Section 1: Cellular Adaptation, Injury, & Death
Question 1
A nurse recalls that monocytes are blood cells that mature (differentiate) into which of
the following?
A. Macrophages
B. Neutrophils
C. Eosinophils
D. Mast cells
Correct Answer: A
Rationale: Monocytes are a type of white blood cell that circulate in the blood and are a
key component of the immune system. Upon leaving the bloodstream and migrating
into tissues, they mature and differentiate into macrophages. Macrophages are
essential for phagocytosis, antigen presentation, and cytokine production during
inflammation and immune responses.
Question 2
While planning care for a patient with inflammation, which principle will the nurse
remember? The predominant phagocyte of early inflammation is the:
A. Eosinophil
B. Lymphocyte
C. Macrophage
D. Neutrophil
Correct Answer: D
,Rationale: Neutrophils are the most abundant type of white blood cells and are the
primary phagocytes that respond to sites of acute inflammation. They are the first
immune cells to arrive at an injury site, where they engulf and destroy pathogens and
cellular debris. This rapid response is a hallmark of acute inflammation.
Question 3
A 10-year-old boy who is mentally retarded is able to carry out activities of daily living,
including feeding and dressing himself. On physical examination, he has brachycephaly
and oblique palpebral fissures with prominent epicanthal folds. A transverse crease is
seen on the palm of each hand. On auscultation of the chest, there is a grade III/VI
systolic murmur. Which of the following diseases is he most likely to develop by age 20?
A. Acute leukemia
B. Hepatic cirrhosis
C. Chronic renal failure
D. Acute myocardial infarction
E. Aortic dissection
Correct Answer: A
Rationale: The clinical presentation is classic for Down syndrome (Trisomy 21). Key
features include brachycephaly, oblique palpebral fissures, epicanthal folds, a single
transverse palmar crease (Simian crease), and congenital heart defects (such as a
septal defect causing a murmur). Children with Down syndrome have a significantly
increased risk of developing acute leukemia, particularly acute lymphoblastic leukemia
(ALL).
Question 4
Chronic inflammation is characterized by which of the following?
A. Infiltration with macrophages, lymphocytes & plasma cells
B. Tissue destruction induced by products of inflammatory cells
C. Repair involving new vessel proliferation (angiogenesis) and fibrosis
D. All of the above
Correct Answer: D
, Rationale: Chronic inflammation is a prolonged process in which tissue injury and
healing occur simultaneously. It is characterized by infiltration with mononuclear cells
(macrophages, lymphocytes, and plasma cells), ongoing tissue destruction from
inflammatory mediators, and attempts at repair through angiogenesis and fibrosis.
Question 5
What are Neutrophil Extracellular Traps (NETs)?
A. A type of white blood cell
B. A chemical mediator of inflammation
C. A component of the complement system
D. Processed chromatin released by neutrophils to control infections
Correct Answer: D
Rationale: NETs are web-like structures composed of processed chromatin and granular
proteins. They are released by neutrophils as a last-resort mechanism to trap and kill
microorganisms. This process, known as NETosis, can also contribute to tissue damage
and thrombosis.
Question 6
What are the major vasoactive amines that mediate inflammation?
A. Histamine and serotonin
B. Prostaglandins and leukotrienes
C. Cytokines and chemokines
D. Bradykinin and complement
Correct Answer: A
Rationale: Histamine and serotonin are key vasoactive amines released during the early
stages of inflammation. They are preformed mediators stored in cells like mast cells
and platelets. They cause vasodilation and increased vascular permeability, which are
critical for the recruitment of other immune cells.