Exam 3 Patho Top Hat

Which statement is a description for the term anemia?

1. Increased white blood cell size

2. Increased erythrocyte number in the circulating blood

3. Decreased erythrocytes in the circulating blood

4. Decreased circulating platelets

3. Decreased erythrocytes in the circulating blood

Which characteristic describes macrocytic anemia?

1. Small cell size

2. Decreased cell thickness

3. Caused by increased folate

4. Presence of megaloblasts

4. Presence of megaloblasts

After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result?

1. Iron deficiency

2. Aplastic

3. Folic acid

4. Pernicious

4. Pernicious

A nurse assesses the patient with anemia for a heart murmur. When the patient asks why the nurse is checking the heart, how should the nurse respond?

1. "A decreased oxygen content of blood from the anemia can cause a heart murmur."

2. "The thinner blood from anemia flows faster and more turbulently than normal blood, causing a murmur."

3. "An increased heart rate in anemia causes low blood pressure; that low pressure causes a heart murmur."

4. "Increased intravascular volume from anemia causes pressure on heart valves; that pressure is heard as a heart murmur."

2. "The thinner blood from anemia flows faster and more turbulently than normal blood, causing a murmur."

What are the common causes of anemia? (Select all that apply. Choose 4.)

1. Impaired production of erythrocytes

2. Blood transfusion

3. Increased red cell destruction

4. Severe bleeding

5. Chronic blood loss

1. Impaired production of erythrocytes

3. Increased red cell destruction

4. Severe bleeding

5. Chronic blood loss

Do active phagocytosis as part of the mononuclear phagocyte system; process and present antigens; participate in wound healing

Macrophages

B-lymphocytes (Plasma cells)

Natural killer cells

Monocytes

Neutrophils

Eosinophils

Macrophages

Defend against parasite

Macrophages

B-lymphocytes (Plasma cells)

Natural killer cells

Monocytes

Neutrophils

Eosinophils

Eosinophils

Do phagocytosis early in inflammation; kill bacteria

Macrophages

B-lymphocytes (Plasma cells)

Natural killer cells

Monocytes

Neutrophils

Eosinophils

Neutrophils

Produce antibodies against specific antigens

Macrophages

B-lymphocytes (Plasma cells)

Natural killer cells

Monocytes

Neutrophils

Eosinophils

B-lymphocytes (Plasma cells)

Kill tumor cells and virus infected cells

Macrophages

B-lymphocytes (Plasma cells)

Natural killer cells

Monocytes

Neutrophils

Eosinophils

Natural killer cells

Precursor cells for macrophages

Macrophages

B-lymphocytes (Plasma cells)

Natural killer cells

Monocytes

Neutrophils

Eosinophils

Monocytes

A nurse recalls that acute lymphocytic leukemia (ALL)

1. is defined as greater than 30% lymphoblasts in the bone marrow.

2. is caused by an abnormal proliferation of myeloid precursor cells.

1. is defined as greater than 30% lymphoblasts in the bone marrow.

A nurse observes Reed-Sternberg cells on the laboratory results. The nurse is caring for an individual with

1. Hodgkin lymphoma.

2. non-Hodgkin lymphoma.

3. Burkitt lymphoma.

1. Hodgkin lymphoma.

Why do lymph nodes enlarge and become tender during an infection?

1. Macrophages are proliferating.

2. Blood flow is decreasing.

3. Microorganisms are colonizing.

4. Edema is accumulating.

1. Macrophages are proliferating.

Which statements regarding Burkitt lymphoma are true? (Select all that apply. Choose 2.)

1. Burkitt lymphoma is a type of Hodgkin lymphoma.

2. Burkitt lymphoma is common in the United States.

3. Burkitt lymphoma is a fast-growing tumor of the jaw and facial bones.

4. Burkitt lymphoma is associated with the Epstein-Barr virus.

3. Burkitt lymphoma is a fast-growing tumor of the jaw and facial bones.

4. Burkitt lymphoma is associated with the Epstein-Barr virus.

Multiple myeloma represents a malignant proliferation of:

1. T lymphocytes

2. Monocytes

3. Plasma cells

4. Neutrophils

3. Plasma cells

A 12-year-old girl is taken to a walk-in clinic in her neighborhood drug store for a sore throat and fever. The mother states that the child has been just lying around and is having her period. The girl reports that she has had two periods in the past month and has to change her sanitary pad every couple of hours. The clinician notes several bruises, and the girl does not remember how she got them. After speaking with a colleague, the clinician advises the mother to take the girl to a local children’s hospital to be evaluated. Later that day, the girl is diagnosed with ALL and begins chemotherapy.

All leukemias have a certain pathophysiologic feature in common. This is:

1. Increased function of granulocytic-monocytic cells

2. Increased function of bone marrow to fight the leukemic cells

3. Overcrowding of the bone marrow

4. Decreased response to biologic response modifiers

3. Overcrowding of the bone marrow

Platelets are essential in what physiological process?

1. Phagocytosis

2. Removal of cellular waste

3. Blood coagulation

4. Cell oxygenation

3. Blood coagulation

Which of the following molecules forms a meshwork to stabilize a blood clot during hemostasis?

