Pathophysiology Week 4-6 Quiz

When a nurse is asked what usually causes encephalitis, what is the nurse's best answer? A. A viral infection B. A bacterial infection C. A parasitic infection D. A fungal infection

A. A viral infection Encephalitis is usually caused by a virus, such as the West Nile virus, and manifests with symptoms similar to meningitis.

The nurse is seeking information about proto-oncogenes. Through a reputable source the nurse learns that a proto-oncogene is: A. A normal, nonmutant gene. B. A frameshift mutation gene. C. An inactive gene. D. A tumor-suppressor gene.

A. Anormal, nonmutant gene. A proto-oncogene normally codes for proteins such as growth factors and growth factor receptors. A normal proto-oncogene does not cause cancer.

Which statement indicates that the nurse understands the different types of headaches? One classification of headaches is called: A. Cluster. B. Hemiparesis. C. Hematoma. D. Neurogenic.

A. Cluster. Common types of headaches include migraine, cluster, and tension.

ALS is caused by: A. Degeneration of lower and upper motor neurons. B. Neurofibromin, a tumor suppressing protein. C. Degeneration of myelin in the brain and spinal cord. D. Spinal cord compression with radicular pain.

A. Degeneration of lower and upper motor neurons. Amyotrophic lateral sclerosis (ALS) is caused by the degeneration of upper and lower motor neurons, resulting in extreme muscle weakness and eventual paralysis.

Autonomic hyperreflexia is caused by: A. Stimulation of sensory/pain receptors below the level of the spinal cord lesion. B. Activation of brain receptors in the ventricles at the level of the spinal cord lesion. C. Structural defects of the spine involving the lamina or neural arch of the vertebra. D. The vertebra sliding forward and onto the vertebra below, which causes pressure.

A. Stimulation of sensory/pain receptors below the level of the spinal cord lesion. In autonomic hyperreflexia, sensory receptors below the level of the cord lesion are stimulated.

A nurse is describing the pathophysiology of a herniated disk. Which information should the nurse include? A. The nucleus pulposus extrudes and compresses the nerve root. B. Bleeding in the white matter of the brain causes pressure on the reflex arc. C. A tangle of malformed vessels is obstructing the annulus fibrosus. D. The arachnoid villi is obstructed and leads to hydrocephalus placing pressure on the cord.

A. The nucleus pulposus extrudes and compresses the nerve root. A herniated disk allows the gelatinous material (the nucleus pulposus) to extrude and compress the nerve root.

A nurse is teaching the staff about tissue loss in cancer wasting. Which information should the nurse include? A factor that contributes to the tissue loss in cancer wasting is: A. The release of cytokines. B. Malabsorption of iron. C. Direct invasion of the bone marrow. D. Defects in erythropoietin production.

A. The release of cytokines. Cytokines, including TNF-α, IL-6, and interferon-δ appear to cause the metabolic alterations associated with tissue loss in cancer wasting.

A nurse is describing the pathophysiology of myasthenia gravis. Which information should the nurse include? A. This is an autoimmune disease mediated by antibodies against the acetylcholine receptors, resulting in defective nerve impulses. B. The lesions may occur in the cerebrum, hypothalamus, or pons, especially at the neuromuscular junctions. C. This is a group of autosomal dominant disorders of the nervous system in the myelin sheath. D. This is a recessive disorder originating from the arachnoidal cap cells in the dura mater.

A. This is an autoimmune disease mediated by antibodies against the acetylcholine receptors, resulting in defective nerve impulses. Myasthenia gravis is an acquired chronic autoimmune disease mediated by antibodies against the acetylcholine receptor (AChR) at the neuromuscular junction.

A patient has a brief episode of neurological deficits that resolves within 12 hours with a return to normal functioning. Which diagnosis will the nurse observe documented on the chart? A. Transient ischemic attack B. Stroke C. Cerebrovascular accident D. Cluster attack

A. Transient ischemic attack The new definition for transient ischemic attack (TIA) is a brief episode of neurologic dysfunction caused by a focal disturbance of brain or retinal ischemia with clinical symptoms typically lasting more than 1 hour; no evidence of infarction; and complete clinical recovery.

