Pathophysiology pre-test
A high school senior sustained a concussion during a football game. Which of the following
signs and symptoms would indicate the presence of postconcussion syndrome in the days and
weeks following his injury?
Select one:
a. Unilateral weakness and decreased coordination
b. Recurrent nosebleeds and hypersomnia
c. Neck pain and decreased neck range of motion
d. Headaches and memory lapses - ANSd. Headaches and memory lapses
(Postconcussion syndrome includes mild symptoms, such as headache, irritability, insomnia,
and poor concentration and memory. Nosebleeds, hypersomnia, unilateral motor changes, and
neck pain are indicative of more severe brain injury and/or soft tissue injury.)
Magnetic resonance imaging of a client's knee has revealed the presence of bursitis. The nurse
should anticipate performing which intervention for bursitis?
Select one:
a. Administering an antihistamine like Benadryl to minimize inflammation
b. Obtaining a surgical permit to repair the bursae
c. Placing an ice pack on the knee to decrease swelling
d. Applying Buck's traction with 10-pound weights - ANSc. Placing an ice pack on the knee to
decrease swelling
(Bursae contain synovial fluid, and they exist to prevent friction on a tendon. They are
necessary in areas where pressure is exerted because of close approximation of joint
structures. Bursae may become injured or inflamed, causing discomfort, swelling, and limitation
in movement of the involved area. Buck's traction, Benadryl, and surgery are not the standard
treatment for bursitis.)
The most recent blood work of a client with a diagnosis of acute myelogenous leukemia (AML)
reveals thrombocytopenia. Where is the client most likely to experience abnormal bleeding as a
result of low platelets?
Select one:
a. Nephrons and ureters
b. Inside the brain
c. Sclerae of the eyes
d. Skin and mucous membranes - ANSd. Skin and mucous membranes
Common sites for spontaneous bleeding from platelet disorders are the skin and mucous
membranes of the nose, mouth, gastrointestinal tract, and uterine cavity. Intracranial
hemorrhage is rare, and neither the sclerae nor the kidneys are typical sites of spontaneous
bleeding.
,Which of the following individuals likely faces the greatest risk for the development of chronic
kidney disease?
Select one:
a. A client with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or
control his diet
b. A client who experienced a hemorrhagic stroke and now has sensory and motor deficits
c. A first-time mother who recently lost 1.5 L of blood during a postpartum hemorrhage
d. A client whose diagnosis of thyroid cancer necessitated a thyroidectomy - ANSa. A client with
a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet
(Chronic kidney disease (CKD) is a pathophysiologic process that results in the loss of
nephrons and a decline in renal function that has persisted for more than 3 months. CKD can
result from diabetes, hypertension, glomerulonephritis, lupus (SLE), and polycystic kidney
disease. The prevalence and incidence of CKD continue to grow, reflecting the growing elderly
population and the increasing number of people with diabetes and hypertension. Hemorrhage
may result in acute renal failure, but it is not associated with chronic kidney disease. Stroke and
loss of the thyroid gland are not noted to underlie cases of chronic kidney disease.)
Which of the following signs and symptoms most clearly suggests the need for endoscopy to
rule out esophageal cancer?
Select one:
a. Recurrent episodes of gastritis that do not respond to changes in diet
b. Dysphagia in an individual with no history of neurologic disease
c. Heartburn after an individual consumes high-fat meals
d. A new onset of gastroesophageal reflux in a previously healthy individual - ANSb. Dysphagia
in an individual with no history of neurologic disease
Dysphagia is by far the most frequent complaint of persons with esophageal cancer. It is
apparent first with ingestion of bulky food, later with soft food, and finally with liquids. Heartburn,
reflux, and gastritis are not health problems that are closely associated with the development of
esophageal cancer.
Major histocompatibility complex (MHC) molecules, with human leukocyte antigens (HLAs), are
markers on all nucleated cells and have an important role in:
Select one:
a. Cell membrane transport
b. Avoiding transplant rejections
c. Identifying blood types
d. Suppressing viral replication - ANSb. Avoiding transplant rejections
MHC and HLA markers are unique for each individual, except possibly for identical twins.
Tissue and organ transplantation success is dependent on how closely matched the MHC
molecules and HLAs are on the donor and recipient. MHC molecules and HLAs are not involved
, in transport or viral replication. Red blood cells do not have a nucleus and thus do not have HLA
or MHC molecules on the surface.
