prepu patho midterm review

In which period of fetal lung development does type II alveolar cells begin to produce surfactant? You Selected:

Canalicular

Which inotropic drugs increase cardiac contractility by increasing the influx of free extracellular calcium ions in the vicinity of the actin and myosin filaments? You Selected:

Cardiac glycosides Explanation:

A nurse is planning a community education program on hypertension. Which parameter should be included to explain the regulation of arterial blood pressure? You Selected:

Cardiac output and systemic vascular resistance Explanation:

A client consistently has an elevated systolic BP greater than 150 mm Hg but a diastolic pressure in the 80s. The health care provider should be assessing for which complication? You Selected:

Crackles in bilateral lung bases caused by left-sided heart failure Explanation:

Which physiologic response results from hyperinflation of the lungs that is seen in emphysema? You Selected:

Increased total lung capacity

The nurse is educating a client suffering from advanced emphysema on how to improve expiratory flow rates. Which breathing technique would the nurse describe as most effective? You Selected:

Pursed-lip breathing

Which concept in gene therapy can be used to control viral infection by preventing the synthesis of viral proteins? You Selected:

RNA interference (RNAi)

An older adult client dressed only in a hospital gown requests a warm blanket for "a draft in her room." Which mechanism of heat loss is most likely the primary cause of her request? You Selected:

Radiation and convection

Clinical manifestations of radiation injury result from acute cell injury, dose-dependent changes in the blood vessels that supply the irradiated tissues, and fibrotic tissue replacement. What are these clinical manifestations?

Radiation cystitis, dermatitis, and diarrhea from enteritis Explanation:

A pregnant client is concerned about her baby having abnormal thyroid function since it "runs in the family." The nurse advises the client to avoid expose to which teratogenic agent? You Selected:

Radioactive iodine

A client diagnosed with liver cancer has been admitted to a palliative care unit for bone metastases. His family shares with the nurse that he is usually a "big eater," but now he just isn't interested in food, which has resulted in muscle loss. Which factors may underlie the client's change in nutritional status?

The action of cytokines and persistent inflammation

When lecturing to a group of students about the pathophysiologic principles behind heart failure, the instructor defines cardiac output as which example? You Selected:

The amount of blood the heart pumps each minute Explanation: Reference:

A 6-year-old boy with intellectual disability secondary to fragile X syndrome has been admitted to the hospital with a mitral valve prolapse. The health care worker caring for the child should have which concepts as part of her knowledge base regarding fragile X syndrome? You Selected:

The boy will pass the gene to all his future daughters, who will become carriers. Explanation:

Which characteristics could apply to healthy somatic cells rather than cancerous cells? You Selected:

The cells are unable to proliferate except by mitotic division. Explanation:

A nurse conducting a genetics class says that one type of RNA delivers the appropriate amino acids to the ribosome. Which type of RNA is the nurse referring to? You Selected:

Transfer

A client with a diagnosed history of arthritis has experienced cartilage damage. The nurse recognizes this may result from which physiologic factor? You Selected:

Unregulated action of the proteases

Select the most likely source of a fever in a 16-month-old female child. You Selected:

Urinary tract infection

A child age 33 days is presented to the emergency department of a hospital by her parents following a 2-day fever. Her temperature is 38°C (100.4°F) tympanically. Which diagnostic test is most clearly indicated?

Urine for culture and sensitivity

A 31-year-old male has been newly diagnosed with early-onset Parkinson disease. As the nurse is educating the client/family, they ask how this happened so early in his life. The nurse will base the response on which statement listed below? You Selected:

"Disruption in some proteins called molecular chaperones causes intracellular molecules to become denatured and insoluble, leading to clumping and the development of inclusion bodies." Explanation:

How could a health care professional most accurately explain an aspect of the underlying structure of DNA to a colleague who is unfamiliar with genetics? You Selected:

"In the base pairs, adenine combines with thymine and guanine with cytosine." Explanation:

The mother of a 7-year-old boy who has recently been diagnosed with childhood asthma has come to the education center to learn more about her son's condition. Which teaching point is most justifiable? You Selected:

"Research has shown that viruses may actually be a factor in childhood asthma." Explanation:

A physician is teaching a group of medical students about the physiologic basis for damage to the circulatory and neurologic systems that can accompany hypotension. Which response by a student would warrant correction by the physician? You Selected:

"Tension and vessel thickness increase proportionately." Explanation:

When a client exposed to a teratogenic agent during the seventh week of pregnancy asks the nurse how this might that impact the fetus's development, which would be the most accurate response? You Selected:

"The external genitalia may be impacted." Explanation:

A client asks, "Why do I have clogged arteries but my neighbor has higher 'bad cholesterol' levels and yet he is just fine?" The health care provider bases the reply on which physiologic principle about lipoprotein?

"You more than likely have small, dense type of 'bad cholesterol' (LDL)." Explanation:

As part of her prenatal care, a pregnant woman and her partner are being taught by a community health nurse. Which point about the teratogenic effects of different substances should the nurse include in teaching? You Selected:

"Your developing baby is most vulnerable during the first 2 months of your pregnancy." Explanation:

Following meiosis, which replicates germ cells and results in the formation of gametes, how many chromosomes do the gametes possess?

23 single chromosomes

A client has a myocardial infarction (MI) that has damaged the right atrium, which results in interference with the SA node. The compensatory mechanism, the AV node, becomes the pacemaker of the heart and beats how many times per minute? You Selected:

45 to 50 beats/minute

What is the risk that a mother with the genetic mutation that causes fragile X syndrome will pass the gene on to offspring? You Selected:

50% of males will be affected

Which client would have a very poor response related to tissue regeneration of his or her injured area?

