Review Questions – Exam 1 1. Normal adaptive cell responses: a. b. c. d. occur in response to an appropriate stimulus continue once the need for the adaptive response ceases are not reversible lead to cellular injury and possible cell death 2. Removal of part of the liver initiates an adaptive response in the remaining liver cells referred to as: a. b. c. d. hypertrophy hyperplasia atrophy metaplasia 3. Which of the following types of cell responses has the potential to progress to neoplasia: a. b. c. d. atrophy hyperplasia metaplasia dysplasia 4. Free radicals cause cellular injury by: a. b. c. d. stopping protein synthesis disrupting lysosomal membranes transforming cells into cancerous cells forming injurious chemical bonds 5. The initiation of the stress response is caused mainly by the nervous and endocrine systems but also involves: 1. the adrenal glands 2. the immune system 3. the pituitary gland 4. hypothalmus a. b. c. d. 1,4 2,3 1,2,3 all of the above 6. Stress may result in: a. b. c. d. increased action by catecholamines decreased blood sugar systemic decrease in protein synthesis decreased muscle contraction 7. The Frank-Starling Law states that an increase in left ventricular end-diastolic volume should: a. decrease heart rate b. decrease myocardial contractility c. increase heart rate d. increase myocardial contractility 8. P.H. is a 70 year old man with atherosclerosis. Some of his blood vessels have large plaques that decrease vessel lumen diameter. The primary effect will be a(n): a. decrease in the pressure gradient b. increase in blood flow c. increase in resisistance d. no effect 9. Risk factors enhancing the development of coronary artery disease include: a. b. c. d. increase high-density lipids high carbohydrate diet elevated LDL levels exposure to environmental toxins 10. Which one of the following conditions would be expected to produce the greatest increase in the work of the heart: a. b. c. d. increased blood pressure and stroke volume output decreased heart rate and increased stroke volume output decreased blood pressure and heart rate decreased stroke volume output and decreased blood pressure 11. The functional cause of angina is: a. valvular heart disease b. atherosclerosis c. imbalance between the supply of oxygen to the heart and the metabolic demands of the heart d. decreased ventricular compliance leading to a decrease in stroke volume and cardiac output 12. Functional changes in the myocardium caused by myocardial infarction include: 1. 2. 3. 4. altered left ventricle compliance decrease in cardiac contractility decrease in stroke volume sinoatrial node dysfunction a. b. c. d. 1,2 3,4 1,2,3 all of the above 13. Signs and symptoms of heart failure are most directly related to: a. b. c. d, dilation of cardiac chambers cardiac hypertrophy impaired pumping ability of the heart dysrhythmias 14. Signs and symptoms of left-sided heart failure include: a. b. c. d. pulmonary edema and cough peripheral edema and orthopnea hepatomegaly and anorexia cyanosis and peripheral edema 15. Dilated cardiomyopathy exerts its greatest effect through: a. production of dysrhythmias b. hypertrophy of the left ventricle c. reduced filling of the heart d. decreased stroke volume output 16. Infective endocarditis is most often caused by: a. b. c. d. bacteria fungi viruses parasites 17. The function of the heart valves is to: a. b. c. d. control the rate at which blood moves through the heart regulate the flow of electrical activity between the atria and ventricles of the heart provide for unidirectional flow of blood through the heart control the inflow of blood into the atria 18. Mitral valve stenosis results directly in the incomplete emptying of the: a. b. c. d. right atrium right ventricle left atrium left ventricle 19. Cardiac dysrhythmias may be caused by: 1. 2. 3. 4. ischemia hypoxia acid-base imbalances altered potassium levels a. b. c. d. 1,2 2,4 1,3,4 all of the above 20. Shock is a complex pathophysiologic process that involves all of the following events EXCEPT: a. decreased perfusion to the kidneys b. acidosis c. hypertension d. rapid heart rate 21. Causes of hypovolemic shock include: a. b. c. d. allergic reactions to drugs cardiac failure vomiting and loss of body fluids massive vasodilation Review Questions – N316 Exam 2 1. Which of the following statements is true: a. b. c. d. hypoventilation causes hypocapnia hyperventilation causes hypercapnia hyperventilation causes hypocapnia hyperventilation results in increased PaCO2 2. The _______ is the maximum of gas that can be displaced (expired) from the lungs: a. b. c. d. vital capacity total lung capacity residual capacity lung capacity 3. Which of the following pathophysiological changes occurs in Adult Respiratory Distress Syndrome: a. b. c. d. increased surfactant production increased lung compliance decreased pulmonary vascular resistance alveolar-capillary membrane damage 4. In chronic bronchitis _______ may lead to closure of the airway, particularly during expiration, when the airways are narrow: a. b. c. d. thick mucus infection hyperventilation thinning smooth