NUR221 - Unit 1 Review

Which term indicates the forecast or predication of how an individual will proceed through the disease process? A. Morbidity B. Prognosis C. Metastasis D. Remission

B The prognosis for a client is the forecast or prediction of how the individual will proceed through the disease process. Morbidity is a negative outcome of disease that affects quality of life. Metastasis refers to the spread of disease from one part of the body to another. Remission refers to the reduction or disappearance of signs and symptoms associated with a disease.

Damage to cells resulting from frostbite is classified as which type of injury? A. Mechanical B. Thermal C. Chemical D. Endogenous

B Thermal injury is caused by extremes of temperature, as occurs with burns and frostbite. Mechanical injury can be caused by impact of a body part causing direct injury, such as falling off a skateboard or a bike. Chemical toxins include both exogenous and endogenous forms. Endogenous toxins are toxins from within the body system that cause harm to cells. Exogenous toxins are toxins from the external environment that cause harm to cells.

A nurse is caring for a client who has a sprained ankle. The client notices that the ankle is swollen, red, and hot. Why did the ankle get hot? A. Exudate accumulated at the site B. Increased blood flow to the site C. The ankle became infected D. A thermal injury occurred

B Vasodilation occurs in response to injury. Vasodilation causes blood flow to increase to the injured site and heat to occur. Thermal injuries, exudate, and infection are not the cause of local heat related to a sprained ankle.

Which condition is most likely to be associated with atrophic changes in breast tissue? A. Puberty B. Pregnancy C. Menopause D. Menarche

C The aging process can result in decreased cell size (atrophy), which translates into decreased organ size. Atrophy also can occur as a response to the removal of hormonal signals that stimulate growth, resulting in involution, or shrinkage, of tissues and organs. Atrophy may result in the manifestation of clinical signs and symptoms stemming from the decrease in size and function of the organ involved.

What is the MOST common cause of chronic pancreatitis? A. Autoimmune disease B. Hereditary disease C. Alcohol use disorder D. Gallstones

C The common causes of chronic pancreatitis are alcohol use disorder (60% to 70%), autoimmune or hereditary disease (10%), and in 20% of cases the cause is unknown. Gallstones cause acute pancreatitis.

Which transport mechanism requires energy? A. Diffusion B. Osmosis C. Facilitated diffusion D. Primary active transport

D Primary active transport requires the direct use of energy in the form of adenosine triphosphate (ATP) when transporting particles across the plasma membrane. Diffusion is the movement of particles from an area of higher concentration to an area of lower concentration, which is an example of passive transport. Osmosis is the process by which water passively moves across the semipermeable plasma membrane. Facilitated diffusion is the movement of some substances across the plasma membrane aided by the use of transport proteins.

Systemic lupus erythematosus is an example of which type of hypersensitivity? A. Type I B. Type II C. Type III D. Type IV

Systemic lupus erythematosus (SLE) is an example of a type III hypersensitivity reaction. SLE is an autoimmune disease and features responses from both the innate and humoral immune systems. Anaphylaxis is an example of a type 1 hypersensitivity reaction. Rh isoimmunization is an example of a type II hypersensitivity reaction. Direct cell-mediated cytotoxicity is an example of a type IV hypersensitivity reaction.

What factor causes extensive scarring in cases of chronic inflammation? A. Fibroblast activity B. Degradation of collagen C. Proteinase activity D. Loss of labile cells

A Fibroblasts are active in chronic inflammation. Fibroblasts are responsible for collagen development, which contributes to the extensive scarring characteristic of chronic inflammation. Degradation of collagen, proteinase activity, and a loss of labile cells do not lead to extensive scarring caused by chronic inflammation.

Without which process would leukocytes be unable to move across endothelial cells and get to the site of injury? A. Diapedesis B. Separation C. Adherence D. Leukocytosis

A In the process of diapedesis, cells can move between and through endothelial junctions. Separation, adherence, and leukocytosis are not associated with leukocytes moving across endothelial cells.

Which term indicated a fully differentiated body part with specialized functions? A. Cell B. Organ C. Tissue D. Organ system

B Organs are defined as fully differentiated body parts with specialized functions. Organ systems are groups of organs working together for a specific function. Cells are the smallest structural and functional units of the human organism. Tissues are groups of similar cell types that combine to form a specific function.

All blood cells are produced from which type of precursor cells? A. Myeloid progenitor B. Lymphoid progenitor C. Pluripotent stem D. Neutrophil

C The pluripotent hematopoietic stem cells originate in the bone marrow and produce two precursor cell types: the lymphoid progenitor and the myeloid progenitor. The immune cells of adaptive immunity all have a common origin in the pluripotent hematopoietic stem cells. Neutrophils are a type of granulocyte produced by myeloid progenitor cells.

Which organelle is responsible for synthesis of proteins by bound ribosomes? A. Rough endoplasmic reticulum B. Smooth endoplasmic reticulum C. Golgi apparatus D. Lysosome

A The rough endoplasmic reticulum contains ribosomes bound to its membrane that synthesize protein and produces lysosomal enzymes (acid hydrolyses). Smooth endoplasmic reticulum is responsible for the synthesis of lipids, lipoproteins, and steroid hormones, and the regulation of intracellular calcium. The Golgi apparatus prepares substances produced by the endoplasmic reticulum for secretion out of the cell. Lysosomes digest cellular debris with hydrolytic enzymes.

The charge nurse is providing staff education on the topic of immunology. Immunology is the study of which? Select all that apply. A. Structure of the immune system B. Function of the immune system C. Phenomena of induced sensitivity and allergy D. Microscopic organisms E. Nature of disease

A, B, C Immunology is the study of the structure and function of the immune system, as well as immunity, induced sensitivity, and allergy.

The nurse is providing education on the essential steps necessary for a successful cellular response. The nurse should include which step(s)? Select all that apply. A. Migration B. Adherence C. Chemotaxis D. Degranulation E. Phagocytosis

A, B, C The cellular response is regulated by inflammatory mediators. Three steps are needed for a successful cellular response: (1) chemotaxis, (2) cellular adherence, and (3) cellular migration. Degranulation is the process by which mast cells break apart and release inflammatory mediators in the form of extracellular granules (grainlike particles). Phagocytosis is the process by which a cell uses its plasma membrane to engulf a large particle.