54-year-old male who had a massive MI 4 days ago and came to the ED today for treatment. Explanation:

The nurse knows that mean arterial pressure is:

60% of diastolic pressure and 40% of systolic pressure Explanation:

Many adaptive cellular responses alter the expression of "differentiation" genes. What can cells do because of this adaptive response? You Selected:

A cell is able to change size or form without compromising its normal function. Explanation: Reference:

Individual differences in appearance, behavior, and disease susceptibility are a result of which of these? You Selected:

A haplotype

A client is admitted to the hospital with severe bradycardia, heart rate in low to upper 40s, after contracting Lyme disease. She asks the nurse why the heart rate is so slow. The most accurate response would be a possible disassociation between the atria and ventricles due to: You Selected:

AV nodal block

A client with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase in her blood pressure over the past several months, culminating in a diagnosis of secondary hypertension. Which factor has most likely resulted in the client's increased blood pressure? You Selected:

Activation of the renin-angiotensin-aldosterone mechanism Explanation:

An older adult client has experienced some hypoxia as a result of chronic respiratory problems. Knowing that oxygen-deprived cells result in an accumulation of lactic acid in the cells, the client may experience which physiologic event? You Selected:

Altered cell membrane permeability Explanation:

The physician mentions that a client has developed alveolar dead space. The nurse interprets this to mean which finding? You Selected:

Alveoli are ventilated but not perfused. Explanation:

The nurse knows that there are many different groups of antihypertensive drugs having varied mechanisms of action. Which medication decreases the exit of adrenergic (sympathetic) stimulation from the central nervous system, thereby decreasing sympathetic outflow? You Selected:

An alpha-2 adrenergic agonist

A client with right lower quadrant abdominal pain is suspected to have acute appendicitis. When assessing the laboratory studies, what results would the nurse know indicate this client has an acute infection?

An increase in bands

Normal physiologic process involves the necessary removal of irreversibly damaged cells. Which term best describes this process?

Apoptosis

Blood transports both oxygen and carbon dioxide in a physically dissolved form to the tissues and organs of the body. It is the measurements of the components of the gases in the blood that are used as indicators of the body's status by health care workers. Why is it more appropriate to measure the blood in the arteries rather than in the veins? You Selected:

Arterial blood most adequately measures the gas exchange function of the lungs. Explanation:

What does the destructive nature of tuberculosis cause in a previously unexposed immunocompetent person? You Selected

Caseating necrosis and cavitation

The carbon dioxide content in the blood affects the regulation of ventilation through its effect on what aspect of the brain? You Selected:

Cerebrospinal fluid pH

Which of the following statements best captures the etiology of the acute response phase of extrinsic (atopic) asthma? You Selected:

Chemical mediators are released from pre-sensitized mast cells. Explanation:

The nurse is assessing a client with an elevated temperature. Which additional assessment findings provide the most useful information for the nurse? You Selected:

Client's heart rate is more rapid than anticipated. Explanation:

A respiratory therapist has asked a client to breathe in as deeply as possible during a pulmonary function test. Inspiration is normally the result of which phenomena? You Selected:

Decreased intrathoracic pressure

From which embryonic tissue do nerve cells develop? You Selected:

Ectoderm

Which statement provides blood work results and rationale that would be most closely associated with acute coronary syndrome? You Selected:

Elevated creatine kinase and troponin, both of which normally exist intracellularly rather than in circulation

Which phenomena best accounts for the increased presence of leukocytes at the site of inflammation?

Existing leukocytes stick to the epithelial cells and move along blood vessel walls. Explanation:

A nurse is assessing a client's apical pulse. The nurse is palpating the point of maximum impulse between which ribs? You Selected:

Fifth and sixth

A client has undergone a screening colonoscopy. The doctor removed several polyps that were sent to pathology and identified as benign. Select the best explanation of a polyp. You Selected

Growth that projects from a mucosal surface Explanation:

Which child most likely has the highest risk of experiencing a wound complication? You Selected:

Has recently been diagnosed with type 2 diabetes Explanation:

The provider is counseling a client who has just been diagnosed with adult polycystic kidney disease, an autosomal dominant disorder. Which statement regarding the transmission of genetic disease is accurate?

Healthy or unaffected children are not carriers of the defective gene. Explanation:

A 26-year-old man who survived childhood acute lymphocytic leukemia (ALL), one of the most common childhood cancers, now complains of weakness, fatigue, and shortness of breath. His treatment for ALL likely included anthracyclines. What is the most likely cause of his symptoms? You Selected:

Heart failure resulting from childhood chemotherapy Explanation:

A client has suffered a head injury during a motorcycle accident resulting in impaired swallowing and aspiration pneumonia. Which statement most accurately captures an aspect of his condition? You Selected:

His vocal folds of the larynx are not performing their normal function. Explanation:

A deficiency in which of these would result in an inhibition of the inflammatory response? You Selected:

Histamine

When explaining the final stages of the inflammatory response to pathogens, the nurse should include which educational topics? You Selected:

How the body can kill the pathogen by generating toxic oxygen and nitrogen products, producing such things as nitric oxide and hydrogen peroxide Explanation:

Which clincial manifestation supports the diagnosis of lead toxicity? You Selected:

Hypertension

While taking a daily walk, the nurse is asked by a neighbor what centric fusion (Robertsonian) translocation means. The neighbor tells the nurse that a family member has been diagnosed with this and is now afraid to have children. Given this diagnosis, what may be potential risks for her offspring?

