Pathophysiology Exam 1

What is the term that refers to the recognizable traits associated with specific genetic information stored in an individual base sequence?

Phenotype

Which term defines visible traits—either physical or biochemical—associated with a specific inheritance pattern that is recognizable?

Phenotype

Select the statement that best describes polygenic inheritance.

Polygenic traits involve multiple genes

Homozygotes are what people are called in whom the two alleles of a given pair are the same (AA or aa). Heterozygotes are what people are called who have different alleles (Aa) at a gene locus. What kind of trait is expressed only in homozygous pairing?

Recessive trait

A client is experiencing muscle atrophy following 2 weeks in traction after a motor vehicle accident. Which factor has most likely contributed to the atrophy of the client's muscle cells?

A reduction of skeletal muscle use secondary to the traction treatment

A client receives a phone call from her gynecologist's office nurse and is informed that her Pap test results identified mild dysplasia. The best explanation for the nurse to provide would be:

"Minor degrees of dysplasia are associated with chronic irritation or inflammation. However, we will need to do additional diagnostic studies to confirm the diagnosis."

A student asks the instructor about the origins of different tissues and their cellular origins during the process of development. Which statement by the instructor best describes the process of cell differentiation?

"A fertilized ovum undergoes a series of divisions, yielding many different cell types."

Which statement would a nurse tell a client to best describe apoptosis?

"Apoptosis is the natural removal of injured or worn out cells."

A single mother who was raised in a traumatic environment is very protective of her child. She expresses a desire to keep her child from experiencing stressful situations in hopes of promoting healthy development. What response by the nurse is most helpful?

"It is normal to experience stressors periodically and this can enhance healthy development."

A new client who suffered a myocardial infarction requires angioplasty and stent placement. He has arrived to his first cardiac rehabilitation appointment. In this first session, a review of the pathogenesis of coronary artery disease is addressed. Which statement by the client verifies to the nurse that he has understood the nurse's teachings about coronary artery disease?

"Sounds like this began because of inflammation inside my artery that made it easy to form fatty streaks which led to my clogged artery."

A client with pulmonary hypertension has hypertrophy of the heart's right ventricle. Which explanation is appropriate to tell the client?

"The cells enlarge in your heart from the increased workload."

A mother who is with her son when a cast is removed from his arm asks the nurse "What is wrong with my son's arm? It looks so small!" What is the nurse's best response?

"The cells have atrophied due to lack of use and will regain their size as he starts to use the arm."

Of the following situations, which one would be an example of a maladaptive cellular change?

44-year-old male with a 60 pack/year smoking history who was diagnosed with a histological grade-3 lung cancer

Which is the correct definition to describe a carrier?

A carrier is heterozygous for a recessive trait but does not manifest the trait

A member of the health care team is researching the etiology and pathogenesis of a number of clients who are under his care in a hospital context. Which aspect of clients' situations best characterizes pathogenesis rather than etiology?

A client who is has increasing serum ammonia levels due to liver cirrhosis.

A clinician who works on a cardiac care unit of a hospital is providing care for a number of clients. Which client most likely has a genetic disorder arising from inheritance of a single gene?

A tall, thin, myopic, 28-year old woman with mitral valve prolapse

As part of a screening program for prostate cancer, men at a senior citizens center are having their blood levels of prostate-specific antigen (PSA) measured. Which statement would best characterize high positive predictive value but low negative predictive value for this screening test?

All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer.

A 14-year-old female has been experiencing severe internal cramps in the region of the pelvis along with weight loss. She has been admitted with rectal bleeding. The physician has diagnosed her with inflammatory bowel disease (IBD). She asks the nurse what causes this disease. Which pathophysiologic basis will guide the nurse's response to this adolescent?

Endoplasmic reticulum stress in the gastrointestinal system

A child with cystic fibrosis (CF) asks the nurse why he has this disease, but his parents are perfectly healthy. The nurse explains:

Both parents are carriers and have a recessive genotype with alleles for CF.

A client with gastroesophageal reflux disease has metaplasia. Which explanation is the cause?

Cells are replaced in response to chronic irritation.

A nurse in the emergency department admits a male client who has experienced severe frostbite to his hands and toes after becoming lost on a ski hill. The nurse recognizes that which phenomena has contributed to his tissue damage?

Decreased blood flow has induced hypoxia.

In which of the following is genetic information stored?

Deoxyribonucleic acid (DNA)

A client has been diagnosed with a neurodegenerative disease called multiple sclerosis (MS). The physician explains to the client that this disease may be caused by dysregulated apoptosis. Later that day, the client asks the nurse what this means. The nurse should reply:

Dysregulated apoptosis has caused an excessive rate of programmed cell death along the neuro-pathways.

A client is brought to the emergency department with reports of shortness of breath. Assessment reveals a full, bounding pulse, severe edema, and audible crackles in lower lung fields bilaterally. The nurse notifies the physician to obtain orders for which of these problems?

Fluid volume excess

The nurse is caring for a client with left-sided heart failure causing chronic activation of the renin-angiotensin-aldosterone system (RAAS). What is the nurse's priority assessment?