The nurse is caring for a client with rheumatoid arthritis. Which categorize rheumatoid arthritis? Select all that apply. A. Autoimmune processes against synovial cells B. Formation of immune complexes C. Genetic susceptibility and a triggering event D. Chronic inflammatory processes predominated by neutrophils E. Disease onset commonly between 30 and 50 years of age

A, B, C, E Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation and hyperplasia of the synovial membranes with increased synovial exudate, leading to swelling and thickening of the synovial membranes, joint erosion, and pain. The onset of the disease typically occurs between the ages of 30 and 50 years. Although the exact cause of RA is unknown, the etiology is likely a combination of genetic susceptibility, an immune-triggering event, and the subsequent development of autoimmunity against synovial cell. Rheumatoid arthritis is not characterized by a predominance of neutrophils.

Which plasma system is responsible for inducing opsonization? A. Kinin B. Complement C. Clotting D. Cell lysis

B The primary role of complement is to destroy and remove microorganisms to prevent infection through opsonization (making bacteria vulnerable to phagocytosis) and cell lysis (destruction). Kinin amplifies the inflammatory response by triggering other inflammatory mediators. Clotting promotes coagulation through a cascade of clotting factors.

Which symptom is a systemic manifestation of influenza? A. Fever B. Chest pain C. Cough D. Runny nose

A Systemic manifestations present throughout the body and are not confined to one area. Fever would be an example of a systemic manifestation. The other options are manifestations that occur directly at the site; these are considered local manifestations.

What type of granulation tissue forms over the inflamed synovium and cartilage in rheumatoid arthritis? A. Matrix tissue B. Ankylosis C. Pannus D. Nodular

C Pannus is granulation tissue that forms over the inflamed synovium and cartilage as a result of accelerated angiogenesis caused by rheumatoid arthritis. Nodules, matrix tissue, and ankylosis are not granulation tissues formed over inflamed synovium and cartilage.

What term describes how a disease starts and develops, from onset to the point when the disease presents itself? A. Etiology B. Pathophysiology C. Pathogenesis D. Pathology

C Pathogenesis is the term to describe how a disease starts and develops, from onset to the point when the disease presents itself. Etiology refers to the precise cause of a disease. Pathophysiology is the term used to define the mechanisms of human body functioning. Pathology refers to studying the causes and effects of disease.

What is a common cause of acute pancreatitis? A. Blockage of ducts by gallstones B. Infection by Helicobacter pylori C. Smoking D. Radiation exposure

A Acute pancreatitis may occur when there is an injury to the acinar cells, zymogen, pancreatic duct, or protective digestive feedback mechanisms in the exocrine pancreas. Common causes include duct blockage by gallstones or excessive alcohol use. Smoking, Helicobacter pylori, and radiation exposure are not associated with acute pancreatitis.

What process is interrupted when antibacterial drugs disrupt the cell wall of a bacterium? A. Protein and DNA synthesis B. Phagocytosis C. Motility D. Adherence

A Antibacterial drugs can inhibit synthesis of the bacterial cell wall, damage the cytoplasmic membrane, and disable nucleic acid metabolism and protein synthesis. Antibacterial drugs do not disrupt phagocytosis, motility, or adherence.

Which cell is MOST likely responsible for an immediate release of chemical mediators right at the site of injury? A. Mast cell B. Platelet C. Eosinophil D. Endothelial

A Mast cells are important inflammatory mediators responsible for immediate release through degranulation. The other cells types are not immediately released in the same manner.

What process may cause columnar cells to turn into squamous cells as a method of adaptation to a persistent stressor? A. Metaplasia B. Dysplasia C. Apoptosis D. Hyperplasia

A Metaplasia refers to the changing of one cell type to another. This is one way that cells can adapt to a persistent stressor. Dysplasia refers to the actual change in cell size, shape, uniformity, arrangement, and structure. Hyperplasia is an increase in cell number. Apoptosis is programmed cell death prompted by a genetic signal and is designed to replace old cells with new.

Phagocytosis is an example of which type of cellular function? A. Ingestion B. Respiration C. Communication D. Reproduction

A Phagocytosis is the process of ingesting large particles such as cells, bacteria, and damaged cellular components by cells called phagocytes. This is one of the specific processes of ingestion that allow the cell to ingest substances necessary for its own use into the cytoplasm. Phagocytosis is not an example of respiration, communication, or reproduction.

The nurse is planning education on the importance of wearing a helmet when riding a bike. What level of prevention is the nurse describing? A. Primary B. Secondary C. Tertiary D. Quaternary

A Primary prevention, such as wearing a bike helmet focuses on protecting people from developing a disease or injury. Secondary prevention is the early detection of disease through screening and early treatment. Tertiary prevention focuses on rehabilitation after diagnosis of a disease or injury. Quaternary prevention relates to overmedicalization.

The major histocompatibility complex (MHC) class I molecule is recognized by which cell type? A. CD8 B. CD4 C. TH1 D. TH2

A The MHC class I molecule is found on nucleated body cells and is recognized by the cytotoxic CD8 T lymphocytes. The MHC class II molecule is found on antigen-presenting cells (APCs) and is recognized by the helper CD4 T lymphocytes (TH1 or TH2).

What causes the loss of cell-mediated and humoral immunity in acquired immunodeficiency syndrome (AIDS)? A. Loss of CD4 lymphocytes B. Loss of CD8 lymphocytes C. Loss of plasma B lymphocytes D. Loss of memory B lymphocytes

A The hallmark of AIDS is the loss of cell-mediated and humoral immunity due to the loss of CD4 TH1 lymphocytes. Human immunodeficiency virus (HIV) is an enveloped retrovirus that infects CD4 helper T lymphocytes, dendritic cells, and macrophages. CD8, plasma B lymphocytes, and memory B lymphocytes are not infected by AIDS.

What membrane surface molecule is expressed on cytotoxic T lymphocytes? A. CD8 B. CD4 C. TH1 D. TH2

A The molecule CD8 is expressed on the surface of cytotoxic T lymphocytes (CD8 T cells). Helper T lymphocytes express CD4 on their surfaces. TH1 and TH2 are the two primary classes of CD4 T lymphocytes.

