophils b. Basophils c. Neutrophils d. Dendritic cells

c. Neutrophils

Burkitt lymphoma is most closely associated with a. Epstein-Barr virus. b. radiation exposure. c. immunodeficiency syndromes. d. history of cigarette smoking.

a. Epstein-Barr virus.

A patient is diagnosed with CML (chronic myeloid leukemia). The patient may experience which of these symptoms? (Select all that apply.) a. Fatigue b. Weight loss c. Abdominal discomfort d. Joint pain e. Sweats

a. Fatigue b. Weight loss c. Abdominal discomfort e. Sweats

When assessing a patient with leukopenia, you know that the patient has what? a. A lower than normal number of white blood cells b. A lower than normal number of platelets c. A lower than normal hematocrit and hemoglobin d. An increased amount of white blood cells

a. A lower than normal number of white blood cells

Which type of leukemia primarily affects children? a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. Hairy cell leukemia

a. ALL (acute lymphoid leukemia)

In general, the best prognosis for long-term disease-free survival occurs with a. ALL (acute lymphoid leukemia). b. CLL (chronic lymphoid leukemia). c. AML (acute myeloid leukemia). d. CML (chronic myeloid leukemia).

a. ALL (acute lymphoid leukemia).

What age group has a larger volume of extracellular fluid than intracellular fluid? a. Infants b. Adolescents c. Young adults d. Older adults

a. Infants

Which clinical findings describe the typical presentation of ALL (acute lymphoid leukemia)? (Select all that apply.) a. Pain in long bones b. Hypercalcemia c. Fever d. None, usually asymptomatic e. Painless enlarged cervical lymph nodes f. Easy bruising

a. Pain in long bones c. Fever e. Painless enlarged cervical lymph nodes

Which disorder is associated with a type III hypersensitivity mechanism of injury? a. Systemic lupus erythematosus b. Graves' disease c. Erythroblastosis fetalis d. Seasonal allergic rhinitis

a. Systemic lupus erythematosus

The patient is a 12-year-old boy with acute lymphoblastic leukemia (ALL). Manifestations of the patient's leukemia prior to treatment may include (Select all that apply.) a. anemia. b. leukocytosis. c. leukopenia. d. thrombocytopenia. e. anuria.

a. anemia. b. leukocytosis. d. thrombocytopenia.

Manifestations from sodium imbalances occur primarily as a result of a. cellular fluid shifts. b. vascular collapse. c.hyperosmolarity. d. hypervolemia.

a. cellular fluid shifts.

Decreased neuromuscular excitability is often the result of a. hypercalcemia and hypermagnesemia. b. hypomagnesemia and hyperkalemia. c. hypocalcemia and hypokalemia. d. hypernatremia and hypomagnesemia.

a. hypercalcemia and hypermagnesemia.

Myasthenia gravis is a type II hypersensitivity disorder that involves a. impaired muscle function. b. symptoms of hyperthyroidism. c. symptoms of arthritis or polyarthralgia. d. symptoms of glomerular disease.

a. impaired muscle function.

The major cause of death from leukemic disease is a. infection. b. malnutrition. c. hypovolemic shock. d. kidney failure.

a. infection.

A patient is diagnosed with myeloma. The nurse teaches the patient about the multiple tumor sites that can develop with this cancer. The possible tumor sites in myeloma include the (Select all that apply.) a. liver. b. spleen. c. bones d. pancreas. e. kidneys.

a. liver. b. spleen. c. bones e. kidneys.

Dramatic hypotension sometimes accompanies type I hypersensitivity reactions because a. massive histamine release from mast cells leads to vasodilation. b. toxins released into the blood interfere with cardiac function. c. anaphylaxis results in large volume losses secondary to sweating. d. hypoxia resulting from bronchoconstriction impairs cardiac function.

a. massive histamine release from mast cells leads to vasodilation.

The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is _ ions. a. sodium b. phosphate c. magnesium d. potassium

a. sodium

Clinical manifestations of extracellular fluid volume deficit include a. weak pulse, low blood pressure, and increased heart rate. b. thirst, dry mucous membranes, and diarrhea. c. confusion, lethargy, coma, and perhaps seizures. d. cardiac dysrhythmias, paresthesias, and muscle weakness.

a. weak pulse, low blood pressure, and increased heart rate.

Hyperaldosteronism causes a. ECV deficit and hyperkalemia. b. ECV excess and hypokalemia. c. hyponatremia and hyperkalemia. d. excessive water reabsorption without affecting sodium concentration.

b. ECV excess and hypokalemia.

