PATHO HESI Flashcards [3rd set]

179 cards

A female client tells the nurse that she does not know which day of the month is best to do breast self exams. Which instruction should the nurse provide?

5-7 days after menses cease

this is because the physiologic alterations in breast size and activity reach their minimal level after menses

A client reports unprotected sex 1 wk ago and is worried about HIV exposure. An initial HIV antibody screen (ELISA) is obtained. The nurse teaches the client that seroconversion to HIV positive relies on antibody production by B lymphocytes after exposure to the virus. When should the nurse recommend the client return for repeat blood testing?

6-12 wks

although the HIV antigen is detectable appx 2 wks after exposure, seroconversion to HIV positive may take up to 6-12 wks after exposure

A nurse is planning to teach self care measures to a female client about prevention of yeast infections. Which instructions should the nurse provide?

Avoid tight fitting clothing and do not use bubble bath or bath salts

Which rxn should the nurse ID in a client who is responding to stimulation of the sympathetic nervous system (SNS)?

Increased HR

any stressor that is perceived as threatening to homeostasis acts to stimulate the SNS and manifests as a flight or flight response, which includes an increased HR

Parasympathetic Nervous System: pupil constriction, bronchial constriction, decreased BP

A client w/ asthma receives a prescription for high BP during a clinic visit. Which prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma?

Metoprolol

the nurse is assessing an older client and determines that the client's left upper eyelid droops, covering more of the iris than the right eyelid. Which description should the nurse use to document this finding?

ptosis on the left eyelid

A client w/ aortic valve stenosis dvps HF. Which pathophys finding occurs in the myocardial cells as a result of the increased cardiac workload?

Increase in size

HTN and incompetent or stenotic heart valves cause an increase in the workload of the heart by increasing afterload which requires an increase in the force of cxn to pump blood out of the heart. Myocardial hypertrophy results because the cells increase in surface area or size by increasing the amt of contractile proteins, but the quantity of fibers remain constant. As myocardial hypertrophy progresses, the heart becomes ineffective as a pump because the ventricular wall cannot dvp enough tension to cause effective contraction, which causes myocardial irritability due to hypoxia

What is the underlying phathophys process b/w free radicals and destruction of a cell membrane?

Enzyme release from lysosomes

Oxidative damage to cells is thought to be a causative factor in disease and aging. If free radicals bind to polyunsaturated fatty acids found in the lysosome membrane, the lysosome, nicknamed "suicide bags" leaks its protein catalytic enzymes intracellularly and the cell is destroyed

Which HC practice is most important for the nurse to teach a postmenapausal client?

consume adequate foods rich in Ca+

A mid-aged male client asks the nurse what findings from his digital rectal exam prompted the HCP to prescribe a repeat serum prostatic surface antigen (PSA) level. What info should the nurse provide?

stony, irregular nodules palpated on the prostate should be further evaluated

Which condition is associated w/ an over-secretion of renin?

Hypertension

renin is an enzyme synthesized and secreted by the juxtaglomerular cells of the kidney in response to renal artery blood volume and pressure chgs. Low renal perfusion stimulates the release of renin, which is converted by angiotensinogen into angiotensin 1, which causes the secretion of aldosterone, resulting in renal reabsorption of sodium, water, and subsequently increases BP

What info should the nurse include in a teaching plan about the onset of menopause?

a. Smoking

b. Oophorectomy w/ hysterectomy

c. Early menarche

d. Genetic influence

e. Chemotherapy exposure

The parents of a child w/ hemophillia A ask the nurse about their probability of having another child w/ it. Which info is the basis for the nurse's response?

a. Sons of female carriers have a 50% chance of inheriting hemophillia

b. Hemophillia is an X-linked recessive disorder

Hemophillia is an inherited disease that manifests in male children whose mom is a carrier. With each pregnancy there is a 50% chance that a male child will inherit the defective gene and manifest hemophillia A

The nurse is caring for a client who had an excision of malignant pituitary tumor. Which findings should the nurse document that indicate the client is dvp'g Syndrome of Inappropriate Antidiuretic Hormone (SIADH) ?

Wt gain w/ low serum sodium

SIADH most frequently occurs when cancer cells manufacture and release ADH, which is manifested by water retention causing wt gain and hyponatremia

A man who was recently dx'd w/ Huntington's disease asks the nurse if his adolescent son should be tested for the disease. What response is best for the nurse to provide?

Genetic counseling should be obtained prior to undertaking any genetic testing procedure

Which rationale best supports an older client's risk of complications r/t dysrhythmia?