What is the PRIMARY cell type involved only in adaptive immunity? A. B lymphocyte B. Neutrophil C. Macrophage D. Dendritic cells

A The primary cell type involved in adaptive immunity is B lymphocytes. Macrophages, neutrophils, and dendritic cells are the primary cell types involved in nonspecific, innate immunity.

The client asks the nurse, "When I squeeze acne pustules on my face, I notice clear fluid seeping from the opening. Should I be concerned?" Which response by the nurse is appropriate? A. "The fluid you are noticing is pus." B. "The fluid you are noticing is water." C. "The fluid you are noticing is exudate." D. "The fluid you are noticing is plasma."

C Exudate is a watery fluid that accumulates at the site of injury and has a high protein and leukocyte concentration. Plasma is the yellow liquid component of blood. Pus is a thick fluid that may be yellow or green. Wounds do not contain water.

Which condition is a fetal or newborn manifestation of Rh isoimmunization? A. Arrhythmia B. Respiratory distress C. Anemia D. Dehydration

C Fetuses suffering from Rh isoimmunization are at increased risk for the development of anemia, hydrops fetalis (swollen fetal tissues), and death. Severe hemolysis of fetal red blood cells can be worsened by increased erythropoiesis. Arrhythmia, respiratory distress, and dehydration are not symptomatic of Rh isoimmunization.

Which term indicates increased cell number caused by increased functional demand? A. Atrophy B. Hypertrophy C. Hyperplasia D. Dysplasia

C Hyperplasia is an increase in cell number, and hypertrophy is an increase in cell size. Both hypertrophy and hyperplasia can be caused by hormone signaling and an increased workload/functional demand. Dysplasia refers to the actual change in cell size, shape, uniformity, arrangement, and structure; it is often a cell's response to a chronic and persistent stressor. Atrophy is the decrease in individual cell size, and it can be caused by decreased functional demand on a cell.

The client sprained the ankle and is told to take ibuprofen to reduce the inflammation. What is the mechanism of action for the drug? A. Blocks chemokines B. Enhances mast cell activation C. Inhibits formation of prostaglandins D. Unknown

C Ibuprofen inhibits the conversion of arachidonic acid to prostaglandins to suppress inflammation. Chemokines are found in white blood cells and are not blocked by nonsteroidal anti-inflammatory drugs (NSAIDs). Mast cell activation is not affected by NSAIDs.

Which antibody class mediates the passive immunity obtained from pregnant parent to the fetus? A. IgA B. IgE C. IgG D. IgM

C IgG is the only immunoglobulin that is able to cross the placenta, providing passive immunity to the developing fetus. IgA provides passive immunity from the birth parent to newborn through breast milk. IgM is the initial circulating antibody produced in response to antigen challenge and the first to be produced by the newborn. IgE on the cell surfaces of mast cells and basophils leads to cellular degranulation upon antigen binding, triggering the release of chemical mediators involved with inflammation and allergies.

The client has a clinic appointment for a possible infection and is told that they have a high monocyte count. What does this count imply? A. The client has a streptococcal infection. B. The client has an acute infection. C. The client has a chronic infection. D. The client does not have an infection.

C Neutrophils are the earliest phagocytic responders. They increase quickly in response to acute infections. Chronic infection is associated with increased monocytes, lymphocytes, and macrophages. Streptococcal infection cannot be characterized solely by increased neutrophils.

A nurse in a rehabilitation unit is assisting a client who has had a stroke with relearning how to perform activities of daily living. What level of prevention is the nurse implementing? A. Primary B. Secondary C. Tertiary D. Quaternary

C Tertiary prevention focuses on rehabilitation after diagnosis of a disease or injury, such as rehabilitation following a stroke. Primary prevention focuses on protecting people from developing a disease or injury. Secondary prevention is the early detection of disease through screening and early treatment. Quaternary prevention relates to overmedicalization.

Which cells become differentiated in the bone marrow? A. Cytotoxic T lymphocytes B. Helper T lymphocytes C. Plasma cells D. T-cell receptors

C The B lymphocytes, developed in the bone marrow, differentiate into plasma cells after antigen-BCR binding. Cytotoxic T lymphocytes direct destruction of antigen-carrying cells. Helper T lymphocytes enhance humoral and cell-mediated responses of the immune system. Each T lymphocyte has a unique receptor, or T-cell receptor (TCR), which is able to bind to antigens, promoting a specific immune response.

Which statement(s) regarding testing a client for acromegaly is an accurate interpretation of the results? Select all that apply. A. Growth hormone levels will need to be collected daily for an entire week. B. The best time to collect growth hormone levels is during the middle of the night. C. Growth hormone should be measured as a component of a glucose tolerance test. D. Following ingestion of 75 g of glucose, it is normal for growth hormone levels to decrease. E. An elevated growth hormone level 1 hour after the glucose ingestion indicates that the negative feedback regulation is normal.

C, D Measurement of growth hormone is most accurate when measured as a component of a glucose tolerance test because growth hormone secretion is influenced by blood glucose levels. Under physiologic conditions, growth hormone levels decrease when blood glucose levels rise via negative feedback regulation. Growth hormone levels can be tested after a glucose tolerance test to determine if there is an alteration in negative feedback, indicating pathologic secretion of growth hormone. Within 2 hours of ingestion of 75 g of glucose, growth hormone is suppressed to less than 1 ng/mL (1 μg/L) under physiologic conditions. An elevated growth hormone level 1 hour after the glucose ingestion indicates that glucose did not suppress growth hormone secretion, leading to the diagnosis of acromegaly.

Antibodies are secreted from which cell type? A. Macrophage B. Cytotoxic T lymphocyte C. Helper T lymphocytes D. Plasma cells

D Antibodies, essential components of adaptive immunity, were first identified in the plasma cells. Effector cells are plasma cells that secrete antibodies. Macrophages are essential in mediating innate immunity. Cytotoxic T lymphocytes direct destruction of antigen-carrying cells. Helper T lymphocytes enhance humoral and cell-mediated responses of the immune system.

Which term indicates cell death associated with inflammation? A. Metaplasia B. Dysplasia C. Apoptosis D. Necrosis

D Cell death by necrosis is a disorderly process associated with inflammation. Necrosis is death of cells related to cell injury. Metaplasia refers to the changing of one cell type to another. Dysplasia refers to the actual change in cell size, shape, uniformity, arrangement, and structure. Apoptosis is programmed cell death prompted by a genetic signal and is designed to replace old cells with new.

