Pathophysiology Test 1
Which is a true statement about oncogenesis? A. Proto-oncogenes code for abnormal proteins involved in the regulation of cell division. B. Tumor suppressor genes and DNA repair genes act to prevent DNA mutation C. Oncogenes prevent cell mutation and therefore prevent malignancy from occurring D. The first stage of oncogenesis is called "promotion"
B
Which is a true statement regarding cellular injury? A. All cellular injury progresses to cellular death B. Dystrophic calcification is a type of cellular injury that is usually not reversible
B
Which of the 3 types of edema are the most immediately life-threatening? A. Pulmonary, liver, and renal B. Pulmonary, cerebral, and laryngeal C. Cardiac, renal, and peripheral D. Pulmonary, bowel, and renal
B
Which of the following is the main contributor to serum osmolality? A. Serum potassium B. Serum sodium C. Serum phosphorus D. Intracellular water
B
Which statement about the action of cortisol in the stress response is true? A. Promotes the absorption of sodium from the renal tubules B. Increases blood glucose levels C. Stimulates the action of the immune system D. Weakens cardiac contractility
B
Which statement best describes anaplasia? A. An increase in cancerous cell proliferation B. Loss of cellular differentiation in cancerous tissue
B
Which type of IV fluid is the most commonly used due to its isotonic tonicity? A. D5 ½ % Na Cl B. 0.9% sodium chloride C. 3% sodium chloride D. 0.45% sodium chloride
B
State the laboratory value which is the best indicator of renal function.
Glomerular filtration rate
What is considered hyperkalemia? (elevated serum potassium)
More than 5mEq/L
A patient with a genetic disorder of Marfan's Syndrome presents to a community health clinic for a routine physical exam. Based on the diagnosis, the physical assessment should focus on which body systems? Select all that apply. A. The cardiovascular system B. The reproductive system C. The musculoskeletal system D. The sensory system (vision)
A, C, D
Describe appropriate nursing interventions for hyperkalemia.
-Restrict foods and IV fluids high in potassium. -Monitor labs and EKGs.
1 pound = _______ kilograms.
0.45
Match the correct definition or description with the correct term. 1. Cellular characteristic includes anaplasia 2. More likely to be encapsulated 3. Well-differentiated cells that resemble the tissue of origin 4. Grows by invasion of surrounding tissue 5. Likely to differentiate normally A. Benign tumor cells B. Malignant tumor cells
1. B 2. A 3. A 4. B 5. A
An 80 year old female is undergoing stress related to the decision whether to have a hip replacement. Which endocrine organs would the RN expect to be involved in the stress response? Select all that apply. A. Hypothalamus B. Parathyroid glands C. Adrenal glands D. Pituitary gland
A, C, D
Normal serum values for sodium?
135 - 145 mEq/dl hypo/hypernatremia
1 kilogram = _______ pounds.
2.2
Normal serum values for potassium?
3.5 - 5.0 mEq/dl hypo/hyperkalemia
A patient experienced a fractured tibia and the extremity was casted. When the cast was removed, the patient noticed that the muscle in the casted extremity had become much smaller and asks the nurse why this had occurred. What is the best explanation by the nurse? A. "Decreased use of the muscle has resulted in a decrease in the size of the muscle cells." B. "For tissue repair to occur, there has been an increase in the workload of the cell, which has caused it to look smaller." C. "Disuse of the muscle has resulted in an increased number of smaller cells." D. "There has been a change in the muscle cell type and the muscle cells have been replaced with epithelial cells."
