Pathophysiology term 1 Questions
Which substance activates the complement cascade? A: Antigen B: Histamine C: Leukotrienes D: Prostaglandins
A: Antigen The complement cascade is activated by the alternative pathway on primary exposure to an antigen. Histamine is an early mediator of this inflammatory response. It is such a potent vasodilator that it can cause significant reductions in blood pressure when released in excessive amounts. Leukotrienes are inflammatory chemicals generated from the lipoxygenase pathway: A4, B4, C4, D4, and E4. Prostaglandins are inflammatory chemicals that contribute to vasodilation and increased permeability.
A series of events occur during acute inflammation resulting from cellular injury. Which event occurs initially? A: Brief constriction of vessel walls B: Phagocytosis results in pus formation C: Neutrophils migrate to the injured area D: Plasma proteins and water move into the interstitial space
A: Brief constriction of vessel walls Immediately after injury, the precapillary arterioles around the injured area contract briefly. When phagocytosis is incomplete, a collection of dead neutrophils, bacteria, and cellular debris, called pus, may form at the site. After edema formation, blood flows through areas of inflammation, causing neutrophils to move to the sides of the blood vessels and roll along the endothelium of the vessel wall. After vessel constrictions, the increased pressure along with increased permeability pushes fluid out of the blood vessels and into the surrounding tissue contributing to local swelling.
The body's covering, the skin, acts as a barrier for infections by doing which of the following? (Select all that apply.) A: Creating a surface environment that inhibits growth of fungi and bacteria B: Blocking the entrance of bacteria to the interior of the body C: Ciliar action that traps pathogens, preventing their access D: Secreting specific antibodies to destroy the bacteria E: Sloughing off skin cells and with them bacteria
A: Creating a surface environment that inhibits growth of fungi and bacteria B: Blocking the entrance of bacteria to the interior of the body D: Secreting specific antibodies to destroy the bacteria E: Sloughing off skin cells and with them bacteria The high fat content of the skin inhibits the growth of bacteria and fungi. The skin is a mechanical barrier that most microorganisms cannot cross. It secretes IgA, an antibody that attacks foreign substances such as bacteria and helps the body's immune system destroy them. The skin protects the body from infections by sloughing off cells, thus lowering the bacterial load the body has to defend against. Cilia sweep away pathogens as structures found in some mucous membrane linings.
Which type of cellular adaptation would create the greatest concern if found on a biopsy report? A: Dysplasia B: Metaplasia C: Hyperplasia D: Hypertrophy
A: Dysplasia Dysplastic cells have significant potential to transform into cancerous cells and are usually regarded as preneoplastic lesions. Metaplasia is the replacement of one differentiated cell type with another. This most often occurs as an adaptation to persistent injury, with the replacement cell type better able to tolerate the injurious stimulation and is fully reversible when the injurious stimulus is removed. Hyperplasia is an increase in cell number usually in response to physiologic demands, hormonal stimulation, or chronic cell injury. This is generally a normal adaptation, and not nearly the concern of the correct option. Hypertrophy is an increase in cell mass accompanied by an augmented functional capacity. This is generally a normal adaptation, and of little or no concern.
The first line of defense against disease is provided by which of the following? (Select all that apply.) A: Intact skin B: Phagocytes C: T lymphocytes D: B lymphocytes E: Mucous membranes
A: Intact Skin E: Mucous membranes Intact skin and mucous membranes provide mechanical and chemical barriers that prevent microorganisms from gaining access to the body's tissues. Phagocytes are blood elements that fight pathogens once they enter the body. T lymphocytes and B lymphocytes are lymph elements that fight pathogens once they enter the body.
Environmental factors that influence the likelihood of exposure to and infection by microorganisms are which of the following? (Select all that apply.) A: Population density B: Cooking practices C: Sanitation D: Weather E: Age
A: Population density B: Cooking practices C: Sanitation D: Weather Environmental factors such as crowded living conditions have an impact on the incidence and type of infections for which a given population is at risk, since it increases possibility of contact with pathogens. Cooking practices have a direct impact on the pathogens in daily food consumed. Poor sanitation allows pathogens to come into direct contact with the population. Weather impacts the breeding ground of some pathogens. While age can impact health, it is not an environmental factor.
Bacteria are categorized by which of their following? (Select all that apply.) A: Shape B: Site of infection C: Need for oxygen D: Reaction to staining E: Association with proteins and lipids
A: Shape C: Need for oxygen D: Reaction to staining Bacteria are named for their shape (cocci, rod, and spirochete), their need for oxygen (aerobic or anaerobic), and their reaction to staining (Gram-positive or Gram-negative). Site of infection is related to parasites. Association with proteins and lipids is related to viruses.
How is acute inflammation different from chronic inflammation? A: acute inflammation is characterized by the predominance of neutrophils B: acute inflammation is characterized by the predominance of macrophages C: acute inflammation is characterized by the predominance of lymphocytes D: acute inflammation is characterized by the predominance of monocytes
A: acute inflammation is characterized by the predominance of neutrophils
A client develops weakness in both lower extremities following a prolonged period of bed rest. This condition is most likely caused by? A: atrophy. B: dysplasia. C: hypertrophy. D: hyperplasia.
A: atrophy. Disuse atrophy develops after prolonged periods of inactivity as a result of shrinkage of skeletal muscle cells. Dysplasia results in the abnormal development or growth of tissues, organs, or cells. Hypertrophy is an increase in cell mass accompanied by an augmented functional capacity. Cells hypertrophy in response to increased physiologic or pathophysiologic demands. Hyperplasia increases the cell's functional capacity by increasing the number of cells. Hyperplasia usually results from increased physiologic demands or hormonal stimulation.
Classic local manifestations of inflammation include all of the following except... A. coolness. B. redness. C. swelling. D. pain.
A: coolness
A critical event in the death of a cell is caused by? A: Disruption of the plasma membrane's permeability barrier B: an increase in cellular protein C: an accumulation of lipofuscin D: chronic nutrient insufficiency
A: disruption of the plasma membrane's permeability barrier. Disruption of the plasma membrane barrier, seen in necrosis, results in cellular death. Hypertrophy results primarily from a net increase in cellular protein content. Atrophy can result in the accumulation of lipofuscin. Atrophy occurs when cells shrink and reduce their differentiated functions in response to a variety of normal and injurious factors, such as nutrient starvation.
