D115 Advanced Pathophysiology for the Advanced Practice Nurse - Complete Master Test Bank | 343 Q&A with Rationales | Comprehensive Study Guide & Exam Prep 2025 | Western Governors University

Which type of genetic disease affects males more frequently than females?

Sex-Linked recessive. Since males only have one X and one Y, if the affected chromosome has the illness, it will be expressed.

In which two conditions are chromosomal abnormalities the leading known cause?

Intellectual disability and fetal miscarriage. Chromosome abnormalities are the leading known cause of intellectual disability and fetal miscarriage.

What are three examples of prenatal diagnostic studies?

Chorionic villus sampling (CVS), amniocentesis, and preimplantation genetic testing (PGT) are examples of prenatal diagnostic studies and are performed in vitro. CVS is a form of genetic testing that provides genetic information found in utero and is usually performed between weeks 11 and 14 of pregnancy. An amniocentesis is a form of genetic testing that evaluates amniotic fluid and is usually performed during the second trimester, between weeks 15 and 20 of pregnancy. PGT is performed on the embryo prior to implantation.

Which genetic disorder is characterized by the presence of a zygote having one chromosome with a normal complement of genes and one chromosome with a missing gene?

Cri du chat syndrome (translated as "cry of the cat") is caused by a DNA deletion. This term describes the cry often heard from a baby affected by the syndrome. Cri du chat syndrome can present as a microcephalic, low birth-weight baby with a piercing cry.

How can an X-linked recessive disease skip generations?

The disease can be transmitted through female carriers.

Since females have two copies of the X chromosome, the mother may provide an unaffected X to a daughter or son. Furthermore, a daughter may not show signs of the disease because she has the other X (the only X the father can give to a female) to cancel it out.

Which type of risk is referred to as the ratio of the disease rate among the entire population to the disease rate in an unexposed population?

Relative risk is a ratio of probability, not an actual occurrence of disease.

What are the empirical risks for most multifactorial diseases based on?

Many factors from lifestyle to genetics affect multifactorial diseases. Observation and evaluation of each case individually provides the most thorough and accurate assessment.

What refers to the silenced gene of a gene pair.

The imprinted gene is the silent gene of a gene pair.

What is the primary reason that some older adults have impaired inflammation and wound healing?

The underlying chronic illness exists.

A generalized inflammatory response seen in chronic illness depletes the body's reserves to fight against illness.

Which cells are the body's primary defense against parasite invasion?

Eosinophils are the body's primary defense against parasites.

What Phagocytes bacteria?

Macrophages work by eating or phagocytosing bacteria.

What is the first response to a foreign pathogen?

Helper T cells

Which characteristic is the most important determinant of immunogenicity when considering the antigen?

Immunogenicity is primarily based on the ability to recognize something foreign.

How are erythrocytes destroyed when mismatched blood is administered, causing an ABO incompatibility?

The complement pathway is activated in response to blood incompatibility.

What is the hypersensitivity reaction that causes atopic dermatitis?

An immediate (type I) hypersensitivity reaction causes atopic dermatitis.

Which four infections are considered fungal infections?

Infection with a fungus is called mycosis and includes dermatophytes (e.g., tineas, which refers to several skin mycoses, including ringworm and athlete's foot) and yeasts, which include candida and aspergillus.

When is the earliest after sexual transmission of HIV that lab results can detect infection?

Lab testing can detect HIV RNA 4 to 10 days after sexual transmission, whereas HIV antibody testing may take 23 to 90 days to result in a positive test. Repeat testing may be needed to rule out a false negative test due to testing too soon after exposure, especially if a high likelihood of exposure is suspected.

What is a characteristic of exotoxins?

Exotoxins are released during bacterial growth.

Which dietary lifestyle choice has been associated with a decreased risk for developing colon cancer?

The results of decreased fat consumption have been widely studied and have demonstrated a decreased risk of developing colon cancer.

Which cancer is an individual who has worked with asbestos for over 40 years most likely to develop?

Asbestos exposure results in an increased risk of lung and lung lining cancer.

Which statement is true regarding ultraviolet (UV) light?

The degree of damage is not affected by the light's wavelength.

UV light causes basal cell carcinoma and squamous cell carcinoma when the UVB rays hit DNA strands, causing thymine base pairs that are side by side to pair together, becoming thymine dimers. These thymine dimers lead to cell death or cancer.

Which cancer does exercise have a convincing impact on reducing?

Exercise-induced myokines cause apoptosis of colon cancer cells.

