Pathophysiology Exam 1 Practice Problems With Complete Solution

A patient is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to ___________ of the remaining liver cells. A. Metaplasia B. Organ atrophy C. Compensatory hyperplasia D. Physiologic hyperplasia - Answer C An older adult patient comes to the clinic complaining of not being able to do what he used to be able to. You know that normal changes associated with aging include: (Select all that apply.) A. Improved blood flow B. Slowed metabolic rate C. Decreased brain weight D. Improved nerve fiber conduction E. Less respiratory capacity - Answer B, C, E A 20-year-old college student has presented to her campus medical clinic for a scheduled Pap smear. The clinician who will interpret the smear will examine cell samples for evidence of: A. Changes in cell shape, size, and organization B. Presence of unexpected cell types C. Ischemic changes in cell sample D. Abnormally high numbers of cells - Answer A The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize? A. White blood cell levels with differential B. Red blood cell levels and morphology C. Urea and creatinine levels D. Liver function panel - Answer B Lead -> anemia, RBC lysis You know it's not A because there is no infection involved. C is focused on kidney function while D is focused on liver function. Both of these would be important in the case of lead poisoning BUT the priority answer is B, because you need first to address the most life-threatening patient needs. The little girl in this question can go into shock or suffer permanent organ damage if her RBCs are low. A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis? A. Inappropriate activation of apoptosis B. Bacterial invasion C. Impaired arterial blood supply D. Metaplastic cellular changes - Answer B Remember that it's not C because to have gangrene, you must have infection Although stress exposure initiates integrated responses by multiple systems, the most important changes are first activated by which system? A. Pulmonary B. Gastrointestinal C. Neuroendocrine D. Cardiovascular - Answer C Which manifestation of stress reflects the non-specific fight or flight response? A. Decreased pupillary light response B. Increased GI motility C. Decreased short-term memory D. Increased cardiopulmonary rates - Answer D This would fall under physiologic responses to stress!! Slide 25 in your lecture powerpoint Stress-induced cortisol hormone secretion is associated with: A. Increased growth hormone level B. Regulation of the stress response C. Increased thyroid-stimulating hormone D. Depressed adrenal gland function - Answer B You know it's not A because I mentioned in an earlier slide that growth hormone levels decrease with stress. We didn't mention thyroid-stimulating hormone as one of the ones associated with the stress repsonse so you can pretty much assume that's not right. And we know adrenal function is not depressed because ACTH from the anterior pituitary stimulates the adrenal glands to release cortisol. Which of the following factors are known to contribute to an individual's ability to adapt to stress? (Select all that apply.) A. Ethnicity B. Age C. Socioeconomic status D. Gender E. Health status - Answer B, C, D, E "Ability to adapt to stress" = mediating factors! Slide 28 of this powerpoint Two people experience the same stressor yet only one is able to cope and adapt adequately. An example of the person with an increased capacity to adapt is the one with: A. A sense of purpose in life B. Circadian rhythm disruption C. Age-related renal dysfunction D. Excessive weight gain or loss - Answer A Back to mediating factors. Which of these things do you think would help a person deal with stress? Disruption in sleep cycle (B) will definitely not help, age-related renal dysfunction (C) is an indicator of poor health status which also would not help, and excessive weight changes (D) are also likely to cause more stress than alleviate it. The characteristic, localized cardinal signs of acute inflammation include: (Select all that apply.) A. Redness B. Fatigue C. Swelling D. Warmth E. Fever - Answer A, C, D The cellular stage of acute inflammation is marked by the movement of leukocytes into the area. Which of the following cells arrives first and in great numbers? A. Basophils B. Lymphocytes C. Neutrophils D. Platelets - Answer C Which of the following mediators of inflammation causes increased capillary permeability and pain? A. Serotonin B. Histamine C. Bradykinin D. Nitric oxide - Answer C An older adult patient has just sheared the skin on her elbow while attempting to boost herself up in bed, an event that has precipitated acute inflammation in the region surrounding the wound. Which of the following events will occur during the vascular stage of the patient's inflammation? A. Outpouring of exudate into interstitial spaces B. Chemotaxis C. Accumulation of leukocytes along epithelium D. Phagocytosis of cellular debris - Answer A Inflammatory exudates are a combination of several types. Which of the following exudates is composed of a large accumulation of leukocytes? A. Serous B. Purulent C. Fibrinous D. Hemorrhagic - Answer B Which of the following wounds is most likely to heal by secondary intention? A. A finger laceration received while cutting onions B. A stage IV pressure ulcer that developed in a nursing home C. A needlestick injury received while administering parenteral medication D. An incision from an open appendectomy - Answer B A patient underwent an open cholecystectomy 4 days ago and her incision is now in the proliferative phase of healing. The nurse knows that the next step in the process of wound healing is: A. Inflammation B. Maturation C. Remodeling D. Coagulation - Answer C A patient arrives at her follow-up appointment 1 month post-hysterectomy and complains to the nurse that her scars do not seem to be healing properly. Upon inspection, the nurse notices that the scars are raised but still within the boundaries of the original incisions. The nurse tells the patient this kind of dysfunction wound healing is called: A. Hypertrophic scarring B. Dehiscence C. Contracture D. A keloid - Answer A A patient with an 18 pack per year history presents to a family practice clinic complaining of painless hoarseness and inability to clear mucus. A biopsy of respiratory tract cells is taken and shows that these cells have been replaced by less mature squamous epithelium cells. The nurse knows this type of change is referred to as: A. Dysplasia B. Metaplasia C. Hyperplasia D. Coagulation - Answer B A report comes back indicating that muscular atrophy has occurred. A nurse recalls that muscular atrophy involves a decrease in muscle cell: A. Number B. Size C. Vacuoles D. Lipofuscin - Answer B During childhood, the thymus decreases in size, and this is referred to as _____ atrophy. A. Physiologic B. Pathologic C. Disuse D. Neurogenic - Answer B When planning care for a cardiac patient, the nurse knows that in response to an increased workload, cardiac myocardial cells will: A. Increase in size B. Decrease in length C. Increase in excitability D. Increase in number - Answer A A 75-year-old male presents with chest pain on exertion. The chest pain is most likely due to hypoxic injury secondary to: A. Malnutrition B. Free radicals C. Ischemia D. Chemical toxicity - Answer C A patient has a heart attack that leads to progressive cell injury that causes cell death with severe cell swelling and breakdown of organelles. What term would the nurse use to define this process? A. Adaptation B. Pathologic calcification C. Apoptosis D. Necrosis - Answer D A group of prison inmates developed tuberculosis following exposure to an infected inmate. On examination, tissues were soft and granular (like clumped cheese). Which of the following is the most likely cause? A. Coagulative necrosis B. Liquefactive necrosis C. Caseous necrosis D. Autonecrosis - Answer C