Exam 4: NSG3280 / NSG 3280 (Latest
Update Update)
Pathophysiology for Nurses I | Review
Questions and Answers | Grade A | 100%
Correct (Verified Solutions) Instant pdf -
Galen
Section 1: Reproductive System Pathophysiology
1. A 32-year-old female presents with severe dysmenorrhea and chronic pelvic
pain. Laparoscopy reveals endometrial tissue on the ovaries and peritoneum. The
NP understands that this condition is primarily caused by:
A) Excessive estrogen production by the ovaries
B) Endometrial tissue growing outside the uterus that responds to hormonal cycles
C) Autoimmune destruction of endometrial cells
D) Retrograde menstruation into the fallopian tubes only
Correct Answer: B
Endometriosis is defined by the presence of endometrial tissue (glands and stroma) outside
the uterus, such as on the ovaries and peritoneum. This ectopic tissue responds to cyclic
hormonal changes and bleeds during menstruation, causing inflammation, pain, and
adhesions. While retrograde menstruation is a proposed mechanism, the primary
pathophysiologic feature is the ectopic location of hormonally responsive endometrial
tissue.
,2. A 24-year-old female with Polycystic Ovary Syndrome (PCOS) presents with
hirsutism and amenorrhea. These clinical findings are driven by which hormonal
imbalance?
A) Excess estrogen and low insulin
B) Excess androgens (hyperandrogenism) and hyperinsulinemia
C) Low LH and high FSH
D) Complete lack of progesterone
Correct Answer: B
PCOS is characterized by insulin resistance leading to hyperinsulinemia, which stimulates
the ovaries to produce excess androgens. This hyperandrogenism causes hirsutism
(excessive hair growth) and disrupts ovulation, leading to amenorrhea. The hormonal
imbalance also leads to multiple small ovarian cysts.
3. What is the primary cause of Pelvic Inflammatory Disease (PID)?
A) Autoimmune attack on the fallopian tubes
B) Ascending infection of sexually transmitted pathogens (e.g., Gonorrhea, Chlamydia)
into the upper reproductive tract
C) Rupture of an ovarian cyst
D) Poor hygiene during menstruation
Correct Answer: B
PID results from microbes, most commonly Neisseria gonorrhoeae and Chlamydia
trachomatis, ascending from the vagina/cervix into the upper reproductive tract. This
causes salpingitis (fallopian tube inflammation) and oophoritis (ovary inflammation). Left
untreated, PID can lead to scarring, infertility, and ectopic pregnancy.
4. A 55-year-old female presents with postmenopausal bleeding. The nurse
recognizes this as a classic "red flag" for which condition?
A) Cervical Cancer
B) Endometrial Cancer
C) Ovarian Cysts
D) Atrophic Vaginitis
,Correct Answer: B
Postmenopausal bleeding is the hallmark symptom of Endometrial Cancer and requires
immediate evaluation with endometrial biopsy. While atrophic vaginitis can cause
spotting, any vaginal bleeding after menopause must be considered endometrial cancer
until proven otherwise. This is a classic "red flag" sign that demands urgent investigation.
5. Which genetic mutation is highly associated with an increased lifetime risk of
both breast and ovarian cancer?
A) p53 deletion
B) BRCA1 and BRCA2 mutations
C) HER2/neu amplification
D) Philadelphia chromosome
Correct Answer: B
BRCA1 and BRCA2 are tumor suppressor genes. Inherited mutations in these genes
significantly impair DNA repair, leading to high lifetime risks of breast and ovarian
cancers. Women with BRCA mutations may have up to an 85% lifetime risk of breast
cancer and up to a 40% risk of ovarian cancer.
6. Dysmenorrhea (painful menstruation) is primarily mediated by the excessive
release of which substance from the endometrium?
A) Estrogen
B) Prostaglandins (specifically F2-alpha)
C) Progesterone
D) Luteinizing Hormone
Correct Answer: B
Primary dysmenorrhea is caused by high levels of prostaglandins (specifically PGF2-alpha)
released during endometrial shedding. These prostaglandins cause strong uterine
contractions, ischemia, and pain. Prostaglandin synthesis inhibitors (NSAIDs) are first-line
treatment because they block this pathway.
, 7. In the pathophysiology of Ovarian Cancer, why is the mortality rate so high
compared to other gynecologic cancers?
A) It grows very rapidly
B) It is resistant to all chemotherapy
C) It is typically asymptomatic in early stages and diagnosed only after metastasis has
occurred
D) It only affects elderly women who cannot tolerate surgery
Correct Answer: C
Ovarian cancer is often called the "silent killer" because it lacks specific early symptoms.
By the time symptoms such as bloating, abdominal distension, or pelvic pain occur, the
disease has usually spread extensively within the peritoneum. This late-stage diagnosis is
the primary reason for its high mortality rate.
8. A complication of untreated Pelvic Inflammatory Disease (PID) involves scarring
of the fallopian tubes. This increases the risk for:
A) Endometrial cancer
B) Ectopic pregnancy and infertility
C) Urinary incontinence
D) Cervical dysplasia
Correct Answer: B
Scarring (fibrosis) from PID damages the ciliated lining of the fallopian tubes. This makes
it difficult for the egg to travel to the uterus (resulting in infertility) or can cause the
fertilized egg to implant in the tube (ectopic pregnancy). Ectopic pregnancy is a life-
threatening emergency.
9. Which finding is consistent with a diagnosis of Breast Cancer presenting as
"Peau d'orange"?