1. Thrombin

2. Collagen

3. Fibrin

4. Fibrinogen

3. Fibrin

Which of the following groups of symptoms would lead you to suspect your pediatric patient has idiopathic thrombocytopenic purpura?

1. Multiple infections and erythematous rash

2. Epistaxis, gum bleeding, and petechiae

3. Lower extremity that is warm to touch, edematous, and painful

4. Fatigue, weakness, and pale skin

2. Epistaxis, gum bleeding, and petechiae

The alteration in level of consciousness associated with thrombotic thrombocytopenic purpura is due to:

1. leukopenia.

2. tissue hypoxia.

3. hepatomegaly. 

4. blood gain.

2. tissue hypoxia.

An adult patient has been hospitalized with thrombocytopenia with a platelet count of 8000/mm³. What action by the healthcare professional is most appropriate?

1. Tell the patient not to get out of bed without assistance.

2. Prepare the patient for transfusions of whole blood.

3. Educate the patient on side effects of heparin.

4. Nothing; this finding is normal in an adult.

1. Tell the patient not to get out of bed without assistance.

Osmosis describes the movement of:

1. sodium

2. glucose

3. water

4. all molecules

3. water

Which of the following electrolytes is found in the highest concentration in the intracellular fluid (ICF)?

1. Sodium

2. Calcium

3. Potassium

4. Chlorine

3. Potassium

Common causes of the increased filtration of fluid from capillaries and lymphatic channels into surrounding tissues (edema) include: (select all that apply)

1. an increased hydrostatic pressure.

2. decreased plasma oncotic pressure.

3. decreased capillary membrane permeability.

4. lymphatic obstruction.

1. an increased hydrostatic pressure.

2. decreased plasma oncotic pressure.

4. lymphatic obstruction.

What does the student learn about ventilation?

1. Hypoventilation causes hypocapnia.

2. Hypoventilation causes alkalosis.

3. Hyperventilation causes hypocapnia.

4. Hyperventilation causes acidosis.

3. Hyperventilation causes hypocapnia.

Which statement describes acidemia?

1. State in which the pH of arterial blood is greater than 7.45

2. State in which the pH of arterial blood is less than 7.35

3. Systemic decrease in hydrogen ion concentration

4. Systemic excess of base

2. State in which the pH of arterial blood is less than 7.35

Which of the following molecules inversely varies its concentration with chloride (Cl–) in the plasma?

1. Magnesium

2. Calcium

3. Sodium

4. Bicarbonate

4. Bicarbonate

A nurse is analyzing an arterial blood gas report of a client with chronic obstructive pulmonary disease and respiratory acidosis. Which compensation mechanism is likely to occur?

1. The kidneys will retain bicarbonate.

2. The kidneys will excrete bicarbonate.

3. The lungs will retain carbon dioxide.

4. The lungs will excrete carbon dioxide.

1. The kidneys will retain bicarbonate.

Patient A is enduring an asthma attack and is brought into the emergency department. The patient’s vital signs are: Temp: 98.4°F, Pulse: 110 beats/min, Resp rate: 24 shallow breaths/min, BP: 136/86 mm Hg. 

ABGs are: 
• Blood pH: 7.30
• PCO2: 58 mm Hg
• PO2: 88 mm Hg
• HCO3−: 28 mEq/L
• SaO2: 88%.

Which condition has Patient A developed?

1. metabolic acidosis

2. metabolic alkalosis

3. respiratory acidosis

4. respiratory alkalosis

3. respiratory acidosis

Patient B is unconscious and brought into the emergency department because of suspected drug toxicity. Vital signs include: Temp: 97.8°F, Pulse: 90 beats/min, Resp rate: 12 breaths/ min, BP: 100/70 mm Hg.

The patient’s ABGs are:
• Blood pH: 7.29
• PCO2: 32 mm Hg
• PO2: 95 mm Hg
• HCO3−: 13 mEq/L
• SaO2: 98%.

Which condition has Patient B developed?

1. metabolic acidosis

2. metabolic alkalosis

3. respiratory acidosis

4. respiratory alkalosis

1. metabolic acidosis

Patient C is having an anxiety attack and comes to the emergency department. Vital signs are as follows: Temp: 98.1°F, Pulse: 121 beats/min, Resp rate: 28 breaths/min, and BP: 138/88 mm Hg.

The patient’s ABGs are:
• Blood pH: 7.58 mm Hg
• PCO2: 28 mm Hg
• PO2: 93 mm Hg
• HCO3−: 22 mEq/L
• SaO2: 92%.

Which condition has Patient C developed?

1. metabolic acidosis

2. metabolic alkalosis

3. respiratory acidosis

4. respiratory alkalosis

4. respiratory alkalosis

Patient D has endured 3 days of nausea and vomiting caused by a virus. Vital signs are as follows: Temp: 101.1°F, Pulse: 98 beats/min, Resp rate: 12 breaths/min, BP: 90/60 mm Hg.