An older client is intolerant of decreased cardiac output which may cause dizziness and falls

• In an older client, CO is decreased and a loss of contractility and elasticity reduces systemic and cerebral blood flow, so dysrhythmias, such as bradycardia or tachycardia is poorly tolerated, and increases the client's risk for syncope, falls, transient ischemic attacks, and possibly dementia

MD is characterized by which pathophys condition?

Skeletal muscle degeneration

The nurse is assessing a client w/ a ruptured small bowel and determines that the client has a temp of 102.8F. Which assessment finding provides the earliest indication that the client is experiencing septic shock?

Hyperpnea

the interrelated pathophys chgs associated w/ the hypermetabolic state of sepsis and septic shock produce a pathologic imbalance b/w cellular O2 demand, supply, and consumption.

Which s/s are associated w/ arterial insufficiency?

Pallor, intermittent claudication

these are 2 signs r/t stage 2 peripheral vascular disease, which results in arterial insufficiency

the severity of diabetic retinopathy is directly r/t which condition?

Poor glucose control

When observing a client for sx of a large bowel obstruction, the nurse should assess for which finding?

Distention of the lower abd

Which pathophys response supports a client's vomiting experience?

Spasmodic reflex of respiratory and gastric mvmts results from stimulation of the chemoreceptor trigger zone

Vomiting is a reflex of spasmodic respiratory mvmts against the glottis causing the forceful expulsion of the contents of the stomach thru the mouth. Stimulation of the emetic center results from afferent vagal and sympathetic nerve pathways that activate the chemoreceptor trigger zone (CTZ)

A nurse is caring for a client with syndrome of inappropriate antidiuretic hormone secretion (SIADH). The nurse should monitor the client closely for

a. Loss of thirst, weight gain

b. Dependent edema, fever

c. Polydipsia, polyuria

d. Hypernatremia, tachypnea

a Loss of thirst, weight gain

SIADH is caused by the excessive release of an antidiuretic hormonr (ADH). As a result of the excess ADH, the client retains water creating a dilutional hyponatremia. SIADH causes hyponatremia, not D.

A client with a markedly distended bladder is diagnosed with hydronephrosis and left hydroureter after an IV pyelogram. The nurse catheterizes the client and obtains a residual urine volume of 1650 ml. This finding supports which pathophysiological cause of the client's urinary tract obstruction?

a. Obstruction at the urinary bladder neck.

b. Ureteral calculi obstruction.

c. Ureteropelvic junction stricture.

d. Partial post-renal obstruction due to ureteral stricture.

a. Obstruction at the urinary bladder neck.

Hydroureter (dilation of the renal pelvis), vesicoureteral reflux (backward movement of urine from the lower to upper urinary tracts), and hydronephrosis (dilation or enlargement of the renal pelvis and calyces) result from post-renal obstruction which can consequently result in chronic pyelonephritis and renal atrophy. Ascending urinary reflux occurs when normal ureteral peristaltic pressure is met with an increase in urinary pressure occurring during bladder filling if the urinary bladder neck is obstructed (A). A large residual urine does not occur with (B, C, and D) because the urine can not get to the bladder.

Physical examination of a comatose client reveals decorticate posturing. Which statement is accurate regarding this client's status based upon this finding?

a. A cerebral infectious process is causing the posturing.

b. Severe dysfunction of the cerebral cortex has occurred.

c. There is a probable dysfunction of the midbrain.

d. The client is exhibiting signs of a brain tumor.

b. Severe dysfunction of the cerebral cortex has occurred.

Decorticate posturing (adduction of arms at shoulders, flexion of arms on chest with wrists flexed and hands fisted and extension and adduction of extremities) is seen with severe dysfunction of the cerebral cortex (B). (A) is characteristic of meningitis. (C) is characterized by decerebrate posturing (rigid extension and pronation of arms and legs). A client with (D) may exhibit decorticate posturing, depending on the position of the tumor and the condition of the client.

A client with a fractured right radius reports severe, diffuse pain that has not responded to the prescribed analgesics. The pain is greater with passive movement of the limb than with active movement by the client. The nurse recognizes that the client is most likely exhibiting symptoms of which condition?

a. Acute compartment syndrome.

b. Fat embolism syndrome.

c. Venous thromboembolism.

d. Aseptic ischemic necrosis.

a- Acute compartment syndrome.

Which clinical finding should the nurse identify in a client who is admitted with cardiac cirrhosis?