Healing and granulation take place from the edges inward and from the bottom of the wound upward until the defect is filled. There is more granulation tissue, and the result is a much larger scar. This is known as? A: healing by secondary intention B: healing by primary intention C: healing by maturation D: healing by tertiary intention
A: healing by secondary intention
A raised scar that extends beyond the original boundaries of the wound is called a? A: keloid B: ulcer C: granuloma D: dehiscence
A: keloid
If the host's immune system is compromised, resident florae may become pathogenic, resulting in A: opportunistic infections. B: Salmonella infection. C: otitis media. D: myocarditis.
A: opportunistic infections. When normal florae are allowed to overgrow as a result of the compromise of the host's immune system, infection can result. Salmonella requires the presence of a specific pathogen. Otitis media is not generally considered an opportunistic infection. Myocarditis is not generally considered an opportunistic infection.
A child with ill-fitting shoes developed a vesicle (small blister) that burst, releasing clear watery fluid. The school nurse would document this drainage as A: serous. B: purulent. C: fibrinous. D: hemorrhagic.
A: serous. Serous exudate is watery fluid such as that which collects under a blister. This type of exudate generally accompanies mild inflammation. Purulent exudate is called pus. Purulent exudate generally occurs in severe inflammation accompanied by bacterial infection. Large pockets of purulent exudate, called abscesses, must generally be removed or drained for healing to take place. Fibrinous exudate is sticky and thick and may have to be removed to allow healing; otherwise, scar tissue and adhesions may develop. Hemorrhagic exudate has a large component of red blood cells. This type of exudate is usually present with the most severe inflammation. Hemorrhagic exudate occurs with severe leakage from blood vessels or after necrosis or breakdown of blood vessels.
The goal of infection control is to A: sever the chain of infection. B: kill pathogens before infection can occur. C: minimize the spread of pathogens within a population. D: prevent the creation of medication-resistant pathogens.
A: sever the chain of infection. The goal of infection control is to block transmission of the microorganism to susceptible victims by severing the chain at one or more links. Pathogens are killed by natural physiologic processes or medication therapy. Minimizing the spread of infection is a secondary outcome of infection control. The prevention of medication-resistant pathogens focuses on the administration of the medication, not on infection control.
In muscle hypertrophy, the hypertrophied cells increase A: in size. B: number. C: calcium. D: accumulations.
A: size. The cellular response to persistent, sublethal stress reflects the cell's efforts to adapt. A common adaptive response is hypertrophy resulting in an increase in cell size. Hyperplasia is an increase in cell number. An increase in calcium would be pathologic and likely result in tetany. An increase in accumulations would be pathologic and likely result in cell injury.
Necrosis is the result of cellular injury that does not allow for cellular adaptation because it is which of the following? (Select all that apply.) A: Too severe B: Too prolonged C: Acute in nature D: Programmed into the cell itself E: A result of a disrupted blood supply
A: too severe B: too prolonged E: a result of a disrupted blood supply Necrosis occurs when the injury is too severe and too prolonged to allow adaptation to the stressors. Necrosis is usually a consequence of disrupted blood supply. A short-term injury usually allows the cell to adapt and so avoid necrosis. Apoptosis controls the rate of cell division and the rate of cell death. If cells are no longer needed, they activate a cellular death pathway, resulting in cell suicide.
What stage is defined by "fight or flight"? Alarm Resistance Exhaustion Adaptation
Alarm Alarm is called "fight or flight" because it gives the body a boost of energy to either run or confront. To survive, the body must move beyond the alarm stage to a stage of resistance (also called adaptation) supportive of the allostatic return to a state of homeostasis. Exhaustion occurs when the body is no longer able to bring about a return to homeostasis following prolonged exposure to noxious agents. To survive, the body must move beyond the alarm stage to a stage of resistance (also called adaptation) supportive of the allostatic return to a state of homeostasis.
Which statement regarding serum magnesium (Mg++) is true? (Select all that apply.) Alcohol-related diseases frequently cause low Mg+ levels. Vomiting is not generally seen as a major cause of Mg+ loss. Mg++ levels present similarly to calcium (Ca++) levels in the blood. Mg+ deficiencies often result in low serum potassium (K+) levels. Mg+ deficiencies must be treated before potassium (K+) deficiencies.
Alcohol-related diseases frequently cause low Mg+ levels. Mg++ levels present similarly to calcium (Ca++) levels in the blood. Mg+ deficiencies often result in low serum potassium (K+) levels. Mg+ deficiencies must be treated before potassium (K+) deficiencies. Chronic alcoholism is a major risk factor for hypomagnesemia, because it is associated with decreased magnesium intake. Signs and symptoms of Ca++ and Mg++ deficiencies are very similar. Hypomagnesemia causes decreased activity of the enzyme that drives the sodium-potassium pump in cell membranes, so intracellular potassium decreases in the myocardium. Hypomagnesemia often causes hypokalemia by increasing urinary excretion of potassium. In such cases, correction of hypomagnesemia is necessary before the hypokalemia can be corrected. Magnesium is lost through emesis.
Which is not one of the recognized components of the general adaptation syndrome? Alarm Allostasis Resistance Exhaustion
Allostasis Allostasis is a dynamic process that supports and helps the body achieve homeostasis. Alarm, resistance, and exhaustion are the three recognized components of Selye's General Adaptation Syndrome.
Which abnormality of intermediate metabolism occurs in cancer cachexia? (Select all that apply.) Anaerobic metabolism Increased gluconeogenesis Increased resting metabolic rate Decreased lactic acid production Energy expenditure for tumor growth
Anaerobic metabolism Increased gluconeogenesis Increased resting metabolic rate Energy expenditure for tumor growth Abnormalities of intermediate metabolism include anaerobic metabolism. The tumor also requires energy for growth, often using anaerobic metabolism which increases lactic acid production and promotes an increase in gluconeogenesis. Abnormalities in substrate metabolism in cancer patients increase total energy expenditure and raise the resting metabolic rate. The tumor also requires energy for growth, often using anaerobic metabolism (because tumor cells may not have sufficient capillary supply), which increases lactic acid production and promotes an increase in gluconeogenesis.
