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NURS 621 Final Exam Blueprint, Verified And Correct Answers
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Module 1 Cells and TissuesCell differentiation
A student asks the instructor about the origins of different tissues and their cellular origins during the
14. process of development. Which of the instructor's following statements best describes the process of cell
differentiation?
“Cells of the hematopoietic system produce the appropriate body cells that are required at each stage of
A)
development.”
B) “A single stem cell differentiates into approximately 200 different types of cells.”
C) “A fertilized ovum undergoes a series of divisions, yielding many different cell types.”
D) “Cells differentiate into necessary body cells peaking after conception and ceasing near the time of birth.”
Ans: C
Feedback:
Cell differentiation and consequent tissue types are the outcome of the series of cell divisions that occur in
the fertilized ovum. It originates neither with a single stem cell nor in the hematopoietic system. Stem cells
allow for limited differentiation throughout the life span, not only antepartum.
Cell division cycle
The nurse is teaching a group of colleagues about the cell division cycle as background to oncology nursing.
9.
Which of the following statements is true of the cell cycle?
A) Some cells lack a G0 phase.
B) Mitosis is a process that occurs in steps over 1 to 2 days.
C) The two broad phases of the cell cycle are mitosis and synthesis.
D) Nondividing cells such as nerve cells are said to be in the S 0 phase.
Ans: C
Feedback:
While consisting of several stages, cell division can be broadly divided into the two phases of mitosis and
synthesis. Some cells lack a G1 stage, not a G0 phase, and mitosis is a fluid and continuous process over 1 to 1½
hours. Nondividing cells are said to be in the G0 phase.
Cellular components and function
A 14-year-old female has been experiencing severe internal cramps in the region of the pelvis and weight
loss.She has been admitted with rectal bleeding.The physician has diagnosed her with inflammatory bowel
3.
disease (IBD). She asks the nurse what causes this disease. The nurse will base her response knowing that
IBD has been linked to
A) liver involvement in faulty glycogen stores.
B) endoplasmic reticulum stress in the gastrointestinal system.
C) oversecretion of insulin from the beta cells in the pancreas.
D) infiltration of the gastrointestinal tract by bacterial toxins.
,Ans: B
Feedback:
Researchers are determining links between the endoplasmic reticulum (ER) and various disease processes.
For examples, ER stress in the GI system has been found to be related to intestinal inflammations such as
those occur with inflammatory bowel disease. The smooth ER of the liver is involved in glycogen stores.
Insulin is synthesized as a large, inactive proinsulin molecule cut apart to produce a smaller, active insulin
molecule within the Golgi complex of the beta cells. Bacterial toxins have exploited the retrograde
transport mechanism.
A professor is teaching a group of students about the role of mitochondria within the cell. Which of the
4.
following statements is true of mitochondria?
A) They are the site of adenosine triphosphate (ATP) production.
B) The number of mitochondria in a cell is equal to the number of nuclei.
C) They are replicated within the smooth endoplasmic reticulum (ER).
D) Mitochondrial DNA is inherited patrilineally.
Ans
A
:
Feedback:
Consistent with their characterization as the “power plants” of the cell, mitochondria are the site of ATP
synthesis for the cell. The number of mitochondria in a given cell type varies, according to the energy
demands of the particular cell. They are self-replicating rather than being produced in the smooth ER, and
they are inherited matrilineally.
Question #57:
Injury to the endoplasmic reticulum due to hypoxia results in
Answer:
A decrease in protein synthesis
Reasoning:
Ribosomes are the primary site for protein synthesis. Hypoxic injury and cellular swelling result in
dilation of the rough endoplasmic reticulum, causing the ribosomes to detach. Loss of the site of
protein synthesis results in decreased protein production
RNA (mRNA, rRNA, tRNA)
During a discussion on cellular components and their function, a student asked the instructor the purpose
1.
of messenger RNA (mRNA). Of the following, which is the most accurate answer?
A) Transports amino acids to the site of protein synthesis
Acts as an inner nuclear support membrane for a rigid network of protein filaments that bind DNA to the
B)
nucleus
Performs an active role of protein synthesis, where mRNA molecules direct the assembly of proteins on
C)
ribosomes to the cytoplasm
D) Assists cells in forming neoplastic progression by altering the response of chromatin in the nuclear matrix
Ans
C
:
Feedback:
The nucleus is the site for the synthesis of three types of RNA that move to the cytoplasm and carry out the
actual synthesis of proteins. Messenger RNA copies and carries the DNA instructions for protein synthesis
to the cytoplasm. Ribosomal RNA is the site of actual protein synthesis; transfer RNA transports amino
acids to the site of protein synthesis.