Which type of granulocyte is present in the greatest number? A. Basophil B. Eosinophil C. Monocyte D. Neutrophil

D Neutrophils are present in the greatest number and are most important in the rapid response to bacterial infection. Eosinophils offer the greatest protection against parasites, whereas basophils complement the actions of mast cells, important in allergic reactions. Monocytes are not a type of granulocyte.

Which factor(s) affects the variability with which a pathogen is able to cause disease? Select all that apply. A. Infectivity B. Virulence C. Superinfection D. Toxigenicity E. Antigenic variability

A, B, C, D, E The following factors affect the variability with which the pathogen is able to elicit disease: virulence, infectivity, toxigenicity, antigenicity, antigenic variability, pathogenic defense mechanisms, coinfection, and superinfection.

Which proteins in the plasma membrane project into either the intracellular or the extracellular environment? A. Transmembrane proteins B. Integral proteins C. Peripheral proteins D. Channel proteins

C Peripheral proteins do not pass through the entire membrane, projecting into either the intracellular or the extracellular environment. Proteins that pass through the entire membrane are known as transmembrane proteins, allowing communication and transport between the extracellular and intracellular environments. Integral proteins are a specific type of transmembrane protein that, because of the tight binding to lipid tails, becomes part of the membrane itself. Integral proteins often form channels that allow for the transport of ions (atoms with an electrical charge) across the plasma membrane.

What type of hypersensitivity reaction involves failure of the development of self-tolerance? A. Immediate hypersensitivity B. Antibody-mediated C. Immune complex D. Autoimmune

D One of the critical functions of the immune system is to distinguish "self" from "nonself." When this recognition fails or is not controlled, an autoimmune reaction (directed at an individual's own tissues) can develop. Immediate hypersensitivity reactions involve degranulation of basophils and mast cells when IgE binds to an allergen. The reaction in antibody-mediated reactions is tissue specific, usually involving destruction of a target cell by antibody binding to antigen on the cell surface. Immune complex reactions involve complement activation stimulated by deposition of bound antigen to antibody.

Which characteristic explains why some pathogens do not cause disease in humans? A. Receptor binding B. Pathogenicity C. Invasiveness D. Potency

A One way that antibodies protect cells from pathogens is by receptor binding. This involves the binding of the antigen to the antibody preventing the antigen from infecting cells. Pathogenicity, invasiveness, and potency explain why pathogens cause diseases in humans.

What is the relationship between sever burns and the development of gastritis? A. Burns shunt blood away from the stomach. B. Eating spicy foods can burn the stomach. C. Burns increase blood flow to the stomach. D. Burns require the use of long-term analgesics, which irritate the stomach.

A Restriction or loss of perfusion to this layer can be a cause of gastritis. Altered tissue perfusion can occur in the case of burns when blood is shunted to vital organs and not to the stomach, causing the protective mucus barrier to form ulcers and perforate. Eating spicy foods, increased blood flow to the stomach, and long-term analgesics are not the reason that burns can cause gastritis.

The nurse is caring for a client with a family history of cardiovascular disease. Which finding would the nurse document as a symptom of cardiovascular disease? A. Chest pain B. Elevated heart rate C. Fever D. Obesity

A Symptoms are indicators that are reported by the ill individual and are considered the subjective manifestations because they cannot be directly observed by the practitioner. Heart rate, fever, and weight can all be measured by the provider. Chest pain is subjective and would be described by the client.

The charge nurse is educating a group of staff nurses about plasma membranes. Which description of the plasma membrane is accurate? A. Contains a single layer of lipids with polar heads B. Contains a single layer of lipids with nonpolar heads C. Contains a bilayer of lipids with polar heads D. Contains a bilayer of lipids with nonpolar heads

C The plasma membrane represents an organized structure composed of lipids, carbohydrates, and proteins arranged in a bilayer. The lipid bilayers are mainly made up of phospholipids. The phosphate connected to the lipid structure is known as the "head." The heads are polar or hydrophilic (having an affinity to water).

Which is a characteristic of resident flora? A. They live on sterile areas of the body. B. They cause harm to the body. C. They provide a type of specific immunity. D. They compete with disease-producing microorganisms.

D Resident flora are microorganisms that live on or within the body in nonsterile areas, such as the skin, mucous membranes, bowel, rectum, or vagina, without causing harm. Inflammatory and immune attacks are generally not waged against these inhabitants as long as the skin and mucosa remain intact. Resident flora compete with disease-causing microorganisms to protect the body against certain infections and to provide a type of natural immunity. They do not harm the body.

What condition causes most cases of chronic sinusitis? A. Nasal congestion B. Nasal polyps C. Allergies D. Untreated acute sinusitis

D Similar to acute sinusitis, chronic sinusitis often begins as stasis of secretions inside the sinuses, which can be triggered by mucosal edema or obstruction of the ostia. Most cases of chronic sinusitis are due to acute sinusitis that either is untreated or does not respond to treatment. Nasal congestion is a symptom of acute sinusitis. Nasal polyps may or may not be present in chronic sinusitis. Although chronic sinusitis can result from allergies, untreated acute sinusitis is more common.

Which characteristic BEST describes the inflammatory response? A. Specific response to microorganisms B. Initiated by certain types of injury C. Hormone-mediated D. Regulated by chemical mediators

D The inflammatory response is orchestrated through the work of potent chemical, also known as inflammatory mediators. The inflammatory response involves many types of injuries and microorganisms. The response is chemical mediated, not hormone-mediated.

How does the inflammatory response know when to retreat? A. Feedback mechanisms regulated by plasma protein systems B. Multiple processes of cellular inhibition C. Inhibition is time-dependent, the inflammatory response lasts 72 hours D. When all microorganisms have been destroyed

A Once the offending agent has been destroyed and removed, feedback systems regulated by the three plasma protein systems (clotting, complement, and kinin), along with the relevant inflammatory mediators, deactivate the inflammatory response, allowing the tissue to heal. The inflammatory response is not time-dependent, doesn't rely on cellular inhibition to stop, and doesn't cease upon the destruction of microorganisms alone.

