HCR 240: Ch. 3
Which statement would a nurse tell a client to best describe apoptosis? "Apoptosis is the natural removal of injured or worn out cells." "Apoptosis describes increase in number of cells." "Apoptosis occurs in irreversibly damaged cells." "Apoptosis is an increase in the size of cells."
"Apoptosis is the natural removal of injured or worn out cells."
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 androgen levels the cells in your endometrial lining have increased in size causing a thickening." "In response to increased uterine wall resistance the endometrial cells have grown in size, resulting in a thicker uterine wall." "In response to estrogen levels endometrial cells have increased in number, resulting in a thickening of the endometrium." "The cells in your uterus are abnormal in size and shape and you will require more tests to know what this means."
"In response to estrogen levels endometrial cells have increased in number, resulting in a thickening of the endometrium."
Which statement would a nurse tell a client that best describes a lab finding of metaplasia? "This is a decrease in the oxygen-carrying capacity of the cells." "This is a change in cell form as it adapts to increased work demands or threats to survival." "This is a decrease in the size of the cell." "This is a change in the number of cells as they adapt to change."
"This is a change in cell form as it adapts to increased work demands or threats to survival."
A client has been exercising his arms repeatedly. Which statement by the nurse explains the increase in the size of the arms? "You have increased your number of cells due to increased oxygenation." "Your cells have hypertrophied in response to increased workload." "You have caused the cells to clump together in response to exercise." "Your cells have atrophied in response to increased oxygen."
"Your cells have hypertrophied in response to increased workload."
A nurse is caring for four clients. Which client is at greatest risk for high blood levels of lead? A 2-year-old anemic child who lives in a turn-of-the-century home A 17-year-old student who takes a woodworking class A 62-year-old smoker with hypercalcemia A 30-year-old office worker with asthma
A 2-year-old anemic child who lives in a turn-of-the-century home
Which client would be an example of an individual experiencing cellular atrophy? A hypertensive, noncompliant client who has developed a progressive increase in left ventricular mass A female client with the change in uterine size as a result of pregnancy A postnephrectomy client whose remaining kidney enlarges to compensate for the loss A middle-aged female experiencing menopause due to loss of estrogen stimulation
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? Drugs only have positive effects on cells. Drugs only have bad effects when they have side effects. Drugs do not injure tissues or cells. Antineoplastic drugs directly damage cells.
Antineoplastic drugs directly damage cells.
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 Cell necrosis Apoptosis Hypoxia
Apoptosis
Which term describes how cells can adapt to changes in threats to survival? Select all that apply. Atrophy Necrosis Apoptosis Hyperplasia Hypertrophy
Atrophy Hypertrophy Hyperplasia
What happens when a cell is confronted with a decrease in work demands? Cell becomes smaller. Cell size increases. Cell dies. Energy expenditure increases.
Cell becomes smaller.
Which process associated with cellular injury is most likely to be reversible? Apoptosis Cell damage resulting from accumulation of fat in the cytoplasm Cell damage resulting from accumulation of free radicals Cellular changes as a result of ionizing radiation
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 increased in size due to increased oxygenation. Cells are replaced in response to chronic irritation. This represents cancerous cells. These are nonreversible cell changes.
Cells are replaced in response to chronic irritation.
A client presents for a scheduled Papanicolaou (Pap) test. What type of problem will the clinician examining the cell samples look for? Abnormally high numbers of cells in a specified field Presence of unexpected cell types Ischemic changes in cell samples Changes in cell shape, size, and organization
Changes in cell shape, size, and organization
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 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.
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? Compensatory hyperplasia Metaplasia Organ atrophy Physiologic hypertrophy
Compensatory hyperplasia
A client has suffered nerve damage in his right arm. What can the nurse expect to happen to the muscles in that arm? Decrease in the size of the cells (atrophy) Increase in size (hypertrophy) as the cells adapt to the change Increase in number of cells (hyperplasia) as they adapt to change Changes in the form of the cells (metaplasia)
Decrease in the size of the cells (atrophy)
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? Increased oxygen consumption Increased mitochondrial growth Decreased size of organelles Decreased programmed cellular death
Decreased size of organelles
Which situation causes atrophy? Select all that apply. Denervation Decreased blood flow Increased endocrine stimulation Disuse Increased nutrition
Denervation Decreased blood flow Disuse
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 Atrophy Hypertrophy
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. 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. 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.
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 cannot cause harm to the cell; only Gram-positive bacilli can harm the cell. Gram-negative bacilli excrete elaborate exotoxins that interfere with cellular production of ATP. Gram-negative bacilli release endotoxins that cause cell injury and increased capillary permeability. Gram-negative bacilli enter the cell and disrupt its ability to replicate.
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. You should take all the medications as prescribed by your health care provider. These medications are safe and most are available over-the-counter as well. It is your right to refuse this medication. I will inform the health care provider of your wishes.
Having uncontrolled GERD can increase your risk for esophageal cancer.
Which assessment supports the finding of lead toxicity? Heart rate 70 beats/min Blood pressure 140/90 mm Hg Hematocrit 40% Hemoglobin 9 g/dL (90 g/L)
Hemoglobin 9 g/dL (90 g/L)
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? Mechanical Hypoxic Endogenous Chemical
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? Inappropriate activation of apoptosis, which means death of your cells. Bacterial invasion into the foot and toe. Impaired arterial blood supply to your toe. Metaplastic cellular changes in your toe.
Impaired arterial blood supply to your toe.
