UNE Pathophysiology Midterm Questions And Answers

UNE Pathophysiology Midterm Questions And Answers While caring for a pregnant patient, the nurse realizes that the hypertrophy of the uterus myometrium is called: A. pathologic hypertrophy B. Physiology hypertrophy C. Stretch hypertrophy D. Trophic Hypertrophy - ANS B. physiologic hypertrophy Which statement ending would be FALSE regarding adaptive changes of cells? Cells can adapt to changes in the environment by: A. atrophy B. hypertrophy C. hyperplasia D. catabolism - ANS D. catabolism The _______ phase of the cell cycle is when DNA replication takes place A. M phase B. G1 phase C. G2 phase D. S phase - ANS D. S phase GTP-binding proteins (G proteins) function to A. activate receptors on the extracellular surface B. activate intracellular enzyme systems C. degrade second-messenger molecues D. synthesize ATP - ANS B. activate intracellular enzyme systems The lipid bilayer of the plasma membrane has low permeability to charge and polar molecules A. true B. False - ANS A. true Which of the following reactions would occur in the body spontaneously without energy input (ATP)? A. translation B. trascription C. calcium extrusion from the cell D. potassium exiting the cell - ANS D. potassium exiting the cell Glycolysis is the metabolic process of breaking down a glucose molecule to form A. 34 ATP B. CO2 and H2O C. oxygen and ATP D. 2 ATP and 2 pyruvate - ANS D. 2 ATP and 2 pyruvate Diffusion and osmosis occur passively A. true B. false - ANS A. true The energy derived from the transport of electrons along the electron transport chain on the inner mitochondrial membrane is used to A. synthesize ATP B. produce NADH C. reduce oxygen to water D. oxidize NADH - ANS A. synthesize ATP Cells respond to environmental stress A. true B. false - ANS A. True Plasma oncotic (colloid osmotic) pressure is maintained by the quantity of plasma A. lipids B. sodium C. proteins D. glucose - ANS C. proteins Edema is the accumulation of fluid in the A. interstitial spaces B. intracellular spaces C. intercapillary spaces D. intravascular spaces - ANS A. interstitial space Which patient should the nurse assess first for isotonic fluid excess? A patient with: A. hyper-secretion of aldosterone B. multiple wound drainage sites C. excessive sweating D. decreased fluid intake - ANS A. hypersecretion of aldosterone Osmosis describes the movenment of A. water B. all molecules C. glucose D. sodium - ANS A. water While reviewing arterial blood gas results, a nurse finds that the patient has a high bicarbonate level. Which condition would be expected to be documented on the patients chart? A. acidosis B. hypomagnesemia C. alkalosis D. hyperkalemia - ANS C. Alkalosis A nurse is checking EKG results and notices a tall T wave. What does the nurse suspects the patient is experiencing? A. hypokalemia B. Hpyonatremia C. Hypernatremia D. Hyperkalemia - ANS D. Hyperkalemia A nurse is planning care for patients with potassium disorders. Which assessment is priority for these patients? A. vision B. cardiac C. Skin D. gastrointestinal - ANS B. Cardiac Which of the following electrolytes is found in the highest concentration in the intracellular fluid (ICF) A. calcium B. Chlorine C. sodium D. potassium - ANS D. potassium The largest fluid compartment in the body is A. intersitial B. intravascular C. peritoneal D. intracellular - ANS D. intracellular A patient asks what aldosterone does. How should the nurse respond? Aldosterone: A. promotes sodium and water excretion B. promotes potassium and water retention C. promotes sodium and water retention D. promotes potassium and water excretion - ANS C. promotes sodium and water retention How do cytotoxic T cells destroy infected cells? A. by stimulating B cell receptor complex B. by activating the kinin system C. by producing antibodies D. by directly killing infected or malignant cells - ANS D. by directly killing infected or malignant cells Which statement is true of adaptive immunity? A. helper T cells are involved in only cell-mediated immunity B. antibodies are the primary cells in cell-mediated immunity C. T cells are ultimately responsible for humoral immunity D. Both humoral and cell mediated immunity develop memory cells - ANS D. both humoral and cell mediated immunity develop memory cells What is one of the purposes of inflammation? A. encourages infection B. concentrate toxins C. prepares an injured area for healing D. inhibits adaptive immune response - ANS C. prepares an injured area for healing During inflammation, which of the following would be acting as phagocytic cells? A. histamine and interferons B. neutrophils and macrophages C. interleukins and cytokines D. platelets and leukocytes - ANS B. neutrophils and macrophages Which of the following cells produce antibodies during and immune reaction? A. plasma cells B. macrophages C. T cells D. mast cells - ANS A. plasma cells Which statement best describes antibodies? A. antibodies can stimulate vasodilation and vasopermeability during inflammation B. antibodies can neutralize, agglutinate, or precipitate infectious organisms or their toxins C. antibodies are ultimately responsible for cell-mediated immunity D. antibodies are another name for natural killer cells that circulate in the body - ANS B. antibodies can neutralize, agglutinate, or precipitate infectious organisms or their toxins A patient has inflammation. What assessment findings should the nurse observe? A. coughing, sneezing, vomiting B. redness, heat, swelling C. pain, cyanosis, wheezing D. jaundice, constipation, vasodilating - ANS B. redness, heat, swelling Prostoglandins cause: A. pain B. clotting C. platelet activation D. mannose release - ANS A. pain One of the functions of the complement system is: A. histamine chemotaxis B. leukocyte degranulation C. opsonization D. cell regeneration - ANS C. opsonization Macrophages and dendritic cells are what type of cells? A. antigen-presenting cells B. antibody cells C. antigen cells D. maturation cells - ANS A. antigen-presenting cells A patient is experiencing an allergic reaction. Which principle should the nurse remember? When mast cells degranulate, the release: A. toxins B. bradykinin C. antibodies D. histamine - ANS D. histamine A patient has poison ivy. Which type of reaction did this patient experience? A. type II B. Type III C. Type I D. type IV - ANS D. Type IV Which disorder might be expected in a patient with immunodeficiency? A. allergy B. alloimmunity c. AIDS d. Autoimmunity - ANS C. AIDS A nurse is describing the allergic response. Which information should the nurse include? After degranulation, the mast cells release histamine that performs the function of: A. dehydration and opsonization of bacteria B. vasodilation and increased vascular permeability C. decreased gastric secretions and attraction of viruses D. bronchodilation - ANS B. vasodilation and increased vascular permeability A patient is experiencing an allergic reaction. When the nurse assesses the skin, fluid-filled blisters surrounded by redness (hives) are noted. Which medical term should the nurse use to describe this finding? A. erythema B. anaphylaxis C. uticaria D. pruritus - ANS C. uticaria A patient undergoes a kidney transplant. The patient starts to reject the new kidney. Which type of reaction is the patient experiencing? A. antibody b. allergy c. alloimmune d. autoimmune - ANS C. alloimmune A healthcare provider is discussing the human immunodeficieny virus (HIV) and how is attacks the body. Which answer below correctly completes the following statement? HIV attaches to CD4 receptors found on: A. viruses B. cytotoxic T cells C. helper T cells D. plasma cells - ANS C. Helper T cells Which of the following patients would have a transfusion reaction? A. a patient with type AB receiving blood from a person with type B B. a patient with type A receiving blood from a person with type O C. A patient with type B receiving blood from a person with type B D. A patient with type O receiving blood from a person with type AB - ANS D. a person with type O receiving blood from a person with type AB A patient has systemic lupus erythematosus. This condition would be classified as an ____________ disease. A. autoimmune B. Antitoxin c. allergen d. alloimmune - ANS A. autoimmune A patient has a phagocyte deficiency. Which of the following cells would be affected? A. basophils B. mast cells C. Helper T cells D. macrophages - ANS D. macrophages The P53 gene is best describes as having which function? A. tumor suppresor B. growth stimulator C. Oncogene D. Mutagen - ANS A. tumor suppressor Which cancer would be expected in a patient who has chronic infection by the Human Papilloma virus (HPV) A. lung B. cervical C. Gastric D. liver - ANS B. Cervical A patient has cancer involving epithelial tissue. Which diagnosis would be documented on the patients chart? A. carcinoma B. sarcoma C. lymphoma D. leukemia - ANS A. carcinoma A patient