Reperfusion injury following an ischemic episode results in further tissue damage because of: A: Production of excessive lactate B:Excessive intracellular calcium C:Excess body fat and adipose tissue D: Production of exotoxins
B: Excess intracellular calcium is a primary mechanism in repercussion injury.
Antibodies respond to antigens by which of the following? (Select all that apply.) A: Forming bacterial toxins to neutralize antigens B: Functioning as antitoxins by neutralizing bacterial toxin C: Causing forming large complexes that precipitate out of solution D: Opsonizing antigens to make them more recognizable to phagocytes E: Initiating complement activation to help antibodies and phagocytic cells to attack pathogens
B: Functioning as antitoxins by neutralizing bacterial toxin C: Causing forming large complexes that precipitate out of solution D: Opsonizing antigens to make them more recognizable to phagocytes E: Initiating complement activation to help antibodies and phagocytic cells to attack pathogens Antibodies function as antitoxins by neutralizing bacterial toxin. Agglutination, opsonization or coating antigens, and supporting complement activation are ways antibodies enhance the localization and removal of antigens from the body. Antibodies do not form bacterial toxins; they function as antitoxins by neutralizing bacterial toxin.
What is the mechanism of cellular injury that occurs when deep sea divers get "the bends"? A: Intracellular calcium accumulation creates muscle tetany. B: Gas bubbles form in the blood, blocking circulation and resulting in ischemia. C: Free radicals form abnormal chemical bonds, which destroy the cellular membranes. D: Carbon monoxide binds tightly to hemoglobin, preventing the red blood cells from carrying oxygen.
B: Gas bubbles form in the blood, blocking circulation and resulting in ischemia. Abrupt changes in atmospheric pressure may result from high-altitude flying, deep sea diving, and explosions. Pressure changes may interfere with gas exchange in the lungs, cause the formation of gas emboli in the bloodstream, collapse the thorax, and rupture internal organs. A well-known example of pressure injury is the condition of "the bends," which afflicts deep sea divers who surface too quickly. The rapid decrease in water pressure results in the formation of bubbles of nitrogen gas in the blood, which may block the circulation and cause ischemic injury. Cell injury results from deficiencies, as well as from excesses of essential nutrients, such as in the case of excessive calcium and the resulting tetany. The free radical is very reactive, forming abnormal chemical bonds in the cell and ultimately destroying the cellular membranes. Some toxins have an affinity for a particular cell type or tissue, whereas others exert widespread systemic
Which type of irreversible cell injury initiates an inflammatory response? A: Apoptosis B: Necrosis C: Hydropic Swelling D: Intracellular accumulations
B: Necrosis-Necrosis causes inflammation and is far more common in pathology.
What is the role of the mast cells in the inflammatory process? A: They form antibodies to fight infection. B: They release histamine, a potent vasodilator. C: They remove microbes and cellular debris through the process of phagocytosis. D: They release fibronectin to form a meshwork trap and stimulate the intrinsic clotting cascade
B: They release histamine, a potent vasodilator. Mast cells in the area of injury degranulate and release packets of histamine and other inflammatory chemicals. Histamine is an early mediator of this inflammatory response. It is a potent vasodilator. B cells are distinguished from other lymphocytes by their ability to produce antibodies. Macrophages are powerful phagocytes, each capable of ingesting numerous microbes. Macrophages are called on to clean up the area after an inflammatory reaction in which dead neutrophils and inflammatory debris have accumulated, and they have a role in wound healing. Factor XII releases fibronectin to form a meshwork trap and stimulate the intrinsic clotting cascade.
A student nurse is learning about the effects of nutrition on wound healing. Which statement made by the student nurse indicated the need for further learning? A: Vitamins are essential for wound healing B: a negative nitrogen balance improves the wound healing process C: fats are essential for would healing D: a protein-rich diet should be give to clients after surgery
B: a negative nitrogen balance improves wound healing
Viruses injure cells differently than other causes of cellular injury because they? A: produce and secrete powerful destructive enzymes that digest cellular membranes and connective tissues. B: are incorporated into the cell, where it uses the cell's RNA or DNA for self-replication. C: cause reperfusion injury as the result of free radical formation. D: injure cells by disrupting chemical bonds through ionization.
B: are incorporated into the cell, where it uses the cell's RNA or DNA for self-replication. Viruses are small bits of genetic material that are able to gain entry into the cell. They may be thought of as intracellular parasites that use the host cell's metabolic and synthetic machinery to survive and replicate. Some bacteria produce and secrete powerful destructive enzymes that digest cellular membranes and connective tissues. Cell death results from ischemia and the resulting formation of reactive oxygen molecules (free radicals). Chemical injuries can result for the disruption of chemical bonds.
Which is a theory of aging? (Select all that apply.) A: Apoptosis B: Free radical C: Immunologic D: Nutritional injury E: Programmed senescence
B: free radical E: Programmed senescence The free radical theory states that aging may also be a result of accumulated metabolic cell damage over time. The programmed senescence theory holds that aging is the result of an intrinsic genetic program. Apoptosis, a type of cellular suicide, is a common event that regulates normal system function. Immunologic theory explains the role of the immune system in cellular injury. Nutritional injury is a common cause of dysfunction and disease, but there is no known relationship to aging
During a chronic inflammation, the body may wall off an infectious agent by forming a? A: keloid B: granuloma C: dehiscence D: ulcer
B: granuloma
A patient who is 85 years old reports to a health care provider every year for a flu shot. This is an important preventative intervention because: A: Telomeres increase with age B: Immune and respiratory reserves decline with age C: rigor mortis can lead to somatic death and aging D: Radiation sickness can make flu and aging worse
B: immune and respiratory reserves decline with age- all the body systems show age-related changes that can be generally described as a decrease in functional reserve or inability to adapt to environmental demands.
The local warmth that occurs during an inflammatory response is the result of A: substances liberated from injured cells. B: increased blood flow. C: leukocytosis. D: swelling.
