NR283 Week 7 CJE Pathophysiology
Question 1
A client in the oncologist's office has leukemia. As the client and family are leaving the office, the
parent says to the nurse, "I didn't quite get it when the doctor explained it. What exactly is happening
in my son's body with this leukemia?" What is an appropriate response by the nurse?
A. "The bone marrow has many good cells, but a few cancer cells are mixed in with the good cells."
B. "The cancer is in the bone marrow and will not go anywhere else in the body."
C. "Cancer cells have overcrowded the blood and spill over into the bone marrow."
✓ D. "There is uncontrolled growth of cancer cells in the bone marrow."
■ Correct Answer: D
, Rationale: Leukemia is defined as uncontrolled proliferation of abnormal cancer cells originating in
the bone marrow. Option A is incorrect — cancer cells vastly outnumber healthy cells. Option B is
wrong because leukemia cells can spread systemically. Option C reverses the direction of spread
(marrow overflows into blood, not vice versa).
Question 2
A young client has a genetic disorder of the red blood cells (RBC), where the RBCs and hemoglobin
synthesis are abnormal. Based on this information, which type of anemia will the nurse educate the
client and parents about?
✓ A. Sickle cell anemia
B. Aplastic anemia
C. Iron-deficiency anemia
D. Pernicious anemia
■ Correct Answer: A
Rationale: Sickle cell anemia is an autosomal recessive genetic disorder causing abnormal
hemoglobin S (HbS), which distorts RBC shape. It is the only choice that is both genetic and
directly affects RBC morphology and hemoglobin synthesis. Aplastic anemia = bone marrow
failure; Iron-deficiency = nutritional; Pernicious = B12 malabsorption.
, Question 7
The nurse cares for a client with traumatic brain injury (TBI). What ongoing nursing assessment is
most important?
A. Measuring the circumference of the client's head.
B. Measuring the client's blood pressure and temperature.
✓ C. Monitoring the client using the Glasgow Coma Scale.
D. Assessing the client's pain level using the 10-point pain scale.
■ Correct Answer: C
Rationale: The Glasgow Coma Scale (GCS) assesses eye opening, verbal response, and motor
response to track level of consciousness — the most sensitive indicator of neurological status in
TBI. A declining GCS score signals deterioration and warrants immediate intervention. Head
circumference is not routinely monitored in adults.
, Question 15
An adult client is diagnosed with gastroesophageal reflux disease (GERD). Click to identify a possible
cause for the GERD. Select one option.
Health History:
• Quit smoking 2 years ago
• Sleeps with the head of bed elevated
• Reported hiatal hernia
• Gastrointestinal surgery as a teenager
■ Correct Answer: Reported hiatal hernia
Rationale: A hiatal hernia allows the stomach to herniate above the diaphragm, weakening the
lower esophageal sphincter (LES) and allowing acid reflux — a direct structural cause of GERD.
Elevating the head of bed and quitting smoking are protective behaviors. GI surgery as a teenager
is not directly linked to GERD causation.
Question 1
A client in the oncologist's office has leukemia. As the client and family are leaving the office, the
parent says to the nurse, "I didn't quite get it when the doctor explained it. What exactly is happening
in my son's body with this leukemia?" What is an appropriate response by the nurse?
A. "The bone marrow has many good cells, but a few cancer cells are mixed in with the good cells."
B. "The cancer is in the bone marrow and will not go anywhere else in the body."
C. "Cancer cells have overcrowded the blood and spill over into the bone marrow."
✓ D. "There is uncontrolled growth of cancer cells in the bone marrow."
■ Correct Answer: D
, Rationale: Leukemia is defined as uncontrolled proliferation of abnormal cancer cells originating in
the bone marrow. Option A is incorrect — cancer cells vastly outnumber healthy cells. Option B is
wrong because leukemia cells can spread systemically. Option C reverses the direction of spread
(marrow overflows into blood, not vice versa).
Question 2
A young client has a genetic disorder of the red blood cells (RBC), where the RBCs and hemoglobin
synthesis are abnormal. Based on this information, which type of anemia will the nurse educate the
client and parents about?
✓ A. Sickle cell anemia
B. Aplastic anemia
C. Iron-deficiency anemia
D. Pernicious anemia
■ Correct Answer: A
Rationale: Sickle cell anemia is an autosomal recessive genetic disorder causing abnormal
hemoglobin S (HbS), which distorts RBC shape. It is the only choice that is both genetic and
directly affects RBC morphology and hemoglobin synthesis. Aplastic anemia = bone marrow
failure; Iron-deficiency = nutritional; Pernicious = B12 malabsorption.
, Question 7
The nurse cares for a client with traumatic brain injury (TBI). What ongoing nursing assessment is
most important?
A. Measuring the circumference of the client's head.
B. Measuring the client's blood pressure and temperature.
✓ C. Monitoring the client using the Glasgow Coma Scale.
D. Assessing the client's pain level using the 10-point pain scale.
■ Correct Answer: C
Rationale: The Glasgow Coma Scale (GCS) assesses eye opening, verbal response, and motor
response to track level of consciousness — the most sensitive indicator of neurological status in
TBI. A declining GCS score signals deterioration and warrants immediate intervention. Head
circumference is not routinely monitored in adults.
, Question 15
An adult client is diagnosed with gastroesophageal reflux disease (GERD). Click to identify a possible
cause for the GERD. Select one option.
Health History:
• Quit smoking 2 years ago
• Sleeps with the head of bed elevated
• Reported hiatal hernia
• Gastrointestinal surgery as a teenager
■ Correct Answer: Reported hiatal hernia
Rationale: A hiatal hernia allows the stomach to herniate above the diaphragm, weakening the
lower esophageal sphincter (LES) and allowing acid reflux — a direct structural cause of GERD.
Elevating the head of bed and quitting smoking are protective behaviors. GI surgery as a teenager
is not directly linked to GERD causation.