A. Jaundice

B. Vomiting

C. Peripheral edema

D. Left upper quadrant pain

c Peripheral edema

Four types of cirrhosis include: alcoholic, post-necrotic, bilary and cardiac cirrhosis, which is associated with severe right sided heart failure, so peripheral edema (C) is most consisted with right sided heart failure. Although (A) and (B) can occur in all types of cirrhosis, the most defining characteristic of cardiac cirrhosis is related to heart failure. Hepatic engorgement can occur in a client with HF or cirrhosis and cause right upper quadrant pain, not (D)

4 types of cirrhosis: alcoholic, post-necrotic, biliary, and cardiac. Cardiac is associated w/ severe right sided heart failure, so peripheral edema is most consistant

The nurse is planning care for a patient who has right a hemispheric stroke. Which nursing diagnosis should the nurse include in the plan of care?

A. Impaired physical mobility related to right sided hemiplegia

B. Risk for injury related to denial of deficits and impulsiveness

C. Impaired verbal communication related to speech language deficits

D. Ineffective coping related to depression and distress about disability

b Risk for injury related to denial of deficits and impulsiveness

With right brain damage, a client experiences difficulty in judgement and spatial perception and is more likely to be impulsive and move quickly, which is why the nurse should note the client is at risk for falls (B). Although clients with right and left hemisphere damage may experience impaired physical mobility, the client with right brain damage will manifest physical impairments on the contralateral side of the body, not the same side (A). The client with a left brain injury may manifest right sided hemiplegia with speech or language deficits (C). A client with left sided brain damage is more likely to be aware of the deficits and experience grief related to physical impairment and depression (D)

Right-brain damage - a client experience difficulty in judgment and spatial perception and is more likely to be impulsive and move quickly, which placing the client at risk for falls

A 27 year old male client with Hodgkin's disease is scheduled to undergo radiation therapy. The client expresses concern about the effect of radiation on his ability to have children. What information should the nurse provide?

A. The radiation therapy causes the inability to have an erection

B. Radiation therapy with chemo causes temporary infertility

C. Permanent sterility occurs in male clients who receive radiation

D. The client should restrict sexual activity during radiotherapy

C. Permanent sterility occurs in male clients who receive radiation

Low sperm count and loss of motility are seen in males with Hodgkin's disease before any therapy. Radiotherapy often results in permanent aspermia, or sterility (C). (A), (B), and (D) are inaccurate

While the nurse obtains a male client's history, review of systems, and physical examination, the client tells the nurse that his breast drains fluid secretions from the nipple. The nurse should seek further evaluation of which exocrine gland function?

A. Posterior pituitary and testes

B. Adrenal medulla and adrenal cortex

C. Hypothalamus and anterior pituitary

D. Parathyroid and islets of Langerhans

C Hypothalamus and anterior pituitary

Breast fluid and milk production are induced by the presence of prolactin secreted from the anterior pituitary gland, which is regulated by the hypothalamus' secretion of prolactin inhibiting hormone in both men and women. Further evaluation of the hypothalamus and the anterior pituitary gland (C) should provide additional information about the secretions or lactation.

Which client is at highest risk for chronic kidney disease secondary to diabetes mellitus?

A. Type 1 DM and a serum hemoglobin-A1 of 3.5%

B. Type 2 DM and retinopathy and mild vision loss

C. Type 2 DM and hypertension controlled by metoprolol

D. Type 2 DM and a history of morbid obesity for 5 years

B. Type 2 DM and retinopathy and mild vision loss

Diabetic retinopathy and nephropathy are related to prolonged hyperglycemia and hypertension which damage the microvasculature of the eyes and kidneys, so a client with Type 1 DM and retinopathy is most likely to develop neuropothy and chronic kidney disease. (A) is demonstrating compliance with therapy (H-A1c target level is no greater than 7%), which indicates tight glucose control and reduces the risk for microvascular complications. The client with controlled hypertension (C) is less likely to develop CKD, although metoprolol, a beta adrenergic receptor antagonist, can mask the signs of hypoglycemia. A client with Type 2 DM is more likely at risk for complications associated with chronic obesity (D)

The nurse is measuring BP on all four extremities of a child with coarctation of the aorta. Which BP finding should the nurse expect to obtain?

A. Higher on the left side

B. Higher on the right side

C. Lower in the arms than in the legs

D. Lower in the legs than in the arms

D- Lower in the legs than in the arms

In coarctation of the aorta, a congenital constriction is found at the aorta near the ductus arteriosus region that lies past the left subclavian arteries, which perfuses the upper extremities. The child should have higher BP in the upper extremities than in the lower legs.