A
A patient hospitalized for dehydration has orders for daily weights. Admission weight is 68 kg. Today's weight is 70 kg. What is the patient's weight today in pounds? A. 154 pounds B. 149 pounds C. 140 pounds D. 136 pounds
A
A patient is admitted with a serum potassium level of 6.2 mEq/L. What is the priority nursing assessment? A. monitoring of heart rhythm B. monitoring of serum calcium levels C. monitoring of serum albumin levels D. monitoring of urinary output
A
Antioxidants help prevent cellular injury caused by which byproduct of oxidative phosphorylation? A. Free radicals B. Carbon dioxide C. Prostaglandins D. Glycogen
A
DNA is a double stranded molecule composed of nucleotides which have a phosphoric acid, a deoxyribose and 4 nitrogenous base pairs. Which base pairs are always matched together? A. Adenine with thymine B. Adenine with guanine C. Guanine with thymine D. Cytosine with adenine
A
Excessive cortisol production can cause which systemic effect? A. Immune suppression B. Hypoglycemia C. Hypovolemia D. Inflammatory reactions
A
Excessive cortisol production can cause which systemic effect? A.Immune suppression B. Hypoglycemia C. Hypovolemia D. Inflammatory reactions
A
The nurse is preparing a teaching brochure for families with a genetic history of Marfan Syndrome. Which statement should the nurse include? A. If one parent had the disease, there is a 50% chance of transmitting the disorder to each offspring B. There is 50% chance of transmitting the disease to male offspring C. The gene for Marfan Syndrome is sex-linked recessive gene and can only be passed on by the mother
A
What is the most common cause of hyperkalemia? A. Renal insufficiency B. Diuretic use C. Osteoporosis D. Metabolic alkalosis
A
What is the name of the process in which the body naturally removes and replaces worn out blood cells? A. apoptosis B. metastatic calcification C. lysosomal autodigestion D. cellular adaptation
A
What physiologic responses would be expected when the catecholamines, epinephrine and norepinephrine are released in association with a stressor? A. increased heart rate, increased cardiac contractility B. increased blood glucose, decreased immune response C. decreased inflammatory response, increased respirations D. decreased urine output, decreased blood pressure
A
What physiologic responses would be expected when the catecholamines, epinephrine and norepinephrine are released in association with a stressor? A.increased heart rate, increased cardiac contractility B. increased blood glucose, decreased immune response C.decreased inflammatory response, increased respirations D. decreased urine output, decreased blood pressure
A
Which of the following is the best example of the body's cellular adaptation of hypertrophy? A.Increase in the thickness of the left ventricular wall in response to increased cardiac workload caused by hypertension B. A high calcium level that results in the increased size of the parathyroid gland C. Epithelial cell changes of the uterine cervix found on a Papanicolaou (pap) smear D. Decrease in reproductive organ size as a result of menopause and decreased estrogen levels
A
Which patient has the least risk of developing cancer? A. A 22 year old female with seasonal rhinitis who takes an antihistamine daily B. A 45 year old obese male who consumes a low fiber, high fat diet C. A 36 year old female whose aunt and sister have been diagnosed with breast cancer
A
Which sensory neurons promote thirst when stimulated? A. osmoreceptors B. baroreceptors C. thermoreceptors D. chemoreceptors
A
How do cancer cells differ from normal cells? (Select all that apply) A. Normal cells have regulated growth. Cancer cells have unregulated growth. B. Normal cells have genetic stability. Cancer cells do not. C. Normal cells have an unlimited lifespan. Cancer cells have a limited lifespan. D. Normal cells divide by mitosis. Cancer cells divide by meiosis.
