Pathophysiology Practice Questions Chapter 3: Cellular Adaptation, Injury, and Death

A client with gastroesophageal reflux disease has metaplasia. Which explanation is the cause? - Cells are increased in size due to increased oxygenation. - This represents cancerous cells. - Cells are replaced in response to chronic irritation. - These are nonreversible cell changes.

Cells are replaced in response to chronic irritation.

Microscopic examination of tissue samples from a deceased client's liver reveal that the hepatocytes contain pathologic vacuoles of fat. The nurse should understand what significance of this finding? - The presence of fat in the cytoplasm of liver cells was likely the result of a genetic predisposition. - The client may have had high levels of exposure to free radicals early in life. - This phenomenon may have been reversible if the client had undertaken lifestyle changes. - The changes to the client's liver resulted from undiagnosed liver metastases.

This phenomenon may have been reversible if the client had undertaken lifestyle changes.

Which of the following describes how atrophied cells survive? - Via increased oxygen consumption - By relying on other cells to increase workload - Through decreased oxygen consumption -Through increased levels of functioning

Through decreased oxygen consumption

Hypertrophy may occur as the result of normal physiologic or abnormal pathologic conditions. The increase in muscle mass associated with exercise is an example of physiologic hypertrophy. Pathologic hypertrophy occurs as the result of disease conditions and may be adaptive or compensatory. Examples of adaptive hypertrophy are the thickening of the urinary bladder from long-continued obstruction of urinary outflow and the myocardial hypertrophy that results from valvular heart disease or hypertension. What is compensatory hypertrophy? - When one kidney is removed, the remaining kidney enlarges to compensate for the loss. - When the body controls myocardial growth by stimulating actin expression to enlarge the heart - When the body increases its major organs during times of malnutrition - When the body stimulates gene expression to begin a progressive decrease in left ventricular muscle mass

When one kidney is removed, the remaining kidney enlarges to compensate for the loss.

A man presents to the emergency department after being out in below-zero weather all night. He asks the nurse why the health care team is concerned about his toes and feet. How would the nurse respond? - Cold causes injury to the cells in the body by injuring the blood vessels, making them leak into the surrounding tissue. - The staff is concerned that you might be a homeless person, and we were wondering how often this has happened to you before and when it will happen again. - After being out in the cold all night your toes and feet are frozen and it will be very painful to warm them again, and the health care team is concerned he might be a drug addict. - Your toes and feet are frozen, and there is a concern about how decreased blood flow may lead to the formation of blood clots as we warm them again.

Your toes and feet are frozen, and there is a concern about how decreased blood flow may lead to the formation of blood clots as we warm them again.

Which client would be an example of an individual experiencing cellular atrophy? - A middle-aged female experiencing menopause due to loss of estrogen stimulation - A female client with the change in uterine size as a result of pregnancy - A hypertensive, noncompliant client who has developed a progressive increase in left ventricular mass - A postnephrectomy client whose remaining kidney enlarges to compensate for the loss

a middle-aged female experiencing menopause due to loss of estrogen stimulation

The obstetric nurse explains to the client that when she stops breast-feeding, her breast tissue will reduce in size. The nurse understands that this regression is due to which physiologic process? - Telomere shortening - Apoptosis - Hypoxia - Cell necrosis

apoptosis

When confronted with a decrease in work demands or adverse environmental conditions, most cells are able to revert to a smaller size and a lower, more efficient level of functioning that is compatible with survival. This decrease in cell size is known as: dysplasia. atrophy. hypertrophy. hyperplasia. metaplasia.

atrophy

The nurse in an infectious-disease clinic will primarily treat injuries to tissues and cells caused by: - biologic agents. - chemical agents. - calcification. - oncogenic agents.

biologic agents

Which process associated with cellular injury is most likely to be reversible? Apoptosis Cellular changes as a result of ionizing radiation Cell damage resulting from accumulation of free radicals Cell damage resulting from accumulation of fat in the cytoplasm

cell damage resulting from accumulation of fat in the cytoplasm

What happens as a cell's workload declines? Select all that apply. - Energy expenditure increases. - Cell size decreases. - Insulin levels increase. - Protein synthesis decreases. - Oxygen consumption decreases.

cell size decreases, protein synthesis decreases, oxygen consumption decreases

A client with diabetes has impaired sensation, circulation, and oxygenation of his feet. He steps on a piece of glass, the wound does not heal, and the tissue area becomes necrotic. Which characterization of the necrotic cell death will be exhibited in this example? - Chronic inflammation - Shrinkage and collapse - Cellular breakage - Rapid apoptosis

cellular breakage

The student is reviewing the aging process. One group of theories of aging involves the shortening of telomeres until a critical minimal length is attained and then senescence ensues. These theories are known as: - cellular theories. - molecular theories. - systems-level theories. - evolutionary theories.

cellular theories

A client presents for a scheduled Papanicolaou (Pap) test. What type of problem will the clinician examining the cell samples look for? - Ischemic changes in cell samples - Changes in cell shape, size, and organization - Presence of unexpected cell types - Abnormally high numbers of cells in a specified field

changes in cell shape, size, and organization

The nurse is caring for a client who choked on a peanut and then collapsed. After partially clearing the obstruction, it was noted the client experienced prolonged hypoxia. The nurse anticipates that the resulting cerebral infarction will lead to which phenomenon? -Rapid phagocytosis -Coagulation necrosis -Caspase activation -Protein p53 deficiency

coagulation necrosis

A client is admitted with frostbite. What will the nurse tell the client about the changes that have occurred due to cold exposure? Cold increases blood viscosity and thrombosis. Cold increases the speed of blood flow through vessel. Cold causes vasodilation and redness. Cold exposure results in hypertrophy of cells in the affected area.