with mutations in the BRCA1 and BRCA2 genes would be expected to develop which type of cancer? A. stomach B. cervical C. breast D. liver - ANS C. breast Cancer cells stimulate new blood vessel growth by releasing: A. angiogenic factors B. telomerase C. autocrine growth factors D. lysosomal enzymes - ANS A. angiogenic factors Which statement is best at defining an oncogene? A. oncogenes stimulate cancer cell growth B. oncogenes activate P53 C. oncogenes suppress cancer proliferation D. oncogenes cause loss of heterozygosity - ANS A. oncogenes stimulate cell growth Which statement correctly describes immortality in cancer cells? A. activation of DNA methylation protects cancer cells from dying B. Activation of oncogenes encourages long lives of cancer cells C. Activation of caretaker genes maintains cancer cell proliferation D. Activation of telomerase allows cancer cells to continue dividing - ANS D. activation of telomerase allows cancer cells to continue dividing Benign Tumors: A. are referred to as cancer B. are usually encapsulated C. metastasize to distant sites D. will travel to lymph nodes - ANS B. are usually encapsulated An oncologist is using the TNM system to stage a patients cancer. The M part of the system stand for: A. Metastasis B. Mammogram C. Mutagen D. MicroRNA - ANS A. metastasis The most common routes of metastasis are through the lymphatic system and: A. lungs B. body cavities C. blood vessels D. connective tissue - ANS C. blood vessels The primary aim of burn wound management is to: A. prevent microbial colonization of the wound B. prevent trauma to burned tissue C. keep the wound dru D. prevent premature wound closure - ANS A. prevent microbial colonization of the wound Most of the manifestations of burn shock can be attributed to: A. decrease capillary permeability B. hypovolemia C. infection D. Cardiac depression - ANS B. hypovolemia Which of the following burns is most painful? A. deep partial thickness B. Third degree C. superficial partial thickness D. first degree - ANS C. superficial partial thickness The first priority in rescuing a burning individual is A. removing his or her clothing B. establishing a patent airway C. eliminating the source of the burn D. covering the wounds - ANS C. eliminating the source of the burn A diet that has which of the following would increase cancer risk? A. fruits and vegetables B. grilled blackened meats C. high fiber content D. whole grains and nuts - ANS B. grilled blackened meats Which of the following cancers is considered to be the most malignant? A. melanoma B. squamous cell carcinoma C. hyperkeratosis D. basal cell carcinoma - ANS A. melanoma Which of the following patients would be at greatest risk of basal cell carcinoma? A. dark complexion, light eyes, underweight B. light complexion, dark eyes, overweight C. medium complexion, light eyes, smoker D. light complexion, light eyes, fair hair - ANS D. light complexion, light eyes, fair hair Proto-oncogenes A. are normal cellular genes that promote growth B. always code for viral proteins C. are the same as oncogenes D. result from sever mutational events - ANS A. are normal cellular genes that promote growth A 28-year-old male is admitted to the burn unit 2 hours after receiving second- and third-degree burns over 50% of his body surface in an industrial explosion. Abnormal vital signs include low blood pressure and tachycardia. Lab results show a high hematocrit due to: A. renal failure B. fluid movement out of the vascular space C. increased vascular protein secondary to increased metabolism D. sickle cell syndrome - ANS B. fluid movement out of the vascular space An oncologist is describing the process of gene silencing. Which process will the oncologist discuss UNE Pathophysiology Midterm A. gene anaplasia B. mutagen amplification C. chromosome translocation D. DNA methylation - ANS D. DNA methylation Ligand - ANS a signalling molecule specific to a receptor Contact Dependent communication - ANS cell interacting with receptor of target cell Paracrine and Apocrine communication - ANS involve release of a chemical in close proximity to a target cell Example of paracrine communication - ANS nitric oxide release from endothelial cells causing vasodilation Example of Autocrine communication - ANS release of estrogen from follicular cells Hormonal - ANS release of chemical signals from glandular cells transported to target cell through circulation system Neurohormone - ANS chemical signals