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HESI ADVANCED PATHOPHYSIOLOG Y FNP V1 100 Practice Questions with Answers.
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HESI ADVANCEDPATHOPHYSIOLOG Y FNP V1
100 Practice Questions
w i t h 1 0 0 % V e r i fi e d
Answers 2.In the negative feedback mechanism that controls blood
glucose levels, an increase in blood glucose stimulates an increase in
insulin, which enhances removal of glucose from the blood. When
glucose has been taken up by cells and blood glucose levels fall, insulin
1. According to Walter B. Cannon, homeostasis is a secretion is inhibited and glucagon and other counterregulatory
stable internal environment achieved through a system of: mechanisms stimulate release of glucose from the liver, which causes
blood glucose levels to return to normal.
A) Interdependent system-wide adaptive responses
3. A client presents to the emergency department following
B) Variable internal and external conditioning factors a major traffic accident. Though outwardly there are no apparent
C) Coordinated physiologic processes that oppose change physical injuries found, the client is experiencing chest pain and
heightened alertness, which the health care worker attributes to the
D) Compatibility between cells and the internal first stage of general adaptation syndrome (GAS). The health care
worker concludes the client is experiencing manifestations related
environment Ans: C to the release of:
Feedback: A) Aldosterone, which interferes with sodium absorption
Walter B. Cannon identified homeostasis, achieved by a B) Epinephrine
coordinated physiologic process that opposes change. Claude Bernard
recognized the importance of compatibility between cells and the C) Too little cortisol
internal environment. Hans Selye identified the general (systemic)
adaptive and interdependent responses to stress. According to Selye, D) Thyroid-stimulating hormone
stressors produce different responses due to the influence of adaptive Ans: B
internal or external factors (conditioning factors).
Feedback:
2. A child has been experiencing hypoglycemic episodes.
“How does the body know when to secrete insulin and when to stop The general adaptation syndromes has three stages—the
secreting it?” The best response by the nurse, explaining the first is alarm (fight or flight); second is resistance (fight); and the third
physiologic background, would be: is exhaustion. The alarm stage is characterized by a generalized
stimulation of the sympathetic nervous system (SNS) and the HPA,
A) “The body knows that if the blood glucose level falls, it will resulting in release of catecholamines and cortisol. Increased insulin
inhibit insulin secretion and release glycogen to release glucose release or TSH release is not part of the GAS.
from the liver.”
B) “It's just a big guessing game; first we give sugar like
orange juice, and then we withhold the carbohydrates if the blood 4. Although stress exposure initiates integrated responses by
glucose level is too high.” multiple systems, the functional results are first manifested as:
Select all that apply.
C) “Your pituitary gland in the brain is the 'master gland,' and
it controls and regulates all the hormones.” A) Enhanced respiratory rate/depth
D) “Once the child starts getting confused, the brain will send B) Cravings for high-carbohydrate foods
a message to the pancreas to stop producing insulin.”
C) Increased alertness and focus
Ans: A
D) Increased glucose utilization
Feedback:
E) Increased GI peristalsis
Ans: A, C, D
Feedback:
Exposure to stress activates an immediate response by the
pg. 1
,neuroendocrine system that plays a role in most of the responses to
stress and attempts to adapt. Results of the coordinated release of
these neurohormones include mobilization of energy, a sharpened
focus and awareness, increased cerebral blood flow and glucose
utilization, enhanced cardiovascular and respiratory functioning,
redistribution of blood flow to the brain and muscles, modulation of
the immune response, inhibition of reproductive function, and a
decrease in appetite.
pg. 2
,5. A client is experiencing significant stress while awaiting B) Growth factors
the results of her recent lymph node biopsy. Among the hormonal
contributors to this response is a release of aldosterone, resulting in C) Attachment factors
which of the following physiologic effects?
A) Decreased release of insulin
B) Increased cardiac contractility
C) Potentiating effects of epinephrine
D) Increased sodium
absorption Ans: D
Feedback:
Mineralocorticoids such as aldosterone increase sodium
absorption by the kidneys. Changes in insulin release and cardiac
contractility are mediated by catecholamines, whereas cortisol
potentiates the action of epinephrine.
6. While looking at cancer cells under a microscope, the
instructor asks the students to describe the cells. Which of the
student answers are accurate? Select all that apply.
A) The cells are in different sizes and shapes.
B) The nucleoli are larger than normal.
C) The cells are contact inhibited.
D) The cells do not resemble the tissue of origin.
E) The cells are attached to an extracellular
matrix. Ans: A, B, D
Feedback:
Undifferentiated cancer cells are marked by a number of
morphologic changes. Both the cells and nuclei display variations in
size and shape. Their nuclei are variable in size and bizarre in shape,
their chromatin is coarse and clumped, and their nucleoli are often
considerably larger than normal. The cells of malignant tumors are
characterized by wide changes of parenchymal cell differentiation
from well differentiated to completely undifferentiated. Normal cells
that are grown in culture tend to display a feature called cell density–
dependent inhibition, in which they stop dividing after the cell
population reaches a particular density. This is sometimes referred to
as contact inhibition since cells often stop growing when they come
into contact with each other. In contrast to normal cells, cancer cells
often survive in microenvironments different from those of the normal
cells. They frequently remain viable and multiply without normal
attachments to other cells and the extracellular matrix.
7. The angiogenesis process, which allows tumors to
develop new blood vessels, is triggered and regulated by tumor-
secreted:
A) Procoagulants
pg. 3
, D) Proteolytic enzymes Feedback:
Ans: B Alterations in apoptotic and antiapoptotic pathways have
been found in many cancers. One example is the high levels of the
Feedbac antiapoptotic protein BCL-2 that occur secondary to a chromosomal
k: translocation in certain B-cell lymphomas. The mitochondrial
Many tumors secrete growth factors, which trigger and
regulate the angiogenesis process. Tumor cells express various cell
surface attachment factors, for anchoring. Tumor cells secrete
proteolytic enzymes to degrade the basement membrane and migrate
into surrounding tissue. Cancer cells may produce procoagulant
materials that affect clotting mechanisms.
8. Which of the following processes characterizes an
epigenetic contribution to oncogenesis?
A) A DNA repair mechanism is disrupted.
B) A tumor suppressor gene is present, but it is not expressed.
C) Cells lose their normal contact inhibition.
D) Regulation of apoptosis in impaired, resulting
in accumulation of cancer cells.
Ans: B
Feedbac
k:
Epigenetic mechanisms of cancer growth involve changes in
the patterns of gene expression without a change in the DNA.
Epigenetic mechanisms may “silence” genes, such as tumor
suppressor genes, so that even though the gene is present, it is not
expressed and a cancer-suppressing protein is not made. Disruption
of DNA repair may contribute to cancer, but this process is not
particular to epigenetics. Similarly, loss of contact inhibition and
impaired apoptosis are associated with cancer but are not specific
manifestations of epigenetic mechanisms.
9. An oncology nurse is caring for a client with newly
diagnosed B-cell lymphoma. Extensive blood work has been drawn
and sent to the lab. Results reveal an elevated antiapoptotic protein
BCL-2 level. The client/family asks, “What does this mean?” The
health care provider bases his or her response on the fact that:
A) The client's immune system is trying to kill the cancer cell
by sending this protein to engulf it.
B) This is a good result. Normal cells undergo apoptosis if
DNA is damaged in any way.
C) This means the cancer cells have found a way to survive
and grow even with damaged DNA.
D) The client's body is trying to limit the blood supply to
the cancer cells by producing high levels of this protein.
Ans: C
pg. 4
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