PATH 370 - Final Exam Practice Questions

The cellular response indicative of injury due to faulty metabolism is

Hydropic swelling

Lactate production

Metaplasia

Intracellular accumulations

intracellular accumulation

After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will

Selectively kill tumor cells

Stimulate immune cells to fight the cancer

Have minimal side effects

Kill rapidly dividing cells

kill rapidly dividing cells

All these cellular responses are potentially reversible except

Necrosis

Metaplasia

Atrophy

Hyperplasia

Necrosis

A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of

Primary prevention

Secondary prevention

Tertiary prevention

Disease treatment

primary prevention

Which is not normally secreted in response to stress?

Norepinephrine

Cortisol

Epinephrine

Insulin

insulin

A disease that is native to a particular region is called

Epidemic

Endemic

Pandemic

Ethnographic

Endemic

Cancer grading is based on

Tumor size

Local invasion

Cell differentiation

Metastasis

cell differentiation

Your patient is scheduled for a staging procedure. She wants to know what that means. The correct response is which of the following?

It is a procedure for determining the extent of tumor spread

It is a histologic examination of tissues to determine the degree of tumor differentiation

Is based on exploratory surgery

It is biochemical testing of tumor cells to determine the genetic basis of the tumor

It is a procedure for determining the extent of tumor spread

The stage during which the patient functions normally, although the disease processes are well established, is referred to as

Latent

Subclinical

Prodromal

Convalescence

subclinical

After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor

Is benign

Is malignant

Is secondary to cancer elsewhere in the body

Has spread

Is malignant

Tumor markers (Select all that apply.)

a. are found only in the blood.

b. are produced by normal cells.

c. help determine cancer origin.

d. help identify progression of cancer.

e. include prostatic-specific antigen.

ANS: B, C, D, E

Tumor markers are substances associated with tumor cells that may be helpful in identifying their tissue of origin and progression and proliferation of cancer cells. Most tumor markers are not very specific for cancer since normal cells in the tissue of origin also produce them. Tumor markers include prostatic-specific antigen. Some tumor cell markers are released into the circulation, but others must be identified through biopsy of metastatic tissue.

Deficits in immune system function occur in cancer as a result of (Select all that apply.)

a. chemotherapy.

b. cancer cells.

c. cancer metastasis to bone marrow.

d. immunotherapy.

e. malnutrition.

ANS: A, B, C, E

Cancer cells secrete substances that suppress the immune system. Bone marrow suppression may be because of invasion of blood-forming cells in the bone marrow, poor nutrition, and chemotherapeutic agents. By contrast, immunotherapy is a method of harnessing the immune system in the treatment of cancer.

The cellular change that is considered preneoplastic is

Anaplasia

Dysplasia

Metaplasia

Hyperplasia

dysplasia

Apoptosis is the process of

Atrophy

Death

Proliferation

Mutation

Death

After suffering a heart attack, a middle aged man is counseled to take a cholesterol lowering medication. This is an example of

Primary prevention

Secondary

Tertiary

Disease treatment

Tertiary prevention

Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by

Norepinephrine

Cortisol

Glucagon

ACTH

norepinephrine

Selye's three phases of the stress response include all of the following except

Allostasis

Resistance

Alarm

Exhaustion

Allostasis

Side effect of chemotherapy include (select all that apply)

Anemia

Nausea

Leukocytosis

Bleeding

Infection

Anemia

Nausea

Bleeding

Infection

A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium intake. This is an example of

Primary prevention

Secondary prevention

Tertiary prevention

Disease treatment

Secondary prevention

Necrotic death of brain tissue usually produces _____ necrosis.

Coagulative

Caseous

Liquefactive

Fat

Liquefactive

3 year old boy who exhibits prolonged bleeding after minor trauma and a prolonged aPTT, nut a normal platelet count, is likely to be diagnosed with

Hemophilia

Liver dysfunction

Disseminated intravascular coagulation

Thrombocytopenia

Hemophilia

Dysfunction of which organ would lead to clotting factor deficiency?

Liver

Kidney

Spleen

Pancreas

Liver

A low mean corpuscular hemoglobin concentration (MCHC) and mean corpuscular volume (MCV) are characteristic of which type of anemia?

Vitamin b12 deficiency

Folate deficiency

Iron deficiency

Erythropoietin deficiency

Iron deficiency

The principle Ig mediator of type 1 hypersensitivity reactions is

IgA

IgG

IgM

IgE

IgE

Most of the carbon dioxide in the blood is transported as

Carboxyhemoglobin

Bicarbonate ion

Dissolved carbon dioxide

Carbonic acid

Bicarbonate ion

The Philadelphia chromosome is a balanced chromosome translocation that forms a new gene called

Bcr-abl

Rob

p53

ARA-c

Bcr-abl

Which form of leukemia demonstrates the presence of the Philadelphia chromosome?