Low healthcare literacy is recognized as a major risk factor in blood pressure control and has been shown to have adverse effects on health outcomes.

true or false

TRUE

By providing patient education at the appropriate literacy level, improved health outcomes may result.

One of the goals of the National Action Plan to Improve Health Literacy is to incorporate research and evidence-based plans of treatment from childhood through university-level education in a manner consistent with an individual's literacy level.

True or false

True

Ensuring the individual can understand all elements of a treatment plan is crucial for understanding and compliance.

What is a red flag for low healthcare literacy?

Low literacy often leads to perceived noncompliance to medical instructions, including medication instructions. Ensuring the patient fully understands all instructions is critical for understanding.

Amniocentesis is recommended for pregnant women with certain health histories.

Which health history would result in an amniocentesis recommendation?

Those who have a family history of genetic disorders

Studies have identified several genes that play a role in the prevention of obesity.

What do these genes influence?

Regulation of appetite-Research has shown that genetic mutations may cause alterations in the regulation of appetite.

Which concept is data reporting that sickle cell disease affects approximately 1 in 600 black Americans an example of?

Prevalence tells us how often disease is seen in a population, which includes all people with the disease at a given time, at any stage in the disease progression.

What describes a chromosomal defect caused by Prader-Willi syndrome?

Prader-Willi syndrome is caused by a disorder of a portion of chromosome 15. Normally, a portion of this chromosome is inherited from both parents. With Prader-Willi syndrome, the chromosome inherited from the father is problematic.

Which action is a purpose of the inflammatory process?

Prevent infection of the injured tissue

The inflammatory response is a defense mechanism designed to remove damaged tissue so the body can heal.

Which leukocytes are elevated in response to acute inflammatory reactions when considering white blood cell differentials?

Monocytes

Neutrophils

Basophils

Eosinophils

Neutrophils are one of the first responders to acute inflammation, and an increase in neutrophils demonstrates an acute inflammatory response.

Which type of immunity is produced by an individual after either natural exposure to the antigen or after immunization against the antigen?

Active-acquired immunity or naturally acquired active immunity occurs when an individual is exposed to a live pathogen and develops the disease or becomes immune as a result of a vaccine.

Which characteristics do atopic individuals have that make them genetically predisposed to develop allergies?

The greater quantities of IgE in atopic individuals make them genetically predisposed to develop allergies. IgE mediates the immune response to allergens; therefore, the more IgE one has, the stronger the response can be to an allergen. Think of it as having more soldiers in the army to fight the war.

A healthcare professional is conducting community education on vaccinations.

Which statement about vaccines should the professional include in the presentation?

Vaccines require booster injections to maintain life-long protection.

Most vaccines require a booster to increase immunity. The initial effects of a vaccine may diminish over time, and boosters improve protection against disease.

Which term describes an agent's ability to produce disease?

Pathogenicity refers to an organism's ability to create or produce disease.

What are signs and symptoms of Cri du Chrat Syndrome?

DNA deletion of chromosome 5. low birth weight, mental retardation, microencephaly, and cat like cry

What are the 3 layers of human defense?

Physical, Mechanical, biochemical barriers

What happens in the physical layer of human defense.

protect against damage and infection are composed of tightly associated epithelial cells including those of the skin and of the membranous sheets lining the gastrointestinal, genitourinary, and respiratory tracts.

What is the second line of defense and the process?

Inflammatory response- rapid and nonspecific, protective response to cellular injury from any cause. It can occur only in vascularized tissue.

How do acute and chronic inflammation differ?

Acute- Short duration, 8-10 days from onset to healing.

Chronic inflammation- can be a continuation of acute inflammation that last 2 weeks or longer. It can also occur as a distinct process without much preceding acute inflammation

What three systemic changes associated with acute inflammatory response

Fever, leukocytosis, plasma protein synthesis

How does the inflammatory response differ in neonates?

Neonates often have transiently depressed inflammatory function, particularly neutrophil chemotaxis and alternative complement activity.

Hypersensitivity Response- I vs II

I - IgE mediated- primary cause of common allergies. Binds with mast cells which release histamine. (initiates allergic reaction).

Histamine release leads to bronchial smooth muscle contraction, bronchoconstriction, and immune response

II- tissue specific- wrong blood type administered or hemolytic disease of the

A vaccine is what kind of immunity

Adaptive

Active immunization is produced by

an individual in response to an antigen or after immunization.

What are some common diseases that are categorized as multifactorial in nature?

HTN, CAD, Cancers, Diabetes, Obesity, Alzheimer's Disease

Symptoms of Chronic suppurative otitis media

Chronic suppurative otitis media- will have hearing loss, purulent drainage, ear pain.