muscle in the airways 5. Individuals with a recent diagnosis of emphysema most often present with: a. b. c. d. productive cough cyanosis dyspnea cor pulmonale 6. Ms. G is seen in the clinic with complaints of chronic gastritis, fatigue, and tingling in her fingers. These clinical manifestations are consistent with which type of anemia: a. b. c. d. folic acid deficiency anemia iron deficiency anemia pernicious anemia aplastic anemia 7. MB is admitted to the emergency room with a diagnosis of polycythemia vera. Her symptoms are mainly the result of: a. b. c. d. a decreased erythrocyte count increased blood viscosity rapid blood flow to major organs neurological involvement 8. Thrombocytopenia results from the deficiency of which of the following: a. b. c. d. prothrombin fibrinogen thrombin platelets 9. The major physiological stimulus for thirst is: a. b. c. d. polyuria hyponatremia increased serum osmolality hypotension 10. Which of the following would indicate a fluid deficit: a. b. c. d. weight loss, increase in blood pressure decreased urine output, weight loss, dry mucus membranes weakness, weight gain, rapid respirations confusion, increased urine output 11. Metabolic acidosis is defined as: a. b. c. d. a decrease in bicarbonate an increase in bicarbonate an increase in carbonic acid a decrease in carbonic acid 12. Hypersensitivity is best defined as: a. b. c. d. a reduced immune response found in most pathological states. a normal immune response to an infectious agent an excessive or inappropriate response of the immune system to a sensitizing agent. antigenic desensitization 13. Seasonal allergic rhinitis is expressed through: a. b. c. d. IgE-mediated reactions tissue specific reactions antigen-antibody complexes type II hypersensitivity reactions 14. GM recently received a kidney transplant. Organ rejection occurred after two weeks. The primary mechanism for the rejection is: a. b. c. d. e. immune response against recipient HLA antigens immune response against donor HLA antigens type IV hypersensitivity both a and b both b and c 15. Systemic lupus erythematosis is an example of: a. b. c. d. autoimmunity alloimmunity homoimmunity alleimmunity 16. Opportunistic infections are: a. infections involving harmless microorganisms that develop in persons with compromised immune function b. hospital acquired infections c. infections that develop in persons who have not been immunized against or exposed to a particular pathogen d. hypersensitivity reactions that develop in persons who are predisposed to allergies Review Questions – N316 Exam 3 1. Clinical manifestations of cystitis include all of the following EXCEPT a. b. c. d. urgency and frequency pain with urination elevated temperature suprapubic pain 2. The most common complication of urinary tract obstruction is: a. b. c. d. incontinence infection hypertension stone formation 3. Acute glomerulonephritis is usually associated with: a. E. coli b. herpes virus c. streptococcus d. fungus 4. ____________ is an immune mechanism that commonly contributes to glomerulonephritis: a. b. c. d. deposition of circulating antigen-antibody complexes in the glomeruli formation of antibodies against the glomerular basement membrane both a and b none of the above 5. Which of the following may cause prerenal acute renal failure: a. b. c. d. pyelonephritis hypovolemia calculi nephrotoxins 6. Anemia accompanies chronic renal failure because of: a. b. c. d. blood loss in the urine renal insensitivity of Vit D inadequate production of erythropoietin inadequate retention of serum iron 7. Which of the following statements concerning chronic renal failure is not true: a. b. c. d. serum creatinine levels increase potassium excretion decreases metabolic alkalosis develops calcium levels may decrease 8. A common manifestation of hiatal hernia is: a. b. c. d. heartburn diarrhea flatus nausea 9. A patient is complaining of abdominal pain, diarrhea, and bloody stools. A possible diagnosis would be: a. b. c. d. ulcerative colitis hiatal hernia cirrhosis gastroesophageal reflux disease 10. The alterations in liver function that occur with persons with cirrhosis are related to: a. formation of fibrous tissue that replaces normal hepatic cells and distorts the structure of the liver b. excessive accumulation of fat within the hepatocytes and biliary ducts c. localized injury to biliary ducts d. abnormal deposition of minerals within hepatic cells 11. Factors which contribute to the development of cholelithiasis include: a. b. c. d. stasis and altered composition of bile diabetes cirrhosis excess consumption of fatty foods 12. Acute pancreatitis results from: a. b. c. d. an infectious process ischemia an autodigestive process an autoimmune response 13. Low fiber diets play a role in the pathogenesis of: a. b. c. d. appendicitis ulcerative colitis diverticulitis cholecystitis 14. An ordered display of a set of chromosomes from a single cell is a: a. b. c. d. autosomal spread karyotype phenotype genotype 15. Jane B, age 13, has only a single X chromosome present. Her condition is called: a. b. c. d. Down syndrome Klinefelter