Fluid volume excess

A particular disease has a debilitating effect on the ability of sufferers to perform their activities of daily living, and is a significant cause of decreased quality of life. However, few people die as a result of the disease's direct effects. There are hundreds of thousands of Americans living with the disease but relatively few new cases in recent years. Which statement best conveys an accurate epidemiologic characterization of the disease?

High morbidity; low mortality; high prevalence, low incidence.

The laboratory technologists are a discussing a new blood test that helps establish a differential diagnosis between shortness of breath with a cardiac etiology and shortness of breath with a respiratory/pulmonary etiology. A positive result is purported to indicate a cardiac etiology. The marketers of the test report that 99.8% of clients who have confirmed cardiac etiologies test positive in the test. However, 1.3% of clients who do not have cardiac etiologies for their shortness of breath also test positive. Which statement best characterizes this blood test?

High sensitivity, low specificity

A client asks why her breasts are enlarged during pregnancy. Which explanation is the best answer?

Hyperplasia due to estrogen stimulation

A client who has undergone radiation therapy is expected to have some necrosis of cells. Necrosis is which type of side effect?

Irreversible cell damage

The nurse is caring for a client whose potassium level is 5.9 mEq/L (5.9 mmol/L). Which treatment should the nurse be prepared to administer?

Medication to promote the movement of potassium into the intracellular space

A nurse understands that the cell cycle of duplicating somatic cells is called:

Mitosis

A client with a diagnosis of schizophrenia has been admitted with suspected hyponatremia after consuming copious quantities of tap water. Which finding does the nurse anticipate uncovering related to this problem?

Muscle weakness, lethargy and headaches.

Which of the following is an error in DNA duplication?

Mutation

An 81-year-old male client who has a diagnosis of orthostatic hypotension is experiencing an episode of particularly low blood pressure. The man's body has responded by increasing levels of angiotensin II in the bloodstream, a hormone which decreases glomerular filtration rate in the kidneys and contributes to an increase in blood pressure. Which phenomena best describes what has occurred?

Negative feedback

The health caregiver is explaining the rationale for administering a hypotonic intravenous solution (lower concentration of solutes in its surroundings) to a client. Which mechanism of membrane transport most likely underlies this action?

Osmosis

A nurse is completing a genetic map of a client's family. The client has brown eyes and his wife has blue eyes. Both the son and the daughter have brown eyes. Which of the following is the same in both children?

Phenotype

A client has been diagnosed with a brain tumor that cannot be removed surgically. During each office visit the nurse will be assessing the client for syndrome of inappropriate antidiuretic hormone (SIADH). Which assessment would alert the clinic nurse that the client may be developing this complication?

Report of decreased urine output, no edema noted in ankles, increasing headache

A 77-year-old female hospital client has contracted Clostridium difficile during her stay and is experiencing severe diarrhea. Which statement best conveys a risk that this woman faces?

She is susceptible to isotonic fluid volume deficit

A female client who is a carrier of a genetic illness asks the nurse if she should have her partner tested for the condition prior to starting a family. What is the nurse's best response?

Since this is a condition that is linked to a recessive gene, testing may be advised

A 6-year-old boy with intellectual disability secondary to fragile X syndrome has been admitted to the hospital with a mitral valve prolapse. The health care worker caring for the child should have which concepts as part of her knowledge base regarding fragile X syndrome?

The boy will pass the gene to all his future daughters, who will become carriers.

A client's history and physical indicate that the client is a carrier of sickle cell anemia. The nurse anticipates which of the following?

The client can transmit the disorder but does not exhibit symptoms.

A 77-year-old man is a hospital inpatient admitted for exacerbation of his chronic obstructive pulmonary disease (COPD), and a respiratory therapist (RT) is assessing the client for the first time. Which aspect of the client's current state of health would be best characterized as a symptom rather than a sign?

The client notes that he has increased work of breathing when lying supine.

The clinical educator of a hospital medical unit has the mandate of establishing evidence-based practice guidelines for the nursing care on the unit. Which statement most accurately captures a guiding principle of the nurse's task?

The guidelines will combine individual expertise with external systematic evidence.

A professor is teaching a group of students about the role of mitochondria within the cell. Which statement is true of mitochondria?

They are the site of adenosine triphosphate (ATP) production.

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.

Knowing that persons with blonde hair exhibit the phenotype of a recessive gene, which genetic scenario would likely underlie such a trait?

aa

Assessment of a client with diabetes reveals that the toes are dark in color and the skin is shrunken and wrinkled, with a clear delineation between affected and unaffected regions. This client likely has:

dry gangrene

A nurse is assessing a client who is a bodybuilder. The nurse documents the increased size of the client's muscle as resulting from:

hypertrophy

The nurse is reviewing the admission assessment of a client admitted with jaundice and abdominal pain. The client tells the nurse that he injured his back about 6 weeks ago and has been taking 750 mg of acetaminophen every 4 hours each day for pain relief. The nurse recognizes that client may have sustained damage of the:

liver

Mendelian, or single-gene, patterns of inheritance include autosomal dominant and recessive traits that are transmitted from parents to their offspring in a predictable manner. A recessive trait occurs when:

two copies (homozygous) of the recessive allele are present.