If chromosome 21 is involved, there is a high risk for producing a child with Down syndrome. Explanation: Reference:

A client diagnosed with septic shock who is experiencing tissue hypoxia likely will activate which pathophysiologic process? You Selected:

Inflammatory mediators

Some messengers, such as thyroid hormone and steroid hormones, do not bind to membrane receptors but move directly across the lipid layer of the cell membrane and are carried to the cell nucleus. What do they do at the cell nucleus? You Selected:

Influence DNA activity

A farmer's long-term exposure to pesticides has made the cells in his alveoli and bronchial tree susceptible to malignancy. Which process has taken place in the farmer's lungs? You Selected:

Initiation

In which client with a transecting spinal cord injury should the nurse anticipate an impaired ability for temperature regulation? You Selected:

Injury at T2

A parent brings his child to the emergency department stating that the child became sick very quickly. The nurse observes the child having to sit upright with the mouth open, drooling, lethargic, with inspiratory and expiratory stridor. What action should the nurse perform at this time? You Selected:

Keep the child calm and decrease anxiety.

The nurse administers nitroglycerin to a client with acute coronary syndrome. Which explanation is the best rationale for this intervention? You Selected:

Limiting the size of the infarction

Adverse effects of emboli on pulmonary circulation and airways include: You Selected:

Local vasoconstriction

What function does hyaluronic acid (a component of the extracellular matrix) performs in the body? You Selected:

Lubricates joints and serves as a supportive structure in the extracellular space throughout the body. Explanation:

Infections with the TORCH agents are reported to occur in 1% to 5% of newborn infants in the United States and are among the major causes of neonatal morbidity and mortality. Which of these are clinical and pathologic manifestations of TORCH? You Selected:

Microcephaly, hydrocephalus, thrombocytopenia Explanation:

Semen analysis indicates that the client's sperm have decreased motility. Which cellular components may be defective within the client's sperm? You Selected:

Microtubules

The parents of a 13-year-old boy with a sore throat for a week, vomiting for two days, swollen lymph glands, and stiff achy joints is now seeking antibiotic treatment after herbal remedies were unsuccessful. Throat cultures reveal infection with group A streptococci. This child is at high risk for development of which cardiac complicaton?

Mitral valve stenosis

The nursing instructor is explaining pressure changes that occur during inspiration. During inspiration, which would be the most appropriate information to include about changes in intrapleural pressure? You Selected:

Negative in relation to alveolar pressure Explanation:

Which statement best conveys an aspect of the respiratory pressures that govern ventilation? You Selected:

Negative intrapleural pressure holds the lungs against the chest wall. Explanation: Reference:

A 16-year-old male presents to the clinic complaining of headaches, trouble hearing the teacher in the front of the classroom, and ringing in the ears. He also revealed that every time he goes swimming underwater, he gets disorientated (which never happened when he was younger). Given these manifestations, the health care provider is going to start testing for: You Selected:

Neurofibromas

A client with pemphigus has multiple mouth sores. Which class of medication is most likely to produce disease remission? You Selected:

Oral steroids

A nurse is assessing a client diagnosed with severe mitral valve stenosis. The nurse anticipates which classic assessment finding? You Selected:

Orthopnea

The health caregiver is explaining the rationale for administering a hypotonic intravenous solution (lower concentration of solutes in its surroundings) to a client. Which mechanism of membrane transport most likely underlies this action? You Selected:

Osmosis

The nurse is aware that to maintain homeostasis a client may experience a variety of physiologic processes. The process by which molecules of a solvent tend to pass through a semipermeable membrane from an area of less concentrated solution into a more concentrated one, resulting in equalizing the concentrations on each side of the membrane, is known as: You Selected:

Osmosis

The oncology nurse understands that the development of effusions in the pleural, pericardial, or peritoneal spaces is often the presenting sign of some tumors. Which cancer is most often associated with accumulation of fluid in the peritoneal cavity? You Selected:

Ovarian cancer

Tissue repair through regeneration occurs in which cells? You Selected:

Parenchymal

A client was in car accident client while not wearing a seatbelt and has sustained multiple rib fractures. During assessment, the nurse is having a hard time hearing heart sounds, and the client reports chest pain/pressure repeatedly. This client may be experiencing: You Selected:

Pericardial effusion

While lecturing on inheritance patterns, a student asks, "My mother has blue eyes and my father has brown eyes. All my siblings have brown eyes except me. How can this happen?" Which explanation is the most accurate response? You Selected:

Phenotypically, the brown-eyed persons are the same, but genotypically they are different. Explanation:

A short, nonsmoking 44-year-old male presents to the emergency room with left-sided chest pain and a cough. He states the pain started abruptly and worsens with deep breathing and coughing. He denies recent injury. Assessment includes shallow respirations with a rate of 36, normal breath sounds, no cyanosis. Which condition is most likely causing his symptoms? You Selected:

Pleuritis related to infection

An unconscious client admitted to the ICU with severe head injuries following a motorcycle accident is experiencing very irregular with long inspiratory gasps interrupted by expiratory effort. The nurse explains to the family that the reason for their respiration abnormality is a result to injury in which part of the brain? You Selected:

Pneumotaxic and apneustic connection

A 40-year-old male presents to the emergency department reporting chest pain and shortness of breath. The health care provider suspects a pulmonary embolism and orders several diagnostic tests. Select the test that would require further follow-up. You Selected:

Positive D-dimer

An older male client has fallen at home and sustained a bruised left hip. Assessment reveals shortness of breath and shallow respirations with a respiratory rate of 40 breaths/min. If the client develops a tension pneumothorax, what additional assessment finding would the nurse observe? You Selected:

Presence of a mediastinal shift Explanation:

Which statement best describes the pressure that drives breathing? You Selected:

