Patho Exam 1 Questions

A client is experiencing multiple stressors simultaneously. In which order does the chain of events occur during the alarm reaction when this client is stressed? 1. A stressor is sensed and the hypothalamus triggers corticotropin-releasing hormone 2. Anterior and posterior pituitary as well as the sympathetic nervous system are stimulated to release hormones 3. Norepinephrine, epinephrine, antidiuretic hormone, and adrenocorticotropic hormone are released 4. Norepinephrine increases blood pressure, and epinephrine causes bronchodilation and increased glycogenolysis 5. Blood glucose increases

1. A stressor is sensed and the hypothalamus triggers corticotropin-releasing hormone 2. Anterior and posterior pituitary as well as the sympathetic nervous system are stimulated to release hormones 3. Norepinephrine, epinephrine, antidiuretic hormone, and adrenocorticotropic hormone are released 4. Norepinephrine increases blood pressure, and epinephrine causes bronchodilation and increased glycogenolysis 5. Blood glucose increases

The nurse is taking a history on a combat veteran. All of the following client statements would support a diagnosis of PTSD EXCEPT: A. "I have been anxious for the past two weeks" B. "I feel disconnected from my wife" C. "I have recurrent nightmares about being shot at" D. "I can't finish reading a book chapter without getting distracted"

A. "I have been anxious for the past two weeks."

During which stage of the general adaptation syndrome is fight-or-flight first exhibited in a client? A. Alarm B. Adaptation C. Exhaustion D. Resistance

A. Alarm

In which stage of the General Adaptation Syndrome is the sympathetic nervous system response initiated? A. Alarm B. Resistance C. Exhaustion D. All of the above

A. Alarm

A nurse is teaching a health and wellness class about relaxation techniques to reduce stress. Which techniques should the nurse include? Select all that apply. A. Imagery B. Massage C. Meditation D. Biofeedback E. Concealment

A. Imagery B. Massage C. Meditation D. Biofeedback

Which information from the client indicates successful teaching by the nurse about the parasympathetic system? A. It slows the heart rate. B. It releases neuropeptide Y. C. It causes inflammatory effects. D. It works to enhance the sympathetic system

A. It slows the heart rate.

Which of the following white blood cells is the primary responder to bacterial infection? A. Neutrophil B. Eosinophil C. Basophil D. Lymphocyte

A. Neutrophil

Which of the following classes of HIV medications prevents the formation of viral RNA into DNA? A. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) B. Protease Inhibitors C. Fusion/Entry Inhibitors D. Integrase Inhibitors

A. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

Which of the following genetic alteration can result in the development of cancer? A. Proto-oncogenes are activated to oncogenes B. Oncogenes are activated to Proto-oncogenes C. Tumor Suppressor genes are activated - if we inactivate them it causes a problem D. An absence of the Familial Adenomatous Polyposis gene

A. Proto-oncogenes are activated to oncogenes

Which of the following physiological responses are evident in the stress response? (Select all that apply) A. Secretion of norepinephrine B. An increased level of ACTH C. Increased release of insulin: inhibits insulin D. Vasodilation: vasoconstriction E. Increased cardiac output

A. secretion of norepinephrine B. An increased level of ACTH E. Increased cardiac output

A PPD is administered to a client. Which of the following are true about the test? A. A positive test indicates that the client has active tuberculosis B. A positive test indicates that the client has been exposed to tuberculosis C. A positive PPD excludes possible exposure to tuberculosis D. The test can be read 24 hours after it is placed

B. A positive test indicates that the client has been exposed to tuberculosis

According to Selye's General Adaptation Syndrome, which stage will the client experience second when stress occurs? A. Alarm B. Adaptation C. Exhaustion D. Allostatic overload

B. Adaptation

Protein markers that stimulate an immune response are called which of the following? A. Leukocyte B. Antigen C. B cell D. T cell

B. Antigen

Which of the following is NOT a characteristic of cancer cells? A. Loss of cell cycle control B. Apoptosis C. Loss of contact inhibition D. Activation of Telomerase

B. Apoptosis

When cortisol levels increase what is the effect on the hypothalamus and pituitary? A. Increased secretion of CRH and ACTH B. Decreased secretion of CRH and ACTH C. Increased secretion of CRH and decreased secretion of ACTH D. Decreased secretion of CRH and increased secretion of ACTH

B. Decreased secretion of CRH and ACTH

Stimulation of the renin-angiotensin aldosterone system has which of the following physiological effects? A. Vasodilation B. Decreased serum potassium C. Decreased blood pressure D. Fluid excretion