Which manifestation, if identified in a client admitted with heart failure, should a nurse associate with the development of hyponatremia? a. Constipation b. GI suction c. Gastrointestinal ulcer d. Hypoactive bowel sounds

b. GI suction

A nurse assesses a newly admitted client and finds that the client has hyperactive reflexes. Which potential electrolyte imbalance(s) should the nurse suspect? Select all that apply: a. Hypermagnesemia b. Hypomagnesemia c. Hypercalcemia d. Hypocalcemia e. Hyperkalemia f. Hypokalemia

b. Hypomagnesemia d. Hypocalcemia e. Hyperkalemia

Causes of hypomagnesemia include a. hyperphosphatemia. b. chronic alcoholism. c. oliguric renal failure. d. clinical dehydration.

b. chronic alcoholism.

Hypernatremia may be caused by a. decreased aldosterone secretion. b. decreased antidiuretic hormone secretion. c. compulsive water drinking. d. excessive dietary potassium.

b. decreased antidiuretic hormone secretion.

Excessive antidiuretic hormone (ADH) secretion can cause a. increased serum sodium b. decreased serum sodium c. increased serum potassium d. decreased serum potassium

b. decreased serum sodium

The imbalance that occurs with oliguric renal failure is a. metabolic alkalosis. b. hyperkalemia. c. hypokalemia. d. hypophosphatemia.

b. hyperkalemia.

A primary effector cell of the type I hypersensitivity response is a. monocytes. b. mast cells. c. neutrophils. d. cytotoxic cells.

b. mast cells.

Clinical manifestations of moderate to severe hypokalemia include a. muscle spasms and rapid respirations. b. muscle weakness and cardiac dysrhythmias. c. confusion and irritability. d. vomiting and diarrhea.

b. muscle weakness and cardiac dysrhythmias.

A patient is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. The most likely diagnosis is a. leukemia. b. myeloma. c. Hodgkin disease. d. back trauma.

b. myeloma.

The process responsible for distribution of fluid between the interstitial and intracellular compartments is a. filtration. b. osmosis. c. active transport. d. diffusion.

b. osmosis.

The fraction of total body water (TBW) volume contained in the intracellular space in adult males is a. three-fourths. b. two-thirds. c. one-half. d. one-third.

b. two-thirds.

An RN is administering the Hep B immunization series to a teenager at a clinic. What type of immunity is this considered? a. Natural Active b. Natural Passive c. Artificial Active d. Artificial Passive

c. Artificial Active

What type of lymphocyte matures in the bone marrow? a. T-lymphocytes b. Cytotoxic T-cells c. B-lymphocytes d. Macrophages

c. B-lymphocytes

What is one key difference between benign and malignant tumors? a. Benign tumors grow rapidly; malignant tumors grow slowly b. Benign tumors are invasive; malignant tumors are not invasive c. Benign tumors do not metastasize; malignant tumors often metastasize d. Benign tumors are poorly differentiated; malignant tumors are well differentiated

c. Benign tumors do not metastasize; malignant tumors often metastasize

A nurse is assessing a client with a possible fluid and electrolye imbalance. Which manifestation, if identified in this client, should the nurse associate with the development of either hyponatremia or hypernatremia? a. Hypertension b. Bradycardia c. Confusion d. Diarrhea

c. Confusion

Which electrolyte imbalances cause increased neuromuscular excitability? a. Hypokalemia and hyperphosphatemia b. Hyperkalemia and hypophosphatemia c. Hypocalcemia and hypomagnesemia d. Hypercalcemia and hypermagnesemia

c. Hypocalcemia and hypomagnesemia

A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type hypersensitivity reaction. a. I b. II c. III d. IV

c. III

Renal insufficiency is a common complication of which disease? a. Chronic myeloid leukemia (CML) b. Chronic lymphoid leukemia (CLL) c. Myeloma d. Hodgkin disease

c. Myeloma

RhoGAM is given to an Rh-negative mother in order to prevent a. the formation of Rh-positive antibodies. b. the primary immunodeficiency of the newborn. c. a type III hypersensitivity disorder. d. anaphylactic response of the mother.

c. a type III hypersensitivity disorder.

While in the hospital for management of acute lymphoid leukemia (ALL), a patient develops severe thrombocytopenia. The most appropriate action for this condition is a. anticoagulant therapy. b. chemotherapy. c. activity restriction. d. isolation.

c. activity restriction.