Which client(s) is at risk for deficit injury that can result in cellular injury and death? Select all that apply. A. A middle-aged client with diabetes who is experiencing ischemia in the lower extremities B. The client with a 40 pack-year history of cigarette smoking admitted with deep vein thrombosis C. Female, 6 months pregnant, who is experiencing severe nausea and vomiting D. Athlete who fell off a bike resulting in a fracture of the tibia E. Exercise coach who has pulled a muscle in the back and experiencing some acute pain F. The young client who has begun an intense exercise routine along with a decreased food intake after being called "fat"

A, B, C, F Damage to cells can result from deficit injury, in which the cell is deprived of oxygenation, hydration, and nutrition. This type of injury is commonly seen in conditions of ischemia (such as a client with diabetes and circulation issues in the lower legs or a client with deep vein thrombosis due to smoking), severe malnutrition (such as prolonged nausea/vomiting during pregnancy), and eating disorders such as anorexia nervosa (such as a client exercising intensely while minimizing food intake). A pulled muscle or bone fracture from an accident does not necessarily cause a deficit injury.

While educating adolescents about menstruation, the nurse mentions that the sloughing off of the inner lining of the uterus (the endometrium) at the start of menstruation occurs by which physiologic process? A. Apoptosis B. Necrosis C. Oxidative stress D. Dysplasia

A

What type of drug is used to regulate the immune response through interference with DNA synthesis in dividing cells? A. Cytotoxic drugs B. Anti-inflammatory medications C. Bacterial derivative drugs D. Fungal derivative drugs

A A common mechanism of cytotoxic drugs includes interference with DNA synthesis in dividing cells. Bacterial and fungal derivative drugs alter signal transduction pathways in T lymphocytes, reducing inflammation by altering the reproductive cell cycle. Anti-inflammatory medications reduce inflammation and suppress the immune response.

Which cellular change is caused by a reduction in functional demand? A. Atrophy B. Hypertrophy C. Hyperplasia D. Dysplasia

A Atrophy is the decrease in individual cell size, and it can occur for several reasons, including a decrease in the functional demand on a cell. Hypertrophy is an increase in cell size, and hyperplasia is an increase in cell number. Both hypertrophy and hyperplasia can be caused by hormone signaling and an increased workload/functional demand. Dysplasia refers to the actual change in cell size, shape, uniformity, arrangement, and structure. Dysplasia is often a cell's response to a chronic and persistent stressor and is likely to resolve when the stressor is removed.

What terms describes the signs and symptoms associated with disease? A. Clinical manifestations B. Precipitating factors C. Insidious D. Subacute

A Clinical manifestations include signs and symptoms associated with disease. Precipitating factors, also called triggers, promote the onset of clinical manifestations. Insidious is used to describe clinical manifestations that do not have a clear onset. Subacute refers to diseases with severity and duration that falls between acute and chronic.

The community health nurse provides a community clinic to provide education on proper infant car seat installation. Which type of disease prevention is the nurse practicing? A. Primary B. Secondary C. Tertiary D. Mandatory

A Disease prevention may be described as primary, secondary, or tertiary. Primary prevention prohibits a disease from occurring (i.e., proper installation of an infant car seat to prevent injury in case of a vehicle accident). Secondary prevention is the early detection of disease through screening and early treatment (i.e., annual screening for breast cancer). Tertiary prevention is rehabilitation of a client after detection of disease (i.e., physical therapy after stroke). Disease prevention is not mandatory; however, reporting of specific diseases is mandated by law for the purpose of preventing spread of those diseases.

Which form of signal transduction resulting from ligand-receptor binding has the potential to produce effects in the entire body system? A. Endocrine B. Paracrine C. Autocrine D. Local mediation

A Endocrine signaling occurs when signal transduction affects cell behavior within the entire organism. Paracrine signaling is ligand binding to receptors that results in signal transduction with a local, rapid effect. Autocrine signaling and local mediation are not forms of cell-to-cell communication.

What is the role of exudate? A. Carries proteins and leukocytes B. Promotes clotting C. Replaces epithelial cells D. Indicates edema in the underlying tissues

A Exudate is a watery fluid that accumulates at the site of injury and has a high protein and leukocyte concentration. Exudate does not promote clotting, cause epithelial cell replacement, or indicate edema in underlying tissues.

Which statement BEST describes the health-illness continuum? A. It is a dynamic entity. B. It is based on objective data. C. It represents two exclusive categories. D. It is focused on physical well-being.

A Health and illness are part of a dynamic continuum. It is based on one's perceptions and is subjective. There are a variety of descriptions one can use along the continuum to describe their current state. These range from "extremely healthy" to "extremely ill." Because it is a dynamic continuum, it represents more than two exclusive categories. The health-illness continuum includes the body, mind, and spirit, not just physical well-being.

The current statistics show that a U.S. state has 8,746 cases of an acute disease per 100,000 people. This number represents which epidemiologic finding? A. Incidence B. Morbidity C. Prevalence D. Homeostasis

A Health statistics are an important aspect of population-focused healthcare. Incidence is the number of new cases within a given time. Incidence represents the probability that a disease will occur in a certain population. Prevalence is the number or percentage of a population living with a particular disease at a given time. Morbidity refers to having a disease or a symptom of disease, or to the amount of disease within a population. Homeostasis is the tendency toward a relatively stable equilibrium between interdependent elements, especially as maintained by physiologic processes.

Which concept is often equated with health? A. Homeostasis B. Disease C. Objectivity D. An uneventful physical examination

A Homeostasis is an important body goal and is often reflected in the client's perception of the health-illness continuum. Disease is the functional impairment of cells, tissues, organs, or organ systems. Because health is reflected in the client's perception of the health-illness continuum, it is subjective, not objective. An uneventful physical examination would only be on aspect of health. The health-illness continuum includes the body, mind, and spirit.

A client has been diagnosed with an illness and no one is sure of the cause. What term describes this condition? A. Idiopathic B. Iatrogenic C. Nosocomial D. Etiologic

A Idiopathic is the term used to describe disease with an unknown etiology. Iatrogenic disease is inadvertently caused by medical treatment. Nosocomial disease results from exposure in the healthcare environment. Etiologic disease has a precise cause.