B. Decreased serum potassium

The nurse is assessing the coping strategies of a client as part of risk factor management for the client's high blood pressure. Which assessment finding should the nurse identify as a maladaptive coping strategy? A. Going to dinner with friends once a week B. Eating twice a day rather than three times C. Attending a meditation class once a week D. Exercising for thirty minutes, twice a week

B. Eating twice a day rather than three times

Stimulation of the parasympathetic nervous system would have which of the following effects? A. Decreased salivation (increased) B. Increased intestinal motility C. Increased heart rate (decreased) D. Bronchodilation (bronchoconstriction)

B. Increased intestinal motility

A nurse is asked by a co-worker which physiologic changes occur when epinephrine is released during the stress response. How should the nurse reply? Select all that apply. A. Retention of water B. Increased lipolysis C. Bronchoconstriction D. Increased blood glucose E. Decreased cardiac output F. Increased force of cardiac contraction

B. Increased lipolysis D. Increased blood glucose F. Increased force of cardiac contraction

Which of the following clinical manifestations are consistent with the common cold? A. Temperature of 38.6 degrees Celsius B. Nasal congestion C. Facial pain when bending forward D. Pleuritic Chest Pain

B. Nasal congestion

Antibiotics are appropriate to treat which of the following respiratory infections? (Select all that apply) A. The Common Cold B. Sinusitis C. Influenza D. Pneumonia E. Tuberculosis

B. Sinusitis D. Pneumonia E. Tuberculosis

Which organism is the most common cause of community acquired pneumonia? A. Haemophilus Influenza B. Streptocossus Pneumoniae C. Mycoplasma Pneumoniae D. Chlamydia Pneumoniae

B. Streptocossus Pneumoniae

Cortisol has an anabolic effect on protein in which area of a client's body? A. The skin B. The liver C. The bones D. The connective tissues

B. The liver

Which of the following factors is most important in determining the degree of dysfunction caused by a benign neoplasm? A. The duration of abnormal cell growth B. The location of the tumor C. The agent responsible for the alteration in growth D. Hereditary factors

B. The location of the tumor

Which of the following results confirm infection with the HIV virus? A. The Elisa (EIA) antibody test is positive B. The western Blot antibody test is positive C. The viral RNA level in undetectable D. The CD4 count is 600 cells/µL

B. The western Blot antibody test is positive

Which of the following pathology reports would be associated with the highest grade of malignancy? A. Highly differentiated with a mitotic index of 7% B. Undifferentiated with a mitotic index of 80% C. Poorly differentiated with a mitotic index of 80% D. Moderately differentiated with a mitotic index of 50

B. Undifferentiated with a mitotic index of 80%

The nurse is assessing a client and recognizes which behaviors as an indication of allostatic overload? Select all that apply. A. Getting a massage once a week B. Waking up frequently during the night C. Turning down invitations to dine with friends D. Attending a music concert with family members E. Increasing the number of calories consumed each day

B. Waking up frequently during the night C. Turning down invitations to dine with friends E. Increasing the number of calories consumed each day

Which client finding supports the nurse's conclusion that a client is in the alarm stage of stress? A. no urine output for 8 hours B. elevated blood glucose levels C. white blood cell count of 4000 D. heart rate of 70 beats per minute

B. elevated blood glucose levels

Which of the following conditions is likely to result in chronic inflammation? (Select all that apply) A. A surgical wound B. Tuberculosis C. A laceration D. An Abscess E. An Abrasion

B. tuberculosis D. an abscess

When a client is stressed, which receptors are stimulated by catecholamines? Select all that apply. A. Endorphin B. α-adrenergic C. β-adrenergic D. Substance P E. Antidiuretic hormone

B. α-adrenergic C. β-adrenergic

A patient receives the first injection in an immunotherapy desensitization treatment. He soon develops hives, coughing, and wheezing. Which of the following actions should be taken first? A. Apply oxygen B. Start an IV C. Administer epinephrine D. Administer an antihistamine

C. Administer epinephrine

A client has been caring for an ailing mother for 18 months. In addition, the client has recently lost a job and is having difficulty finding a new one. Blood pressure has recently been running higher than normal. What is the client experiencing? A. Allostasis B. Homeostasis C. Allostatic overload D. Chronic homeostasis

C. Allostatic overload

A patient is being treated for cancer with chemotherapy that causes bone marrow suppression. Which of the following conditions can be attributed to bone marrow suppression? A. Pain B. Anorexia C. Anemia D. Nausea and Vomiting

C. Anemia

A patient is scheduled to begin external beam radiation to the right axilla. Which of the following instructions should be given to this patient? A. Apply a heating pad to promote circulation to the area - avoid heat B. Use cold compresses to relieve pain - avoid cold C. Do not apply deodorant to the right axilla D. Immobilize the right arm - won't help