Which situation causes hypertrophy? Increase in workload Increase in blood flow Decrease in blood flow Decrease in workload
Increase in workload
A client has been exposed to ultraviolet (UV) radiation. Which effect from the exposure is the nurse's primary concern? Increase in epidermal wrinkling Second-degree sunburn Increased risk of cancer Severe decrease in sebaceous secretions
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? Results in the accumulation of endogenous waste products in the cytoplasm Interferes with DNA synthesis and mitosis Decreases the action potential of rapidly dividing cells Stimulates pathologic cell hypertrophy and hyperplasia
Interferes with DNA synthesis and mitosis
The radiologist is reviewing potential types of radiation therapy for a client. Select the type of radiation that directly breaks down chemical bonds in a cell. Ionizing radiation Ultraviolet radiation Non-ionizing radiation Sunlight radiation
Ionizing radiation
Small amounts of lead accumulate to reach toxic levels in the human body. Lead is found in many places in the environment and is still a major concern in the pediatric population. What would the nurse teach the parents of a child who is being tested for lead poisoning? Keep your child away from peeling paint. Keep your child away from anything ceramic. Do not let your child read newspapers. Do not let your child tour a mine on a school field trip.
Keep your child away from peeling paint.
Which statement is true in relation to lead exposure? Increased calcium levels increase the risk of lead poisoning. Lead is absorbed through the gastrointestinal tract or the lungs. Increased iron increases the risk of lead poisoning. Lead is absorbed through the skin.
Lead is absorbed through the gastrointestinal tract or the lungs.
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? Monitor blood cholesterol levels and get sufficient sleep each night. Make dietary changes and limit UV exposure. Exercise regularly and take acetylsalicylic acid (ASA) 81 mg daily. Monitor blood glucose levels regularly and avoid tobacco use.
Make dietary changes and limit UV exposure.
The nurse is caring for a client with compensatory hyperplasia. What is the most likely cause of the hyperplasia? Benign prostate enlargement Skin warts Partial hepatectomy Pregnancy
Partial hepatectomy
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? Dermatitis, diarrhea from enteritis, and hunger Radiation cystitis, diarrhea from enteritis, and muscle spasms Radiation cystitis, dermatitis, and diarrhea from enteritis Diarrhea from enteritis, hunger, and muscle spasms
Radiation cystitis, dermatitis, and diarrhea from enteritis
What information should be included in the teaching plan of care for the parents of a child diagnosed with Tay-Sachs disease? The disorder involves tissue hyperplasia. The primary organ affected is the heart. Symptoms are often noted at birth. The disorder involves accumulation of abnormal lipids.
The disorder involves accumulation of abnormal lipids.
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. The changes to the client's liver resulted from undiagnosed liver metastases. The client may have had high levels of exposure to free radicals early in life. The presence of fat in the cytoplasm of liver cells was likely the result of a genetic predisposition.
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 Through increased levels of functioning Through decreased oxygen consumption By relying on other cells to increase workload
Through decreased oxygen consumption
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 does not pose a risk if it's cloudy or overcast outside. Ultraviolet radiation increases the risk of skin cancer. Ultraviolet radiation is only a problem in the summer months near the beach. Ultraviolet radiation, in small doses, poses no risk of skin cancer. Ultraviolet radiation damages DNA.
Ultraviolet radiation increases the risk of skin cancer. Ultraviolet radiation damages DNA.
Which condition is an example of physiologic hyperplasia? Benign prostatic hyperplasia Skin warts Uterine enlargement in pregnancy Endometrial hyperplasia
Uterine enlargement in pregnancy
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 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.
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? 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. 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. Cold causes injury to the cells in the body by injuring the blood vessels, making them leak into the surrounding tissue. 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.
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. hyperplasia. hypertrophy. metaplasia. atrophy.
atrophy.
The nurse in an infectious-disease clinic will primarily treat injuries to tissues and cells caused by: chemical agents. calcification. biologic agents. oncogenic agents.
biologic agents.
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: molecular theories. cellular theories. systems-level theories. evolutionary theories.
cellular theories.
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: wet gangrene. gas gangrene. liquefactive gangrene. dry gangrene.
dry gangrene.
The practitioner examines his client's foot and observes the great toe to be black and dry. The practitioner explains to the client that the dead tissue is caused by: caseous necrosis. gas gangrene. dry gangrene. liquefaction necrosis.
dry gangrene.
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: second-hand smoke exposure. congenital heart problems. liver problems as an infant. exposure to lead.
exposure to lead.
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: photosensitivity and a decreased risk of skin cancer in skin that has been exposed to the sun. white, scaly patches of skin that appear on black people after they have a sunburn. extreme photosensitivity and a greatly increased risk of skin cancer in skin that has been exposed to the sun. patches of pink, leathery pigmentation that replace normal skin after a sunburn.
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. hypoplasia. atrophy. 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: hyperplasia. hypertrophy. metaplasia. dysplasia.
hypertrophy.
A pregnant client reports that she constantly craves tuna sandwiches and eats one every day. The nurse determines that the client is at greatest risk for: low protein values of tuna. developing intolerance to red meat consumption. increased mercury levels that may affect fetal development. high caloric content of the tuna causing an increase in weight gain.
increased mercury levels that may affect fetal development.
A client has developed cell atrophy. The most likely cause would be: reinnervation. overuse. ischemia. endocrine stimulation.
ischemia.
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, columnar cells may turn into squamous cells as a method of adaptation known as: hyperplasia. anaplasia. metaplasia. dysplasia.
metaplasia.
A client with diabetes who is diagnosed with a gangrenous right heel ulcer presents with a wound that has no line of demarcation, is spreading rapidly, and has a foul odor. The health care worker recognizes these manifestations as: moist gangrene. gas gangrene. dry gangrene. internal gangrene.
moist gangrene.