A, B
Which of the following are types of endogenous stressors? Select all that apply. A. Decreased perfusion to the legs B. Electrolyte imbalance C. Liver failure D. Radiation injury E. Fractured rib from vehicle crash
A, B, C
A nurse is helping increase public awareness of early detection and screening for cancer. Which types of cancer have methods for early detection and screening? (Select all that apply). A. breast B. prostate C. colon D. pancreatic E. lung
A, B, C, E
Which are considered chemical causes of cellular injury? (Select all that apply) A. tobacco smoke B. alcohol C. lead poisoning D. frostbite E. chemotherapy
A, B, C, E
Which signs would the nurse expect to find in a patient with end-stage colon cancer? (Select all that apply) A. weight loss B. pain C. hypocalcemia D. hypercoagulable state
A, B, D
A nursing student is referred to Student Health for physical symptoms due to test anxiety. What are likely to be the recommendations of the Student Health RN? Select all that apply. A. get regular exercise B. get enough sleep C. stay up all night before an exam D. take over-the-counter stimulants to increase concentration levels E. Know your study material well by keeping up with your assignments so that you don't have to cram the night before an exam
A, B, E
Which of the following represent examples of how chronic irritation leads to metaplasia? Select all that apply. A. Smoking leads to metaplasia in the bronchi B. Physiologic changes of pregnancy lead to metaplasia in the uterus and breasts C. Chronic GERD leads to metaplasia in the esophagus
A, C
Which of the following are true statements about dystrophic calcification? Select all that apply. A. Dystrophic calcification is a type of abnormal deposition of calcium salts B. Dystrophic calcification commonly occurs in the lungs, renal tubules, and blood vessels C. Dystrophic calcification will cause an elevation of the serum calcium level D. Dystrophic calcification can lead to aortic stenosis when found in the aortic valve E. Dystrophic calcification affects previously damaged tissue
A, D, E
Match the pattern of stress response to the clinical examples given: A. patient with seasonal allergic rhinitis. B. an athlete who tears a meniscus in a soccer game C. caregiver of a patient with Alzheimer's disease 1. acute time limited stress 2. chronic intermittent stress 3. chronic sustained stress
A-2 B-1 C-3
Match the stage of the General Adaptation Syndrome with the correct answer. A. Cortisol levels drop and the body adapts, remaining in a continued state of arousal. B. The body's ability to resist is lost and the body becomes more susceptible to illness. C. Activation of the HPA axis, the nervous system, and the adrenal glands. 1. Alarm 2. Resistance 3. Exhaustion
A-2 B-3 C-1
Match the cellular adaptation to its description. A. An increase in cell size as well as increase in the amount of the functioning tissue mass. B. A reversible change in which one adult cell type is replaced by another adult cell type. C. A decrease in the size of a tissue organ resulting from a decrease in cell size of the individual cells or the number of cells. D. Characterized by deranged cell growth of a specific tissue that results in precancerous cells that vary in size, shape, and growth. E. An increase in the number of cells in an organ or a tissue above what is normal. 1. Atrophy 2. Hypertrophy 3. Hyperplasia 4. Dysplasia 5. Metaplasia
A-2 B-5 C-1 D-4 E-3
Match the following types of cellular injury with their descriptions. A. Unregulated cellular death. B. Temporary deprivation of oxygen to body cells caused by decreased tissue perfusion. C. Programmed cellular death. D Inadequate levels of oxygen in the tissues most commonly due to depletion of ATP. 1. Ischemia 2. Apoptosis 3. Necrosis 4. Hypoxia
A-3 B-1 C-2 D-4
Match the tumor marker with the associated cancer it is used to detect. A. PSA B. CA-125 C. HER 2 D. CEA 1. Ovarian cancer 2. Colorectal cancer 3. Prostate cancer 4. Breast cancer
A-3 B-1 C-4 D-2
Match the name of the genetic disease with an example of each. A. Marfan's Syndrome. B. Phenylketonuria. C. Cleft lip/palate. 1. Multifactoral inheritance disorder 2. Autosomal recessive disorder 3. Autosomal dominant disorder
A-3 B-2 C-1
State what will happen when cells are exposed to the following types of solutions? A. Isotonic solution B. Hypertonic solution C. Hypertonic solution
A. Cells will not change size. B. Cells will shrink. C. Cells will swell.
A 50 year old male suddenly has chest pain related to acute coronary syndrome. Which phase of the stress response is he in?
Alarm
Exposure to radiation during the first trimester of pregnancy can affect fetal development of which organs/systems? (select all that apply) A. central nervous system B. heart C. extremities D. eyes
All
True or false: Cell differentiation is defined as the process by which dividing cells are transformed into cells which are different from the parent cell.