The nurse is preparing to administer atropine, an anticholinergic, to a client who is scheduled for a cholecystectomy. The client asks the nurse to explain the reason for the prescribed medication. What is the best response for the nurse to provide?

A. Provide a more rapid induction of anesthesia

B. Decrease the risk of bradycardia during surgery

C. Induce relaxation before induction of anesthesia

D. Minimize the amount of analgesia needed postoperatively

B Decrease the risk of bradycardia during surgery

Atropine may be prescribed to increase the automaticity of the SA node and prevent a dangerous reduction in HR during surgical anesthesia. (A), (C), and (D) do not address the therapeutic action of atropine use perioperatively.

A client's family asks why their mother with heart failure needs a pulmonary artery catheter now that she is in the ICU. What information should the nurse include in the explanation to the family?

A. A central monitoring system reduces the risk of complications undetected by observation

B. A pulmonary artery catheter measures central pressure for monitoring fluid replacement

C. Pulmonary artery catheters allow for early detection of lung problems

D. The healthcare provider should explain the many reasons for its use.

B A pulmonary artery catheter measures central pressure for monitoring fluid replacement

Pulmonary artery catheters are used to measure central pressures and fluid balance. Even though all clients in the ICU require close monitoring, they do not all need a PA catheter (A). PA lines do not detect pulmonary problems (C). (D) avoids the family's question.

Dysrhythmias are a concern for any client. However, the presence of a dysrhythmia is more serious in an elderly person because

A. elderly persons usually live alone and cannot summon help when symptoms appear.

B. elderly persons are more likely to eat high-fat diets which make them susceptible to heart disease.

C. cardiac symptoms, such as confusion, are more difficult to recognize in the elderly.

D. elderly persons are intolerant of decreased cardiac output which may result in dizziness and falls.

D elderly persons are intolerant of decreased cardiac output which may result in dizziness and falls.

Cardiac output is decreased with aging (D). Because of loss of contractility and elasticity, blood flow is decreased and tachycardia is poorly tolerated. Therefore, if an elderly person experiences dysrhythmia (tachycardia or bradycardia), further compromising their cardiac output, they are more likely to experience syncope, falls, transient ischemic attacks, and possibly dementia. Most elderly persons do not eat high-fat diets (B) and most are not confused (C). Although many elderly persons do live alone, inability to summon help (A) cannot be assumed.

A male client who has never smoked but has had COPD for the past 5 years is now being assessed for cancer of the lung. The nurse knows that he is most likely to develop which type of lung cancer?

A. Adenocarcinoma.

B. Oat-cell carcinoma.

C. Malignant melanoma.

D. Squamous-cell carcinoma.

A Adenocarcinoma.

Adenocarcinoma is the only lung cancer not related to cigarette smoking (A). It has been found to be directly related to lung scarring and fibrosis from preexisting pulmonary disease such as TB or COPD. Both (B and D) are malignant lung cancers related to cigarette smoking. (C) is a skin cancer and is related to exposure to sunlight, not to lung problems.

The nurse is assessing the laboratory results for a client who is admitted with renal failure and osteodystrophy. Which findings are consistent with this client's clinical picture?

A. Blood urea nitrogen 40 m and creatinine 1.0

B. Cloudy, amber urine with sediment, specific gravity of 1.040

C. Serum potassium of 5.5 mEq and total calcium of 6 mg/dl

D. Hemoglobin of 10 g and hypophosphatemia

C Serum potassium of 5.5 mEq and total calcium of 6 mg/dl

In renal failure, normal serum electrolyte balance is altered because the kidneys fail to activate vitamin D, calcium absorption is impaired, and serum calcium decreases, which stimulates the release of PTH causing reabsorption of calcium and phosphate from the bone. A decreased tubular excretion and a decreased glomerular filtration rate results in hypocalcemia, hyperphosphatemia, and hyperkalemia (C). (A) is reflective of a non-renal cause, such as dehydration or liver pathology. (B) is more indicative of infection. Renal failure causes anemia and hyperphosphatemia, NOT (D).

What histologic finding in an affected area of the body would suggest the presence of chronic inflammation?