Pressure in the pleural cavity

There are two forms of endoplasmic reticulum (ER) found in a cell. They are the rough and the smooth ER. What does the rough ER do in a cell? You Selected:

Produces proteins

The nurse is educating a client who is about to undergo a stem cell transplant, mentioning that a single stem cell can give rise to many cells needed for normal tissue repair. With stem cell division, one daughter cell retains the stem cell characteristics while the other daughter cell becomes which type of cell leading to terminal differentiation? You Selected:

Progenitor

The nurse is caring for a client who has a positive tuberculin test and has close contact with family with active tuberculosis. Which treatment is most appropriate for the client? You Selected:

Prophylactic treatment with isoniazid Explanation:

A client is admitted to the outpatient diagnostic unit for further testing to identity the cause of the uncontrolled secondary hypertension. In preparation, the nurse should anticipate that which diagnostic procedure will provide the most definitive diagnosis? You Selected:

Renal arteriography

What is the primary purpose of tissue regeneration in wound healing?

Replace injured tissue to its original structure Explanation:

Which type of tissue forms the architecture of liver sinusoids and lymphoid tissues such as the spleen?

Reticular connective tissue

Which type of ribonucleic acid (RNA) structure translates the instructions needed for protein synthesis

Ribosomal RNA

Which organism is a common cause of bacterial pneumonia in both community and hospital settings?

S. aureus

A client in the intensive care unit has a blood pressure of 87/39 mm Hg and has warm, flushed skin accompanying his sudden decline in level of consciousness. The client also has arterial and venous dilatation and a decrease in systemic vascular resistance. What is this client's most likely diagnosis? You Selected:

Septic shock

Following a kitchen accident with a knife, the client's cut has experienced a decrease in the amount of bleeding and has developed a clot. The nurse knows this is primarily a result of the release of which humoral factor? You Selected:

Serotonin

A client who presented with shortness of breath and difficulty climbing stairs has been diagnosed with pulmonary fibrosis, a disease characterized by scarring of the alveoli. Upon assessment of the lungs, what clinical manifestations should the nurse expect? You Selected:

Short, shallow breaths.

A nurse is evaluating a client to determine the effectiveness of medications given to reduce left ventricular afterload. Which hemodynamic parameter is most appropriate for the nurse to monitor?

Systemic vascular resistance (SVR)

The nurse is assessing the ECG of a client who is experiencing unstable angina. The nurse observes: You Selected:

T-wave changes

A client is scheduled for a bronchoscopy related to a history of "bronchitis" for the last 3 months that has been unresponsive to antibiotics. The nurse shares with the client that a primary purpose for this bronchoscopy is to help diagnose which complication? You Selected:

Taking tissue biopsy and looking for abnormal cells Explanation:

The health care provider is assessing a 6-month-old infant. The parents state that the child appeared normal at birth and in the first few months; however, they have seen the following changes in their infant: progressive weakness, muscle flaccidity, and decreased attentiveness. The health care provider suspects: You Selecte

Tay-Sachs Disease

A student is reviewing the pathways for apoptosis. Which statement best describes the physiologic function of the extrinsic pathway that ultimately results in cellular death? You Selected:

The endotoxin found in the outer cell membrane of gram-negative bacteria acts as a signaling molecule which activates the extrinsic pathway. Explanation:

The oncologist is reviewing data to determine if a client diagnosed with a malignant tumor is at risk for developing metastasis. Select the option that places the client at greatest risk. You Selected

The establishment of a dedicated vascular system Explanation:

A researcher is involved in the production of insulin through recombinant DNA technology. Which statement could the researcher best provide as a rationale for her work? You Selected:

The gene fragment responsible for insulin production can be isolated and reproduced. Explanation:

A group of researchers has identified that the prevalence of two particular genetic disorders share a statistical correlation. Which statement best conveys the genetic rationale for this situation? You Selected:

The genes causing each disorder are likely in the same section of the same chromosome. Explanation

Analysis has shown that a client's right atrial pressure is 30 mm Hg. What is the most likely conclusion that the client's care team will draw from this piece of data? You Selected:

The pressure is excessive given that the right atrium should be at atmospheric pressure. Explanation:

When a client with a kidney transplant develops graft versus host disease, signs and symptoms develop first in which organ? You Selected:

The skin with pruritis and maculopapular rash Explanation:

The medical team is assessing a newly admitted client who is hypothermic following a night spent lost on a ski slope. The health care professionals would recognize that which phenomenon most likely contributed to minimizing the client's heat loss in a cold environment? You Selected:

The tissue thickness of the outer shell increased and preserved heat. Explanation:

As part of an orientation to a genetic counseling practice, a group of medical students are differentiating between autosomal recessive disorders and autosomal dominant disorders. Which statement is true of autosomal recessive disorders? You Selected:

They tend to have a more uniform symptomology than autosomal dominant disorders.

Which statement about vascular compliance is accurate? You Selected:

Veins can act as a reservoir for storing large quantities of blood. Explanation:

A person with blood pressure of 68/38 fainted after donating a unit of blood. The blood bank technician stated that the person was experiencing low preload from loss of blood volume. The nurse knows that preload refers to which of the following? You Selected:

Venous return to the heart Explanation:

A 66-year-old obese man with diagnoses of ischemic heart disease has been diagnosed with heart failure that his care team has characterized as attributable to systolic dysfunction. Which assessment finding is inconsistent with his diagnosis? You Selected:

Ventricular dilation and wall tension are significantly lower than normal. Explanation:

When caring for a postoperative client, in order to promote wound healing, which of these nutrients does the nurse encourage the client to consume? You Selected:

Vitamin C

A client with diabetes has an admission hemoglobin A1c (HbA1c) level of 13 (goal is 6) and an abdominal wound that will not heal. The nurse knows that hyperglycemia (poor blood glucose control) has an effect on wound healing, especially related to neutrophils affecting: You Selected:

ability to engulf and kill bacteria because of poor phagocytic function. Explanation:

What does it mean that some cell populations have self-renewing multipotent stems cells? Some cells:

can differentiate into different epithelial cell types throughout life. Explanation:

When performing an assessment on a school-aged child, the nurse notes that the mucous membranes along the gum margins have a noticeable blue-colored line. At this point, the nurse should ask the parents about possible: You Selecte

exposure to lead.