A nurse is explaining variant genes to a group of nursing students. When discussing the retinoblastoma gene, what type of gene is the nurse describing? A. An oncogene B. A tumor-suppressor gene C. A caretaker gene D. A growth-factor gene

B. A tumor-suppressor gene One of the first discovered tumor-suppressor genes, the retinoblastoma (RB) gene, normally strongly inhibits the cell division cycle.

A patient developed a subdural hematoma within 12 hours of the injury. Which diagnosis will the nurse observe documented on the chart? A. Subacute subdural hematoma B. Acute subdural hematoma C. Chronic subdural hematoma D. Subchronic subdural hematoma

B. Acute subdural hematoma Acute subdural hematoma develops within 48 hours of the injury.

A patient with HIV has painful burning dysesthesias and paresthesias, especially in the extremities. What condition will the nurse see documented in the chart? A. CNS neoplasms B. HIV neuropathy C. HIV-associated dementia/cognitive disorders D. Opportunistic infections

B. HIV neuropathy Painful, burning dysesthesias and paresthesias, typically in the extremities, are present in individuals with HIV neuropathy.

During the assessment of a patient with meningitis, the nurse wants to test for nuchal rigidity. Which test will the nurse implement? A. Babinski B. Kernig C. Temperature D. Homan

B. Kernig Meningismus (nuchal rigidity) may be elicited through a positive Kernig or Brudzinski sign.

The nurse is caring for a patient with myasthenia gravis. If either a myasthenic or cholinergic crisis occurs, the nurse should: A. Administer edrophonium chloride (Tensilon). B. Monitor for respiratory arrest. C. Assess for levels of IgM. D. Check for spondylolysis.

B. Monitor for respiratory arrest. As in myasthenic crisis, the individual is in danger of respiratory arrest during a cholinergic crisis.

The nurse is assessing the patient for meningitis. The nurse bends the patient's neck, and the patient experiences neck pain and rigidity. How would the nurse chart this? A. Negative Kernig sign B. Positive Brudzinski sign C. Negative Brudzinski sign D. Positive Kernig sign

B. Positive Brudzinski sign A positive Brudzinski sign (passive flexion of the neck produces neck pain and increased rigidity) is an indication of meningitis.

A patient has a recent spinal cord injury. Which term should the nurse use to describe the loss of reflex function below the level of injury/lesion? A. Autonomic hyperreflexia B. Spinal shock C. Degenerative disk disease D. Low back pain

B. Spinal shock In spinal shock, reflex function is completely lost in all segments below the lesion.

A nurse is preparing a presentation on progressive neurological disorders. Which concept should be taught? A. Multiple sclerosis—demyelinating disorder affecting both central and peripheral nervous systems B. Guillain-Barré syndrome—impaired central nerve damage causing descending motor paralysis C. Amyotrophic lateral sclerosis—degenerative disorder of both upper and lower motor neurons D. Myasthenia gravis—IgE antibodies attach to acetylcholine receptors at the neuromuscular junctions

C. Amyotrophic lateral sclerosis—degenerative disorder of both upper and lower motor neurons Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig disease, is a degenerative disorder of both upper and lower motor neurons that causes progressive muscle weakness and wasting.

Which statement made by the cancer patient indicates the need for more teaching? A major cause of cancer pain is: A. Direct pressure on tissues. B. Metastases to bone. C. Cancer cells residing in lymph nodes. D. Release of inflammatory chemicals.

C. Cancer cells residing in lymph nodes. Cancer cells in lymph nodes are not associated with pain. Direct pressure, obstruction, invasion of a sensitive structure, stretching of visceral surfaces, tissue destruction, infection, and inflammation all can cause pain.

Which of the following treatments to help cancer-related or chemotherapy-related anemia should the nurse discuss with the patient? A. Exercise B. Chemotherapy C. Erythropoietin D. Calcium and magnesium supplements

C. Erythropoietin Exogenous erythropoietin can be administered to stimulate bone marrow production of red blood cells.

A patient's forehead hit the steering wheel during a motor vehicle accident. Which part of the brain received the coup injury? A. Occipital B. Left hemisphere C. Frontal D. Brainstem

C. Frontal Focal brain injuries produced by something striking the front of the head usually produce only coup injuries, or those occurring directly beneath the point of impact.