C. Do not apply deodorant to the right axilla

A client develops a stress-related disease. Which stage of the general adaptation syndrome marked the onset of this disease? A. Alarm B. Reaction C. Exhaustion D. Termination

C. Exhaustion

Which cancer is most likely to be difficult to treat? A. Grade I, T1 N0 M0 B. Grade II, T1 N3, M0 C. Grade III, T3, N3, M1 D. Grade IV, T2, N0, M0

C. Grade III, T3, N3, M1

The nurse is teaching a patient who is diagnosed as being HIV+. Which of the following points should the nurse include in the teaching? (Select all that apply) A. The HIV virus can be eliminated from the body if the patient adheres to their HAART regimen B. The HIV virus uses the patient's red blood cells to replicate (NO uses CD4) C. HIV can be effectively managed with medications D. The patient can still pass the infection to others E. The patient is unlikely to contract opportunistic infections if the CD4 count is above 500

C. HIV can be effectively managed with medications D. The patient can still pass the infection to others E. The patient is unlikely to contract opportunistic infections if the CD4 count is above 500

The most common immunoglobulin (antibody) is which of the following? A. IgA B. IgE C. IgG D. IgM

C. IgG

When a client is stressed and epinephrine is released, which clinical manifestation will the nurse observe? A. Dilated pupils B. Slowed heart rate C. Increased blood glucose D. Decreased blood pressure

C. Increased blood glucose

When a client's body continues to mobilize and react to the actions of cortisol, norepinephrine, and epinephrine, which stage of the general adaptation syndrome is the client experiencing? A. Alarm B. Reaction C. Resistance D. Exhaustion

C. Resistance

Which of the following chemical mediators is involved in generating a febrile response to an infection? A. Histamine B. Bradykinin C. TNF-α D. Leukotrienes

C. TNF - a

Which one of the following characteristics of the immune system distinguishes antibody-mediated from cell-mediated immunity? A. The cells are called leukocytes B. The responses are specific to foreign invaders C. The long-term immunity can be transferred from person to person D. The cells arise from pluripotent stem cells

C. The long-term immunity can be transferred from person to person

Which of the following best describes an autoimmune disorder? A. The person has an inadequate number of immune cells B. The person cannot produce antibodies to foreign antigens C. The person forms antibodies against their own tissues D. The person does not have HLA coding for proteins on their cells.

C. The person forms antibodies against their own tissues

The nurse is evaluating the coping skills of a few clients experiencing stress. Which clients have maladaptive coping strategies? Select all that apply. A. "I close my eyes and visualize a happy movement of my life during stress." B. "I eat several chocolate bars to help me concentrate during stressful exams." C. "I take slow, deep breaths whenever I am stressed." D. "I drink herbal tea when I'm stressed." E. "I find ways to avoid situations and interactions that stress me out."

Client B Client E

Which of the following wounds would heal by secondary intention? A. An abrasion B. A sutured surgical wound C. A Stage I Pressure Ulcer D. A Stage III Pressure Ulcer

D. A stage III pressure ulcer

An influenza vaccine is indicated for which of the following clients? A. A healthcare worker B. A 55 year old with chronic lung disease C. A healthy 70 year old D. All of the above

D. All of the above

A person who is bitten by an animal with suspected rabies will be initially given an injection of antibodies against the rabies virus. This is an example of which type of immunity? A. Natural Active Immunity B. Artificial Active Immunity C. Natural Passive Immunity D. Artificial Passive Immunity

D. Artificial Passive Immunity

Which effect will the nurse expect to occur when a client's body releases cortisol? A. Increased sweating B. Decreased heart rate C. Decreased blood glucose D. Increased gastric secretions

D. Increased gastric secretions

Which type of tissue is best able to be regenerated into its original condition? A. Peripheral nerves - do not regenerate B. Myocardium - do not regenerate C. Liver cells - regenerates but not as well as oral mucosa D. Oral mucosa

D. Oral mucosa

A patient infected with HIV has a CD4 count of 190 cells/µL. What does this indicate about the patient's condition? A. The patient is in the window period B. The patient is in the latent phase of infection C. The patient has chronic HIV infection D. The patient has AIDS

D. The patient has AIDS

Which of the following is unlikely to transmit HIV? A. Blood B. Vaginal Secretions C. Breast Milk D. Urine

D. Urine

Which of the following is NOT a physiological response to stress? A. An increase in cortisol levels B. An increase in catecholamines sympathetic nervous system hormones C. An increase in blood pressure D. A decrease in inflammatory response

D. a decrease in inflammatory response