B: increased blood flow. Because of the dilated blood vessels and open capillaries, more blood is carried to the injured area and contributes to the redness, pain, heat, and swelling of inflammation. While there may be effects on the vascular system resulting from cellular injury, it is more likely to affect vessel permeability. Leukocytosis is the recruitment and emigration of leukocytes that are focused on destroying possible pathogens. Swelling is one of the cardinal symptom of inflammation, but it is not responsible for local warmth at the injury site.
Normal florae protect the body from pathogenic bacteria by which of the following? (Select all that apply.) A: Attacking the pathogenic bacteria directly B: Producing vitamins essential to the body's defenses C: Making the environment inhospitable to the pathogens D: Taking up space in the body, and thus denying harmful bacteria residency E: Using nutrients in the environment that the pathogenic bacteria need
B:Producing vitamins essential to the body's defenses C: Making the environment inhospitable to the pathogens D: Taking up space in the body, and thus denying harmful bacteria residency E: Using nutrients in the environment that the pathogenic bacteria need Normal florae of the gut produce vital vitamins that are absorbed and utilized by the body and stimulate cross-protective antibodies. These flora occur naturally and have a role in defense by occupying space. Staphylococcus epidermidis lives on the skin using nutrients in the environment that pathogenic organisms need to live (but usually is not pathogenic). Normal florae do not protect the body by direct interaction with pathogens.
A heart that has to pump harder in order to effectively circulate blood is likely to undergo which type of cellular adaptation? A: Atrophy B: Metaplasia C: Hypertrophy D: Hyperplasia
C: Hypertrophy Cells hypertrophy in response to increased physiologic or pathophysiologic demands. If the heart has to pump harder than normal to meet the body's demand for oxygen and nutrients, the cardiac cells will become larger, resulting in cardiac hypertrophy. Atrophy results in cell death that would render the cells non-functional. Metaplasia is the replacement of one differentiated cell type with another. Muscle contraction could possibly be lost rather than enhanced. Hyperplasia would result in an increased number of cells rather than an enhanced pumping capacity.
The first type of antibody to be secreted on initial exposure to an antigen is? A: IgE B: IgA C: IgM D: IgG
C: IgM
Which process will provide active immunity? A: Hepatitis B immune globulin for a needle-stick injury B: Antibodies transferred through breast feeding C: Polio vaccine to prevent poliomyelitis D: Tetanus antitoxin
C: Polio vaccine to prevent poliomyelitis Active immunity confers a protected state owing to the body's immune response as a result of active infection or immunization such as with the polio vaccine. Passive immunity involves the transfer of plasma (sera) containing preformed antibodies against a specific antigen from a protected or immunized person to an unprotected or nonimmunized person. Examples of preformed antibodies include immunoglobulin, antibodies transferred in secretions such as breast milk, and antitoxins.
An increase in which of these characteristics would be present in cells that demonstrate hypertrophy? A: Lipofuscin B: Size of vacuoles C: Size of cells D: Number of cells
C: Size of cells Hypertrophy is defined as an increase in cell mass (cellular enlargement). A lipofuscin is a yellow to brown, granular, iron-negative lipid pigment found particularly in muscle, heart, liver, and nerve cells; it is the product of cellular wear and tear, accumulating in lysosomes with age. A vacuole is a small cavity in the cytoplasm of a cell, bound by a single membrane and containing water (hydropic swelling), food, or metabolic waste. Cells that are capable of mitotic division generally increase their functional capacity by increasing the number of cells by hyperplasia.
Which is an example of active immunity? (Select all that apply.) A: Placental transfer of maternal antibodies B: Injection of pooled gamma globulin C: Yearly flu vaccination D: Pneumonia vaccine E: Breast feeding
C: Yearly flu vaccine D: Pneumonia vaccine Vaccinations, such as the yearly flu and pneumonia vaccines, stimulate the host immune system to mount an immune response and produce long-lived memory cells and antibody-secreting cells that provide lasting protection, a process called active immunity. Immunity acquired by the newborn via the placenta or via breast milk and gamma globulin injections are examples of passive immunity in which antibodies produced by one individual are transferred to another. These antibodies provide only short-term protection, because the host does not produce memory cells or antibodies.
Lymphocytes that have CD8 proteins on their cell surface are categorized as? A: natural killer cells B: helper cells C: cytoxic cells D: B cells
C: cytoxic cells
A patient's white blood cell count indicates a shift to the left. This indicates that the client's A:major white blood cell supply has shifted to the left side of the body. B: main blood circulatory pathway is through the left side of the heart. C: immature neutrophil count is increased as a result of a bacterial infection. D: white blood cell count is greater than their red blood cell count.
C: immature neutrophil count is increased as a result of a bacterial infection. During acute bacterial infection, larger numbers of immature neutrophils (bands) are released into the blood, which is termed a "shift to the left." The major white blood cell supply shifting to the left side of the body is not a realistic situation and not descriptive of the term "shift to the left." The blood circulatory pathway being through the left side of the heart describes cardiac circulation, not the term "shift to the left." White blood cell count is not relevant, and not descriptive of the term "shift to the left."
Which is an example of passive immunity? A: transplant rejection B: response to vaccination C: placental transfer of antibodies D response to disease
C: placental transfer of antibodies
The inflammatory response is a ______________ reaction to cell injury. A: systemic B: random C: sequential D: linear
C: sequential
Which of the filling describes fibrinous exudate? A: watery, with few proteins or cells B: purulent exudate C: thick and clotted D: containing many white blood cells E: containing many red blood cells
C:thick and clotted
Catabolic processes are accelerated by which of the following? (Select all that apply.) Fever Diseaset Starvation Emotional stress Increased insulin levels
Catabolic processes are accelerated by which of the following? (Select all that apply.) Fever Disease Starvation Emotional stress Catabolism is the degradative phase of metabolism when complex molecules are broken down into simpler substances; this can be triggered during times of fever, disease, starvation, or stress. Hormonal secretions such as insulin and sex hormones trigger anabolism.
The laboratory analysis conducted on a child with chronic nasal drainage reveals an elevated number of eosinophils on a white blood cell differential. Based on this finding, which is most likely the cause of the nasal drainage? A: Bacterial infection B: Viral infection C: Chronic inflammation D:Allergies
D: Allergies Eosinophils are particularly associated with an increase in number during allergic reactions, particularly with sinus infections. Neutrophils, not eosinophils, are seen to increase in numbers related to bacterial and viral infections. Traditionally, the band count has been used to differentiate bacterial from viral infections, and a greater shift to the left is viewed as a more severe infection. Basophils are also involved in wound healing and chronic inflammatory conditions.
