NR 507 Advanced Pathophysiology EXAM 1–
Questions WITH Answers latest 2024
A member of the health care team is researching the etiology and pathogenesis of a number of
clients who are under his care in a hospital context. Which of the following aspects of clients'
situations best characterizes pathogenesis rather than etiology?
-A client who has been exposed to the mycobacterium tuberculosis bacterium
-A client who has increasing serum ammonia levels due to liver cirrhosis
-A client who was admitted with the effects of methyl alcohol poisoning
-A client with multiple skeletal injuries secondary to a motor vehicle accident
A client who has increasing serum ammonia levels due to liver cirrhosis
A 60 year-old man has presented to a clinic and is requesting screening for tumor markers after
reading about them in a magazine. What can the clinician most accurately tell the man about
the clinical use of tumor markers?
-"Tumor markers are a very useful screening tool, but they only exist for a very few types of
cancer."
-"Tests for the presence of tumor markers are limited by the fact that they are only accurate in
the very early stages of cancer."
-"Tumor markers are an excellent screening tool, but it's only practical to test for those cancers
that you're at risk of."
-"Tumor markers alone aren't enough to confirm whether you have cancer or not, so they're not
a very useful screening tool."
-"Tumor markers alone aren't enough to confirm whether you have cancer or not, so they're not
a very useful screening tool."
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Which target of both chemotherapy and radiation treatment accounts for adverse as well as
therapeutic effects?
,-Cell-surface receptors
-Circulating hormone levels
-Blood vessels
-Rapidly proliferating cells
Rapidly proliferating cells
A 41-year-old female with a family history of breast cancer has had a baseline mammogram.
She states that she performs monthly self-breast exams but really has a hard time evaluating
her lumps since she has numerous cysts. At her annual mammogram, the technician views a
suspicious area and refers her to the radiologist. She asks the nurse in the office, "How can a
lump appear so quickly?" The nurse's response is based on which of the following principles?
-A tumor is undetectable until it has doubled 30 times and contains at least 1 billion cells.
-Many tumor cells never leave the M-phase of the cell cycle.
-Cancer cells are undifferentiated and come in various shapes and sizes.
-If the breast has a lot of cysts, then the fluid within those sacs makes it difficult to feel the hard
lumps of a cancer.
-A tumor is undetectable until it has doubled 30 times and contains at least 1 billion cells.
A 77-year-old male client with a diagnosis of stomach cancer has been found to have
metastases in his liver. The client and his family are surprised at this turn of events, stating that
they do not see how he could have developed cancer in his liver. Which of the following facts
would underlie the reply that the care team provides?
-The parenchymal tissue of the liver is particularly susceptible to secondary malignancies.
-The portal circulatory system brings venous blood from the GI tract into the liver.
-Hepatic stromal tissue shares characteristics with cancerous cells, including lack of anchorage
dependence.
-The proximity of the liver to the stomach allows for direct spread of cancerous cells due to a
lack of contact inhibition.
-The portal circulatory system brings venous blood from the GI tract into the liver.
A 61-year-old male client is scheduled to begin chemotherapy for the treatment of his bone
cancer shortly. Staff at the cancer center have educated the man and his wife about the goals,
course, and expectations of his treatment. Which of the following medications and treatments
might the man anticipate needing during and after his course of treatment?
-Analgesia and corticosteroids
-Antiemetics and packed red blood cell (PRBC) transfusions
-Whole blood transfusion and antiplatelet aggregators
-Diuretics and selective serotonin reuptake inhibitors (SSRIs)
,-Antiemetics and packed red blood cell (PRBC) transfusions
As part of a screening program for prostate cancer, men at a senior citizen's center are having
their blood levels of prostate-specific antigen (PSA) measured. Which of the following
statements would best characterize high positive predictive value but low negative predictive
value for this screening test?
-All of the men who had high PSA levels developed prostate cancer; several men who had low
PSA levels also developed prostate cancer.
-All of the men who had low PSA levels were cancer-free; several men who had high levels also
remained free of prostate cancer.
-Men who had low PSA levels also displayed false positive results for prostate cancer; men with
high levels were often falsely diagnosed with prostate cancer.
-The test displayed low sensitivity but high specificity.
-All of the men who had high PSA levels developed prostate cancer; several men who had low
PSA levels also developed prostate cancer.
A patient has been diagnosed with a neurodegenerative disease called multiple sclerosis (MS).
The 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 NP should reply:
-The cells around your nerves don't know how to die correctly.
-The cytoplasm should neutralize the various apoptotic inhibitors but isn't working correctly.
-Dysregulated apoptosis has caused an excessive rate of programmed cell death along the
neuro-pathways.
-There is an inappropriately low rate of apoptosis occurring within the cells.
-Dysregulated apoptosis has caused an excessive rate of programmed cell death along the
neuro-pathways.
During a crime scene investigation, the coroner confirms that rigor mortis has set in. This helps
to confirm an approximate time of death. The forensic nurse can explain this process (rigor
mortis) to a group of students based on the fact that:
-Troponin is being prevented from forming a cross-bridge between the actin and myosin.
-The activated by ATP, cross-bridges become attached to the actin filament.
-The myosin head catalyzes the breakdown of ATP to provide the energy need so that a cross-
bridge can be formed.
-At death, the body is unable to complete the actin/myosin cycle and release the coupling
between the myosin and actin, creating a state of muscular contraction
-At death, the body is unable to complete the actin/myosin cycle and release the coupling
between the myosin and actin, creating a state of muscular contraction
, A nurse is teaching clients about the benefits of smoking cessation. What should the nurse
include as the most accurate reason for the development of a chronic "smoker's cough"?
-Damage to cilia in the respiratory tract make it necessary to cough to clear the airway.
-Smoke is an irritant that chronically triggers the coughing centers in the brain.
-Build-up of fluids in the alveolar spaces promotes a cough in an attempt to clear secretions.
-Substances in the smoke interfere with gas exchange and hypoxia triggers a cough response.
-Damage to cilia in the respiratory tract make it necessary to cough to clear the airway.
The nurse is caring for a client preparing for a bone marrow transplant who has undergone
chemotherapy and radiotherapy to destroy the existing bone marrow. The client asks how the
donation can replace all the different types of blood cells. What is the nurse's best response?
-We inject new bone marrow directly into the bone and from there it will create new cells.
-The cells we are injecting are hematopoietic stem cells and can transform into different cells.
-You will also need several transfusions of different types of blood products to replace the cells.
-The donation contains all the different types of blood cells and will multiply once in your body.
-The cells we are injecting are hematopoietic stem cells and can transform into different cells.
Of the following situations, which one would be an example of a maladaptive cellular change?
-18 year old body builder who has developed extremely large pectoral muscles following years
of weight lifting.
-31 year old marathon runner who has developed hypertrophied myocardial cells.
-54 year old female who has developed ovarian atrophy following loss of estrogen stimulation
during menopause.
-44 year old male with a 60 pack/year smoking history who was diagnosed with a histological
grade 3 lung cancer.
-44 year old male with a 60 pack/year smoking history who was diagnosed with a histological
grade 3 lung cancer.
A client is experiencing muscle atrophy following two weeks in traction after a motor vehicle
accident. Which of the following factors has most likely contributed to the atrophy of the
client's muscle cells?
-High levels of insulin and IGF-1 in the client's blood during immobilization.
-Denervation of the affected muscles during the time of traction.
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