What type of hypersensitivity reaction involves degranulation of basophils and mast cells when IgE binds to an allergen? A. Immediate hypersensitivity B. Antibody-mediated C. Immune complex D. Autoimmune

A In an immediate hypersensitivity reaction, the initial exposure to an allergen in a vulnerable individual stimulates the production of IgE. When IgE encounters and binds an allergen, mast cells and basophils degranulate, release chemical mediators, and cause injury to cells, producing the symptoms associated with allergy. The reaction in antibody-mediated reactions is tissue specific, usually involving destruction of a target cell by antibody binding to antigen on the cell surface. Immune complex reactions involve complement activation stimulated by deposition of bound antigen to antibody. An autoimmune reaction involves failure of the development of self-tolerance.

Which cell type produces inflammatory mediators? A. Endothelial B. Basement membrane C. Epithelial D. Neural

A Inflammatory mediators are located in the blood plasma (fluid part of blood) and in many cells, including platelets, mast cells, polymorphonuclear neutrophils (PMNs), basophils, neutrophils, endothelial cells, monocytes, and macrophages. Epithelial cells line the surfaces of organs in the body and function as a protective barrier. Neural cells are located in the brain and are unrelated to inflammation. The basement membrane separates tissue to protect against mechanical stress.

While reviewing the history of a new client to the clinic, the nurse notes a strong family history of cardiac disease. To focus on minimizing this disease, which topic(s)/factor(s) will the nurse's educational focus be during this visit? Select all that apply. A. Analyzing typical dietary intake B. Controlling weight C. Encouraging activity D. Having the client discuss genetics with family E. Maintaining blood pressure within normal limits

A, B, C, E The presence of select risk factors increases a person's chances of developing coronary heart disease. Modifiable (therefore teachable topics) factors include elevated blood cholesterol level, elevated blood pressure, cigarette smoking, obesity, and sedentary lifestyle. Nonmodifiable factors that cannot be changed by behavior include one's genetic predisposition, family history, and gender. A high-protein with low-carbohydrate diet does not necessarily align with dietary approaches to stop hypertension (DASH), because many sources of protein are also high in fat and calories.

Which is a mechanism(s) by which a pathogen causes disease in humans? Select all that apply. A. Direct destruction of the host cell B. Interference with the host cell's metabolic function C. Attack of the pathogen by the host cell's immune cells D. Exposure of the host cell to toxins E. Potency of the pathogen

A, B, D The mechanisms by which the pathogen causes disease in the human host cell includes one or more of the following: direct destruction of the host cell by the pathogen, interference with the host cell's metabolic function, and exposing the host cell to toxins produced by the pathogen. An attack of the pathogen by the host cell's immune cells is a mechanism to prevent infection. The potency of the pathogen affects the pathogen's success at causing disease but is not a direct cause of the disease itself.

Acute sinusitis is inflammation of the lining of the paranasal sinuses lasting how long? A. 1 to 4 weeks B. 4 to 8 weeks C. 8 to 12 weeks D. 12 to 16 weeks

B Acute sinusitis is inflammation of the lining of the paranasal sinuses lasting 4 to 8 weeks. Subacute sinusitis lasts 8 to 12 weeks. Recurrent acute sinusitis occurs when the client has up to four episodes per year, with the sinus inflammation resolving completely between episodes.

What is a graft between unrelated individuals called? A. Autograft B. Allograft C. Syngeneic graft D. Polymorphic graft

B An allograft is a graft between unrelated individuals. An autograft comes from different sites on the same person. A syngeneic graft is a graft between genetically identical individuals/monozygotic twins. Polymorphic does not refer to a graft type, rather describes the phenomena of major histocompatibility complex (MHC) molecules occurring in more than one form.

Anaphylaxis is mediated by which class of antibody? A. IgA B. IgE C. IgG D. IgM

B Anaphylaxis can occur from exposure to drugs, environmental compounds, insect venom or stings, or food products that stimulate an exaggerated immune response. Reexposure to an allergen is responsible for triggering this IgE-mediated event. Anaphylaxis is not mediated by antibodies IgA, IgG, or IgM.

Which BEST describes why yeast infections of common in women on antibiotics? A. Yeast grows well when exposed to the sugar, which is found as a carrier substance in most antibiotics. B. Destroying one type of resident flora (bacteria) can allow overproliferation of another competing type (yeast). C. Yeast prefers a warm, moist, and dark environment, such as that present in the female perineum. D. Antibiotics allow yeast to access sterile environments in the body.

B Antibiotics destroy the helpful resident bacteria living in nonsterile areas of the body. The resident fungi no longer have to compete with the destroyed resident bacteria. The fungi over proliferate, resulting in a fungal infection. The other options do not specifically attribute to yeast infection in women who are taking antibiotics.

What is the PRIMARY cell type involved in cell-mediated immunity? A. B lymphocyte B. Cytotoxic T lymphocyte C. Macrophage D. Dendritic cell

B The primary cell type involved in cell-mediated immunity is the cytotoxic T lymphocytes. B lymphocytes and dendritic cells are the primary cell types involved in adaptive immunity. Macrophages are essential cell types involved in innate immunity.

What is the process that makes cells with the same genetic material develop into specific cell types? A. Reproduction B. Differentiation C. Proliferation D. Stimulation

B Cell division occurs at different times depending on the cell type and on the signals sent to the cell for division. Differentiation, or changes in physical and functional properties of cells, directs the cell to develop into specific cell types. As all cells contain identical genetic material, differentiation explains why one cell contributes to the development of one tissue while another can develop into a different tissue. This process occurs by the repression of certain genes in a cell and the expression of others in the same cell. Proliferation is the increase in cell number. Differentiation and proliferation are components of cellular reproduction. Stimulation is not a component of cellular reproduction.

What is another term for an activated monocyte? A. Lymphocyte B. Macrophage C. Polymorphonuclear leukocyte D. Plasma cell

B Circulating monocytes become activated when in contact with an antigen, prompting differentiation into macrophages and movement out of the circulation into the tissues. The B lymphocytes differentiate into plasma cells after antigen-BCR binding. Leukocytes, also known as white blood cells, are the basic functional units of the immune system. Polymorphonuclear leukocytes are also known as granulocytes.