What is Gate Control Theory

pain transmission is modulated by a balance of impulses conducted to the spinal cord where cells in the

substantia gelatinosa function as a "gate".

What is the parathyroid gland responsible for

produces parathyroid hormone (PTH)-

which is the single most important factor in the regulation of

serum calcium concentration.

What is TH responsible for

TH is

responsible for growth, maturation, and function of cells, body

systems throughout the body and across the life span.

Symptoms of hypothyroidism

decreased energy, lethargy, heat intolerance,

lowered basal temperature, diastolic HTN, MYXEDEMA

one of the most important contributors to

insulin resistance and DM

Obesity

The definition of legal blindness is the best corrected vision of 20/100.

true or false

FALSE

The definition of legal blindness is the best corrected vision of 20/200.

A male patient presents with sinus congestion, clear nasal discharge, and a cough that is worse when he is reclined.

What is the probable condition causing these symptoms?

Allergic rhinitis is marked by sinus congestion, clear nasal discharge, post nasal drip that causes a sore throat, and cough that is worse when supine.

unilateral tonsillar enlargement during acute tonsillitis is suggestive of

Unilateral tonsillar enlargement during acute tonsillitis is suggestive of a tonsillar abscess. If the patient does not have trouble swallowing, is drooling, or has a muffled voice, then it could be an enlarged tonsil rather than an abscess. Because of the risk of airway obstruction, it is imperative that tonsillar abscess is ruled out during the assessment.

Which two statements are true regarding epinephrine?

Dopamine is the precursor of both epinephrine and norepinephrine.

Epinephrine induces general vasodilation because of the predominance of β-adrenergic receptors in the muscle vasculature.

Which structure is specifically involved in pain transmission?

The substantia gelatinosa, which is at the tip of the posterior horn of the spinal cord, is directly involved in pain transmission.

Previousquestion

Which mechanism of heat loss involves electromagnetic waves?

Radiation is heat loss due to magnetic waves from surfaces of higher temperatures to ambient air that is cooler.

Which theory of pain best describes phantom limb pain?

The neuromatrix theory proposes that the brain produces patterns of nerve impulses drawn from various inputs, such as genetic, psychological, and cognitive experiences, and suggests that pain may be felt in the absence of input from the body. This theory would explain the phantom limb pain the woman is experiencing.

What is the most critical aspect of correctly diagnosing a seizure disorder and establishing its cause?

Exploring health history is critical in an individual with a seizure disorder. The history often provides information such as childhood seizures or a previous head injury which leads to the definitive diagnosis. The history also guides further testing to determine if systemic causes might be producing seizure activity.

Which symptoms exhibited by a patient are consistent with Alzheimer disease?

memory loss, impaired judgment, personality changes, and a reduced ability to care for herself.

why it is important to ask about a family history of Alzheimer disease.

Known genetic mutations increase the risk of Alzheimer disease. Specific mutations lead to early-onset Alzheimer disease, whereas other mutations are associated with late-onset. The patient does not have relatives with the condition.

The size of the brain increases in Alzheimer disease.

True or false

FALSE

Cell death in Alzheimer disease leads to a reduced size of the brain, with wider sulci and enlarged ventricles.

Is brain cell loss in Alzheimer disease confined to a specific area of the brain?

No. Brain cell loss in Alzheimer disease is widespread throughout the brain, typically beginning in the hippocampus and frontal lobes but progressing widely.

Alzheimer disease is characterized by a marked decrease in acetylcholine.

True or false

TRUE

Acetylcholine is essential in memory and learning.

Name the location of amyloid plaques (intracellular or extracellular) and describe what they contain

Amyloid plaques are extracellular and contain beta-amyloid, which comes from a normal membrane protein called amyloid precursor protein.

Describe what neurofibrillary tangles are, where they are located, and why they are important.

Neurofibrillary tangles are intracellular. They are tangled strands of abnormal tau protein that interfere with normal intracellular transport of nutrients and promote neural cell death.

List the brain functions that typically are lost first in Alzheimer disease.

The brain functions that are typically lost first in Alzheimer disease are learning and memory and thinking and planning.

What do diffuse axonal injuries (DAIs) of the brain often result in?

DAIs occur with all brain injuries and affect neurons in widespread areas of the brain. Depending on severity, this may result in altered or loss of consciousness.