CML (chronic myeloid leukemia)

Risk factors for atherosclerosis include

Female gender

Hyperlipidemia

High protein diet

Low fiber diet

Hyperlipidemia

Regarding iron deficiency anemia, what laboratory features are typically decreased? (Select all that apply)

MCV

MCH

MCHC

WBC

Thrombocytes

MCV

MCH

MCHC

What is necessary for a red blood cell production

Phosphate

Iron

Magnesium

Calcium

Iron

A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction.

I

II

III

IV

III

The primary functions of the circulatory system are (select all that apply)

Transport oxygen

Transport nutrients

Remove metabolic waste

Reabsorb leaking fluid

Return leukocytes to the circulation

Transport oxygen

Transport nutrients

Remove metabolic waste

A patient is diagnosed with CML. The patient may experience which of these symptoms (select all that apply)

Fatigue

Weight loss

Abdominal discomfort

Joint pain

Sweats

Fatigue

Weight loss

Abdominal discomfort

Sweats

Which group of clinical findings describes the typical presentation of ALL (acute lymphoid leukemia)?

Pain in long bones, infection, fever, bruising

Vertebral fracture, hypercalcemia, bone pain

Elevated wbc count found on routine exam, asymptomatic

Painless enlarged cervical lymph node, fever, weight loss

Pain in long bones, infection, fever, bruising

Patients with immunodeficiency disorders are usually first identified because they

Run high fevers

Have unusually high wbc counts

Develop brain infections

Develop recurrent infections

develop recurrent infections

Widespread activation of the clotting cascade secondary to massive trauma is called

Hemophilia B

Disseminated intravascular coagulation (DIC)

Hageman disease

Idiopathic thrombocytopenia purpura

Disseminated intravascular coagulation (DIC)

What laboratory finding is usually found in aplastic anemia

Leukocytosis

Thrombocytopenia

Neutrophilia

Pancytopenia

Pancytopenia

The prothrombin time (PT) and INR (international normalized ratio) measures the integrity of

Platelet function

Extrinsic pathway

Intrinsic pathway

Fibrinolysis

Extrinsic pathway

Peripheral edema is a result of

Arterial insufficiency

Venous thrombosis

Hypertension

Atherosclerosis

Venous thrombosis

A cause of thrombocytopenia includes

Hypoxemia

Reduced erythropoietin

Chemotherapy

Secondary polycythemia

chemotherapy

Metaplasia is

replacement of one differentiated cell type with another

The cellular change that is considered preneoplastic is

dysplasia.

Which is not normally secreted in response to stress?

insulin

After bronchoscopy and histologic examination of a suspected tumor, your patient is diagnosed with primary bronchial carcinoma. Thus, the tumor

is malignant

Many of the responses to stress are attributed to activation of the sympathetic nervous system and are mediated by

norepinephrine

An increase in organ size and function due to increased workload is termed

hypertrophy

Tumor markers (Select all that apply.)

a. are found only in the blood.

b. are produced by normal cells.

c. help determine cancer origin.

d. help identify progression of cancer.

e. include prostatic-specific antigen.

B, C, D, E

Deficits in immune system function occur in cancer due to (Select all that apply.)

chemotherapy, cancer cells, cancer metastasis to bone marrow, and malnutrition

a patient with high blood pressure who is otherwise healthy is counseled to restrict sodium intake. This is an example of

secondary prevention

the cellular response indicative of injury due to faulty metabolism is

intracellular accumulations

Cancer grading is based on

cell differentiation

After surgery to remove a lung tumor, your patient is scheduled for chemotherapy, which will

kill rapidly dividing cells

selye's three phases of the stress response include all of the following except

allostasis

All these cellular responses are potentially reversible except

necrosis

Coagulative necrosis is caused by

interrupted blood supply

A 17-year-old college-bound student receives a vaccine against an organism that causes meningitis. This is an example of

primary prevention

Allostasis is best defined as

the overall process of adaptive change necessary to maintain survival and well-being

malignant neoplasms of epithelial origin are known as

carcinomas

a disease that is native to a particular region is called

endemic

The stage during which the patient functions normally, although the disease processes are well established, is referred to as

subclinical

A patient with fever, hypotension and lactic acidosis is most likely to be experiencing what type of shock?

Cardiogenic

Septic

Anaphylactic

Neurogenic

Septic

A patient experiences anaphylactic shock. The nurse expects to observe which signs and symptoms in the patient? (Select all that apply)

A. Stupor

B. Hypotension

C. Urticaria

D. Angioedema

E. Wheezing

B, C, E

Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?

Cardiogenic

Hypovolemic

Anaphylactic

Neurogenic

anaphylactic

Left sided heart failure is characterized by

Pulmonary congestion

Decreased systemic vascular resistance

Jugular vein distention

Peripheral edema

Pulmonary congestion

A patient presents to the emergency department with a diastolic blood pressure of 132 mm Hg, retinotherapy, and symptoms of an ischemic stroke. This symptomology is likely the result of

Arthrosclerosis

Angina

Myocardial infarction

Hypersensitive crisis

Hypersensitive crisis

Which blood pressure reading is considered to be indicative of pre hypertension according to the JNC-7 criteria

118/78

128/82

140/88

138/94

128/82

While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of low-density lipoproteins (LDLs). What is the significance of this finding?