cold increases blood viscosity and thrombosis

The client is found to have liver disease, resulting in the removal of a lobe of the liver. Adaptation to the reduced size of the liver leads to which phenomenon in the remaining liver cells? - Organ atrophy - Physiologic hypertrophy - Metaplasia - Compensatory hyperplasia

compensatory hyperplasia

Which muscle change places an individual at high risk factor for injury? - Decrease in diastolic pressure - Increase in lean mass - Decrease in fat mass - Decrease in muscle mass

decrease in muscle mass

A client's condition has resulted in a decrease in work demands of most cells in the body. Which change within the cell will likely result from this decrease in work? - Decreased programmed cellular death - Decreased size of organelles - Increased mitochondrial growth - Increased oxygen consumption

decreased size of organelles

Which situation causes atrophy? Select all that apply. - Denervation - Increased endocrine stimulation - Decreased blood flow - Increased nutrition - Disuse

disuse, decreased blood flow, denervation

A client's lab report returns and a nurse is explaining to the client the significance of the changes. The nurse states that the finding is implicated as a precursor of cancer. Which finding was most likely on the lab report? - Metaplasia - Dysplasia - Hypertrophy - Atrophy

dysplasia

A nurse practitioner is preparing to perform a client's Pap test and is answering the client's questions about the clinical rationale for the procedure. The nurse should describe what phenomenon? - Epithelial samples in clients with a high risk for cervical cancer often contain metastatic cells. - Dysplasia of the cervical epithelium is associated with a high risk of cancer. - Calcification of cervical cells is closely associated with the development of cervical cancer. - Cell hypertrophy in the columnar epithelium that covers the cervix is a known risk factor for cancer.

dysplasia of the cervical epithelium is associated with a high risk of cancer

When performing an assessment on a school-aged child, the nurse notes that the mucous membranes along the gum margins have a noticeable blue-colored line. At this point, the nurse should ask the parents about possible: - exposure to lead. - congenital heart problems. - second-hand smoke exposure. - liver problems as an infant.

exposure to lead

Which assessment supports the finding of lead toxicity? Blood pressure 140/90 mm Hg Hematocrit 40% Heart rate 70 beats/min Hemoglobin 9 g/dL (90 g/L)

hemoglobin

Select the statement that best describes apoptosis. - Unregulated by enzymatic digestion of cell components - Responsible for initiating an inflammatory response - The release of products of cell death is uncontrolled. - Highly selective in eliminating injured or aged cells

highly selective in eliminating injured or aged cells

Which pathophysiologic process is most likely to result in metastatic calcification? Liver cirrhosis Impaired glycogen metabolism Benign prostatic hyperplasia Hyperparathyroidism

hyperparathyroidism

A client has developed heart failure. The doctor reviews the client's chest x-ray and notes that the heart has enlarged. The changes in the size and shape of the heart are the result of: - atrophy. - hypertrophy. - hypoplasia. - hyperplasia.

hypertrophy

The nurse explains to the hypertensive client that the increased workload required to pump blood against an elevated arterial pressure results in a progressive increase in left ventricular muscle mass. This is an example of: - dysplasia. - hypertrophy. - metaplasia. - hyperplasia.

hypertrophy

A 70-year-old client is being treated for a recent ischemic stroke that has left the client with deficits. These deficits likely result from which mechanism of cell injury? - hypoxia and adenosine triphosphate (ATP) depletion - apoptosis - impaired calcium homeostasis - interference with DNA synthesis

hypoxia and adenosine triphosphate (ATP) depletion

The nurse is conducting a physical assessment of a homeless man during a night when the wind chill factor is -10°F (-23°C). When assessing the man's fingers and toes for frostbite, the nurse looks for which type of cellular injury? - Chemical - Mechanical - Endogenous - Hypoxic

hypoxic

A client has been exposed to ultraviolet (UV) radiation. Which effect from the exposure is the nurse's primary concern? - Increase in epidermal wrinkling - Increased risk of cancer - Severe decrease in sebaceous secretions - Second-degree sunburn

increased risk of cancer

Which describes hypertrophy? - increased number of cells - change of cell type - increased size of the cell - decreased size of cells

increased size of the cell

Which situation causes hypertrophy?

increased workload

The radiologist is reviewing potential types of radiation therapy for a client. Which type of radiation directly breaks down chemical bonds in a cell? ionizing radiation non-ionizing radiation sunlight radiation ultraviolet radiation

ionizing radiation

A client has an increased serum lactic acid level. The physician understands this is indicative of which disease process? - Toxicity of lead exposure - Ischemia - Free radical injury - Apoptosis

ischemia

Which statement is true in relation to lead exposure? - Lead is absorbed through the gastrointestinal tract or the lungs. - Increased iron increases the risk of lead poisoning. - Lead is absorbed through the skin. - Increased calcium levels increase the risk of lead poisoning.

lead is absorbed through the gastrointestinal tract or the lungs

The nurse is counseling a heavy smoker about the dangers of smoking. The nurse tells the smoker that due to persistent irritation of the lungs from carcinogens, the normal ciliated columnar epithelial cells of the trachea may transform into stratified squamous epithelial cells as a method of adaptation known as: - dysplasia. - anaplasia. - metaplasia. - hyperplasia.

metaplasia

Which change exemplifies physiologic hypertrophy? - Muscle mass increase with exercise - Lung size increase in emphysema - Heart size increase in hypertension - Cell size increase with hypoxia

muscle mass increase with exercise

Which condition is an example of physiologic hyperplasia? - Endometrial hyperplasia - Skin warts - Benign prostatic hyperplasia - Uterine enlargement in pregnancy

uterine enlargement in pregnancy