False
A 20 year old student exhibits agitation, sweaty palms and a "racing heart" immediately before taking an exam. What is the physiologic explanation for these symptoms? A. release of cortisol from the adrenal cortex B. release of catecholamines from the adrenal medulla C. activation of the renin-angiotensin-aldosterone system D. activation of the parasympathetic nervous system
B
A patient has developed severe diarrhea due to a clostridium difficile bacterial infection. The patient is at greatest risk for which complications? A. hypovolemia and hyperkalemia B. hypovolemia and hypokalemia C. hypervolemia and hypocalcemia D. hypervolemia and hyponatremia
B
A patient with a history of hypertension, diabetes and atherosclerosis is admitted to the hospital for pain in his right foot. He states that he has had pain and "poor circulation" in the right leg for months. On inspection, it is noted that all of his toes are turning dark and dry, and there is a definite line of demarcation between the toes and the foot. He is complaining of a dull ache, the foot is cold to touch and the R pedal pulse is not palpable. Which process of necrosis is occurring? A. liquefactive necrosis B. gangrene necrosis C. apoptosis D. caseous necrosis
B
A patient with a long history of uncontrolled high blood pressure is told that his heart is enlarged on a chest x-ray. What is the most likely explanation for this? A. The heart muscle has developed atrophy from weakness and minimal use. B. The heart muscle has developed hypertrophy due to its increased workload. C. The heart muscle has developed dysplasia due to the cells increasing in number. D. The heart muscle has developed metaplasia due to oxygen deprivation
B
BRCA 1 and BRCA 2 are tumor suppression genes associated with genetic susceptibility in what type of cancer? A. prostate B. breast C. pancreatic D. lung
B
Hormones, negative feedback loops and sensors detecting changes in the body are examples of how the body maintains which process? A. apoptosis B. homeostasis C. cellular adaptation D. inflammation
B
Hormones, negative feedback loops and sensors detecting changes in the body are examples of how the body maintains which process? A. apoptosis B. homeostasis C. cellular adaptation D. inflammation
B
Lab values for a newly admitted patient are reported to the nurse. Which serum value represents a patient care priority? A. Magnesium 2.5 mg/dL B. Potassium 6.7 mEq/dL C. Calcium 8.6 mg/dL D. Sodium 135 mEq/dL
B
The nurse in the newborn nursery is discussing the genotype of Down's syndrome with a nursing student. Which statement should the nurse include in the discussion? A. Down's syndrome is caused by a monosomy X chromosome. B. Down's syndrome is caused by the trisomy of the 21st chromosome. C. Down's syndrome is always characterized by some degree of mental retardation. D. Down's syndrome is characterized by long face, large mandible and everted ears
B
Thirst, poor skin turgor, hypotension, dark, concentrated urine, and a weak, rapid pulse are clinical signs of which fluid volume disorder? A. Diabetes insipidus B. Hypovolemia C. Hypervolemia D. Hyponatremia
B
What happens to the size of a red blood cell in the presence of a hypertonic solution? A. No change in cell size B. Cell shrinks C. Cell ruptures
B
What is the main cause of gene mutations within the DNA? A. meiosis with 23 haploid chromosomes in the germ cell B. base pair substitutions or deletions within the DNA. C. inherited autosomal cell alterations within the DNA. D. Mitosis with end result of 23 chromosome pairs in the autosomal cells.
B
What is the most reliable method for determining daily fluctuations in body fluid volume? A. Intake and output B. Daily weight C. Serum sodium levels D. Tissue turgor
B
What is the nursing diagnosis in a patient with diabetes insipidus? A. fluid volume excess B. fluid volume deficit C. syndrome of inappropriate ADH D. hyperaldosteronism
B
What is the physiologic end result in activation of the renin-angiotensin-aldosterone system? A. increase in blood sugar B. increase in blood pressure C. decrease in immune system function D. decrease in blood pressure
B
Which hormone in the body is responsible for calcium regulation? A. Angiotensin II B. Parathyroid hormone C. Antidiuretic hormone D. Cortisol
B
Which is a true statement about cancer? A. Cancer is the leading cause of death in the US. B. Some cancers are considered curable. C. Most cancers are due to heredity factors. D. The most common cancer is pancreatic cancer.