A 70-year-old male client has been admitted to a hospital for the treatment of a recent
hemorrhagic stroke that has left him with numerous motor and sensory deficits. These deficits
are most likely the result of which of the following mechanisms of cell injury?
Select one:
a. Free radical injury
b. Impaired calcium homeostasis
c. Hypoxia and ATP depletion
d. Interference with DNA synthesis - ANSc. Hypoxia and ATP depletion
Stroke is characterized by impaired cerebral circulation and consequent death of neurons from
cellular hypoxia. Free radical injury, abnormal DNA synthesis, and impaired calcium
homeostasis are not direct consequences of lack of blood flow to body cells.
A 48-year-old male client, who normally enjoys good health, has been admitted to the hospital
for the treatment of polycythemia vera. The nurse who is providing care for the client should
prioritize assessments aimed at the early identification of which of the following health
problems?
Select one:
a. Thromboembolism
b. Hyperventilation
c. Vasculitis
d. Orthostatic hypotension - ANSa. Thromboembolism
The increased blood viscosity that accompanies primary polycythemia creates a significant risk
of thromboembolism. Hypertension, not hypotension, is also a common sign. Vasculitis and
hyperventilation are unlikely to result directly from polycythemia vera.
A 59-year-old woman with a recent diagnosis of breast cancer has begun a course of hormone
therapy. What is the goal of this pharmacologic treatment?
Select one:
a. Increasing serum hormone levels to promote tumor cell lysis
b. Blocking effects of estrogen on the growth of malignant cells
c. Blocking the entry of malignant cells into the axillary lymph nodes
d. Blocking the effects of progesterone on tumor growth - ANSb. Blocking effects of estrogen on
the growth of malignant cells
Hormone therapy is used to block the effects of estrogen on the growth of breast cancer cells.
Among the most common drugs used for hormone therapy is tamoxifen, a nonsteroidal
antiestrogen that binds to estrogen receptors and blocks the effects of estrogens on the growth
of malignant cells in the breast. Such drugs do not directly block axillary node involvement or
induce tumor cell lysis.
A high school senior sustained a concussion during a football game. Which of the following
signs and symptoms would indicate the presence of postconcussion syndrome in the days and
weeks following his injury?
Select one:
a. Unilateral weakness and decreased coordination
b. Recurrent nosebleeds and hypersomnia
c. Neck pain and decreased neck range of motion
d. Headaches and memory lapses - ANSd. Headaches and memory lapses
(Postconcussion syndrome includes mild symptoms, such as headache, irritability, insomnia,
and poor concentration and memory. Nosebleeds, hypersomnia, unilateral motor changes, and
neck pain are indicative of more severe brain injury and/or soft tissue injury.)
Magnetic resonance imaging of a client's knee has revealed the presence of bursitis. The nurse
should anticipate performing which intervention for bursitis?
Select one:
a. Administering an antihistamine like Benadryl to minimize inflammation
b. Obtaining a surgical permit to repair the bursae
c. Placing an ice pack on the knee to decrease swelling
d. Applying Buck's traction with 10-pound weights - ANSc. Placing an ice pack on the knee to
decrease swelling
(Bursae contain synovial fluid, and they exist to prevent friction on a tendon. They are
necessary in areas where pressure is exerted because of close approximation of joint
structures. Bursae may become injured or inflamed, causing discomfort, swelling, and limitation
in movement of the involved area. Buck's traction, Benadryl, and surgery are not the standard
treatment for bursitis.)
The most recent blood work of a client with a diagnosis of acute myelogenous leukemia (AML)
reveals thrombocytopenia. Where is the client most likely to experience abnormal bleeding as a
result of low platelets?
Select one:
a. Nephrons and ureters
b. Inside the brain
c. Sclerae of the eyes
d. Skin and mucous membranes - ANSd. Skin and mucous membranes
Common sites for spontaneous bleeding from platelet disorders are the skin and mucous
membranes of the nose, mouth, gastrointestinal tract, and uterine cavity. Intracranial
hemorrhage is rare, and neither the sclerae nor the kidneys are typical sites of spontaneous
bleeding.
,Which of the following individuals likely faces the greatest risk for the development of chronic
kidney disease?