A. Predominance of neutrophils

B. Absence of fibroblasts and proteases

C. Decrease in degradation products

D. Increase in monocytes and macrophages

D Increase in monocytes and macrophages

A predominance of monocytes and macrophages in an inflamed area indicates the start of a chronic infection (D). Macrophages are responsible for cleaning up the healing wound through phagocytic and debridement actions, and monocytes assist in the healing of the wound after neutrophils have entered the area. (A) arrives during the acute stage of inflammation rather than at the later, chronic stage. (B) accumulates at the scene of a chronic infection. (C) increases due to the accumulation of dead neutrophils at the site.

A client is admitted to the Emergency Department with a tension pneumothorax. Which assessment should the nurse expect to identify?

A. An absence of lung sounds on the affected side.

B. An inability to auscultate tracheal breath sounds.

C. A deviation of the trachea toward the side opposite the pneumothorax.

D. A shift of the point of maximal impulse to the left, with bounding pulses.

C-A deviation of the trachea toward the side opposite the pneumothorax.

Tension pneumothorax is caused by rapid accumulation of air in the pleural space, causing severely high intrapleural pressure. This results in collapse of the lung, and the mediastinum shifts toward the unaffected side, which is subsequently compressed (C). (A, B, and D) are not demonstrated with a tension pneumothorax.

A client who is receiving a whole blood transfusion develops chills, fever, and a headache 30 minutes after the transfusion started. The nurse should recognize these symptoms as characteristic of what reaction?

A. A mild allergic reaction

B. A febrile transfusion reaction

C. An anaphylactic transfusion reaction

D. An acute hemolytic transfusion reaction

B-A febrile transfusion reaction

Symptoms of a febrile transfusion reaction (B) include sudden chills, fever, headache, flushing and muscle pain. An allergic reaction (A) is the response of histamine release which is characterized by flushing, itching and urticaria. An anaphylactic reaction (C) exhibits an exaggerated allergic response that progresses to shock and possible cardiac arrest. An acute hemolytic reaction (D) presents with fever and chills, but is hallmarked by the onset of low back pain, tachycardia, tachypnea, vascular collapse, hemoglobinuria, dark urine, acute renal failure, shock, cardiac arrest, and death.

A deficiency of intrinsic factor should alert the nurse to assess a client's history for which condition?

A. Emphysema

B. Hemophilia

C. Pernicious anemia

D. Oxalic acid toxicity

C- Pernicious anemia

Pernicious anemia is a type of anemia due to failure of absorption of cobalmin (Vit B12). Th emost common cause of lack of intrinsic factor, a glycoprotein produced by the parietal cells of the gastric lining.

A client is brought to the ER after a snow-skiing accident. What intervention is most important for the nurse to implement?

A. Review the EKG tracing

B. Obtain blood for coagulation studies

C. Apply a warming blanket

D. Provide heated PO fluids

A. Review the EKG tracing

Airway, breathing, and circulation are priorities in client assessment and treatment. Continuous cardiac monitoring is indicated because hypothermic clients have an increased risk for dysrhythmias. Coagulation studies and re-warming procedures can be initiated after a review of the EKG tracing.

The nurse reviews the complete blood count (CBC) findings of an adolescent with acute myelogenous leukemia (AML). The hemoglobin is 13.8 g/dl, hematocrit is 36.7%, WBC is 8,200 mm3, and platelet count is 115,000 mm3. Based on these findings, what is the priority nursing diagnosis for this client's plan of care?

A. Impaired gas exchange

B. Risk for infection

C. Risk for injury

D. Risk for activity intolerance

C Risk for injury

A client with AML is at risk for anemia, neutropenia, and thrombocytopenia. These CBC findings indicate that the platelet count is low (Normal 250,000-400,000 mm3), which places this client at an increased risk for injury (C), usually marked as bruising or bleeding. There is no evidence of impaired gas exchange (A) due to respiratory compromise, risk of infection (B) due to neurtropenia, or risk for activity intolerance (D) due to anemia and fatigue.

A mother is crying as she holds and rocks her child with tetanus who is having muscular spasms and crying. After administering diazepam (Valium) to the child, what action should the nurse implement?

A. Lay the child down and ask the mother to stay near the child in the crib

B. Encourage the mother to take a break and leave the room to stop crying

C. Keep all light sources off and close the window blinds to the room

D. Use calm, reassurance and understanding to comfort the mother

A Lay the child down and ask the mother to stay near the child in the crib

Controlling environmental stimulation such as noise, light, or tactile stimuli helps reduce CNS irritability related to acute tetanus. The mother should be instructed to minimize handling of the child during episodes of muscle spasticity and to stay calmly near the child. The mother's presence with the child provides security and support, so (B) is not indicated. Reducing external stimuli (C) may have some effect in reducing the child's distress but light tends to be less irritating than vibratory or auditory stimuli and is essential for careful observation. Although a calm, reassuring manner and sympathetic understanding (D) can help reduce the mother's anxiety, the most comforting measure for the child is the presence of the mother.