released from nervecells rather than a gland Example of neurohormones - ANS release of ATP from the pituitary gland Neurotransmitter - ANS release of neurotransmitter through a synapse to a target receptor cell Membrane functions - ANS barrier structure organize transport across the barrier signal transduction Signal Transduction - ANS proteins serve as receptors, transporters, enzymes, surface markers, CAMs Receptors - ANS 1. Ligand binds to an intergral protein 2. Ligand bind to a receptor on an ion channel resulting in opening or closing of a channel 3. Ligand binds to receptor Receptor Modulation - ANS ability to dine tune signals in cells Metabolism - ANS how cells utilize energy to do work Energy - ANS capacity to do work -cannot be destroyed -can be transformed Anabolism - ANS building reaction where we take small molecule and construct macromolecules - ATP is used Example of anabolism - ANS amino acids made into proteins Catabolism - ANS Break down reactions -energy released as ATP Cellular Respiration - ANS combustion of glucose in the presence of oxygen CO2 & H2O & energy What is ATP made out of? - ANS ADP + Pi + energy Oxidation - ANS removal of energy rich elevtrons Three Phases of Catabolism - ANS 1. Digestion 2. Glycolysis and oxidation 3. Citric Acid Cycle Phase 1 - Digestion - ANS large molecules are broken down into smaller subunits: proteins into amino acids, polysaccharides into simple sugars, ad fats into fatty acids and glycerol. These processes occur outside the cell and are activated by secreted enzymes Phase 2 - Glycolysis and Oxidation - ANS the most important part of phase 2 is glycolysis, the splitting of glucose. Glycolysis produces 2 molecules of ATP per glucose molecule through oxidation, or the removal and transfer of a pair of electrons. the total process is called oxidative cellular metabolism and involves ten biochemical reactions. Phase 3 - Citric Acid Cycle - ANS most of the ATP is generated during this final phase, which begins with the citric acid cycle and ends with oxidative phosphorylation. About 2/3 of the total oxidation of carbon compounds in most cells is accomplished during this phase. The major end products are carbon dioxide and 2 dinucleotides - reduced nicotinamide adenine dinucleotide (NADH) and the reduced form of flavin adenine dinucleotide (FADH2) - both of which transfer their electrons into the electron-transport chain Phase 1 - ANS extracellular digestion of large marcomolecules to simple subunits Phase 2 - ANS intracellular breakdown of subunits to acetyl CoA accompanied by production of limited ATP and NADH Phase 3 - ANS Production of NADH yeilding ATP via electron transport; waste products (H2O, CO2, NH3, and urea) are excreted Where does glycolysis occur - ANS in the cytoplasm (anaerobic) Where does the Citric Acid Cycle occur? - ANS in the mitochondria (aerobic) Where does the electron transport chain occur? - ANS in the mitochondria (aerobic) ATP is responsible for - ANS -cellular transport -muscle contraction -enzyme reactions Proliferation - ANS process which cells divide Phases of Mitosis - ANS - interphase - prophase -metaphase -anaphase -telophase Check Points of Cell proliferation - ANS -G1 -S -G2 -M G1 (Gap 1) - ANS preparing to undergo DNA replication - the period between the M phase and the start of DNA synthesis S (synthesis) - ANS DNA replication - DNA is synthesized in the Nucleus G2 (Gap 2) - ANS prepare for mitosis and cytokenesis - RNA and protein synthesis occur, the period between the completin of DNA synthesis and the M phase M - ANS Mitosis - includes both nuclear and cytoplasmic division Cyclins - ANS molecules that gradulaly accumulate during cell cycle, bind to and activate CDK CDK - ANS Cyclin Dependent Kinase - ability to phosphorilate proteins to activate them Normal Cells - ANS can adapt to stress from function in a normal way. if the cell doesn't adapt cellular injury can occur. Atrophy - ANS cell number is normal, size is smaller Hypertrophy - ANS same number of cells, large in size Hyperplasia - ANS more cells than began with Ischemia - ANS loss of blood flow Anoxia - ANS lack of oxygen - without oxygen there is a lack of metabolism and use of ATP Necrosis - ANS uncontrolled cell death Apoptosis - ANS programmed cell death Reprofusion Injury - ANS thrombus leading to anoxia and ischemia, cells swell and function is impaired. Can be fixed with surgery. Cells have generated free radicals which can lead to necrosis Cell Death - ANS happens with irreversible cell injury -Necrosis -apoptosis Erythropoietin A. is secreted by the kidney B. production is stimulated by hypoxia C. is released by the kidney to stimulate platelet formation D. both a and b are correct - ANS D. both a and b are correct Hemostasis involves all of the following except: A. prostacyclin I B. vasoconstriction C. intrinsic pathways D. platelet plug formation - ANS A. prostocyclin I In macrocytic-normochromic anemia A. erythrocytes become sickled when oxygen levels are low B. erythrocytes are abnormally small but have normal hemoglobin C. erythrocytes are enlarged D. erythrocytes have low levels of hemoglobin due to iron deficiency - ANS C. erythocytes are enlarged Hypoxemia causes A. arterioles, capillaries and venules to dilate B. the heart to contract more forcefully C. the rate and depth of breathing to increase D. all of the above are correct - ANS D. all of the above are correct The key protein that polymerizes during clot formation is A. factor X B.fibrin C. thrombin D. plasmin - ANS B. Fibrin Which principle should be used to guide nursing care of a patient with disseminated intravascular coagulation (DIC) A. an abnormal antibody, called the M protein, becomes the most prominent blood protein B. a unique mediastinal mass causes dyspnea and chest pain C. an onvercrowding of the bone marrow from uncontrolled proliferation of leukocytes causes infection D. tissue ischemia, clotting and significant hemorrhage occur - ANS D. tissue ischemia, clotting and significant hemorrhage occur Excess clotting occurs with A. hemophilia B. thrombocythemia C. thrombocytopenia D. all of the above are correct - ANS B. thrombocythemia Anemia refers to a deficiency of A. erythrocytes B. platelets C. hemoglobin D. both a and c are correct - ANS D. both a and c are correct Heme is an iron-containing moiety found in A. thrombocytes B. basophils C. erythrocytes D. eosinophils - ANS C. erythrocytes Maternal-fetal blood incompatibility may exist in which condition? A. Rh negative mother, Rh positive fetus B. Rh positive mother, Rh negative fetus C. Rh positive father, Rh negative mother D. Rh negative father, positive mother - ANS Rh negative mother, Rh positive fetus Acidosis - ANS a systemic increase in hydrogen ion concentration or a loss of base. Alkalosis - ANS a systemic decrease in hydrogen ion concentration or an excess of base Metabolic Acidosis - ANS concentration of non-carbonic acids increase or bicarbonate is lost from extracellular fluid or cannot be regenerated by kidneys. Metabolic Alkalosis - ANS excessive loss of metabolic acids occurs, bicarbonate concentration increases. can be caused by vomitting Respiratory Acidosis - ANS occurs when there is alveolar hypoventilation resulting in an excess of carbon dioxide in the blood. Respiratory Alkalosis - ANS occurs when there is alveolar hyperventilation Innate Immunity - ANS natural or native immunity, includes natural barriers and inflammation - the second line of defense First Line of Defense - ANS Physical Barriers Mechanical Barriers Biochemical Barriers Physical Barriers - ANS the external covering of the body Mechanical Barriers - ANS mucous, sweat, saliva, tears, and earwax Biochemical barriers - ANS the normal flora of the gut and vagina Second Line of Defense - ANS Inflammation Inflammation - ANS programmed to respond to cellular or tissue damage The inflammatory Response - ANS 1. occurs in tissues with a blood supple 2. is activated rapidly within seconds after damage occurs 3. depends on the activity of both cellular and chemical components 4. nonspecific, meaning that it takes place in approximately the same way regardless of the type of stimulus or whether exposure to the same stimulus has occurred in the past Cytokines - ANS constitute a large family of small molecular weight soluble intracellular signalling molecules that are secreted, bind to specific cell membrane receptors and regulate innate or adaptive immunity Chemokines - ANS members of a special family of cytokines that are chemotactic and primarily attract leukocytes to sites of inflammation Interleukins - ANS are produced predominantly by macrophages and lymphocytes in response to stimulation of PRRs or by other cytokines Tumor Necrosis Factor - ANS secreted by macrophages and other cells in response to stimulation of TLRs Interferons - ANS members of a family of cytokines that protect against viral infections and modulate the inflammatory response