Intro to Pathophysiology - Practice Questions

NURS 200 - In class questions

A patient has worn a leg cast for 8 weeks following a tibial fracture. During cast removal, the nurse notes that the affected leg is noticeably smaller than the unaffected leg. Which cellular adaptation has most likely occurred?

Atrophy

A 35-year-old patient begins a supervised resistance training program after years of inactivity. Three months later, the patient's skeletal muscles have increased in size and strength. Which cellular change best explains this finding?

Physiologic hypertrophy

Cells respond differently depending on the intensity and duration of stress. Which statement best reflects this principle?

Cells attempt to maintain homeostasis through adaptation before irreversible injury occurs.

Mr. Johnson's heart has maintained adequate blood flow for many years despite chronic hypertension because the cardiac muscle enlarged in response to the increased workload. Which concept best explains this response?

Adaptation

A cell experiences prolonged oxygen deprivation. Which event would most strongly suggest that cellular injury has become irreversible?

Loss of plasma membrane integrity

Several years later, Mr. Johnson experiences an acute myocardial infarction. Which type of cell death is most likely occurring?

Necrosis

Which sequence best describes the progression of disease?

Homeostasis → cellular adaptation → cellular injury → organ dysfunction → symptoms

Mr. Johnson reports becoming short of breath while climbing stairs. His blood pressure is 168/96 mmHg, and an echocardiogram demonstrates left ventricular hypertrophy. Which finding represents a symptom?

Shortness of breath

The nurse reviews Mr. Johnson's health record: hypertension for 15 years, shortness of breath with activity, blood pressure 168/96 mmHg, and left ventricular hypertrophy on echocardiogram. Which option correctly matches the patient information with the appropriate pathophysiology terminology?

Etiology: hypertension; Pathogenesis: LVH; Sign: BP 168/96; Symptom: shortness of breath

Which nursing interventions are most likely to slow progression from cellular adaptation to cellular injury? Select all that apply.

• Recommend a low-sodium diet

• Encourage adherence to prescribed antihypertensive medications

• Teach the importance of blood pressure monitoring

• Encourage regular physical activity as tolerated

Despite treatment recommendations, Mr. Johnson's blood pressure remains uncontrolled. Which finding would most concern the nurse because it suggests adaptation is no longer sufficient?

New-onset shortness of breath at rest

Mr. Johnson's primary complaint is shortness of breath when climbing stairs. Before making any diagnosis, which statement best reflects a pathophysiologic approach to understanding his condition?

Identify which body systems and physiologic processes may be contributing to his symptoms.

Mr. Johnson's echocardiogram shows that the wall of his left ventricle has become thicker over time, and he is diagnosed with left ventricular hypertrophy. Which tissue type is undergoing the primary adaptive response responsible for maintaining cardiac output?

Muscle tissue

Mr. Johnson's left ventricular hypertrophy allows his heart to maintain cardiac output despite years of hypertension. Which statement best explains this adaptive response?

Individual cardiac muscle cells enlarge and increase ATP production to generate greater contractile force.

Mr. Johnson has long-standing hypertension. Over time, excess collagen accumulates within the extracellular matrix of his heart. What is the most likely consequence of this change?

The ventricular wall becomes stiffer, making it more difficult for the heart to relax and fill.

Mr. Johnson's hypertrophied heart requires more ATP to maintain cardiac output. Which organelle would you expect to be especially abundant?

Mitochondria

Mr. Johnson says, “My father also had high blood pressure, so I guess there was nothing I could do.” Which response is most appropriate?

Both inherited genes and environmental factors contribute to hypertension.

Two identical twins have the same DNA sequence. One develops hypertension at age 50 while the other remains healthy. Which explanation best illustrates epigenetics?

Environmental exposures may alter gene expression without changing the DNA sequence.

A patient’s tumor contains one mutated copy of a gene that continuously stimulates cell proliferation. Which alteration is most consistent with this finding?

Activation of a proto-oncogene into an oncogene

Two patients have tumors of similar size. Tumor A has a high growth fraction, while Tumor B contains a larger proportion of cells in G0. Which interpretation is most accurate?

Tumor A contains a greater proportion of cells actively progressing through the cell cycle.

A patient’s cancer cells have entered the bloodstream but have not yet formed a secondary tumor. Which additional event must occur for metastasis to be established?

The cells must exit the circulation and grow in a distant tissue.

A 58-year-old man is concerned about his risk of developing cancer. Which factor represents the greatest modifiable risk factor for cancer development?

Smoking one pack of cigarettes daily

Which statement best explains how mutations contribute to cancer development?

Oncogenes result from activation of proto-oncogenes and promote excessive cell proliferation.

A patient asks why cancer cells stimulate the formation of new blood vessels. Which response by the nurse is most accurate?

Angiogenesis allows tumors to obtain oxygen and nutrients needed for continued growth.

Which characteristic is most indicative of a malignant tumor?

Ability to invade surrounding tissues and metastasize

A patient with breast cancer has a primary tumor measuring 3 cm, cancer involving several axillary lymph nodes, and metastatic lesions in the liver. Which TNM component indicates the most advanced disease?

M (Distant metastasis)