A client with long QT syndrome has the gene that increases potassium channels. How will this affect membrane potentials? It will cause: You Selected:

delayed return to resting potential. Explanation:

The practitioner examines his client's foot and observes the great toe to be black and dry. The practitioner explains to the client that the dead tissue is caused by: You Selecte

dry gangrene.

The nurse is teaching new nursing assistants on the unit about the phenomenon of muscle hypertrophy. Which client on the unit is most likely to experience muscle hypertrophy? A client with:

hypertension, obesity, and decreased activity tolerance. Explanation:

Performing chorionic villi sampling prior to 10 weeks' gestation is not recommended because of the danger of: You Select

limb reduction defects in the fetus.

A yellow-brown pigment that accumulates in neurons and may be a sign of cellular stress is: You Selected:

lipofuscin. Explanation:

A client had a positive Pap smear. The surgeon diagnosed "cancer in situ of the cervix." The client asks, "What does this mean?" From the following statements, which is most appropriate in response to this question? The tumor has: You Selected:

not crossed the basement membrane, so it can be surgically removed with little chance of growing back. Explanation:

A client with a history of disabling claudication now is in the emergency department with a lower limb that is turning dark purple to black associated with faint Doppler pedal pulses. The client will more than likely undergo: You Selected:

percutaneous transluminal angioplasty and stent placement.

Teratogenic substances cause abnormalities during embryonic and fetal development. These substances have been divided into three classes. These classes are called: You Select

radiation; drugs and chemical substances; and infectious agents. Explanation

The oncologist has assessed a client diagnosed with cancer and determined that radiation therapy is the best course of treatment. The therapy will be most effective for: You Selected:

radiosensitive tumors that are fast growing. Explanation:

A client diagnosed with cancer has been prescribed monoclonal antibodies as a treatment option. He asks the health care provider, "What are you talking about? I've never heard of this treatment. Is it experimental?" The health care provider explains somatic cell hybridization to the client by explaining that:

researchers inject mice with an antigen from human cancer cells. They then harvest the antibody-producing cells from the mice and individually fuse them with a cancerous cell. Explanation:

A 60-year-old male client diagnosed with a solid abdominal tumor appears with cachexia. The nurse recognizes this as a consequence of: You Selected:

secretion of cytokine TNF-α.

A nurse who had a needlestick injury 15 years ago has developed hepatitis C and now progressed to liver failure. This nurse was hoping that the growth factor, transforming growth factor-alpha (TGF-alpha), would have been able to repair her liver since this growth factor's function is to: You Selected:

stimulate replication of hepatocytes.

Hypertension in older adults is a common finding. This is because of the age-related rise in systolic blood pressure. Among the aging processes, what is a contributor to hypertension? You Selected:

Decreased baroreceptor sensitivity Explanation

Which factor can increase the absorption of lead into a client's system? You Selected:

Decreased calcium levels in the blood

The stroke volume is the amount of blood ejected with every contraction of the ventricle. It is broken down into quarters. What is the approximate amount of the stroke volume per quarter? You Selected:

60%, 20%, 20%, and little blood

Which individual is experiencing an immunologic lung disorder affecting ventilation that has caused the formation of a granuloma on chest x-ray? You Selected:

A 30-year-old male who has been diagnosed with sarcoidosis Explanation:

Which cell cycle phase occurs after mitosis in which DNA synthesis ceases while RNA and protein synthesis and cell growth continue to take place? You Selected:

G1 phase

Which client should the emergency department staff suspect to be high risk for the development of a thoracic aortic aneurysm? You Selected:

A 66-year-old client with facial edema, a cough, and neck vein distention Explanation:

An infant who is 4 days postpartum has been diagnosed with a single-gene disorder. The parents of the child have a number of questions about the etiology of the health problem, which the physician is attempting to address in detail. Which teaching point most accurately captures an aspect of single-gene congenital disorders? You Selected:

A particular defect can be caused by mutations at several different loci.

Which process characterizes an epigenetic contribution to oncogenesis?

A tumor suppressor gene is present, but it is not expressed. Explanation:

A client with chronic renal failure secondary to diabetes has just been diagnosed with secondary hypertension. This increase in blood pressure is likely caused by which physiologic factor? You Selected:

Activation of the renin-angiotensin-aldosterone mechanism Explanation:

A 77-year-old lifetime smoker has been diagnosed with a tumor in his lung at the site of an old tubercule scarring site, located in a peripheral area of his bronchiolar tissue. What is this client's most likely diagnosis? You Selected:

Adenocarcinoma

A client is currently receiving chemotherapy treatment and has developed thrombocytopenia. The most appropriate intervention for the nurse to implement would be: You Selected:

Administration of erythropoietin

Which client with a diagnosis of asthma and a history of GI reflux is at greatest risk for developing an asthma attack? You Selected:

Adult with a respiratory virus

A female older adult client has presented with a new onset of shortness of breath, and the client's physician has ordered measurement of her brain natriuretic peptide (BNP) levels along with other diagnostic tests. What is the most accurate rationale for the physician's choice of bloodwork? You Selected:

BNP is released as a compensatory mechanism during heart failure and measuring it can help differentiate the client's dyspnea from a respiratory pathology. Explanation:

A 12-year-old boy's severe wound that he received from a dog bite has begun to heal and currently shows no signs of infection. Which processes occurred first during this process of repair by connective tissue deposition? You Selected:

Angiogenesis

A 45-year-old client who experienced exposure to radiation during an industrial accident several years prior is being assessed. Which phenomena may underlie the genetic changes that have been noted in the client

Base pairs may have been rearranged by the radiation in the accident. Explanation:

An 81-year-old female client of a long-term care facility has a history of congestive heart failure. The nurse practitioner caring for the client has positioned her sitting up at an angle in bed and is observing her jugular venous distention. Why is jugular venous distention a useful indicator for the assessment of the client's condition?