Which type of cellular adaptation is most likely to occur as the result of chronic ischemia to a region? A: Hypertrophy B: Hyperplasia C: Metaplasia D: Atrophy
D: Atrophy Ischemia is inadequate blood supply to a tissue. Chronic sublethal ischemia usually results in cell atrophy. Hypertrophy would result in an increase in cell size in response to increased physiologic demand. Hyperplasia would result in an increased number of cells in response to increased physiologic demand. Metaplasia is the replacement of one differentiated cell type with another better suited for the situation.
Which specialized cells are associated with the immune response? A: Monocytes B: Neutrophils C: Macrophages D: Lymphocytes
D: Lymphocytes Antibodies are associated with the immune response. Antibodies are produced by B lymphocytes. Monocytes, neutrophils, and macrophages are associated with the response to infection.
Which condition occurs in the presence of cellular damage? A: Cells shrink B: ATP production increases C: Osmotic pressure decreases D: Sodium and water move into the cell
D: Sodium and water move into the cell. Cellular injury causes failure of the sodium-potassium pump, resulting in migration of sodium ions into the cell. The accumulation of intracellular sodium creates an osmotic gradient that pulls water into the cell, resulting in hydropic swelling. Cells actually swell, not shrink, as a result of cellular damage. Cellular damage results in the cell's inability to perform normal metabolic functions owing to insufficient cellular energy in the form of adenosine triphosphate (ATP). Osmotic pressure increases to accommodate for swelling.
Plasma cells are? A: activated monocytes B: precursors of platelets C: specialized natural killer cells D: antibody-secreting B lymphocytes
D: antibody-secreting B lymphocytes
The laboratory analysis conducted on a patient with acute-onset fever and malaise reveals an elevated neutrophil count. This finding suggests that the problem is most likely a A: viral infection. B: sinus infection. C: parasitic infection. D: bacterial infection.
D: bacterial infection. During an acute infection, neutrophilia, or an increase in the number of circulating neutrophils, occurs as the bone marrow releases stored neutrophils. Neutrophils are early responders to an acute bacterial infection and arrive in large numbers very quickly. Viral, sinus, and parasitic infections do not generally result in an increase in neutrophils.
Which cellular response is maladaptive? A: Shrinkage of cell size B: Increase in cell size C: Increase in the number of cells D: Change in the shape or arrangement of cells
D: chance in the shape or arrangement of cells Dysplasia (abnormal variations in shape and arrangement of cells) represents an unsuccessful attempt of the cells to adapt. Cells shrink in response to a migration of fluid to balance fluid loss elsewhere in the body. Cells hypertrophy (increase in size) in response to increased physiologic or pathophysiologic demands. Cells that are capable of mitotic division generally increase their functional capacity by increasing the number of cells (hyperplasia) as well as by hypertrophy. Hyperplasia usually results from increased physiologic demands or hormonal stimulation. Persistent cell injury also may lead to hyperplasia.
Which of the filling describes purulent exudate? A: thick and clotted B: water, with few proteins or cells C: containing many red blood cells D: containing many white blood cells
D: containing many white blood cells
Which of the following findings is a systemic sign of inflammation? A: swelling B: pain C: loss of function D: elevated c-reactive protein
D: elevated C-reactive protein
Cellular hypoxia results in? A: increased pH. B: enhanced ATP activity. C: loss of intracellular calcium. D: failure of the sodium-potassium pump.
D: failure of the sodium-potassium pump Hypoxia is a loss of oxygen to the cell that causes ATP activity to cease. ATP provides the power required to drive the sodium-potassium pump. pH decreases in hypoxia (respiratory acidosis). Hypoxia is a loss of oxygen to the cell that causes ATP activity to cease. Deposits of calcium salts occur in conditions of altered calcium intake, excretion, or metabolism.
When inflammation is chronic, the predominant cell type is? A: neutrophil B: basophil C: granulocyte D: lymphocyte
D: lymphocyte
A patient education intervention that will help decrease the emergence of resistant infections is to instruct the patient to A: take antibiotics for all viral infections to prevent bacterial infections. B: share antibiotics with family to prevent a further outbreak of bacterial infections. C: stop taking the prescribed antibiotics as soon as feeling better to prevent superbacteria development. D:take all the antibiotics ordered even if feeling well after a few days to prevent antibiotic defiant bacteria.
D: take all the antibiotics ordered even if feeling well after a few days to prevent antibiotic defiant bacteria. The patient should take all the antibiotics ordered, even if feeling better, to eradicate the moderately resistant microorganisms. Viruses are not impacted by antibacterial medications. Sharing antibiotics indicates that the full course of the medication isn't being taken, and so contributing to the development of resistant microorganisms. If medication is stopped prematurely, moderately resistant organisms are selected for and become the predominant species, making it more difficult to eradicate next time.
Which component of the blood surrounds & consumes foreign material in phagocytosis? A: blood plasma B: blood platelets C: red blood cells D: white blood cells
D: white blood cells
Clinical manifestations of extracellular fluid volume deficit include which of the following? (Select all that apply.) Decreased postural blood pressure Flat neck veins Weight loss Dizziness Vomiting Oliguria
Decreased postural blood pressure Flat neck veins Weight loss Dizziness Oliguria The clinical manifestations of extracellular fluid volume deficit include postural blood pressure drop, flat neck veins, weight loss, dizziness, and oliguria. Vomiting may contribute to, but is not a symptom of, extracellular fluid loss.
Clinical manifestations of extracellular fluid volume excess include which of the following? (Select all that apply.) Edema Crackles Weight gain Bounding pulse Distended neck veins Decreased urinary output
Edema Crackles Weight gain Bounding pulse Distended neck veins Edema, crackles, sudden weight gain, bounding pulse, and distended neck are signs of extracellular fluid volume excess. Decreased urinary output is not a sign of extracellular fluid volume excess.