The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). This condition is most often related to which predisposing condition?

A. Small cell lung cancer

B. Active TB infection

C. Hodgkin's lymphoma

D. Tricyclic antidepressant therapy

A Small cell lung cancer

Cancer is the most common cause of the syndrome of inappropriate antidiuretic hormone (SIADH), with small cell lung cancer being the most common cancer that increases ADH, which causes dilutional hyponatremia and fluid retention. (B, C, and D) are also possible causes but secondary to CNS trauma or disease.

The nurse is assessing a postmenopausal woman who is complaining of urinary urgency and frequency and stress incontinence. She also reports difficulty emptying her bladder. These complaints are most likely due to which condition?

A. Cystocele

B. Bladder infection

C. Pyelonephritis

D. Irritable bladder

A Cystocele

This constellation of signs in a postmenopausal woman are characteristic of cystocele.

An initial disturbance in a system sets off a chain of events that does not favor stability and often abruptly displaces a system from its steady state: what is that?

a. Positive Feedback

b. Negative Feedback

c. Disease

d. Homeostasis

a. positive feedback

What organ shrinks with age?

a. Prostate

b. Gums

c. Heart

d. All of the above

b. gums

Which of the following is true?

a. An infant will have a slower heart rate than an adult

b. The elderly have better temperature sensations

c. There are more sweat glands in an elderly person

d. There is less thirst perception in the elderly

d. there is less thirst perception in the elderly

Which of the following is true?

a. Women snore more than men

b. Men have higher calcium levels

c. Women have a lower hemoglobin than men

d. Men have a lower creatinine level than women

c. Women have a lower hemoglobin than men

An increase in normal adaptive response to the decreased availability of oxygen at high altitude is termed which?

a. Circadian

b. Acclimatization

c. Population

d. Diurnal

b. Acclimatization

What does it mean when the cause of the disease is unwanted medical treatment?

a. Idiopathic

b. Ecogenetic

c. Genotypical

d. Iatrogenic

d. Iatrogenic

Which term is used for the first two months of life?

a. Infancy

b. Childhood

c. Prenatal

d. Neonatal

d. Neonatal

Which is an objectively identifiable aberration of the disease?

a. Symptom

b. Syndrome

c. Stage

d. Sign

d. Sign

Which of the following is true regarding catecholamines?

a. They are from the parasympathetic nervous system

b. They cross the blood brain barrier

c. They include epinephrine and norepinephrine

d. They cause of decrease in heart rate

c. They include epinephrine and norepinephrine

Which of the following is a true statement?

a. Antidiuretic hormone is not important for blood volume regulation

b. Endorphins increase with stress, resulting in a decrease in pain perception

c. Epinephrine and cortisol act very differently

d. Cortisol negates epinephrine's activity

b. Endorphins increase with stress, resulting in a decrease in pain perception

Which of the following metabolic processes is a component of anabolic metabolism?

a. Protein synthesis

b. Glycolysis

c. Citric acid cycle

d. Oxidative phosphorylation

a. Protein synthesis

Which of the following electrochemical mechanism is responsible for maintaining cell volume?

a. The calcium pump

b. Glucose transporters

c. The sodium-potassium pump

d. ATP-binding cassette (ABC) transporters

c. The sodium-potassium pump

Cellular hypoxia results in:

a. Enhanced ATP activity

b. Loss of intracellular calcium

c. Increased pH

d. Failure of the sodium-potassium pump

d. Failure of the sodium-potassium pump

A 75 yo woman develops weakness in her lower extremities after a prolonged period of bed rest. This is most likely caused by:

a. Atrophy of her leg muscles

b. Dysplasia of her leg muscles

c. Hypertrophy of her leg muscles

d. Hyperplasia of her leg muscles

a. Atrophy of her leg muscles

Which of the following types of cellular adaption is most likely to occur from chronic ischemia?

a. Hypertrophy

b. Metaplasia

c. Atrophy

d. Hyperplasia

c. Atrophy

What is the mechanism of cellular injury that occurs when deep sea divers get 'the bends'?