Blood backs up into the jugular vein because there are no valves at the point of entry into the heart. Explanation:

A client is in hypovolemic shock after massive blood loss in a car accident. The client's peripheral blood vessels have consequently collapsed making it hard to insert an IV line. How does the Laplace law account for this pathophysiologic phenomenon? You Selected:

Blood pressure is no longer able to overcome vessel wall tension. Explanation:

An agricultural worker is picking fruit on a day when the air temperature is 106°F (41.1°C). Which process will most likely be occurring while he works

Blood volume to his skin surface will be increasing to dissipate heat. Explanation:

A client presents to the clinic with a swollen, painful "hang nail" on the index finger and a large pustule that needs to be lanced. The health care worker knows that which mediator of inflammation causes this increase in capillary permeability and pain? You Selected:

Bradykinin

An infant born 10 weeks premature was placed on mechanical ventilation. Eight weeks later a nursing assessment reveals a barrel chest, tachycardia, rapid and shallow breathing, hypoxemia, hypercapnia, and poor weight gain. Based on this assessment, which diagnosis is most likely? You Selected:

Bronchopulmonary dysplasia

Which elevated serum marker for systemic inflammation is now considered a major risk factor for atherosclerosis and vascular disease? You Selected:

C-reactive protein

The health care provider is reviewing diagnostic results of a client with suspected ovarian cancer. Select the result that would be of most concern. You Selected:

CA 125

A nurse caring for a client with progressive cancer notes that the client has experienced significant loss of skeletal muscle and fat. The nurse documents this as: You Selected:

Cachexia

A 6-year-old child cuts her leg while playing outside. An inflammatory process begins the healing process by moving leukocytes and platelets through the endothelial lining of blood vessels. This process results in linking actin and structures with which extracellular tissue component? You Selected:

Cadherins

A community health care nurse is teaching a group of female high school students about the importance of regular papanicolaou (Pap) tests. The nurse recognizes that which fact underlies the rationale for this teaching? You Selected:

Cancer of the uterine cervix develops incrementally at a cellular level. Explanation:

A 5-year-old girl's diagnosis of bone cancer required an aggressive treatment regimen. The client immediately receives doxorubicin chemotherapy. The nurse administering this medication should perform a detailed assessment of which body system that has been greatly affected by this drug? You Selected

Cardiac

A physical assessment of a 28-year-old female client indicates that the blood pressure in her legs is lower than that in her arms and that her brachial pulse is weaker in her left arm than in her right. In addition, her femoral pulses are weak bilaterally. Which possibility would her care provider be most likely to suspect? You Selected:

Coarctation of the aorta Explanation:

Several cancers have been identified as inheritable through an autosomal dominant gene resulting in people who inherit these genes being at increased risk for developing the cancer. Which cancer carries the highest risk of developing the cancer in someone who carries the gene? You Selected:

Colon cancer

Which response best describes a granulomatous inflammatory response to a foreign body like a splinter? You Selec

Connective tissue encapsulates the splinter and isolates it. Explanation:

A physiology instructor asks the students about the purpose of the promoter region on a DNA strand. Which student response is most accurate? You Selected:

Contains amino acids that the RNA polymerase recognized and binds to, thus starting the replication process

A client arrives in the emergency department suffering a traumatic brain injury as a result of a car accident. While assessing this client, the nurse notices the client has an irregular breathing pattern consisting of prolonged inspiratory gasps interrupted by expiratory efforts. The underlying physiologic principle for these signs would include: You Selected:

Damage has occurred at the connection between the pneumotaxic and apneustic centers. Explanation: Reference:

A 79-year-old female resident of an assisted living facility receives care from a community nurse on a regular basis for treatment of a chronic venous leg ulcer. Which factor would the nurse be most justified in ruling out as a contributing factor to the client's impaired wound healing? You Selected:

Decreased antibody levels

A client diagnosed with breast cancer will undergo a surgical procedure that includes biopsy of the sentinel node. What can be accomplished by this biopsy? You Selected:

Determine the extent of the disease

A client has developed pericarditis. The nurse knows this condition will increase the risk for developing which condition?

Diastolic dysfunction

When blood pressure is measured, pressure rises during ventricular contraction, then falls during relaxation. As the pressure falls, there is a brief rise as the aortic valve closes. This rise is known by which terminology?

