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2020 ADVANCED PATHOPHYSIOLOGY HESI RN QUESTIONS and ANSWERS
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2020 ADVANCED PATHOPHYSIOLOGY HESI RN QUESTIONSand ANSWERS
2020
Forming fibrous membranesAns: C
Feedback: Malignant tumors affect area
tissues by liberating enzymes and toxins that destroy tumor
ADVANCED tissue and normal tissue. In addition, the malignant cells
compress area vessels, causing ischemia and tissue necrosis. The
PATHOPHYSIOL
high metabolic rate of tumor growth causes the tumor to
deprive the normal tissues of essential nutrients.
OGY FNP
PRACTICE
QUESTIONS and
ANSWERS
1. Following routine colonoscopy screening, a client is
told that he had several polyps removed. The client began crying
stating, “I just can't deal with cancer. I'm too young.” The nurse
responds:A) “Don't worry. We have some great cancer
doctors on staff. I'm sure chemo will help you fight it.”B) “Maybe
if you're lucky, they have stopped it from metastasizing to your
liver.”C) “A simple intestinal surgery will cure you.”D) “Most
colon polyps are not cancerous. The biopsy results will direct
your care.”Ans: D Feedback:A polyp is a growth that
projects from a mucosal surface, such as the intestine. Although
the term usually implies a benign neoplasm, some malignant
tumors also appear as polyps. Adenomatous polyps are considered
precursors to adenocarcinomas of the colon.
2. A lung biopsy and magnetic resonance imaging have
confirmed the presence of a benign lung tumor in a client. Which
of the following characteristics is associated with this client's
neoplasm?A) The tumor will grow by expansion and is likely
encapsulated.B) The cells that constitute the tumor are
undifferentiated, with atypical structure.C) If left untreated,
the client's tumor is likely to metastasize.D) The tumor is likely
to infiltrate the lung tissue that presently surrounds it.Ans:
A Feedback: Benign neoplasms typically
grow by expansion rather than invasion. As well, they are usually
contained within a fibrous capsule. Malignant tumors are
associated with undifferentiated cells, metastasis, and infiltration
of surrounding tissue.
3. A newly diagnosed lung cancer client asks how his tumor
spread (metastasized) so fast without displaying many
signs/symptoms. The nurse responds that malignant tumors affect
area tissues by:A) Increasing tissue blood flowB) Providing
essential nutrientsC) Liberating enzymes and toxinsD)
,2020 ADVANCED PATHOPHYSIOLOGY HESI RN QUESTIONS
and ANSWERS
4. A client had a positive Pap smear. The surgeon nutrients and physical growth conditions. Bacteria prefer to
diagnosed“cancer in situ of the cervix.” The client asks, “What colonize as biofilm and communicate with other bacteria within
does this mean?” From the following statements, which is most the biofilm, but biofilm is not necessary for growth. Viruses (not
appropriatein response to this question? The tumor has:A) Been bacteria) form a capsid. Although some bacteria have projections
walled off within a strong fibrous capsuleB) Developed a for motility, these are not necessary for growth.
distant infiltrationC) Not crossed the
basement membrane, so it canbe surgically removed with little
chance of growing backD)
Grown undifferentiated cells that no longer look
like thetissue from which it aroseAns: C Feedback:
Cancer in situ is a localized preinvasive lesion. As an
example, in breast ductal carcinoma, in situ the cells have not
crossed the basement membrane. Depending on its location, an
insitu lesion usually can be removed surgically or treated so
that thechances of recurrence are small. For example, cancer in
situ of thecervix is essentially 100% curable.
5. While studying to become chemo-certified, the nurse
reviews some basic concepts about cancer cells. When a client
asksabout why the tumor grows so fast, the nurse will respond
based on which of the following physiological principles? Select
all that apply.A) Cancer cells have shorter cell cycle times than
normal cells.B) Cancer cells do not die when they are
programmed to die.C) Growth factors prevents
cancer cells from entering resting (G0) cell cycle phase.D) Cancer
cells will reach a balance between cell birth and cell death
rate.E)
Cancer cells never reach a flattened growth
rate.Ans: B, C
Feedback: One of the reasons cancerous tumors
oftenseem to grow so rapidly relates to the size of the cell pool
that is actively engaged in cycling. It has been shown that the cell
cycle time of cancerous tissue cells is not necessarily shorter than
that ofnormal cells. Rather, cancer cells do not die on schedule,
and growth factors prevent cells from exiting the cell cycle and
enteringthe G0 or noncycling phase. The ratio of dividing cells to
resting cells in a tissue mass is called the growth fraction. The
doubling time is the length of time it takes for the total mass of
cells in a tumor to double. As the growth fraction increases, the
doubling time decreases. When normal tissues reach their adult
size, an equilibrium between cell birth and cell death is reached.