a. Free radicals form abnormal chemical bonds which destroy the cellular membranes

b. Carbon monoxide binds tightly to hemoglobin, preventing the RBCs from carrying O2

c. Intracellular calcium accumlation create muscle tetany

d. Gas bubbles from in the blood, blocking circulation and resulting in ischemia

d. Gas bubbles from in the blood, blocking circulation and resulting in ischemia

Which type of cellular adaption would create the greatest concern if found on a biopsy report?

a. Dysplasia

b. Metaplasia

c. Hyperplasia

d. Atrophy

a. Dysplasia

Which of the following is the process by which mRNA is synthesized from single stranded DNA?

a. Sense stranding

b. Replication

c. Translation

D. Transcription

d. Transcription

Which of the following is not one of the 4 cell types found in adult humans?

a. Epithelium

b. Connective tissue

c. Hematopoietic tissue

d. Nervous tissue

c. Hematopoietic tissue

If a patient has a recessive trait, which of the following is the genotype of this patient?

a. aa

b. AA

c. Aa

d. aA

a. aa

Which of the following chromosomal abnormalities has been linked with Down Syndrome?

a. Translocation

b. Inversion

c. Deletion

d. Duplication

a. duplication

Which of the following refers to a deficiency of factor VIII that causes a bleeding disorder?

a. Marfan Syndrome

b. Phenylketonuria

c. Hemophilia

d. Huntington

c. Hemophilia

Which of the following is a retrovirus that causes cancer?

a. Rhinovirus

b. Parvovirus

c. Epstein-Barr virus

d. Poxvirus

c. Epstein-Barr virus

Which of the following genes contributes specifically to some breast cancer?

a. Rb

b. BRCA1

c. P53

d. VHL

b. BRCA1

Which is used to describe the histologic characteristics of tumor cells?

a. Staging

b. Cachexia

c. Grading

d. Angiogenesis

c. Grading

Which of the following offers the best prognosis for the cure of cancer?

a. Early detection

b. Aggressive chemotherapy

c. Adjunct radiation

d. Gene therapy

a. Early detection

Which of the following is true about cancer?

a. Most deaths occur in those over 75 years old

b. Men have 1 in 3 lifetime risk of cancer

c. The combined 5 year survival rate for cancer is 62%

d. It is the leading cause of death

c. The combined 5 year survival rate for cancer is 62%

What is the purpose of the TNM classification system?

a. It provides information for ongoing research efforts to develop a cure for cancer

b. It tracks the progress of the disease and the effectiveness of treatment

c. It enables the MD to determine the underlying cause of the malignancy

d. It provides tumor data for the Centers for Disease Control and Prevention

b. It tracks the progress of the disease and the effectiveness of treatment

Why do patients with advanced cancer develop cachexia?

a. Cancer cells produce an enzyme that robs normal cells of nutrients

b. They lack an adequate number of normal cells to support metabolism

c. They have an increased basal metabolic rate

d. The process of cancer cell destruction utilizes most of the body's nutrients

a. Cancer cells produce an enzyme that robs normal cells of nutrients

Which of the following explains the genetic basis for cancer development?

a. Exposure to ionizing radiation

b. Decreased immune function

c. Infection by oncogenic bacteria

d. Loss or defect of tumor suppressor genes

d. Loss or defect of tumor suppressor genes

Bacteria are categorized by their: (select all that apply)

a. Shape

b. Need for oxygen

c. Reaction to staining

d. Size

e. Color

a. Shape

b. Need for oxygen

c. Reaction to staining

If the host's immune system is compromised resident florae may become pathogenic resulting in:

a. Opportunistic infection

b. Salmonella infection

c. Otitis media

d. Myocarditis

a. Opportunistic infection

Patient education to reduce emergence of resistant infections includes:

a. Stop taking prescribed antibiotics when fever is gone to avoid overuse

b. Take antibiotics for viral infections that cause temperature elevation

c. Take all the antibiotics ordered even when feeling recovered

d. Share antibiotics with susceptible family members to prevent spread of infection

c. Take all the antibiotics ordered even when feeling recovered

Which of the following occurs first after cellular injury?

a. Vessel walls rupture

b. Neutrophils migrate to the injured area

c. Plasma proteins and water move from the intracellular space to the interstitial space

d. Vessel walls briefly constrict

d. Vessel walls briefly constrict

Which of the following is an example of active immunity?

a. Injection of pooled gamma globulin

b. Breast-feeding

c. Passed from mother to infant via the placenta

d. Pneumonia vaccine

d. Pneumonia vaccine

A patient's WBC count indicates a shift to the left. What should the nurse assess for?