The nurse is providing education to a client on the goals of the body's inflammatory response. Which client statement indicates to the nurse that additional teaching is needed? A. "A major goal of the inflammatory response is to increase blood flow to the site of injury." B. "A major goal of the inflammatory response is to form an antigen-antibody response." C. "A major goal of the inflammatory response is to dilute harmful substances at the site of injury." D. "A major goal of the inflammatory response is to remove injured tissue."

B During the vascular response, there is an increase in blood flow to the site of injury. The increased blood and fluid at the site help to dilute harmful substances and remove injured tissue. The antigen-antibody response happens with an immune response, not an inflammatory response.

Which tissue formations occur as a protective mechanism during some cases of chronic inflammation where an area is walled off in order to protect surrounding unaffected tissues? A. Adenomas B. Granulomas C. Basement membranes D. Granulation tissues

B Granulomas typically form when the injury is too difficult to control by the usual inflammatory and immune mechanisms, such as with foreign bodies or certain microorganisms. In response to inflammatory mediators, granulomas form to wall off affected areas. Adenomas are benign tumors. Basement membranes create an anatomical wall where cells meet connective tissues. Granulation tissues is vascularized tissue that forms as chronic inflammation evolves.

Which term indicates increased cell size caused by an increase in functional demand? A. Atrophy B. Hypertrophy C. Hyperplasia D. Dysplasia

B Hypertrophy is an increase in cell size, and hyperplasia is an increase in cell number. Both hypertrophy and hyperplasia can be caused by hormone signaling and an increased workload/functional demand. Dysplasia refers to the actual change in cell size, shape, uniformity, arrangement, and structure; it is often a cell's response to a chronic and persistent stressor. Atrophy is the decrease in individual cell size, and it can be caused by decreased functional demand on a cell.

Which antibody class is involved in hypersensitivity reactions? A. IgA B. IgE C. IgG D. IgM

B Immediate hypersensitivity reactions are also known as type I reactions or IgE-mediated hypersensitivity responses to antigen challenges. Initial exposure to an allergen in a vulnerable individual stimulates the production of IgE, an immunoglobulin important in the development of protective immunity. The other immunoglobulins are not involved in hypersensitivity reactions.

Which symptom is considered a local manifestation associated with a paper cut? A. Fever B. Pain C. Headache D. Hypertension

B Local refers to those manifestations that are found directly at the site of disease and are confined to that specific area. Pain would be considered a local manifestation associated with a paper cut. The other signs and symptoms listed refer to systemic manifestations.

What type of macrophage is specific to the liver? A. Microglial cells B. Kupffer cells C. Langerhans cells D. Histiocytes

B Macrophages are known by different cell names that are determined by the location of tissues where they reside. These cell types include Kupffer cells (liver), microglial cells (brain), and histiocytes (loose connective tissue). Langerhans cells are immature dendritic cells in the skin.

The nurse is caring for a client with an acute, bacterial infection. Which laboratory value does the nurse expect to be elevated? A. Eosinophil count B. Neutrophil count C. Basophil count D. Monocyte count

B Neutrophils are present in the greatest number and are most important in the rapid response to bacterial infections. Basophils become elevated in allergic reactions. Eosinophils are elevated with parasitic infections. Monocytes are more likely to be elevated with chronic infections.

The client visits the clinic for a possible infection. The client is told that the neutrophil count is high. What does this count imply? A. The client has a streptococcal infection. B. The client has an acute infection. C. The client has a chronic infection. D. The client does not have an infection.

B Neutrophils are the earliest phagocytic responders. They increase quickly in response to acute infections. Chronic infection is associated with increased monocytes, lymphocytes, and macrophages. Streptococcal infection cannot be characterized solely by increased neutrophils.

Which term is defined as the study of the mechanisms of human body functioning? A. Pathology B. Physiology C. Anatomy D. Pathophysiology

B Physiology is the study of the mechanisms of human body functioning. Pathology is the study of changes in cells and tissues as a result of injury or disease. Anatomy is the study of body structures. Pathophysiology is the study of mechanisms of disease.

Which assessment is effective in detecting asymptomatic disease? A. Client history B. Screening tests C. Family pedigree D. Observation

B Screening tests are often used to identify disease that does not present with signs and symptoms. Family pedigree, observation, and eliciting client history are not used to identify asymptomatic disease. They may be used to collect data and determine the need for further screening but alone are not effective in detecting disease.

A woman is diagnosed with cervical intraepithelial neoplasia (CIN) with absent glandular cell involvement and no invasive squamous cell disease. When clarifying treatment options and education this client about the new diagnoses, which topic(s) will the nurse include in the discussion. Select all that apply. A. Total hysterectomy B. Cryosurgery C. CO2 laser ablation D. Electrocoagulation diathermy ablation E. No surgical treatment options warranted at this time

B, C, D Treatment to remove superficial cells (ablative) is an option for women with cervical intraepithelial neoplasia (CIN) in the absence of glandular cell involvement or invasive squamous cell disease. Cryosurgery, a form of cold therapy that destroys mildly dysplastic cells, is a common ablative therapy for cervical dysplasia. Liquid nitrogen is applied to the dysplastic cells on the exocervix, identified by colposcopy via a probe placed in the desired area. CO2 laser ablation is accomplished by directing a laser toward the cervical lesion under colposcopic guidance, destroying the tissue by vaporization. Heat ablation methods include cold coagulation and electrocoagulation diathermy ablation, with variations in temperature and time of treatment associated with depth of cervical tissue destruction. In cases of carcinoma, a hysterectomy may be indicated.

The nurse is caring for a client with a communicable disease. Which is true about the type of disease? Select all that apply. A. All infectious diseases are communicable. B. Communicable diseases are spread from person to person. C. Blood is a common carrier for communicable diseases. D. Communicable diseases are caused by infections that live and reproduce in a human host. E. Body fluids can carry communicable diseases from one person to another.

B, C, D, E Not every infectious disease is communicable. Communicable diseases are spread from one person to another. Blood and body fluids are common carriers for communicable diseases. Communicable diseases are caused by infections that live and reproduce in a human host.

Which nurse's statement BEST demonstrates understanding of the phrase, "People should not be defined by their pathophysiology?" A. "My fractured tibia client in room 702." B. "The skull fracture child in room number 4." C. "The client admitted with uncontrolled hypertension." D. "The alcoholic client who has cirrhosis."