The inward-pulling force of particles in the vascular fluid is called _______ pressure. a. capillary hydrostatic b. interstitial osmotic c. capillary osmotic d. interstitial hydrostatic

c. capillary osmotic

Clinical manifestations of hyponatremia include a. weak pulse, low blood pressure, and increased heart rate. b. thirst, dry mucous membranes, and diarrhea. c. confusion, lethargy, coma, and perhaps seizures. d. cardiac dysrhythmias, paresthesias, and muscle weakness.

c. confusion, lethargy, coma, and perhaps seizures.

Total body water in older adults is a. increased because of decreased adipose tissue and decreased bone mass. b. increased because of decreased renal function and hormonal fluctuations. c. decreased because of increased adipose tissue and decreased muscle mass. d. decreased because of renal changes that cause diuresis with sodium excretion.

c. decreased because of increased adipose tissue and decreased muscle mass.

Clinical manifestations of severe symptomatic hypophosphatemia are caused by a. excess proteins. b. renal damage. c. deficiency of ATP. d. hypocalcemia.

c. deficiency of ATP.

Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with a. hyponatremia. b. hypocalcemia. c. hypophosphatemia. d. hypokalemia.

c. hypophosphatemia.

The effects of histamine release include a. vasoconstriction. b. bronchodilation. c. increased vascular permeability. d. decreased gut permeability.

c. increased vascular permeability.

Which patient is most at risk for hyperkalemia? a. A 67 year old taking thiazide diuretics b. A 48 year old with a feeding tube c. A patient who is a chronic alcoholic d. A 30 year old who just underwent a large blood transfusion

d. A 30 year old who just underwent a large blood transfusion

How do clinical conditions that increase vascular permeability cause edema? a. Through altering the negative charge on the capillary basement membrane, which enables excessive fluid to accumulate in the interstitial compartment b. By causing movement of fluid from the vascular compartment into the intracellular compartment, which leads to cell swelling c. Through leakage of vascular fluid into the interstitial fluid, which increases interstitial fluid hydrostatic pressure d. By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure

d. By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure

Which form of leukemia demonstrates the presence of the Philadelphia chromosome? a. ALL (acute lymphoid leukemia) b. CLL (chronic lymphoid leukemia) c. AML (acute myeloid leukemia) d. CML (chronic myeloid leukemia)

d. CML (chronic myeloid leukemia)

Which event is likely to lead to hyponatremia? a. Insufficient ADH secretion b. Excess aldosterone secretion c. Administration of intravenous normal saline d. Frequent nasogastric tube irrigation with water

d. Frequent nasogastric tube irrigation with water

The hypersensitivity reaction that does not involve antibody production is type a. I. b. II. c. III. d. IV.

d. IV.

The principle Ig mediator of type I hypersensitivity reactions is a. IgA. b. IgG. c. IgM. d. IgE.

d. IgE.

An important mediator of a type I hypersensitivity reaction is a. complement. b. antigen-antibody immune complexes. c. T cells. d. histamine.

d. histamine.

A person who has hyperparathyroidism is likely to develop a. hypokalemia. b. hyperkalemia. c. hypocalcemia. d. hypercalcemia.

d. hypercalcemia.

A patient has a positive Chvostek sign. The nurse interprets this as a sign of a. hypercalcemia. b. hypermagnesemia. c. decreased neuromuscular excitability. d. increased neuromuscular excitability.

d. increased neuromuscular excitability.

The patient diagnosed with acute lymphoid leukemia (ALL) must undergo several weeks of chemotherapy. The most serious complication of chemotherapy is a. vomiting. b. anemia. c. alopecia. d. infection

d. infection

A diagnostic laboratory finding in myeloma is a. Bence Jones proteins in the urine. b. decreased platelet count. c. increased IgM antibody titer. d. elevated blood glucose levels.

a. Bence Jones proteins in the urine.

Which disorder is considered a primary immunodeficiency disease? a. HIV/AIDS b. Malnutrition immunodeficiency c. Cancer immunodeficiency d. Radiation immunodeficiency

a. HIV/AIDS

Autoimmune diseases result from which of the following? (Select all that apply.) a. Overactive immune function b. Increase in self-tolerance c. Failure of the immune system to differentiate self and nonself molecules d. Communicable infections e. Environmental toxin exposure

a. Overactive immune function c. Failure of the immune system to differentiate self and nonself molecules e. Environmental toxin exposure