A) A mobile, rubbery lump
B) Bloody nipple discharge
C) Dimpling and thickening of the skin resembling an orange peel due to lymphatic
Update Update)
Pathophysiology for Nurses I | Review
Questions and Answers | Grade A | 100%
Correct (Verified Solutions) Instant pdf -
Galen
Section 1: Reproductive System Pathophysiology
1. A 32-year-old female presents with severe dysmenorrhea and chronic pelvic
pain. Laparoscopy reveals endometrial tissue on the ovaries and peritoneum. The
NP understands that this condition is primarily caused by:
A) Excessive estrogen production by the ovaries
B) Endometrial tissue growing outside the uterus that responds to hormonal cycles
C) Autoimmune destruction of endometrial cells
D) Retrograde menstruation into the fallopian tubes only
Correct Answer: B
Endometriosis is defined by the presence of endometrial tissue (glands and stroma) outside
the uterus, such as on the ovaries and peritoneum. This ectopic tissue responds to cyclic
hormonal changes and bleeds during menstruation, causing inflammation, pain, and
adhesions. While retrograde menstruation is a proposed mechanism, the primary
pathophysiologic feature is the ectopic location of hormonally responsive endometrial
tissue.
,2. A 24-year-old female with Polycystic Ovary Syndrome (PCOS) presents with
hirsutism and amenorrhea. These clinical findings are driven by which hormonal
imbalance?
A) Excess estrogen and low insulin
B) Excess androgens (hyperandrogenism) and hyperinsulinemia
C) Low LH and high FSH
D) Complete lack of progesterone
Correct Answer: B
PCOS is characterized by insulin resistance leading to hyperinsulinemia, which stimulates
the ovaries to produce excess androgens. This hyperandrogenism causes hirsutism
(excessive hair growth) and disrupts ovulation, leading to amenorrhea. The hormonal
imbalance also leads to multiple small ovarian cysts.
3. What is the primary cause of Pelvic Inflammatory Disease (PID)?
A) Autoimmune attack on the fallopian tubes
B) Ascending infection of sexually transmitted pathogens (e.g., Gonorrhea, Chlamydia)
into the upper reproductive tract
C) Rupture of an ovarian cyst
D) Poor hygiene during menstruation
Correct Answer: B
PID results from microbes, most commonly Neisseria gonorrhoeae and Chlamydia
trachomatis, ascending from the vagina/cervix into the upper reproductive tract. This
causes salpingitis (fallopian tube inflammation) and oophoritis (ovary inflammation). Left
untreated, PID can lead to scarring, infertility, and ectopic pregnancy.
4. A 55-year-old female presents with postmenopausal bleeding. The nurse
recognizes this as a classic "red flag" for which condition?
A) Cervical Cancer
B) Endometrial Cancer
C) Ovarian Cysts
D) Atrophic Vaginitis
,Correct Answer: B
Postmenopausal bleeding is the hallmark symptom of Endometrial Cancer and requires
immediate evaluation with endometrial biopsy. While atrophic vaginitis can cause
spotting, any vaginal bleeding after menopause must be considered endometrial cancer
until proven otherwise. This is a classic "red flag" sign that demands urgent investigation.
5. Which genetic mutation is highly associated with an increased lifetime risk of
both breast and ovarian cancer?
A) p53 deletion
B) BRCA1 and BRCA2 mutations
C) HER2/neu amplification
D) Philadelphia chromosome
Correct Answer: B
BRCA1 and BRCA2 are tumor suppressor genes. Inherited mutations in these genes
significantly impair DNA repair, leading to high lifetime risks of breast and ovarian
cancers. Women with BRCA mutations may have up to an 85% lifetime risk of breast
cancer and up to a 40% risk of ovarian cancer.
6. Dysmenorrhea (painful menstruation) is primarily mediated by the excessive
release of which substance from the endometrium?
A) Estrogen
B) Prostaglandins (specifically F2-alpha)
C) Progesterone
D) Luteinizing Hormone
Correct Answer: B
Primary dysmenorrhea is caused by high levels of prostaglandins (specifically PGF2-alpha)
released during endometrial shedding. These prostaglandins cause strong uterine
contractions, ischemia, and pain. Prostaglandin synthesis inhibitors (NSAIDs) are first-line
treatment because they block this pathway.
, 7. In the pathophysiology of Ovarian Cancer, why is the mortality rate so high
compared to other gynecologic cancers?
A) It grows very rapidly
B) It is resistant to all chemotherapy
C) It is typically asymptomatic in early stages and diagnosed only after metastasis has
occurred
D) It only affects elderly women who cannot tolerate surgery
Correct Answer: C
Ovarian cancer is often called the "silent killer" because it lacks specific early symptoms.
By the time symptoms such as bloating, abdominal distension, or pelvic pain occur, the
disease has usually spread extensively within the peritoneum. This late-stage diagnosis is
the primary reason for its high mortality rate.
8. A complication of untreated Pelvic Inflammatory Disease (PID) involves scarring
of the fallopian tubes. This increases the risk for:
A) Endometrial cancer
B) Ectopic pregnancy and infertility
C) Urinary incontinence
D) Cervical dysplasia
Correct Answer: B
Scarring (fibrosis) from PID damages the ciliated lining of the fallopian tubes. This makes
it difficult for the egg to travel to the uterus (resulting in infertility) or can cause the
fertilized egg to implant in the tube (ectopic pregnancy). Ectopic pregnancy is a life-
threatening emergency.
9. Which finding is consistent with a diagnosis of Breast Cancer presenting as
"Peau d'orange"?
A) A mobile, rubbery lump
B) Bloody nipple discharge
C) Dimpling and thickening of the skin resembling an orange peel due to lymphatic