C An important thing to keep in mind when caring for individual clients is that people should not be defined by their pathophysiology. Calling a client by their disease state ignores the holistic physical, spiritual, emotional, and psychological components that comprise all of us. Health professionals should avoid calling clients "alcoholics" or "fractured tibia client in room 702" and replace these labels with "the client with alcohol use disorder" or "the client in room 702 with a fractured tibia."

What type of hypersensitivity reaction involves complement activation stimulated by deposition of bound antigen to antibody? A. Immediate hypersensitivity B. Antibody-mediated C. Immune complex D. Autoimmune

C Cellular and tissue damage caused by type III immune complex-mediated reactions are the indirect result of complement activation stimulated by antigen- antibody complexes. Immediate hypersensitivity reactions involve degranulation of basophils and mast cells when IgE binds to an allergen. The reaction in antibody-mediated reactions is tissue specific, usually involving destruction of a target cell by antibody binding to antigen on the cell surface. An autoimmune reaction involves failure of the development of self-tolerance.

Which white blood cells are activated by chemical mediators to aid the body in clearing debris? A. Basophils B. Eosinophils C. Neutrophils D. Monocytes

C Chemical mediators activate neutrophils to move into the injured area and begin the work of healing. Chemical mediators do not activate basophils, eosinophils, or monocytes to promote debris removal.

A client has splashed scalding water on the arm while straining pasta. The area is red and painful, and blisters form. How is the burn classified? A. Superficial burn B. Superficial partial-thickness burn C. Deep partial-thickness burn D. Full-thickness burn

C Deep partial-thickness burns damage the upper epidermis and penetrate into the lower dermis as seen with a burn from scalding water. Superficial burns damage only the epidermis. Superficial partial-thickness burns damage the upper dermis. Full-thickness burns damage the epidermis and dermis and can penetrate subcutaneous layers as well.

Which term is defined as the functional impairment of cells, tissues, organs, or organ systems? A. Injury B. Pathophysiology C. Disease D. Syndrome

C Disease is defined as the functional impairment of cells, tissues, organs, or organ systems. Injury causes changes to cells, pathophysiology refers to the study of mechanisms of disease, and syndrome is used to describe specific conditions with predictive patterns.

Which BEST explains why some viruses are capable of eliciting a chronic infection in the body? A. Release of virions B. Immunocompetence C. Period of latency D. Receptor binding

C During the period of latency, the virus is integrating itself into the host cell's genetic material. This period of latency is a characteristic associated with chronic infections. The release of virions results in infection of nearby cells. Receptor binding explains why some geographic locations have differences in human infection. Immunocompetence refers to the ability of the body to produce a normal immune

What type of burn can interrupt cardiac conduction and lead to sudden death? A. Thermal B. Chemical C. Electrical D. Radiation

C Electrical currents can disrupt cardiac conduction and cause immediate death. Thermal burns, chemical burns, and burns caused by radiation do not alter the cardiac conduction system.

What is likely the clinical manifestation if a gram-negative bacteria containing endotoxin in the bacterial cell envelope becomes pathogenic? A. Constipation B. Leukopenia C. Fever D. Vomiting

C Endotoxin causes inflammatory mediators to be released, leading to a massive inflammatory response. This response can result in a state of septic shock accompanied by severe diarrhea, fever, and leukocytosis. Vomiting, leukopenia, and constipation are not likely responses to endotoxin.

What is epigenetics? A. The study of how genetics began B. The study of epidemiology and genetics C. The study of genetic control by factors other than DNA sequencing D. The study of DNA sequencing and its impact on genetic control

C Epigenetics is the study of genetic control by factors other than DNA sequencing. Epigenetics controls the "on" and "off" switch of genes and which proteins are transcribed. The other answer choices do not reflect the definition of epigenetics.

Which example BEST represent pathogenesis of disease? A. Venous thrombosis leading to myocardial infarction B. Increased rates of stroke in those with hypertension C. The rate of influenza spread at any given time D. Liver cell destruction occurring long before cirrhosis of the liver

D Pathogenesis is best defined as the beginning of disease. It encompasses the time of when the disease process begins to the point of manifestation of the disease. Destruction of the liver cells long before cirrhosis is an example of pathogenesis. Incidence is the rate of occurrence of a disease at any given time. Etiology is the cause of a particular disease. Risk factors are those factors which increase the chance of a client having a disease.

Which complication of wound healing is caused by poor tissue perfusion? A. Keloid formation B. Wound dehiscence C. Adhesions D. Ulceration

D Poor perfusion can lead to ulceration. Ulcers are circumscribed, open, craterlike lesions of the skin or mucous membranes. These areas are necrotic and open to further invasion by microorganisms. Wound dehiscence is a problem of deficient scar formation, in which the wound splits or bursts open, often at a suture line. Keloid development is the opposite of dehiscence. Adhesions are fibrous connections between serous cavities and nearby tissues, which do not allow the surrounding tissues to move freely.

What is the rationale for AIDS treatment with antiretroviral therapy? A. Monotherapy with reverse transcriptase inhibitors B. Monotherapy with protease inhibitors C. Monotherapy with integrase strand transfer inhibitors D. Triple therapy with reverse transcriptase, protease, and integrase strand transfer inhibitors

D Specific drugs included in antiretroviral therapy for AIDS treatment are designed to delay disease progression by suppressing viral replication and addressing issues of drug resistance. These drugs can be categorized into classes known as nucleoside and nucleotide analog reverse transcriptase inhibitors (NRTIs), nonnucleotide reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and integrase strand transfer inhibitors (INSTIs). The use of antiretroviral therapy has increased effectiveness over monotherapy or combined two-drug therapy.

Which component is part of the cellular cytoskeleton? A. Mitochondria B. Gene C. Cytoplasm D. Actin

D The main cytoskeleton components include microtubules (thin protein structures composed of tubulin) and microfilaments. Thin microfilaments comprise the protein actin. Intermediate microfilaments comprise filaments with a diameter sized between thin and thick filaments. Thick microfilaments comprise the protein myosin. The cellular cytoskeleton does not include mitochondria, cytoplasm, or genes.