The patient’s ABGs are:
• Blood pH: 7.61 mm Hg
• PCO2: 49 mm Hg
• PO2: 99 mm Hg
• HCO3−: 49 mEq/L
• SaO2: 99%.

Which condition has Patient D developed?

1. metabolic acidosis

2. metabolic alkalosis

3. respiratory acidosis

4. respiratory alkalosis

2. metabolic alkalosis

When considering water balance, which statement demonstrates the correct balance?

1. Isotonic fluids cause increased cellular swelling.

2. Hypertonic fluid causes increased cellular swelling.

3. Hypotonic fluid causes cellular swelling.

4. Hypernatremia causes cellular swelling.

3. Hypotonic fluid causes cellular swelling.

Which statement is true regarding potassium balance?

1. Potassium is the major extracellular electrolyte.

2. During acidosis, potassium shifts into the cell.

3. Aldosterone is secreted when potassium is decreased.

4. Insulin causes the movement of potassium into the cell.

4. Insulin causes the movement of potassium into the cell.

Which of the following is NOT a clinical manifestation of hypokalemia? 

1. Decreased insulin secretion

2. Impaired renal function

3. Decreased neuromuscular excitability

4. Increased contractility of skeletal muscle

4. Increased contractility of skeletal muscle

Pain in internal organs and the lining of the body cavities is called

1. peripheral neuropathic pain

2. referred pain

3. chronic pain

4. visceral pain

4. visceral pain

Nociceptors are free nerve endings in the afferent peripheral nervous system that selectively respond to different stimuli. They are categorized according to the stimulus to which they respond and the properties of the nerve fibers associated with them. The fibers that transmit longer-lasting, persistent dull, aching, or burning sensation are:

1. Unmyelinated C fibers

2. A-delta fibers

3. A-beta fibers

4. Enkephalins

1. Unmyelinated C fibers

Which type of pain arises from connective tissue, muscle, bone, and skin?

1. Referred

2. Segmental

3. Neuropathic

4. Somatic

4. Somatic

The nurse is talking with a husband whose wife served in the military. His wife suffered a below- the-knee amputation. The husband states that his wife is constantly complaining of her amputated leg hurting. He is confused as to why the leg can hurt when it is no longer even present. Which of the following ideas explain what is happening? Select all that apply (choose 2).

1. Visceral pain

2. Phantom limb pain

3. Gate-control pain theory

4. Referred pain

5. Neuromatrix pain theory

2. Phantom limb pain

5. Neuromatrix pain theory

A teenager sustains a severe closed head injury following an all-terrain vehicle (ATV) accident and is in a state of deep sleep that requires vigorous stimulation to elicit eye opening or make minimal movements. How should the nurse document this in the chart?

1. Confusion

2. Lethargy

3. Stupor

4. Coma

3. Stupor

A nurse recalls that increased intracranial pressure can occur because of:

1. loss of cerebrospinal fluid.

2. increased cerebral activity.

3. loss of cerebral function.

4. cerebral edema.

4. cerebral edema.

n unconscious person is admitted to the hospital after a motorcycle accident. The person experienced a brief loss of consciousness at the scene followed by an awake, lucid period of 1 hours. The nurse suspects this individual has a(n):

1. subdural hematoma.

2. epidural hematoma.

3. open penetrating trauma.

4. mild concussion.

2. epidural hematoma.

An older adult with a history of alcohol abuse has sustained a fall and is now diagnosed with a hematoma located between the dura mater and the surface of the brain, often resulting from tearing of bridging veins. Which type of hematoma fits this description?

1. Subdural

2. Epidural

3. Extradural

4. Intracerebral

1. Subdural

Spinal shock is characterized by:

1. loss of voluntary motor function with preservation of reflexes.

2. cessation of spinal cord function below the lesion.

3. loss of spinal cord function at the level of the lesion only.

4. temporary loss of spinal cord function above the lesion.

2. cessation of spinal cord function below the lesion.

Why does a person with a spinal cord injury experience bradycardia during autonomic hyperreflexia?

1. The vagus nerve reduces the heart rate as a response to low blood pressure caused by a spinal cord injury.

2. The sympathetic nervous system directly stimulates the sinoatrial node, slowing the heart rate to counteract hypertension.

3. The carotid sinus detects increased blood pressure and signals the vagus nerve to slow the heart rate in response to hypertension.

4. The lack of parasympathetic nervous system function below the injury leads to an increase in heart rate as a compensatory response.

3. The carotid sinus detects increased blood pressure and signals the vagus nerve to slow the heart rate in response to hypertension.

A 68-year-old patient is admitted to the emergency department with symptoms of sudden onset of weakness on the right side of the body, slurred speech, and difficulty walking. The patient reports a history of hypertension and atrial fibrillation. Based on the clinical presentation and risk factors, the nurse suspects the patient is experiencing:

1. Ischemic stroke due to cerebral thrombosis

2. Hemorrhagic stroke due to a ruptured aneurysm

3. Cryptogenic stroke due to an unknown cause

4. Transient ischemic attack (TIA)

1. Ischemic stroke due to cerebral thrombosis