B
Which of the following are biochemical mechanisms of cellular injury which may be reversible? (Select all that apply) A.Lysosomal autodigestion with eosinophilia. B. Free radical injury C. Hypoxia leading to ATP depletion. D. Impaired calcium homeostasis.
B, C, D
Which of the following are biochemical mechanisms of cellular injury which may be reversible? (Select all that apply) A. Lysosomal autodigestion with eosinophilia. B. Free radical injury C. Hypoxia leading to ATP depletion. D. Impaired calcium homeostasis
B, C, D
Which are true statements regarding intracellular accumulations? Select all that apply. A. Examples are inadequate levels of lipids, glycogen, and proteins B. They may be acquired or genetic C. Examples of endogenous pigments are bile, lipofuscin, hemosideran, and melanin D. They usually result from a metabolic alteration or chronic injury E. Alzheimer's and Parkinson's are examples of abnormal protein buildup
B, C, D, E
A patient is diagnosed with a benign tumor. What characteristics does the tumor have? Select all that apply. A. Crab-like infiltration B. Encapsulated C. Well-differentiated D. Spreads by metastasis E. Cells resemble tissue of origin
B, C, E
Which physiologic responses occur in the alarm stage of the General Adaptation Syndrome? Select all that apply. A. Increase in lymphocyte activity B. Activation of the sympathetic nervous system C. Activation of the parasympathetic nervous system D Increased catecholamine release
B, D
A 50 year old male smoker experiences pain in his calves intermittently when he walks long distances. He is diagnosed with peripheral arterial disease. Which cause of cellular injury is most likely related to his symptoms? A. Chemical cause due to tobacco smoke B. Physical cause due to the mechanical forces of walking. C. Hypoxia due to ischemia to his leg muscles. D. Biologic cause most likely due to infection
C
A 56 year old obese woman has suffered from gastroesopheal reflux disease (GERD) for many years due to chronic irritation from acid reflux. During a recent hospitalization for an exacerbation, she is found to have developed a change in cell type indicative of "Barrett's esophagus". Which cellular adaptation has occurred? A. physiologic hypertrophy B. pathologic atrophy C. pathologic metaplasia D. physiologic dysplasia
C
A patient has undergone a breast biopsy and has been told that she has stage T1N1MO breast cancer. How can the nurse best explain this finding to the patient? A. The tumor is very large and has metastasized to several distant tissues. B. The tumor is benign and not infiltrating any surrounding tissue. C. The tumor is small and has spread to one lymph node but has not metastasized. D. The tumor is small and has metastasized to one distant organ.
C
A patient is admitted with fluid volume excess. The nurse would anticipate which clinical symptom? A. weight loss B. hypotension C. weight gain D. sunken eye sockets
C
A patient takes on a new job as a laborer and develops calluses on both hands. What is the best explanation for the development of the calluses? A. Aging has produces a change in epithelial cells resulting in atrophy. B. Cellular ischemia and epithelial cell damage caused cellular metaplasia C. Hyperplasia has resulted in an increased number of skin cells D. Hypertrophy of the muscle cells developed as a result of increased function
C
A patient with severe hypokalemia is at risk for which potentially life threatening complication? A. fluid volume deficit B. liver failure C. cardiac dysrhythmias D. fluid volume overload
C
After genetic testing, a child is diagnosed with the Tay-Sachs disease. The parents ask the nurse how their child could have the disease when neither parent has it. Which statement provides the most appropriate response? A. The mother passed the x-linked recessive trait to the child B. The father passed the y-linked recessive trait to the child C. Both parents must carry the recessive gene and pass it on to the child D. Tay-Sachs is a multifactorial genetic problem
C
The nurse on an oncology floor has admitted a patient with metastatic cancer. The patient asks how cancer moves from one place in the body to another. What is the best answer by the nurse? A. "Cancer cells replicate and form a chain from the original tumor site to the metastatic site." B. "Potential cancer cells are present in every organ, but become stimulated when a primary cancer is activated" C. "Cancer cells break off from the original site and are carried through the blood and lymph systems to other parts of the body." D. "Cancer cells secrete hormones that are transported in the blood and stimulate cell growth at distant sites."
