NURSING 6501ADVANCED PATHOPHYSIOLOGY MIDTERM- SPRING 2020
Question 1
When endothelial cells are injured, what alteration contributes to atherosclerosis?
Selected Answer:
The release of toxic oxyg
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NURSING 6501ADVANCED PATHOPHYSIOLOGY MIDTERM- SPRING 2020
Question 1
When endothelial cells are injured, what alteration contributes to atherosclerosis?
Selected Answer:
The release of toxic oxygen radicals that oxidize low-density lipoproteins (LDLs)
A patient has been diagnosed with an empyema. What does the healthcare professional tell the patient about this condition?
Selected Answer:
We will have to drain the pus out of your pleural space.
A patient has been admitted for a possible small intestinal obstruction. What is the first sign the healthcare professional assesses for that would indicate the presence of this condition?
Selected Answer:
Vomitin g
Autocrine stimulation is the ability of cancer cells to do what?
Selected Answer:
Secrete growth factors that stimulate their own growth
A patient had a myocardial infarction that damaged the SA node, which is no longer functioning as the pacemaker of the heart. What heart rate would the healthcare
provider expect the patient to have?
Selected Answer:
40 to 60 beats/min
Which type of immunity is produced by an individual after either natural exposure to the antigen or after immunization against the antigen?
Selected Answer:
Active-acquired immunity
In teaching a women's community group, which risk factor does the healthcare professional teach is related to high morbidity of cancer of the colon, uterus, and kidney?
Selected Answer:
Women who have a high body mass index
A student asks the healthcare professional to describe exotoxins. Which statement by the professional is best?
Selected Answer:
Exotoxins are released during the lysis of bacteria.
A student studying biology asks the professor to describe how the ras gene is involved in cancer proliferation. What explanation by the professor is best?
Selected Answer:
A mutation in this gene allows continuous cell growth.
A healthcare professional cares for older adults in a skilled nursing facility. What should the professional assess for in these individuals related to cardiovascular functioning?
Selected Answer:
Increased rate of falling and dizzy spells
A healthcare professional is educating a patient on asthma. The professional tells the patient that the most successful treatment for chronic asthma begins with which action?
Selected Answer:
Avoidance of the causative agent
A healthcare professional is conducting community education on vaccinations. Which statement about vaccines does the professional include in the presentation?
Selected Answer:
Most bacterial vaccines contain attenuated organisms.
Renal failure is the most common cause of which type of hyperparathyroidism?
Selected Answer:
Seconda ry
Which renal change is found in older adults?
Selected Answer:
Decrease in the number of nephrons
What is the single most common cause of cellular injury?
Selected Answer:
Hypoxic injury
What organic compound facilitates transportation across cell membranes by acting as receptors, transport channels for electrolytes, and enzymes to drive active pumps?
Selected Answer:
Protein s
In regulating vascular mediators released from mast cells, the role of eosinophils is to release what?
Selected Answer:
Histaminase, which limits the effects of histamine during acute inflammation
A patient in the clinic reports projectile vomiting without nausea or other gastrointestinal symptoms. What action by the healthcare professional is most appropriate?
Selected Answer:
Administer intravenous hydration.
What does vomiting-induced metabolic alkalosis cause?
Selected Answer:
Retention of bicarbonate to maintain the anion balance
A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500 mg/dL; positive urine glucose and ketones; serum potassium (K +) 2 mEq/L; serum sodium (Na +) 130 mEq/L. The patient reports that he has been sick with the flu for 1 week. What relationship do these values have to his insulin deficiency?
Selected Answer:
Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis.
A student asks the professor how a faulty negative-feedback mechanism results in a hormonal imbalance. What response by the professor is best?
Selected Answer:
Decreased hormonal secretion is a response to rising hormone levels.
The acute inflammatory response is characterized by fever that is produced by the hypothalamus being affected by what?
Selected Answer:
Endogenous pyrogens
A student asks the professor to differentiate Type 2 diabetes mellitus from Type 1. The professors' response would be that Type 2 is best described as what?