A patient is preparing to receive adjuvant therapy for cancer. What should the nurse tell the patient to reinforce teaching? This type of therapy: A. Is given after cancer surgery. B. Is given before cancer surgery. C. Enhances proto-oncogenes. D. Inhibits proto-oncogenes.

C. Is given after cancer surgery. Adjuvant chemotherapy is given after surgical excision of a cancer with the goal of eliminating micrometastases.

When explaining cancer that extends to organs or tissues distant from the site of origin, what term should the nurse use? A. Apoptosis B. Benign C. Metastasis D. Malignancy

C. Metastasis Metastasis is the extension of cancer to distant tissues and organs.

While reviewing a patient's health history, which finding will most alert the nurse to the possible development of a chronic subdural hematoma? A. Peripheral nerve trauma B. Brain cancer C. Prior brain atrophy D. Meningitis

C. Prior brain atrophy Prior brain atrophy is a major risk factor in the development of chronic subdural hematomas.

An oncologist is discussing the process of metastasis. Which information should the oncologist include? For metastasis to occur, tumor cells must be capable of: A. Withstanding extreme temperatures. B. Detecting elevated calcium levels. C. Surviving in the bloodstream. D. Eliminating lymph nodes.

C. Surviving in the bloodstream. Cancers often spread first to regional lymph nodes through the lymphatics and then to distant organs through the bloodstream.

A patient with cancer has poor muscle functioning and fatigue. Which cytokines/inflammatory mediators does the nurse suspect is causing these problems? A. Interleukin-6 and T-cell necrosis factor B. B-cell stimulating factor and interleukin-4 C. Tumor necrosis factor and interleukin-1 D. Interleukin-7 and tumor stimulating factor

C. Tumor necrosis factor and interleukin-1 Other areas of research for fatigue include muscle function consequences from metabolic products of cancer treatment and associated muscle loss from circulating cytokines (e.g., tumor necrosis factor [TNF] and interleukin-1 [IL-1]).

A patient has a subdural hematoma. A nurse realizes that the bleeding is occurring: A. Deep within the herniated nucleous. B. Deep within the brain. C. Between the dura mater and the skull. D. Between the dura mater and the brain.

D. Between the dura mater and the brain. Subdural hematomas (bleeding between the dura mater and the brain) arise in 10% to 20% of persons with traumatic brain injury.

A patient with a spinal cord injury (T6 level) reports a headache. The patient's blood pressure is 296 systolic, and the patient is sweating. Which intervention is most appropriate? A. Prepare the patient for surgery. B. Administer pain medication for headache. C. Start CPR. D. Check the patient's bladder.

D. Check the patient's bladder. The most common cause is a distended bladder or rectum, but any sensory stimulation can elicit autonomic hyperreflexia.

A nurse is describing the pathophysiology of subarachnoid hemorrhage (SAH). Which information should the nurse include? A. Muscle spasms occur in response to injury. B. Intracranial pressure is unchanged. C. Brain myelin is demylinated by the bleeding. D. Impaired reabsorption of cerebrospinal fluid occurs.

D. Impaired reabsorption of cerebrospinal fluid occurs. The blood clogs arachnoid granulations/villi (impairing CSF reabsorption).

A patient is experiencing leukopenia from cancer and chemotherapy treatment. Which condition should the nurse assess for in this patient? A. Allergic reactions B. Autoimmune disease C. Bleeding D. Infection

D. Infection Leukopenia, which is manifested by a decreased white blood cell count, increases an individual's risk for infection and sepsis.

Which intervertebral disks should the nurse assess first for herniation? A. C5-C7 B. T6-T8 C. T12-L3 D. L4-S1

D. L4-S1 Because of the loads and strain the lower back endures, the disks of L4-L5 and L5-S1 are the most likely to herniate.