Common causes of hemorrhagic strokes

Hypertension, ruptured aneurysms or vascular malformation, bleeding into a tumor, hemorrhage associated with bleeding disorders, anticoagulation, head trauma, and illicit drug use are common causes of hemorrhagic stroke

Risk factors for a stroke

General risk factors for stroke include hypertension, cigarette smoking, diabetes, insulin resistance, polycythemia and thrombocytopenia, presence of lipoprotein-a, impaired cardiac function, hyperhomocysteinemia, atrial fibrillation, and Chlamydia pneumoniae

Select four causes of microcephaly from the list below.

Autosomal recessive genetic alterations or defects in any 1 of 16 chromosomes can cause primary microcephaly (present at birth). Microcephaly may be caused by X-linked genetic disorders with the altered gene on the X chromosome. Environmental causes that include toxin exposure, radiation, intrauterine infection, or chemical exposure may be the initiating factor in secondary microcephaly. Maternal anorexia has been shown to have an almost two-fold risk of microcephaly. Other causes can include infection, trauma, metabolic disorders, and the presence of other genetic syndromes.

What test do you do for a child with frequent headaches

Headaches in children are unusual and require investigation. Headaches and nausea in the morning may indicate increased intracranial pressure. The pressure increases while the head is in a dependent or flat position due to a reduction in venous drainage. Intracranial pressure may decrease once the head is no longer in a dependent or flat position as venous drainage is improved and the contents of the cranium are reduced. The FNP is likely worried that an increase in intracranial pressure could indicate the presence of a brain tumor.

Which three substances would a healthcare professional teach a patient with a history of panic disorder to avoid?

Panic-prone individuals respond to panicogens (chemicals that produce panic symptoms), which include carbon dioxide, caffeine, cholecystokinin, sodium lactate, and adrenergic receptor agonists, such as yohimbine. Therefore, a healthcare professional would advise a patient with a history of panic disorder to avoid carbon dioxide and coffee and soda pop that contain caffeine or to consider decaffeinated varieties of these beverages.

For which neurotransmitter is there a decrease in receptor binding found in individuals with depression?

Decreased receptor binding for serotonin is found in major depression.

Which monoamine findings are associated with mania?

While the precise pathophysiology is not completely understood, the monoamine theory of depression and observational results related to the effect of medications on monoamine levels suggests that low levels of monoamines are associated with depression, while higher concentrations are associated with mania.

Bipolar disorder increases what

Increased amygdala volume, increased norepinephrien levels

Depression has decreased what levels

serotonin

A woman with a history of schizophrenia asks the nurse practitioner, "Now that I am pregnant, how will my mental illness affect my baby?"

Which statement is true regarding the effect on the woman's child?

Schizophrenia is believed to be caused by brain abnormalities that occur during the prenatal period of cell proliferation and migration.

Openly defiant behavior that stands out against other children's behavior and causes problems within the home and school is oppositional defiant disorder.

True or False

True

Defiant behavior when compared to others of the same age that causes problems in family, social, and academic interactions is one of the diagnostic symptoms of oppositional defiant disorder.

A provider is examining an 11-year-old boy who reports trouble sleeping, frequent headaches, stomach aches, and fatigue. The mother accompanying the patient states that her son is often hesitant to go to school.

Which disorder is most consistent with these findings?

Anxiety associated with places and people is considered social anxiety.

What are three actions of glucocorticoids?

-Glucocorticoids decrease uptake of glucose into muscle cells, adipose cells, and lymphatic cells.

-Glucocorticoids also have a direct effect on carbohydrate metabolism in many ways.

-Furthermore, glucocorticoids increase blood glucose concentration by promoting liver gluconeogenesis.

What cells in the pancreas synthesize insulin.

Beta cells are the type of cell within the pancreatic islet that make and secrete insulin. Beta cells are either diminished or dysfunctional in patients with diabetes, which leads to hyperglycemia.

What are three clinical manifestations of hypothyroidism?

The lower levels of thyroid hormone result in decreased energy metabolism, resulting in constipation, bradycardia, and lethargy.

Hypofunction of the adrenal cortex symptoms

Hypofunction of the adrenal cortex leading to cortisol deficiency causes Addison disease, which manifests itself with hyperpigmented skin, diarrhea, and abdominal pain.

Hypofunction of the adrenal cortex leading to cortisol deficiency causes Addison disease, which manifests itself with anorexia, nausea, and personality changes.

Hyperfunction of the adrenal cortex symtoms

Hyperfunction of the adrenal cortex leading to cortisol excesses causes Cushing syndrome, which manifests itself with easy bruising, muscle wasting, and skin striae.