Which is a false statement? Epinephrine and cortisol act similarly. Cortisol and epinephrine work in synergy. Antidiuretic hormone is important for blood volume regulation. Endorphins decrease with stress, resulting in an increase in pain perception.
Endorphins decrease with stress, resulting in an increase in pain perception. Endorphins increase with stress and lessen pain. Epinephrine and cortisol do produce similar effects. Cortisol and epinephrine actually do have a combined effect that is greater than the sum of their individual effects. Antidiuretic hormone is important for blood volume regulation, since it regulates fluids in the blood.
Whatever the dietary form of nutritional intake, the required basic nutrients for metabolic processes are derived from which of the following? (Select all that apply.) Fats Glucose Proteins Potassium Carbohydrates
Fats Proteins Carbohydrates The metabolic process requires nutrition in the form of fats, proteins, and carbohydrates, which are broken down into simpler substances. Glucose is an outcome of carbohydrate breakdown. Potassium is a mineral that is found in various forms of nutrition.
Which cardiovascular disorder has not been linked to excessive catecholamine levels in the blood? Stroke Hypertension Myocardial infarction Heart valve disfunction
Heart valve disfunction There is no current research that associates heart valve dysfunctions with excessive catecholamine levels. Strokes have been associated with excessive catecholamine levels because of the affect of increased fat collects that can be released into the blood stream. Hypertension has long been associated with chronic stress and the resulting affect of catecholamine levels on the development of atherosclerosis. Catecholamines increase platelet activity resulting in clot formation and elevate serum lipid levels, significant factors in the pathogenesis of myocardial infarction.
Which statements are true regarding serum potassium (K+) levels? (Select all that apply.) Hypokalemia is capable of causing elevated diastolic pressure. Hyperkalemia can result in weakness in the lower extremities. Hyperkalemia can be characterized by intestinal cramping. Hypokalemia can often cause muscle weakness. Hypokalemia can result in a paralytic ileus.
Hyperkalemia can result in weakness in the lower extremities. Hyperkalemia can be characterized by intestinal cramping. Hypokalemia can often cause muscle weakness. Hypokalemia can result in a paralytic ileus. Both low and high levels of K+ produce skeletal muscle weakness in an ascending pattern in the lower extremities first, with flaccid paralysis. Hyperkalemia causes intestinal cramping and diarrhea. Hypokalemia results in abdominal distention, diminished bowel sounds, and a paralytic ileus. Hypokalemia results in smooth muscle relaxation which results in decreased diastolic pressure.
Which statement is false regarding hypophosphatemia? Hypophosphatemia is caused by factors that increase phosphate intake. Signs and symptoms include anorexia, malaise, paresthesias, and impaired cardiac function. Hypophosphatemia occurs when plasma phosphate concentration decreases below 2.5 mg/dL. Signs of hypophosphatemia are seldom seen until plasma concentration fall below 1.5 mg/dL.
Hypophosphatemia is caused by factors that increase phosphate intake. Hypophosphatemia is caused by factors that decrease phosphate intake, shift phosphate from extracellular fluid into cells, increase phosphate excretion, and cause loss of phosphate through abnormal routes. Anorexia, malaise paresthesias, and impaired cardiac functioning are classic signs of hypophosphatemia. A serum level below 2.5 mg/dL is by definition hypophosphatemia. Symptoms are seldom observable until phosphate levels fall below 1.0 mg/dL.
Which statement is true regarding the interplay of the hormones insulin and glucagon in maintaining blood glucose levels? Insulin lowers blood glucose levels, whereas glucagon increases blood glucose levels. Insulin and glucagon have similar actions on raising blood glucose levels. Insulin and glucagon lower blood glucose levels but in different ways. Insulin must have glucagon for cellular uptake.
Insulin lowers blood glucose levels, whereas glucagon increases blood glucose levels. Insulin facilitates the transport of glucose into cells and reduces blood glucose levels, whereas glucagon promotes glycogenolysis and gluconeogenesis, which increase blood glucose levels. Insulin and glucagon have opposite actions. Insulin does not require glucagon for cellular uptake.
Which nursing assessment datum supports the client's risk for postoperative wound separation? (Select all that apply.) Is a vegetarian 45-year-old woman 5′3″ tall and weighs 189 lbs Drinks six to eight soft drinks a day Has experienced several prior surgeries
Is a vegetarian 5′3″ tall and weighs 189 lbs C Drinks six to eight soft drinks a day Poor protein intake affects wound healing. Client is obese; obesity is among the primary causes of nonclosure of postoperative wounds. A high glucose intake from soft drinks increases risk of obesity. Neither age nor gender alone are not primary causes on poor wound healing. Prior surgeries are not risk factors for possible poor wound healing.
Which is a true statement regarding cortisol? It produces stress response effects similar to those of epinephrine. Its activity is shorter than that of epinephrine. It has no known effect on the immune system. It is associated with the alarm stage.
It produces stress response effects similar to those of epinephrine. Cortisol does produce a stress response similar to that seen with epinephrine but with differences in length of duration. Cortisol's affect is longer acting than that of epinephrine. Cortisol's affects on the immune system has been documented. Epinephrine not cortisol is associated with the alarm stage.
Which statement is true regarding epinephrine? It has the exact same effects as norepinephrine. It causes a decrease in glycogenolysis. It causes a decrease in muscle strength. It results in increased cardiac output.
It results in increased cardiac output. Epinephrine increases heart rate, venous return, and cardiac output. Epinephrine produces some of the same effects as norepinephrine, but it has greater influence on cardiac action. Epinephrine increases glycogenolysis and the release of glucose from the liver. Epinephrine increases muscle strength, mental alertness, and vigilance.
The significant symptoms of cancer cachexia are primarily caused by a combination of which of the following? (Select all that apply.) Chemotherapy lowering metabolic rate Loss of appetite from sensory changes Tumor utilization of nutrients Lowered metabolic needs Stress
Loss of appetite from sensory changes Tumor utilization of nutrients Cancer cachexia is a result of several factors, including anorexia and nutrient utilization by tumor cells. Chemotherapy increases metabolic rate. Metabolic needs are increased, not lowered. Stress can result in anorexia but it is not the cause of this severe condition.