Select one:
a. A client with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or
control his diet
b. A client who experienced a hemorrhagic stroke and now has sensory and motor deficits
c. A first-time mother who recently lost 1.5 L of blood during a postpartum hemorrhage
d. A client whose diagnosis of thyroid cancer necessitated a thyroidectomy - ANSa. A client with
a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet
(Chronic kidney disease (CKD) is a pathophysiologic process that results in the loss of
nephrons and a decline in renal function that has persisted for more than 3 months. CKD can
result from diabetes, hypertension, glomerulonephritis, lupus (SLE), and polycystic kidney
disease. The prevalence and incidence of CKD continue to grow, reflecting the growing elderly
population and the increasing number of people with diabetes and hypertension. Hemorrhage
may result in acute renal failure, but it is not associated with chronic kidney disease. Stroke and
loss of the thyroid gland are not noted to underlie cases of chronic kidney disease.)
Which of the following signs and symptoms most clearly suggests the need for endoscopy to
rule out esophageal cancer?
Select one:
a. Recurrent episodes of gastritis that do not respond to changes in diet
b. Dysphagia in an individual with no history of neurologic disease
c. Heartburn after an individual consumes high-fat meals
d. A new onset of gastroesophageal reflux in a previously healthy individual - ANSb. Dysphagia
in an individual with no history of neurologic disease
Dysphagia is by far the most frequent complaint of persons with esophageal cancer. It is
apparent first with ingestion of bulky food, later with soft food, and finally with liquids. Heartburn,
reflux, and gastritis are not health problems that are closely associated with the development of
esophageal cancer.
Major histocompatibility complex (MHC) molecules, with human leukocyte antigens (HLAs), are
markers on all nucleated cells and have an important role in:
Select one:
a. Cell membrane transport
b. Avoiding transplant rejections
c. Identifying blood types
d. Suppressing viral replication - ANSb. Avoiding transplant rejections
MHC and HLA markers are unique for each individual, except possibly for identical twins.
Tissue and organ transplantation success is dependent on how closely matched the MHC
molecules and HLAs are on the donor and recipient. MHC molecules and HLAs are not involved
, in transport or viral replication. Red blood cells do not have a nucleus and thus do not have HLA
or MHC molecules on the surface.
A 70-year-old male client has been admitted to a hospital for the treatment of a recent
hemorrhagic stroke that has left him with numerous motor and sensory deficits. These deficits
are most likely the result of which of the following mechanisms of cell injury?
Select one:
a. Free radical injury
b. Impaired calcium homeostasis
c. Hypoxia and ATP depletion
d. Interference with DNA synthesis - ANSc. Hypoxia and ATP depletion
Stroke is characterized by impaired cerebral circulation and consequent death of neurons from
cellular hypoxia. Free radical injury, abnormal DNA synthesis, and impaired calcium
homeostasis are not direct consequences of lack of blood flow to body cells.
A 48-year-old male client, who normally enjoys good health, has been admitted to the hospital
for the treatment of polycythemia vera. The nurse who is providing care for the client should
prioritize assessments aimed at the early identification of which of the following health
problems?
Select one:
a. Thromboembolism
b. Hyperventilation
c. Vasculitis
d. Orthostatic hypotension - ANSa. Thromboembolism
The increased blood viscosity that accompanies primary polycythemia creates a significant risk
of thromboembolism. Hypertension, not hypotension, is also a common sign. Vasculitis and
hyperventilation are unlikely to result directly from polycythemia vera.
A 59-year-old woman with a recent diagnosis of breast cancer has begun a course of hormone
therapy. What is the goal of this pharmacologic treatment?
Select one:
a. Increasing serum hormone levels to promote tumor cell lysis
b. Blocking effects of estrogen on the growth of malignant cells
c. Blocking the entry of malignant cells into the axillary lymph nodes
d. Blocking the effects of progesterone on tumor growth - ANSb. Blocking effects of estrogen on
the growth of malignant cells
Hormone therapy is used to block the effects of estrogen on the growth of breast cancer cells.
Among the most common drugs used for hormone therapy is tamoxifen, a nonsteroidal
antiestrogen that binds to estrogen receptors and blocks the effects of estrogens on the growth
of malignant cells in the breast. Such drugs do not directly block axillary node involvement or
induce tumor cell lysis.
