chapter 3: Cellular Adaptation, Injury, and Death (prepu questions)

Which statement should a nurse include when teaching a class on health promotion related to keeping cells healthy? Select all that apply.

"Air and water pollution contain chemicals capable of tissue injury." "Tobacco smoke can cause tissue injury."

The ED nurse explains to the orientee that extremes of temperature can cause cell injury. The nurse knows that the orientee understands when he states:

"Exposure to cold may lead to hypoxic tissue injury."

The nurse is reviewing an ultrasound report for a client that reveals endometrial hyperplasia. The client asks what this finding means. How should the nurse respond?

"In response to estrogen levels endometrial cells have increased in number, resulting in a thickening of the endometrium."

Many adaptive cellular responses alter the expression of "differentiation" genes. What can cells do because of this adaptive response?

A cell is able to change size or form without compromising its normal function.

Which client would be an example of an individual experiencing cellular atrophy?

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

The nurse is reviewing the effects of various pharmaceutical agents. Which fact about the effect of medications on the body will the nurse apply in practice?

Antineoplastic drugs directly damage cells.

Normal physiologic process involves the necessary removal of irreversibly damaged cells. Which term best describes this process?

Apoptosis

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?

Apoptosis

Which process associated with cellular injury is most likely to be reversible?

Cell damage resulting from accumulation of fat in the cytoplasm

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

Cells are replaced in response to chronic irritation.

A client's ECG reveals that he is suffering from a myocardial infarction. Prompt interventions are chosen to minimize further myocardial harm. What damage is the care team trying to prevent?

Cellular hypoxia

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?

Compensatory hyperplasia

Which factor can increase the absorption of lead into a client's system?

Decreased calcium levels in the blood

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 size of organelles

Which situation causes atrophy? Select all that apply.

Disuse Denervation Decreased blood flow

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?

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?

Dysplasia of the cervical epithelium is associated with a high risk of cancer.

Which statement is true concerning dysplasia? Select all that apply.

Dysplasia results in cell growth that produces a variety of specific tissue cell shapes. Dysplasia is known to frequently exist in the respiratory tract. Dysplasia is a strong precursor of cancer. Dysplasia can result from chronic irritation.

Mercury is a toxic substance, and the hazards of mercury-associated occupational and accidental exposures are well known. What is the primary source of mercury poisoning today?

Fish such as tuna and swordfish

Which theory points to the influences of accumulated cellular damage as a major determinant of aging?

Free radical

Biologic agents differ from other injurious agents in that they are able to replicate and can continue to produce their injurious effects. How do Gram-negative bacteria cause harm to the cell?

Gram-negative bacilli release endotoxins that cause cell injury and increased capillary permeability.

The nurse is caring for a client with gastroesophageal reflux disease (GERD) who is questioning taking the acid reducing medication because it is "just a little heartburn." What is the nurse's best response?

Having uncontrolled GERD can increase your risk for esophageal cancer

Which assessment supports the finding of lead toxicity?

Hemoglobin 9 g/dL (90 g/L)

Select the statement that best describes apoptosis.

Highly selective in eliminating injured or aged cells

Which pathophysiologic process is most likely to result in metastatic calcification?

Hyperparathyroidism

A client is admitted with an alteration in arterial blood gases. Cellular injury is most likely to result from which aspect of this abnormality?

Hypoxia

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?

Hypoxic

A client with diabetes and severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. The client asks, "How this can happen?" Which pathophysiologic process should the nurse explain to this client?

Impaired arterial blood supply to your toe.

Which situation causes hypertrophy?

Increase in workload

A client has been exposed to ultraviolet (UV) radiation. Which effect from the exposure is the nurse's primary concern?

Increased risk of cancer

Despite the low levels of radiation used in contemporary radiologic imaging, a radiology technician wants to minimize personal exposure to ionizing radiation. What is the primary rationale for the technician's precautions about radiation exposure?

Interferes with DNA synthesis and mitosis

A client has an increased serum lactic acid level. The physician understands this is indicative of which disease process?

Ischemia

Which statement is true in relation to lead exposure?

Lead is absorbed through the gastrointestinal tract or the lungs.

Intracellular buildup of substances that can be either normal or toxic occurs in which area of the cell?

Lysosome

A public health nurse is conducting a wellness seminar in which a participant has asked how to minimize the potentially harmful effects of free radicals. What should the nurse recommend?

Make dietary changes and limit UV exposure.

A client with hyperparathyroidism has hypercalcemia. Which result is a likely consequence?

Metastatic calcification

Which change exemplifies physiologic hypertrophy?

Muscle mass increase with exercise

What happens as a cell's workload declines? Select all that apply

Oxygen consumption decreases. Protein synthesis decreases. Cell size decreases.

Clinical manifestations of radiation injury result from acute cell injury, dose-dependent changes in the blood vessels that supply the irradiated tissues, and fibrotic tissue replacement. What are these clinical manifestations?

Radiation cystitis, dermatitis, and diarrhea from enteritis

How do free radicals damage cells?

Reacting with proteins and lipids thereby damaging cell membranes

Parents of a 4-year-old child discovered the child has been chewing and swallowing imported toy figurines that have tested positive for lead. Which blood test should the care team prioritize?

Red blood cell (RBC) levels

Which child is at greatest risk of lead toxicity?

The child with a lead level of 10 μg/mL (0.48 μmol/L)

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?

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

A nurse is teaching a class on health promotion and includes information about the risk from ultraviolet radiation. Which concepts should be included in this class? Select all that apply.

Ultraviolet radiation increases the risk of skin cancer. Ultraviolet radiation damages DNA.

Which condition is an example of physiologic hyperplasia?

Uterine enlargement in pregnancy

A client has developed acute encephalopathy from lead toxicity. The nurse will likely assess which manifestations in this client? Select all that apply.

Vomiting Ataxia Seizures Papilledema Coma

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.

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?

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.

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:

atrophy.

The nurse in an infectious-disease clinic will primarily treat injuries to tissues and cells caused by:

biologic agents.

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.

In a genetic disorder called xeroderma pigmentosum, an enzyme needed to repair sunlight-induced DNA damage is lacking. This autosomal recessive disorder is characterized by:

extreme photosensitivity and a greatly increased risk of skin cancer in skin that has been exposed to the sun.

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:

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:

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

Which describes hypertrophy?

increased size of the cell

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

A client has developed cell atrophy. The most likely cause would be:

ischemia.

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:

lead exposure

A mother rushes her 4-year-old child to the emergency department after she found an empty Tylenol (acetaminophen) bottle beside her child. The nurse is trying to explain why it is so important to give the child ipecac to induce vomiting in order to prevent:

liver failure.

Which cellular change(s) is considered adaptations to the external environment? Select all that apply.

metaplasia hyperplasia hypertrophy

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:

metaplasia.

The physical therapist is evaluating a male client who has increased his muscle mass by exercising. The therapist understands this physiologic process is known as:

physiologic hypertrophy.

Which process associated with cellular injury is most likely to be reversible?

sponse: Cell damage resulting from accumulation of fat in the cytoplasm

A client has been diagnosed with a gram-negative bacillus. The health care providers know these bacteria may produce clinical manifestations such as high temperature, high respiratory rate, and low blood pressure. These manifestations are primarily caused by:

the outer layer of the bacterial membrane acting as an endotoxin.