syndrome Fragile X syndrome Turner syndrome 16. Based on Jane B’s condition, which of the following would you expect to see clinically: a. b. c. d. severe cognitive deficits sterility high pitched voice flat nasal bridge Final Review Questions 1. All of the following represent general characteristics of cancerous cells EXCEPT: a. decreased nuclear size b. local increase in cell number c. abnormal cellular arrangement d. variation in cell shape 2. Metastasis can be defined as the process where tumors spread from primary sites to distant sites. Which of the following shows a correct sequence in the process of metastasis: a. b. c. d. 3. Which of the following is not a possible cause of anemia in people with cancer: a. b. c. d. 4. hyponatremia and hypoosmolality hyperkalemia and hypoosmolality hyponatremia and urine hyperosmolality hypokalemia and hyperosmolality JD, a 25 year old female, is admitted to the hospital with Grave’s disease. You would expect to see which of the following signs on admission: a. b. c. d. 8. decrease in urine output edema vomiting thirst A 54 year old patient with lung cancer is evaluated for SIADH. Which of the following would the nurse expect to find in the patient with SIADH: a. b. c. d. 7. to eradicate cancer to avoid damage to normal structures to replace chemotherapy to prevent excessive toxicity Diabetes insipidus and diabetes mellitus both have which of the following manifestations: a. b. c. d. 6. chronic bleeding iron deficiency magnesium deficiency medical therapies All of the following represent goals of radiation therapy EXCEPT: a. b. c. d. 5. local extension, penetration into blood/lymph, transport transport, vascularization, adherence of tumor cells vascularization, invasion of lymph and vascular system, transport vascularization, local extension, transport weight gain to 155 pounds with height of 5 feet 8 inches heart rate 90/min and respiratory rate 16/min skin hot and moist, protrusion of the eyeballs constipation, normal menses Gigantism differs from acromegaly in terms of: a. level of attained height b. age of onset c. presence of accompanying metabolic derangements d. level of hormone excess that is present 9. Signs and symptoms of Cushing’s syndrome are related to abnormal cortisol levels. Common manifestations include: a. b. c. d. weight loss, fatigue, hypotension weight gain, hypoglycemia, hyponatremia weight gain, hypertension, stretch marks in skin weight loss, hyperglycemia, lean trunk 10. BK, a 12 year old male, is admitted with type I diabetes mellitus. The initial signs and symptoms you would expect to see include: a. b. c. d. recurrent infections, visual changes, fatigue, serum glucose fluctuations polydipsia, polyuria, polyphagia, weight loss, serum glucose fluctuations vomiting, abdominal pain, dehydration, low serum glucose weakness, confusion, weight gain, glucose in the urine 11. SD, a 65 year old female is admitted to the medical unit complaining of a blister on her foot that has not healed. She says it looks “dark and ugly”. She indicates that she didn’t realize the blister was there until she removed her shoe and found it bloody. She explains it is difficult for her to read because she has frequent blurred vision. Susan is most likely experiencing which of the following complications of diabetes mellitus: 1. 2. 3. 4. diabetic neuropathy peripheral vascular disease infection coronary artery disease a. b. c. d. 1,3,5,7 2,4,6,7 1,2,3,5 all of the above 5. microvascular disease 6. retinopathy 7. nephropathy 12. Which type of intracranial hematoma can occur several weeks after the injury: a. b. c. d. acute subdural hematoma epidural hematoma chronic subdural hematoma subarachnoid hematoma 13. Mr. J is in an automobile accident and at impact his forehead struck the windshield. In this situation, the coup injury occurred: a. b. c. d. frontal region temporal region parietal region occipital region 14. Which of the following intracranial volumes is least able to compensate for changes in intracranial pressure: a. b. c. d. cerebrospinal fluid volume blood volume brain tissue volume all are equally able to compensate 15. A sudden, explosive, disorderly discharge of cerebral neurons is: a. b. c. d. reflex seizure epilepsy intracerebral ischemic event 16. Which of the following is the cause of Parkinson disease: a. b. c. d. loss of acetylcholine excess secretions of acetylcholine loss of dopamine excess secretion of dopamine 17. The diagnosis of Alzheimer’s disease is dependent upon: a. b. c. d. the presence of biochemical markers in the blood results of brain imaging performance on psychological tests elimination of other causes of dementia 18. Mr. A demonstrates left-sided weakness of his upper and lower extremities. The symptoms disappear in 24 hours. He most likely experienced a: a. b. c. d. stroke in evolution lacunar stroke transient ischemic attack cerebral hemorrhage 19. T.V experienced an embolic stroke on the left side of his brain. Common manifestations may include all of the following EXCEPT: a. b. c. d. weakness on his right extremities aphasia impulsive behavior memory deficits