Selected Answer:
Resistance to insulin by insulin-sensitive tissues
A student asks about the mechanism that results in type II hypersensitivity reactions. What description by the professor is best?
Selected Answer:
Cytotoxic T lymphocytes or lymphokine-producing helper T 1 cells directly attack and destroy cellular targets.
A healthcare professional is educating a patient about asthma. The professional states that good control is necessary due to which pathophysiologic process?
Selected Answer:
Uncontrolled inflammation leads to increased bronchial hyperresponsiveness and eventual scarring.
What is the role of the normal intestinal bacterial flora?
Selected Answer:
Facilitating the motility of the colon
An amniocentesis indicates a neural tube defect when an increase in which protein is evident?
Selected Answer:
Alpha fetoprotein
Oxygenated blood flows through which vessel?
Selected Answer:
Pulmonary artery
A patient is having an IgE-mediated hypersensitivity reaction. What action by the healthcare professional is best?
Selected Answer:
Give the patient an antihistamine.
Which normal physiologic change occurs in the aging pulmonary system?
Selected Answer:
Stiffening of the chest wall
A patient's chart indicates Kussmaul respirations. The student asks the healthcare professional what this is caused by. What response by the professional is most accurate?
Selected Answer:
A compensatory measure is needed to correct metabolic acidosis.
A patient asks the healthcare professional why tissue damage occurs in acute rejection after organ transplantation. What response by the professional is best?
Selected Answer:
Th1 cells release cytokines that activate infiltrating macrophages, and cytotoxic T cells directly attack the endothelial cells of the transplanted tissue.
A patient asks the healthcare professional to describe the cause of gastroesophageal reflux disease (GERD). What response by the professional is best?
Selected Answer:
Presence of Helicobacter pylori in the esophagus
What is the inflammatory effect of nitric oxide (NO)?
Selected Answer:
Decreases mast cell function, and decreases platelet aggregation
A healthcare professional is caring for a patient undergoing chemotherapy. What is the skin-related health risk the professional should assess the patient for and be prepared to treat?
Selected Answer:
Infectio n
Which chamber of the heart endures the highest pressures?
Selected Answer:
Left ventricle
A healthcare professional is caring for a patient who has continuous increases in left ventricular filing pressures. What disorder would the professional assess the patient for?
Selected Answer:
Pulmonary edema
A healthcare professional is assessing a child whose parents report poor grades in school, trouble paying attention, and naughty behaviors that have become so frequent the child is always in trouble. For which health condition should the professional facilitate testing?
Selected Answer:
Hypoxic injury
It has been determined that a patient's tumor is in stage 2. How does the healthcare professional describe this finding to the patient?
Selected Answer:
Cancer is locally invasive.
A professor has taught the students about the pathogenesis of abdominal pain. Which statement by a student indicates the professor needs to review the material?
Selected Answer:
Low concentrations of anaerobes, such
as Streptococci, Lactobacilli, Staphylococci, Enterobacteria, and Bacteroides, produce abdominal pain.
A patient has a peptic ulcer related to h. pylori bacteria. What treatment does the healthcare professional educate the patient on?
Selected Answer:
Antibiotic therapy
What effect is a result of inhibiting the parasympathetic nervous system with a drug such as atropine?
Selected Answer:
Salivation decreases.
A student is preparing to irrigate a patient's wound and gathers supplies, including hydrogen peroxide. What response by the health care professional is best?
Selected Answer:
Tell the student to get some normal saline instead.
Which cardiac chambers have the thinnest wall and why?
Selected Answer:
The right and left atria; they are low-pressure chambers that serve as storage units and conduits for blood.
Free radicals play a major role in the initiation and progression of which diseases?
Selected Answer:
Cardiovascular diseases such as hypertension and ischemic heart disease
A student asks why carbon monoxide causes tissue damage. What response by the professor is best?
Selected Answer:
Binds to hemoglobin so that it cannot carry oxygen
The glomerular filtration rate is directly related to which factor?
Selected Answer:
Perfusion pressure in the glomerular capillaries
What is one function of the tumor cell marker?
Selected Answer:
To screen individuals at high risk for cancer
A patient has a pulmonary capillary wedge pressure of 30mmHg. What assessment finding by the healthcare professional would be most consistent with this reading?