When comparing women with men, what differences in basal metabolic rate (BMR) would be expected? The presence of less fat tissue in men causes a lower BMR. Men have a higher BMR because they are physically larger. Women have a higher BMR because they are usually smaller. The presence of more fat tissue in women causes a higher BMR.
Men have a higher BMR because they are physically larger. This is generally true since the average man is likely to have more body mass than the average woman. Women also tend to have more adipose tissue than men. Women typically have a metabolic rate 5% to 10% less than that of men, probably because of differences in body mass. Fat is less metabolically active than muscle so influences a lower BMR.
Which statement explains the metabolic needs related to fever of 104°F (40°C) and chills? Applying ice will help reduce metabolic rate. Shivering minimizes any raise in metabolic rate. Metabolic rate is not increased by febrile shivering. Metabolic rate increases incrementally with a rise in temperature.
Metabolic rate increases incrementally with a rise in temperature. For each 1°F increase in body temperature, metabolic needs increase 7%. Ice will increase shivering, thus increasing metabolic needs. Shivering and fever increase metabolic needs.
The hormone ADH (antidiuretic hormone) release is stimulated by which of the following? (Select all that apply.) Fever Pain Anxiety Hypovolemia Hyper-osmolality of the extracellular fluid
Pain Anxiety Hypovolemia Hyper-osmolality of the extracellular fluid Factors that increase release of ADH into the blood include pain, psychological stressors, decreased circulating fluid volume, and increased osmolality of the extracellular fluid. Fever generally does not trigger the release of ADH.
Microorganisms can be categorized into which of the following? (Select all that apply.) A: Spirochetes B: Parasites C: Bacteria D: Viruses E: Fungi
Parasites Bacteria Viruses Fungi Microorganisms are categorized into groups that include parasites, which represent four families of the animal kingdom: Protozoa, Nemathelminthes, Platyhelminthes, and Arthropoda. Microorganisms are also categorized into groups that include bacteria, which are single-celled organisms that can live alone; viruses, which are organisms that are made of a protein coat and DNA/RNA and that are obligate intracellular organisms; and fungi, which are nonphotosynthetic, eukaryotic microorganisms. Spirochetes belong to a phylum of distinctive Gram-negative bacteria.
Clinical manifestations of hypocalcemia include which of the following? (Select all that apply.) Positive Trousseau sign Positive Chvostek sign Hyperactive reflexes Muscle twitching Constipation Paresthesias
Positive Trousseau sign Positive Chvostek sign Hyperactive reflexes Muscle twitching Paresthesias Calcium imbalances alter normal neuromuscular irritability. Clinical manifestations of hypocalcemia are those of increased neuromuscular irritability, including a positive Trousseau sign, a positive Chvostek sign, hyperactive reflexes, muscle twitching, and paresthesias. Hypercalcemia causes decreased neuromuscular irritability (muscle weakness, fatigue, headache, lethargy, parorexia, nausea, constipation).
Which hormone is responsible for lactation and interferes with ovulation? Growth hormone Testosterone Estrogen Prolactin
Prolactin Prolactin is responsible for lactation and breast development while interfering with ovulation. Growth hormone affects protein, lipid, and carbohydrate metabolism. Testosterone regulates male secondary sex characteristics and libido. Estrogen attenuates the HPA stress response. It also regulates female secondary sex characteristics.
On which area does cortisol have an anabolic effect? Lymphoid Protein Muscle Skin
Protein Cortisol has an anabolic effect on protein, leading to an increased rate of protein synthesis. Cortisol has a catabolic effect on lymphoid tissue. Cortisol has a catabolic effect on muscle tissue. Cortisol has a catabolic effect on skin.
The concentration of which cation indicates the serum osmolality of a patient? Sodium level Calcium level Potassium level Magnesium level
Sodium level The serum sodium concentration reflects the osmolality of the blood. Imbalances of body fluid concentration are recognized by abnormal serum sodium concentration. The osmolality of the blood is not determined by the serum concentration of calcium, potassium, or magnesium.
Which term refers to a state of tension that can lead to disruption or threaten physical stability? Stress Adaptive Exhaustion Homeostasis
Stress Stress is defined as a state of tension that can lead to disruption or threaten homeostasis. Adaptive changes occur when a body function changes to work within its environment. Exhaustion occurs when there is a negative sequela. Homeostasis is dynamic change.
Which is true regarding catecholamines? They are from the parasympathetic nervous system. They include epinephrine and norepinephrine. They cross the blood-brain barrier. They cause a decrease in heart rate.
They include epinephrine and norepinephrine. Catecholamines include epinephrine and norepinephrine. Norepinephrine is secreted from the sympathetic nerves, and epinephrine is secreted from the adrenal medulla. Epinephrine and norepinephrine cannot cross the blood-brain barrier. Epinephrine and norepinephrine cause increased heart rate, blood pressure, and blood flow to skeletal muscles.
The main cause of extracellular fluid volume deficit is an increase in saline in the same concentration as the normal extracellular fluid and hypertension. a decrease in saline in the same concentration as the normal extracellular fluid or third spacing. an increase in saline in the extracellular fluid compared with the intracellular fluid. an abnormally increased extracellular fluid compared with the intracellular fluid.
a decrease in saline in the same concentration as the normal extracellular fluid or third spacing. The extracellular fluid volume deficit is caused by removal of a sodium-containing fluid from the body or from "third spacing" (e.g., ascites—fluid in the peritoneal cavity, or from bowel obstruction—rapid fluid accumulation into the bowel). The removal, not an increase in, of a sodium-containing fluid would result in extracellular fluid volume loss. The sodium remains in the body.
Cardiac consequences of an extended period of malnutrition and starvation include additional cardiac stress caused by increased oxygen demands during refeeding. complete early recovery of cardiac symptoms by refeeding sufficient calories. ongoing compensation to prevent heart failure during recovery. requirements to limit fatty acids in replacement calories.
additional cardiac stress caused by increased oxygen demands during refeeding. The body's ability to compensate for and prevent heart failure during starvation is sometimes overwhelmed by the increased metabolic demands of refeeding. Increased oxygen demands increase the work of breathing. There is an increased metabolic demand on the heart to compensate for refeeding. There is not a compensation to prevent heart failure, but rather additional stress. Dietary fat is given to replace energy needs and decrease carbon dioxide production.