,Aerobic and anaerobic metabolism and byproducts
A 62-year-old male collapsed while unloading a truck of heavy sacks of feed for his cattle. When he arrived in
10. the emergency department, blood gases reveal a slightly acidic blood sample. The nurse caring for this patient is
not surprise with this result based on which of the following pathophysiological rationales?
The skeletal muscles are producing large amounts of lactic acid and release it into the bloodstream during heavy
A)
work/exercise.
B) During exercise, catabolism will break down stored nutrients and body tissues to produce energy.
Large amounts of free energy are released when ATP is hydrolyzed and then converted into adenosine
C)
diphosphate.
D) Within the mitochondria, energy from reduction of oxygen is used for phosphorylation of ADP to ATP.
Ans: A
Feedback:
Heart muscle is efficient in converting lactic acid to pyruvic acid and then using the pyruvic acid for fuel. Pyruvic
acid is an important source of fuel for the heart during heavy exercise when the skeletal muscles are producing
large amounts of lactic acid and releasing it into the bloodstream. Therefore, the blood sample would be acidic by
nature. Catabolism will break down stored nutrients and body tissues to produce energy. ATP conversion into
ADP and phosphorylation of ADP to ATP are both aerobic metabolism processes.
During a myocardial infarction (MI), a patient with a 97% occlusion of his left descending artery develops
16. ventricular arrhythmias due to the amount of ischemia occurring in the myocardium. While educating the patient
about MIs, the nurse will base her teaching on the fact that
permanent damage will occur in the myocardium if the vessel is not opened within a 1- to 2-minute window
A)
following the occlusion.
treatment needs to be sought immediately so that the buildup of lactic acid is limited and cellular changes can be
B)
reversed.
C) once the oxygen supply has been occluded, cellular changes are irreversible even if oxygenation is restored.
the body will grow new genes through the process of angiogenesis, thereby avoiding any permanent damage to
D)
the myocardium.
Ans: B
Feedback:
Ischemia is characterized by impaired oxygen delivery and impaired removal of metabolic end products such as
lactic acid. Ischemia commonly affects blood flow through limited numbers of vessels and produces local tissue
injury. In some instances, the cellular changes due to ischemia are reversible if oxygenation is restored. If not
restored, permanent damage can occur.
Question #27:
Tissue ischemia and a decrease in mitochondrial oxygenation results in
Answer:
Decreased ATP production
Reasoning:
Tissue ischemia and a decrease in mitochondrial oxygenation results in cellular swelling. A
decrease in oxygen delivery results in a decrease in ATP production. Tissue ischemia and a
decrease in mitochondrial oxygenation result in calcium influx. A decrease in oxygen and ATP
production result in decrease protein synthesis
, Question #25:
The most common cause of hypoxic injury is
Answer:
Hypoxia
Pathophysiology of frostbite
A nurse in the emergency department admits a male client who has experienced severe frostbite to his hands and
9. toes after becoming lost on a ski hill. The nurse recognizes that which of the following phenomena has
contributed to his tissue damage?
A) Decreased blood viscosity has resulted in interstitial bleeding.
B) Reactive vasodilation has compromised perfusion.
C) Autonomic nervous stimulation has resulted in injury.
D) Decreased blood flow has induced hypoxia.
Ans: D
Feedback:
Damage from exposure to cold results from hypoxia, ice crystal formation, and vasoconstriction. Blood viscosity
increases, not decreases, and vasoconstriction occurs rather than vasodilation.
Other questions from Module 1 Quiz
Reasoning:
Because of the large concentration gradient existing across the cell membrane,
potassium ions tend to diffuse outward. As they do so, they carry their positive charges
with them, causing the inside to become negative in relation to the outside. This new
potential difference repels further outward movement of the positively charged
potassium ions. The membrane is said to be polarized
Question #20:
When educating a patient about to undergo a pacemaker insertion, the nurse explains the normal
phases of cardiac muscle tissue. During the depolarization phase, the nurse will stress that
membranes must be depolarized before they can be reexcited. Within the cell, the nurse
understands that
Answer:
Potassium channels open while sodium channels close, causing repolarization to the resting
state.
A patient has been diagnosed with a neurodegenerative disease called multiple sclerosis (MS). The
5. physician explains to the patient that this disease may be caused by dysregulated apoptosis. Later that day,
the patient asks the nurse what this means. The nurse should reply,
A) “The cells around your nerves don't know how to die correctly.”
B) “The cytoplasm should neutralize the various apoptotic inhibitors but isn't working correctly.”
C) “Dysregulated apoptosis has caused an excessive rate of programmed cell death along the neuropathways.”
D) “There is an inappropriately low rate of apoptosis occurring within the cells.”
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