Increased LDL levels are associated with increased risk of coronary artery disease

Measures to decrease LDL levels in the elderly would be unlikely to affect the progression of this disease

Increased LDL levels are indicative of moderate alcohol intake and patient should be advised to abstain

Elevated LDL levels are an expected finding in the elderly and therefore are not particularly significant

Increased LDL levels are associated with increased risk of coronary artery disease

A patient with forward effects of heart failure may present with which symptoms? (Select all that apply)

A. Impaired memory

B. Mental fatigue

C. Stupor

D. Confusion

E. Aggression

A, B, D

Sepsis has been recently redefined as

a. severe hypotension in an infected patient.

b. a systemic inflammatory response to infection.

c. a systemic infection with viable organisms in the bloodstream.

d. a systemic inflammatory response to ischemia.

B. A systemic inflammatory response to infection

Hypotension associated with neurogenic and anaphylactic shock is due to

Hypovolemia

Peripheral pooling of blood

Poor cardiac contractility

High afterload

Peripheral pooling of blood

Hypertension with a specific, identifiable cause is known as ____ hypertension

Primary

Orthostatic

Secondary

Malignant

Secondary

The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with

Perfumes

Incompatible blood products

Animal proteins or dander

Antibiotics

Antibiotics

Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of

Myocardial infarction

Cardiac tamponade

Congestive heart failure (CHF)

Cardiomyopathy

Cardiac tamponade

cor pulmonale refers to

Biventricular failure

Left ventricular hypertrophy secondary to lung disease

Right ventricular hypertrophy secondary to pulmonary hypertension

Right ventricular failure secondary to right ventricular infarction

Right ventricular hypertrophy secondary to pulmonary hypertension

After being diagnosed with hypertension, a patient returns to the clinic 6 weeks later. The patient reports "moderate" adherence to the recommended lifestyle changes and has experienced a decreased from 165/96 to 148/90 mm Hg in blood pressure. What is the most appropriate intervention for this patient at this time?

Continue lifestyle modifications only

Continue lifestyle modifications plus diuretic therapy

Continue lifestyle modifications olive ACE inhibitor therapy

Continue lifestyle modifications plus b-blocker therapy

Continue lifestyle modifications only

Acute coronary syndrome in the presence of thrombosis may present as (select all that apply)

Unstable angina

MI

Sudden cardiac arrest

Bleeding

Hypovolemia

Unstable angina

MI

sudden cardiac arrest

After sitting in a chair for an hour an elderly patient develops moderate lower extremity edema. His edema is most likely a consequence of

Arterial obstruction

Isolated left sided heart failure

Right sided heart failure

Peripheral vascular disease

right sided heart failure

Restriction of which electrolytes is recommended in the management of high blood pressure?

Calcium

Potassium

Sodium

Magnesium

Sodium

The common denominator in all forms of heart failure is

Poor diastolic filling

Reduced cardiac output

Pulmonary edema

Tissue ischemia

reduced cardiac output

Angiotensin-converting enzyme (ACE) inhibitors block the

Release of rennin

Conversion of angiotensin I to angiotensin II

Conversion of angiotensinogen to angiotensin I

Effect of aldosterone on the kidney

Conversion of angiotensin I to angiotensin II

which type of leukemia primarily affects children

ALL (acute lymphoid leukemia)

what laboratory finding is usually found in aplastic anemia?

pancytopenia

peripheral edema is a result of

venous thrombosis

Patients who experience anemic episodes when exposed to certain drugs most likely have

glucose-6-phosphate dehydrogenase deficiency

a normal bleeding time in association with normal platelet count, and increased prothrombin time (PT) and INR, is indicative of

Vitamin K deficiency

a serious complication of deep vein thrombosis is

pulmonary embolus

A diagnostic laboratory finding in myeloma is

Bence Jones proteins in the urine

red blood cells differ from other types in the body, because they

have no cytoplasmic organelles

the philadelphia chromosome is a balanced chromosome translocation that forms a new gene called

BCR-ABL

Which form of leukemia demonstrates the presence of the Philadelphia chromosome?

CML (chronic myeloid leukemia)

A commonly ingested substance associated with prolongation of the bleeding time is

aspirin

Activated partial thromboplastin time (aPTT) is a measure of integrity of

intrinsic pathway

autologous stem cell transplantation is a procedure in which

stem cells are harvested from the patient and then returned to the same patient

a 58-year-old woman is seen in the clinic for reports of severe back pain. Her chest x-ray demonstrates generalized bone demineralization and compression fracture. Blood studies demonstrate elevated calcium levels. This is most likely

Myeloma

A child with a history of recent strep throat infection develops glomerulonephritis. This is most likely a type _____ hypersensitivity reaction.

III

The cause of the most common form of anemia is

iron deficiency

Excessive red cell lysis can be detected by measuring the serum

bilirubin

Most of the carbon dioxide in the blood is transported as

bicarbonate ions

transfusion reactions involve RBC destruction caused by

recipient antibodies

pernicious anemia is caused by a lack of

intrinsic factor