Selected Answer:
Pink, frothy sputum
A patient is in severe shock and is receiving vasopressin. A student asks the health care professional to explain the rationale for this treatment. What response by the professional is most accurate?
Selected Answer:
Antidiuretic hormone causes vasoconstriction to help increase blood pressure.
What are blood pressure variations associated with?
Selected Answer:
The renin-angiotensin system's effect on vasoconstriction
A person wants to know if eating only plant-based foods is advisable as a way to cut cholesterol to near-zero levels. What response by the health care professional is best?
Selected Answer:
No, many hormones are made from cholesterol.
A student asks why some vaccinations are given orally and some are given by injection. What response by the professor is best?
Selected Answer:
Different routes allow the speed of onset of the antigen to be varied, with the intravenous route being the fastest.
A healthcare professional is working with a person who drinks several 6-packs of beer a week. What testing does the professional encourage the person to get?
Selected Answer:
Hepatic function
Within a physiologic range, what does an increase in left ventricular end-diastolic volume (preload) result in?
Selected Answer:
Increase in afterload
People diagnosed with neurofibromatosis have varying degrees of the condition because of which genetic principle?
Selected Answer:
Expressivi ty
The data reporting that sickle cell disease affects approximately 1 in 600 American blacks is an example of which concept?
Selected Answer:
Rati o
A person has hypothyroidism. What chemical does the healthcare professional advise the person to include in the diet?
Selected Answer:
Iodin e
A patient has been diagnosed with a renal stone. Based on knowledge of common stone types, what self-care measure does the healthcare professional plan to teach the patient when stone analysis has returned?
Selected Answer:
Increase water intake.
A professor has taught a student about skeletal alterations seen in chronic kidney disease. Which statement by the student indicates the professor needs to give more information?
Selected Answer:
The effectiveness of calcium and phosphate resorption from bone is impaired.
What pathologic change occurs to the kidney's glomeruli as a result of hypertension?
Selected Answer:
Ischemia of the tubule
A professor has taught the students about the sources of increased ammonia in patients with hepatic encephalopathy. What statement by a student indicates the professor should review this material?
Selected Answer:
Ammonia-forming bacteria in the colon are sources of increased ammonia.
What physical sign does the healthcare professional relate to the result of turbulent blood flow through a vessel?
Selected Answer:
Murmur heard on auscultation
A student asks the professor how a faulty negative-feedback mechanism results in a hormonal imbalance. What response by the professor is best?
Selected Excessive hormone production results from a failure to turn
Answer: off the system.
A class of students has learned about contributing factors to duodenal ulcers. What statement indicates to the professor that the students need a review?
Selected Answer:
Gastric emptying is slowed, causing greater exposure of the mucosa to acid.
The action of platelet-derived growth factor is to stimulate the production of which cells?
Selected Answer:
Fibroblast cells
What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?
Selected Answer:
Macula densa
A patient has been diagnosed with primary emphysema but claims there is no history of smoking. What action by the healthcare professional is most appropriate?
Selected Answer:
Get baseline arterial blood gasses.
The student asks the professor to explain what characteristic is demonstrated by lungs with decreased compliance?
Selected Answer:
Inability to diffuse oxygen
The student wants information about a patient's renal function. What test does the healthcare professional tell the student to evaluate?
Selected Answer:
Serum blood urea nitrogen and creatinine
Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct?
Selected Answer:
Antidiuretic hormone
When comparing the clinical manifestations of both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS), which condition is associated with only DKA?
Selected Answer:
Kussmaul respirations
A patient had a thyroidectomy and now reports tingling around the mouth and has a positive Chvostek sign. What laboratory finding would be most helpful to the healthcare professional?
Selected Answer:
Serum calcium
A parent wants to know how to prevent type 1 diabetes in the newborn. The healthcare professional explains that prevention is not possible, because which of these is a major characteristic of type 1 diabetes mellitus?
Selected Answer:
An autoimmune cause factor
A student asks the healthcare professional to explain the function of the papillary muscles. What response by the professional is best?