Hyperfunction of the adrenal cortex leading to cortisol excesses causes Cushing syndrome, which manifests itself with moon face, thinning hair on the scalp, and buffalo hump.

A family is concerned that their elderly family member is not eating.

Which three education topics should be addressed with the family regarding anorexia of the elderly?

With aging, decreased saliva affects both taste and swallowing, often leading to anorexia. Additionally, anorexia of aging is common, and family members need to understand this. Offering oral care guidance and suggesting foods that taste good to the patient and are easy to chew with the teeth or dentures may be effective interventions. Furthermore, social stimulation has been shown to be effective in elderly patients with anorexia, providing relaxation and enjoyment during food intake.

What is the major cause of non-endemic congenital hypothyroidism in developed countries?

Thyroid dysgenesis occurs in 1 in 4,500 births and is associated with developmental abnormalities of the thyroid gland.

The principal hormones influencing growth are GH and the IGFs.

True or false

true

There are many hormones that influence growth, but the principal hormones are GH and the IGFs.

List three endocrine organs that need evaluation and provide a rationale for each.

-The thyroid gland should be evaluated because adequate thyroid hormone is required for normal bone growth.

-The adrenal gland should be evaluated because Cushing syndrome, while rare, results in hypersecretion of corticosteroids leading to short stature.

-The pituitary gland should be evaluated since growth hormone is secreted by the pituitary gland. Hypofunction of the pituitary gland results in growth problems.

Koplik's spots are small red papules with white centers found on buccal mucosa by the lower molars and are indicative of measles.

True or False

TRUE Koplik's spots are a prodromic viral enanthem of measles manifesting approximately two to three days before the measles rash begins.

What are three deteriorations in abilities that commonly characterize dementia?

Dementia is the progressive failure (an acquired deterioration) of many cerebral functions that include impairment of intellectual function with a decrease in orienting, memory, language, executive attentional functions, and alterations in behavior.

Which two clinical manifestations are characteristic of cluster headaches?

The cluster headache attack usually begins without warning and is characterized by severe unilateral tearing, burning, and periorbital, retrobulbar, or temporal pain lasting from 30 minutes to two hours. This pain may be disabling.

Which two statements are true regarding myelodysplasia?

Although myelodysplasia is defined as a defect in the formation of the spinal cord, the term is also used to refer to anomalies of both the vertebral column and spinal cord. Birth defects in which the vertebrae fail to close are known as spina bifida (split spine).

Which four problems are experienced by individuals with depression?

Insomnia, hypersomnia, and other disturbances in sleep cycles frequently accompany depression. Increases or decreases in body weight, which may be due to side effects of medication or changes in self-worth, may also accompany depression. Loss of appetite and anorexia frequently accompany unipolar depression, and overeating frequently accompanies other types of depression. Approximately 20 to 30% of people with unipolar depression have an altered hypothalamic-pituitary-thyroid (HPT) system.

Symptoms of post-traumatic stress disorder (PTSD) in children may mimic symptoms of attention deficit hyperactivity disorder (ADHD).

True or False

True

Symptoms of PTSD in children often lead to being restless, being fidgety, and trouble staying focused and organized, leading to a false diagnosis of ADHD.

A patient has a hernial protrusion of a sac-like cyst containing meninges, spinal fluid, and a portion of the spinal cord through a deficit in the spinal column.

Which condition does this describe?

Myelomeningocele is a type of spina bifida, a neural tube defect, which is rarely covered by skin and protrudes from the back exposing spinal cord tissue.

Which hormone is involved in the regulation of serum calcium levels?

PTH-Found in the tissue of the thyroid are parafollicular cells, or C cells. C cells secrete various regulatory peptides, including calcitonin, and, in much smaller quantities, the neuropeptides ghrelin, serotonin, and somatostatin. At high levels, calcitonin, also called thyrocalcitonin, lowers serum calcium levels by inhibiting bone-resorbing osteoclasts.

What are three areas of possible microvascular complications in chronic diabetes mellitus?

Of the options provided, the area's most often affected by chronic complications of diabetes mellitus are the retina, kidneys, and nerves. One area most often affected by complications of diabetes mellitus is the retina. Microvascular retinal damage is a major cause of blindness and a complication of diabetes. Renal damage and failure due to microvascular damage of the kidneys is also a complication of diabetes. Furthermore, nerve damage is a common diabetes complication resulting in chronic pain and disability.

Pediatric type 1 diabetes occurs when approximately 20% of beta cells have been damaged or destroyed.

True

False

False

Type 1 diabetes occurs when approximately 90% of beta cells have been damaged or destroyed.