C
What is a commonly accepted theory for cellular changes in aging - also known as "replicative senescence"? A. Increased oxidative phosphorylation by the mitochondria. B. Enhanced synthesis of structural proteins. C. Progressive shortening of telemeres D. Enhanced replication of DNA
C
A patient is admitted to the hospital with episodes of syncope (fainting spells). An echocardiogram reveals that the patient has severe aortic stenosis due to calcification of her aortic valve. Relate the symptoms to the disease process. A. The patient's coronary arteries are blocked and there is inadequate blood flow to the myocardium. B. The patient's aortic valve is overstretched and leaking blood back into the left ventricle. C. The patient's carotid artery is narrowed and delivering inadquate blood flow to the brain. D. The patient's aortic valve is narrowed and is delivering inadquate blood flow to the brain
D
A student is learning to use a Punnet Square as a pattern for prediction of genetic disorders. Which type of genetic disease can be predicted using a Punnet Square? A. multifactorial disorder B. chromosomal deletion disorder C. chromosomal inversion disorder D. single gene disorder
D
Secretion of antidiuretic hormone may increase during physiologic stress. What effect does this have on the body? A. increase in blood sugar B. increase in urine output C. increase in serum sodium D. increase in body fluid volume
D
Stimulation of the renin-angiotensin-aldosterone mechanism will result in which physiological changes? A. Increase in the contractility of the heart B. Release of water and decrease in blood pressure C. Increase in the reabsorption of hydrogen ions D. Water conservation and increase in blood pressure
D
Upon physical examination, the nurse identifies Trousseau's and Chvostek's signs. Based on these findings, the nurse would suspect which electrolyte disorder? A. Hypermagnesemia B. Hypokalemia C. Hypernatremia D. Hypocalcemia
D
What is the name of the process of programmed cell death in which the body removes and replaces cells? A. caseous necrosis B. dry gangrene C. liquefactive necrosis D. apoptosis
D
Which theory of aging relates to the shortening of telomeres? A. The Programmed Theory of Genetic Influence B.The Damage or Error Theory of Random Environmental Influence C. The Oxidative Phosphorylation Theory of Free Radicals D. The Cellular Theory of Replicative Senescence
D
True or false: Atrophied cells are nonfunctional and irreversibly injured.
False
What is considered hypokalemia? (decreased serum potassium)
Less than 3.5 mEq/L
Describe appropriate nursing interventions for hypokalemia.
Replace potassium via oral or IV fluids (NEVER IV PUSH)
True or false: Hydrostatic pressure is the pushing force exerted by fluid in the capillaries. When hydrostatic pressure is high it can result in fluid moving from the capillaries into the interstitium.
True
True or false: Hyperplasia and hypertrophy are often triggered by the same stressors and therefore may occur simultaneously
True
True or false: Increases in the number of cells of the breast and the uterus during pregnancy are examples of physiologic hyperplasia.
True
True or false: Research has shown that exercise, adequate sleep and nutrition, and having a positive outlook on life can help prevent stress-related diseases.
True
True or false: When cells are exposed to environmental stressors, they either adapt, become reversibly injured or die.
True
True or false: When comparing the intracellular and extracellular fluid compartments, the intracellular compartment contains the most fluid
True