Dicrotic notch

A client with lung cancer is scheduled for the removal of the right lung. The nurse should anticipate that after surgery the client will experience a significant decrease in which physiologic measurement

Diffusion capacity

Which diagnosis will present the highest risk for hypercapnic/hypoxemic respiratory failure? You Selected

Drug overdose

Endocrine glands are epithelial structures that have had their connection with the surface obliterated during development. How are these glands described? You Selected:

Ductless and produce secretions Explanation:

Cranial radiation therapy (CRT) has been used to treat brain tumors, ALL, head and neck soft tissue tumors, and retinoblastoma in children. Childhood cancer survivors who had CRT as therapy for their cancers are prone to growth hormone deficiency. In adults, what is growth hormone deficiency associated with? You Selected:

Dyslipidemia

A physician is working with a family whose daughter has been recently diagnosed with the chromosomal disorder Turner syndrome. The physician would recognize that which statement about the characteristics of human chromosomes is accurate? You Selected:

Each of the 22 pairs of autosomes has a homologue. Explanation:

Which term describes the chemical processes involved in converting carbohydrates, fats, and proteins from the foods we eat into the energy to perform these tasks? You Selected:

Energy metabolism

Which type of receptor binds with insulin? You Selected:

Enzyme-linked

A mother rushes her toddler into the emergency department stating, "My baby can't breathe." Initial assessment reveals the child is struggling to breathe in an upright position. He has both inspiratory and expiratory stridor and is using his chest muscles to breathe. The nurse suspects the child has which acute respiratory infection? You Selected:

Epiglottitis

Which fact underlies the application of RNA interference in the treatment of disease? You Selected:

Faulty gene activity that produces unwanted proteins can sometimes be stopped. Explanation

A client with malignant melanoma has been prescribed alpha interferon, a biologic response modifier. Since this drug prolongs the cell cycle, increasing the percentage of cells in the G0 phase, and stimulates NK cells and T-lymphocyte killer cells, the nurse can anticipate that they may experience which common side effects? You Selected:

Fever, chills, and fatigue

Inflammation can be either local or systemic. What are the most prominent systemic manifestations of inflammation?

Fever, leukocytosis or leukopenia, and the acute phase response Explanation: Reference:

Why is the risk of scarring and deformity greater in chronic inflammation than it is in acute inflammation

Fibroblasts instead of exudates proliferate in chronic inflammation. Explanation:

The client's ultrasound shows a true aneurysm that involves the entire circumference of the vessel and has a gradual and progressive dilation of the vessel. The provider tells the client the aneurysm is which of the following forms? You Selected:

Fusiform

In the ICU setting, clients who develop shock need thorough head-to-toe assessments. Which clinical manifestation would alert the health care provider that the client may be developing ischemia associated with gastrointestinal redistribution of blood flow? You Selected:

Gastric bleeding Explanation:

The nurse is caring for a client with liver failure. What process of conversion does the nurse know will be impaired due to the inability of the liver to remove lactic acid from the bloodstream? You Selected:

Gluconeogenesis

Which lab result strongly suggests an immunologic response in the client with possible rheumatic heart disease?

Group A (β-hemolytic) streptococcal antibodies

A young college football player was bought to the emergency room after collapsing on the football field during practice. When arriving he was unconscious and his ECG was abnormal. Subsequently he died after arresting in the emergency room. What does the physician suspect is the likely cause of this?

Hypertrophic cardiomyopathy Explanation:

The nurse is caring for an 83-year-old client recovering from hip replacement surgery. The nurse recognizes that this client is at greatest risk for which complications of wound healing? You Selected:

Immobility resulting from his surgery

A client has suffered damage to his pericardium following a motor vehicle accident. Which consequence could be a possible complication of damaged pericardium that his care providers should assess for? You Selected:

Impaired regulation of myocardial contraction

A client with pneumonia will experience a decrease in the diffusion of gases in the lung that leads to which compensatory response in the alveoli? You Selected:

Increase in the thickness of the alveolar-capillary membrane Explanation:

The nurse is caring for a client admitted with carbon monoxide (CO) poisoning who is extremely agitated, dyspneic, and confused. The nurse understands that treatment with a hyperbaric chamber with 100% oxygen administration would result in which physiologic response? You Selected:

Increase the amount of oxygen that can be carried in the dissolved state. Explanation:

As a result of dehydration, a client's epithelial cells are producing insufficient amounts of mucus. Consequently, the client's mucociliary blanket is compromised. Which change would the care provider anticipate as a direct result of this change? You Selected:

Increased amounts of bacteria in the lung

Acute respiratory failure is commonly signaled by varying degrees of hypoxemia and hypercapnia. Which physiologic findings are considered a direct result of respiratory acidosis that develops as a result of hypercapnia? You Selected:

Increased cerebral blood flow Explanation:

The nurse caring for older adults in an extended care facility suspects one of the clients has an infection. What is the earliest manifestation the client could exhibit? You Select

Increased mental confusion

Which physiologic response increases an obese woman's risk for the development of breast cancer? You Selected:

Increased sex hormone production

The oxyhemoglobin buffer system changes with the metabolic needs of the tissues. What can cause a shift to the right in the dissociation curve? You Selected:

Increased tissue metabolism

A client undergoes a splenectomy following an automobile accident. The nurse monitors for which anatomical change most likely to occur following surgery? You Selected:

Increased white blood cell (WBC) count

There are two types of stimuli that affect the raising or lowering of body temperature. What are these stimuli?