Selected Answer:
The papillary muscles open the semilunar valves.
The Bainbridge reflex is thought to be initiated by sensory neurons in which cardiac location?
Selected Answer:
Atri a
A healthcare professional is caring for four patients. Which patient does the professional assess for neurogenic diabetes insipidus (DI)?
Selected Answer:
Anterior pituitary tumor
A patient suffered multiple traumatic injuries and received many blood transfusions within a few days of the injuries. For which medical condition should the healthcare professional monitor the patient for?
Selected Answer:
Hemosidero sis
A patient has portal hypertension-induced splenomegaly. Which lab value would the healthcare professional associate with this condition?
Selected Answer:
Low platelet count
A healthcare professional tells a student that a patient has lost atrial kick. What would the student expect to see when examining this patient?
Selected Answer:
Signs of decreased cardiac output
Which primary characteristic is unique for the immune response?
Selected Answer:
The response is innate, rather than acquired.
Why is leakage of lysosomal enzymes during chemical injuries significant?
Selected Answer:
Enzymatic digestion of the nucleus and nucleolus occurs, halting DNA synthesis.
A healthcare provider notes that tapping the patient's facial nerve leads to lip twitching. What electrolyte value is correlated with this finding?
Selected Answer:
Ca ++: 8.2
mg/dL
What are tumor cell markers?
Selected Answer:
Receptor sites on tumor cells that can be identified and marked
A Rh-negative woman gave birth to a Rh-positive baby. When discussing Rho[D] immunoglobulin with her, what information should the healthcare professional provide?
Selected Answer:
It prevents alloimmunity and hemolytic anemia of the newborn.
If a patient develops acidosis, the nurse would expect the oxyhemoglobin dissociation curve to react in which manner?
Selected Answer:
Shift to the right, causing more oxygen (O 2) to be released to the cells
What is the role of reverse transcriptase in HIV infection?
Selected Answer:
It converts RNA into double- stranded DNA.
During acidosis, the body compensates for the increase in serum hydrogen ions by shifting hydrogen ions into the cell in exchange for which electrolyte?
Selected Answer:
Oxyg en
A female patient has been diagnosed with an uncomplicated urinary tract infection. What self-care measure does the healthcare provider teach the patient that is specific to this type of infection?
Selected Answer:
After using the bathroom, wipe from front to back.
During the cardiac cycle, why do the aortic and pulmonic valves close after the ventricles relax?
Selected Answer:
Reduced pressure in the ventricles creates a negative pressure, which pulls the valves closed.
What is the blood type of a person who is heterozygous, having A and B alleles as codominant?
Selected A
Answer: B
Where is two thirds of the body's water found?
Selected Answer:
Intracellular fluid compartments
The student asks the professor why water and electrolytes are transported in both directions through tight junctions and intercellular spaces rather than across cell membranes. What response by the professor is best?
Selected Answer:
A balance of cations and ions among the electrolytes on each side of the cell membranes cannot be maintained.
A healthcare professional is assessing a child who has complete trisomy of the twenty- first chromosome. What findings does the professional relate to this condition?
Selected Answer:
An IQ of 25 to 70, low nasal bridge, protruding tongue, and flat, low-set ears
A patient had a motor vehicle crash and suffered critical injuries to the brainstem. What physiological responses would the healthcare professional expect to see?
Selected Answer:
Pulse and blood pressure changes
How do free radicals cause cell damage?
Selected Answer:
Giving up an electron, which causes injury to the chemical bonds of the cell membrane
What is the only surface inside the nephron where cells are covered with microvilli to increase the reabsorptive surface area called?
Selected Answer:
Proximal convoluted tubules
What causes the edema that occurs during the inflammatory process?
Selected Answer:
Emigration of neutrophils
After a partial gastrectomy, gastric bypass, or pyloroplasty, clinical manifestations that include increased pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which mechanism?
Selected Answer:
Rapid gastric emptying
A patient has a history of excessive use of magnesium-containing antacids and aluminum-containing antacids. What lab value does the healthcare professional correlate to this behavior?
Selected Answer:
Potassium 2.5 mEq/L
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