Cancer cells, however, continue to divide until limitations in
blood supply and nutrients inhibit their growth. When this occurs,
the doubling time for cancer cells decreases. The initial growth
rate is exponential and then tends to decrease or flatten out over
time.
6. Although growth rate is variable among types of
bacteria,the growth of bacteria is dependent on:A) Biofilm
communicationB) Availability of nutrientsC) An intact
protein capsidD) Individual cell motilityAns: B
Feedback:
Bacterial growth is dependent upon the availability of
, 2020 ADVANCED PATHOPHYSIOLOGY HESI RN QUESTIONS
and ANSWERS
7. Which of the following outpatients are at a greater risk children, adolescents, and young adults
for developing Treponema pallidum, the cause of syphilis? (Chlamydophilapneumoniae); and respiratory disease acquired from
Select all that apply. infected birds (Chlamydophilapsittaci).
A) A homeless adolescent female performing oral sex
for money
B) A male who frequents clubs catering to exotic
dancers and sexual favors
C) A homosexual male couple who have had a
monogamous relationship for the past 20 years
D) An older adult female living in a condominium
who regularly has sex with three to four different
men/week
Ans: A, B, D
Feedback:
Treponema pallidum is a sexually transmitted
infection that is spread by direct physical contact. The Borrelia
type of spirochete is spread from animals to humans through
lice or tick bites. Leptospira spirochetes spread from animals to
humans through contact with infected animal urine.
Spirochetes are anaerobic; therefore, they would not invade
the host through oxygen-filled aerobic lungs.
8. Chlamydiaceae have characteristics of both viruses and
bacteria and are a rather common sexually transmitted infectious
organism. After entry into the host, they transform into a
reticulate body. The health care provider should monitor which of
the following clients for this possible infection? Select all that
apply.
A) An adult male who raises a number of exotic birds in
his home
B) A drug abuser looking to share needles/syringes
C) A newborn with a noticeable eye infection
D) A teenager who swims in the lake
regularly Ans: A, B, C
Feedback:
Chlamydiaceae are in the form of an elementary body
when infectious and outside of the host cell. Once an organism
enters the cell, it transforms into a large reticulate body. This
undergoes active replication into multiple elementary bodies,
which are then shed into the extracellular environment to initiate
another infectious cycle. Chlamydial diseases of humans include
sexually transmitted genital infections (Chlamydophila
trachomatis); ocular infections and pneumonia of newborns (C.
trachomatis); upper and lower respiratory tract infections in
, 2020 ADVANCED PATHOPHYSIOLOGY HESI RN QUESTIONS
and ANSWERS
9. A client has been diagnosed with Coxiellaburnetii the cardiac cycle?
infection. She asked the health care provider how she
could havegotten this disease. The health care provider's A) Atrial depolarization
best response is:
B) Ventricular depolarization
A) “Probably while walking outside without your shoes on.”
C) Ventricular repolarization
B) “While swimming in an unsanitary pond.”
D) Depolarization of the AV
C) “Drinking contaminated milk.”
node Ans: C
D) “Eating undercooked fish.”
Feedback:
Ans: C
Feedbac
k:
In humans, Coxiella infection produces a disease called Q
fever, characterized by a nonspecific febrile illness often
accompanied by headache, chills, arthralgias, and mild
pneumonia. The organism produces a highly resistant sporelike
stage that is transmitted to humans when contaminated animal
tissue is aerosolized (e.g., during meat processing) or by ingestion
of contaminated milk.
10. A teenage male develops a severe case of
“athlete's foot.”He asks, “How did I get this?” The health
care worker explains that certain fungi become infectious
(called dermatophytes) and exhibitwhich of the following
characteristics?
A) Prefer to grow in warm environments like shoes/socks
B) Like a moist environment
C) Limited to cooler cutaneous surfaces
D) Need higher blood flow
to surviveAns: C
Feedback:
Dermatophytes are not able to grow at core body
temperature, preferring the cooler surface skin areas
instead ofmoist skin folds. Diseases caused by these
organisms, includingringworm, athlete's foot, and jock itch,
are collectively called superficial mycoses.
11. A male client with a history of angina has presented to
the emergency department with uncharacteristic chest pain,
and his subsequent ECG reveals T-wave elevation. This finding
suggestsan abnormality with which of the following aspects of
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