Anabolism is best described as excessive intake of steroids to improve growth. construction of organic molecules by cells. hormonally induced cell breakdown. the destructive phase of metabolism.
construction of organic molecules by cells. Anabolism is the constructive phase of metabolism and involves the creation of organic molecules by cells. Larger molecules are built from smaller ones, and in the process, energy is used. Steroid abuse is described as excessive intake of steroids to improve growth. While hormonal secretions such as insulin and sex hormones trigger anabolism; this is not the best available definition of anabolism. Catabolism is the degradative phase of metabolism. Complex molecules are broken down into simpler substances, often with the concurrent release or production of chemical energy.
The greater proportion of ingested carbohydrates and amino acids that is not used immediately for cellular energy is converted to glycogen for storage. stored in elemental form in the liver. eliminated from the body as metabolites. converted to fat and stored as adipose tissue.
converted to fat and stored as adipose tissue. Storage of carbohydrates and amino acids is limited in the body. Those not immediately used by the tissues are converted to fat and stored, along with ingested fat, as adipose tissue. Glucagon enables the conversion of amino acids (proteins) into glucose precursors. The liver does not store unused carbohydrates and amino acids. Metabolites are the intermediates and products of metabolism.
Metabolic processes create the energy needed to perform essential body processes by destroying phosphate bonds. combining ATP with PEP. storing glucose in cells. cellular proliferation.
destroying phosphate bonds. Energy necessary for normal cellular function is produced with the destruction of the phosphate bonds and release of high-energy phosphate radicals from ATP. Growth hormone disinhibits gene expression in the liver in favor of transcription of phosphoenolpyruvate (PEP) carboxykinase, a key enzyme in hepatic gluconeogenesis. Storing glucose in cells provides ready access to energy. Cellular proliferation requires energy.
Physiologic stress significantly increases blood glucose levels by release of the hormones insulin and proinsulin. glucocorticoids, especially cortisol. mineralocorticoids, especially aldosterone. that inhibit insulin release from the pancreas.
glucocorticoids, especially cortisol. Glucocorticoid hormones, primarily cortisol, stimulate gluconeogenesis by the liver. Blood glucose levels 6 to 10 times normal may occur with significant cortisol secretion. Physiologic stress does not significantly increase the blood glucose levels via the secretion of insulin or proinsulin; or glucocorticoids, especially cortisol. Physiologic stress does not sig
Negative nitrogen balance is a condition often seen throughout pregnancy. in severely burned patients. in low-carbohydrate dieting. during the rapid growth of adolescence.
in severely burned patients. A negative nitrogen balance occurs when protein breakdown exceeds daily protein intake and synthesis. If the daily caloric intake is insufficient, the body catabolizes dietary and tissue protein for energy, as is the case after severe burns and during fever, illness, or stress. Severe burns contribute to a catabolic state and a negative nitrogen balance because of protein loss and use of amino acids to form stress proteins. Pregnancy does not trigger a catabolic state that results in a negative nitrogen balance. A low-carbohydrate diet often focuses on an increase in protein intake thus making a negative nitrogen balance unlikely. Rapid physical growth is likely offset with increased protein intake, thus making a negative nitrogen balance unlikely.
Which statement is true regarding total body fluid? (Select all that apply.) In women, body water is about 50% of body weight. The percentage of water by weight increases with age. A full-term newborn infant is about 75% water by weight. In a standard adult male, body water is about 60% of body weight. An increase in body fat will generally result in a decrease of water weight.
in women, body water is about 50% of body weight. A full-term newborn infant is about 75% water by weight. In a standard adult male, body water is about 60% of body weight. An increase in body fat will generally result in a decrease of water weight. The statement concerning the % of body water found in a woman is true. It is true that the percentage of body weight generally increases with age. A full-term newborn's weight is generally 75% water. The relative increase in body fat that occurs with normal aging results in a decrease in water weight. The percentage of water by weight decreases with age. The decrease in this percentage with increased age is due primarily to the relative increase in body fat that occurs with normal aging.
Aging adults are more prone to dehydration as a result of lack of thirst triggers resulting from increased osmolality of extracellular fluid. increased osmolality of intracellular fluid. decreased osmolality in extracellular fluid. decreased osmolality in intracellular fluid.
increased osmolality of extracellular fluid. As the kidneys age, the tubules become less responsive to antidiuretic hormone (ADH) and tend to lose too much water. The excess water loss is accompanied by a decrease in thirst mechanism. As a result, the elderly person is prone to dehydration. Intracellular fluid status is not related to the thirst triggers. An increase in the osmolality of extracellular fluid would result in a risk for dehydration.
Fluid distribution between the interstitial and intracellular compartments occurs by filtration across permeable capillaries. capillary hydrostatic pressure. capillary osmotic pressure. osmosis.
osmosis. The distribution of fluid between the interstitial and intracellular compartments occurs by osmosis. The distribution of fluid between the vascular and interstitial compartments is the net result of filtration across permeable capillaries
The second day following a cholecystectomy, the client experiences nausea and vomiting and is unable to take food orally. This presents a serious threat to proper wound healing, because solid food is necessary for wound healing. large amounts of nitrogen are lost in emesis. postoperative nutrition is more important than preoperative nutrition. poor hydration predisposes patients to nonclosure of surgical wounds. .
poor hydration predisposes patients to nonclosure of surgical wounds. Poor preoperative nutrition and dehydration are among the primary threats to healing of postoperative wounds. Nutrition can be maintained without reliance on solid foods. It is not true that large amounts of nitrogen are lost in emesis; the client is at risk for dehydration. The client's healing abilities is more dependent on the presurgical nutritional status.
Normally, the highest amount of daily fluid loss occurs via the urinary tract. bowels. skin. lungs.
urinary tract. In a healthy person, the largest volume of fluid is excreted in the urine. Fluid loss via the bowels would not exceed that of the urinary tract unless severe diarrhea is present. Fluid loss via the skin would not exceed that of the urinary tract unless profuse sweating was present. Fluid loss via the lungs would not exceed that of the urinary tract unless the respiratory rate was greatly increased.