a. Leukemia

b. Weakness

c. Infection

d. Immunosuppression

c. Infection

The lab analysis on a child with chronic nasal drainage show elevated numbers of eosinophils in the blood. What is the likely cause of the drainage?

a. Bacterial infection

b. Allergies

c. Viral infection

d. Sinus infection

b Allergies

A child with ill-fitting shoes develops a vesicle (small blister) that burst, releasing clear watery fluid. The school nurse would document this drainage as:

a. Serous

b. Vesicular

c. Purulent

d. Sanguineous

a. Serous

Which of the following specialized cells are associated with the immune response?

a. Neutrophils

b. Monocytes

c. Macrophages

d. Lymphocytes

d. Lymphocytes

A severe life-threatening type 1 hypersensitivity reaction is:

a. Angioedema

b. Urticarial

c. Anaphylaxis

d. Hives

c. Anaphylaxis

What pathophysiologic abnormality underlies systemic lupus erythematosus (SLE)?

a. Immune deficiency

b. Type 2 hypersensitivity

c. Autoimmunity

d. Immunosuppression

c. Autoimmunity

Which of the following terms best describes the symptoms of petechiae. easy bruising, bleeding gums, occult hematuria or retinal hemorrhage?

a. Neutropenia

b. Leukopenia

c. Anemia

d. Thrombocytopenia

d. Thrombocytopenia

If I get a kidney transplant from my sister, what is it called?

a. Allogenic transplant

b. 'Gift of Life'

c. Autologous transplant

d. peripheral stem cell transplant

a. Allogenic transplant

Which of the following is a malignant disorder of mature antibody-secreting B lymphocytes or plasma cells?

a. Multiple myeloma

b. Hairy cell leukemia

c. ALL

d. CML

a. Multiple myeloma

Which disease has the presence of Reed-Sternberg cells?

a. B-cell lymphoma

b. NK-cell lymphoma

c. Hodgkin lymphoma

d. T-cell lymphoma

c. Hodgkin lymphoma

Which of the following assists in the diagnosis of multiple myeloma?

a. Elevated liver enzymes

b. Bence Jones proteins

c. Hyperkalmia

d. Erythrocytosis

b. Bence Jones proteins

What statement is true regarding HIV-1?

a. It is a causative agent in the US

b. It produces a milder form of the disease

c. It is most commonly found in West Africa

d. The latency period is longer than HIV-2

a. It is a causative agent in the US

What is the result of increased hydrostatic pressure in blood vessels?

a. Increased levels of albumin

b. Fluid movement into interstitial space

c. Vasoconstriction

d. Hypertension

b. Fluid movement into interstitial space

Which is a manifestation of left heart failure?

a. Peripheral edema

b. Increased exercise tolerance

c. Pulmonary edema

d. Paroxysmal nocturnal dyspnea (PND)

c. Pulmonary edema

A patient develops compartment syndrome. Which of the following are expected manifestations? (select all that apply)

a. Pain

b. Paresthesia

c. Rubor

d. Ischemia

e. Inflammation

f. Coolness

g. Edema

a. Pain

b. Paresthesia

d. Ischemia

f. Coolness

Which are manifestations of increased intracranial pressure (ICP)?

a. Intense thirst

b. Projectile vomiting

c. Pinpoint pupils

d. Altered mental status

e. Decerbrate positioning

f. Bradycaridia

g. Hypotension

b. Projectile vomiting

d. Altered mental status

e. Decerebrate positioning

f. Bradycardia

Which of the following is true about chronic airway disease?

a. Chronic obstructive pulmonary disease (COPD) is characterized by progressive increase in ciliary function

b. Asthmatic attacks produce edema and increased mucus

c. COPD produces reversible constriction of airways

d. Asthma results in hyperinflation of alveoli

b. Asthmatic attacks produce edema and increased edema

Which hormone is elevated in early pregnancy, and is detected by pregnancy screening tests?

a. Estrogen

b. Follicle stimulating hormone

c. Beta chorionic gonadotropin

d. Prolactin

c. Beta chorionic gonadotropin

A patient with peripheral artery disease experiences intermittent pain with walking. What is the mechanism responsible?

a. Vein engorgement resulting in tissue compression

b.. Hyperglycemic damage to arterioles, resulting in intimal destruction

c. Arteriole occlusion results in ischemia to muscles

d. Thromboembolism in capillaries causes inflammation of blockage of blood drainage from legs

c. Arteriole occlusion results in ischemia to muscles