Innocuous and noxious Explanation:

In which stage of mitosis does the cell not undergo division but does double its mass? You Selected:

Interphase

A client has an increased serum lactic acid level. The physician understands this is indicative of which disease process? You Selected:

Ischemia

A nursing instructor is explaining arterial circulation to a group of nursing students. What is the most appropriate information for the nurse to provide concerning arterial pressure gradient in the arterial side of systemic circulation? You Selected:

It contains one-sixth of the total blood volume. Explanation:

An instructor is explaining to a group of students the way in which muscles and their associated tendons can be so strongly attached. The instructor makes references to the role of the basal lamina. Which statement most accurately captures an aspect of the basal lamina? You Selected:

It is present where connective tissue contacts the tissue it supports. Explanation:

Most febrile illnesses are due to common infections and are relatively easy to diagnose. In certain instances, however, it is difficult to establish the cause of a fever. In these instances, the elevation in temperature is referred to as a fever of unknown origin (FUO). What is a common cause of FUO? You Selected:

Malignancies

Which disorder is a single-gene mutation? You Selected:

Marfan syndrome

Stimulation of the sympathetic nervous system during stress or exercise causes local constriction because of the release of which hormone? You Selected:

Norepinephrine

The nurse is assessing clients who are febrile. Which client is at greatest risk due to fever? You Selected

Older adult client with heart failure Explanation:

When explaining a new diagnosis of complete heart block to a client and family, the nurse should include which statement? You Selected:

One consequence of this type of block is a very slow heart rate that limits circulation to the brain." Explanation:

An older adult client asks the nurse what causes the functional decline that occurs with the process of aging. The best response would include which physiologic mechanism? You Selected:

Oxidative stress

A big difference in the treatment of childhood cancer as opposed to adult cancer is that chemotherapy is the most widely used treatment therapy for childhood cancer. What is the reason for this?

Pediatric tumors are more responsive to chemotherapy than adult cancers. Explanation:

Following surgery, a client had a chest x-ray that reported some opacities in the lung bases likely due to atelectasis. Which pathophysiologic process will result from this condition? You Selected:

Perfusion without ventilation

A client presents to the emergency department reporting bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. What is a potential diagnosis for this client

Raynaud disease

How do free radicals damage cells? You Selected:

Reacting with proteins and lipids thereby damaging cell membranes Explanation: Reference:

The health care provider is preparing to assess a client who has been diagnosed with hypertrophic cardiomyopathy. The provider anticipates the assessment data will include which finding? You Selected:

Reduced chamber size

An intensive care nurse caring for a client who is diagnosed with an anterior wall myocardial infarction (MI) notes frequent premature ventricular complexes on the ECG monitor and is concerned the client could develop a lethal dysrhythmia if one of the premature ventricular complexes fires on which phase of the cardiac action potential? You Selected:

Relative refractory period en

A nurse seeing that a disorder has a Mendelian inheritance pattern interprets this to mean that the disorder is:

Single-gene disorder

A nurse is explaining the conduction system of the heart to a client who is experiencing an dysrhythmia. Which would be the most accurate explanation?

Sinoatrial node (SA), internodal pathways, atrioventricular (AV) node, AV bundle, Purkinje fibers Explanation:

If the parasympathetic neurotransmitter releases acetylcholine, the nurse should anticipate observing what changes in the ECG pattern? You Selecte

Slowing of heart rate to below 60 beats/minute Explanation: Reference:

Which type of bronchogenic carcinoma has the greatest association with tobacco smoking and tends to metastasize to the brain? You Selected:

Small cell

The nurse is providing care for a 21-year-old female client with gas gangrene secondary to her compound fracture in her arm. Which assessment finding would the nurse most reasonably expect to find when caring for a client with a diagnosis of gas gangrene? You Selected:

Spreading edema

When a person rises from a lying to a standing position, heart rate increases. What description would the nurse use to explain the physiologic basis for this response? You Selected:

Stretch on baroreceptors in the heart and blood vessels

Select the option that best describes metastasis. You Selected:

The development of a secondary tumor.

The circulatory system is a closed system that is divided into two parts. Which statement is correct about the closed system? You Selected:

The low pressure pulmonary circulation links circulation and gas exchange in the lungs. Explanation:

A physician is explaining to a group of medical students the concept of Virchow's triad as it applies to venous thrombosis. Which clinical observation of a 50-year-old male client is most likely unrelated to a component of Virchow's triad? You Selected

The man has decreased cardiac output and an ejection fraction of 30%. Explanation:

A pathologist is examining histological (tissue) samples from a client with an autoimmune disease. Which characteristic of muscle samples would signal the pathologist that the samples are cardiac rather than skeletal muscle?

The muscle cells are arranged as an interconnecting lattice-work. Explanation:

The nurse is caring for a client with a stab wound. The nurse recognizes that deficiency of which of these elements of the blood will interfere with hemostasis at the site of injury? You Selected:

Thrombocytes

Which of the following describes how atrophied cells survive? You Selected:

Through decreased oxygen consumption

Which hormone messenger moves directly across the lipid bilayer of the cell membrane and is transported to the cell nucleus?

Thyroid hormones

Which process would most likely be considered an anomaly during the cellular phase of inflammation? You Selected

Vasoconstriction

A client who is recovering from burn injuries is discussing his prognosis with a physician. Which teaching point about expectations for healing should the physician offer? You Selected:

You may find that the scar is a bit smaller than the area of the wound." Explanation:

On the third day following an acute myocardial infarction, the client is being discharged home. The nurse is explaining how the heart tissue heals following an MI. "Since today is your third day after your heart attack, the tissue is likely:

acutely inflamed."

A client has been diagnosed with a gram-negative bacillus. The health care providers know these bacteria may produce clinical manifestations such as high temperature, high respiratory rate, and low blood pressure. These manifestations are primarily caused by: You Selected:

the outer layer of the bacterial membrane acting as an endotoxin. Explanation: Reference:

In an ICU setting, one assessment that would lead the nurse to suspect that shock has led to decreased blood flow to vital organs is:

urine output less than 20 mL/hour

A newly pregnant female is worried about her baby. She recently returned from a mission trip to Africa. She was told there was a rubella outbreak in the next village. She has been given a TORCH screening test. If she has exposed her fetus to rubella, the nurse would expect the infant to display which possible birth defects?

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