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WorksheetsFall 2021 Exam 1 Review
Total questions: 40
Worksheet time: 20mins
A tissue that has abnormal or deranged cell growth, in which the cells are less organized with greater variability than those of original tissue is called:
Metaplasia
Dysplasia
Hyperplasia
Atrophy
The process of atrophy is a result of: Select all that apply.
Aging
Increased work demand
A lack of blood supply
Loss of endocrine stimulation
Increased neural stimulation
A father and mother are carriers of Cystic Fibrosis. Their 2-year-old daughter has CF. The couple tells the nurse that they are planning to have a second baby. Because their daughter has CF, they are sure that their next baby won't be affected. How should the nurse respond?
“Good planning. You need to take advantage of the odds in your favor."
“I think you’d better check with your doctor first.”
“You are both carriers, so each baby has a 25% chance of being affected.”
“Hope for a boy! Boys are not affected by CF.”
Which of the following pathways is correct regarding the HIV virus?
HIV binds to CD8+ receptor → viral RNA and reverse transcriptase are released → viral DNA is transported to nucleus → new viral proteins are produced at ribosomes → virus moves and infects other CD8+ cells
HIV binds to CD4+ receptor → viral RNA and reverse transcriptase are released → viral DNA is transported to nucleus → new viral proteins are produced at ribosomes → virus moves and infects other CD4+ cells
HIV binds to CD4+ receptor → viral DNA is transported to nucleus → viral RNA and reverse transcriptase are released → virus moves and infects other CD4+ cells → new viral proteins are produced at ribosomes
HIV binds to CD8+ receptor → viral DNA is transported to nucleus → viral RNA and reverse transcriptase are released → virus moves and infects other CD8+ cells → new viral proteins are produced at ribosomes
A new nurse is receiving a report at the start of shift and is told that the patient in room 38A has dry gangrene. The nurse should be aware that dry gangrene:
Results in an area of cold, swollen, and pulseless skin that is moist, black, and taught
Is characterized by rapid spread
Is the result of a Clostridium perfringens bacterial infection
Is often due to arterial insufficiency
Your patient says “My roommate has HIV. We share dishes and the same bathroom. I think I may have HIV!” How would you respond to this patient?
“You should get tested.”
“Casual contact is the main form of transmission.”
“Have you had any symptoms like fever, diarrhea, or an opportunistic infection such as pneumonia?”
“HIV is transmitted by blood-blood contact, unprotected sex, IV drug use, or perinatally”
Which of the following correctly orders the pathogenesis of SARS-CoV-2?
1. New SARS-CoV-2 viral particles are released to infect other host cells.
2. Viral proteins are assembled within the endoplasmic reticulum.
3. Spike protein on SARS-CoV-2 attaches to the ACE2 receptor.
4. The virus enters the cell and begins synthesis of viral RNA.
2, 4, 3, 1
1, 2, 3, 4
3, 4, 2, 1
4, 3, 1, 2
Hypothermia causes ____________, leading to tissue ________ and __________.
Vasodilation; ischemia; necrosis.
Vasoconstriction; ischemia; necrosis.
Vasodilation; hypovolemia; cerebral edema
Vasoconstriction; hypovolemia; cerebral edema
Which statement is true with regard to calcium accumulations within the body?
Calcium salts accumulate in healthy, living cells with normal body function
Dystrophic calcification occurs in chronic tuberculosis
Metastatic calcification occurs in damaged tissue
Calcification of tissue is the result of hypocalcemia
Parents Alex and Jo have just been told their 4 month old baby Riley has Tay-Sachs disease. Alex and Jo ask you to explain the pathophysiology behind this disease. Your best answer is:
Excessive metabolism of purines resulting in high concentrations of urate crystals in the body, causing renal failure
An accumulation of bilirubin within the blood
A buildup of fatty acids within the brain causing toxicity, resulting in paralysis and death
An accumulation of structural proteins in the brain causing neurofibrillary tangles
A patient has been diagnosed with a benign tumor and asks the nurse “What makes my tumor different from the bad kind?” The nurse’s best response is:
A benign tumor is well encapsulated and the cells retain differentiation, which means that it will not spread to other areas of your body
A benign tumor is fast growing, so the doctor can catch it more easily
A benign tumor is absent of normal tissue, so malignant cancer can’t develop
A benign tumor does not have access to blood supply so it cannot metastasize
A clinical instructor is discussing cancer-related genes with a student nurse. Which statement by the student indicates further teaching is required?
Oncogenes are protective genes that, when mutated, turn into proto-oncogenes which cause cancer.
In their normal state, tumor suppressor genes negatively regulate proliferation.
Proto-oncogenes are protective genes that, when mutated, turn into oncogenes which cause cancer.
When mutated, tumor suppressor genes fail to stop cancer cells from proliferating
A labor and delivery nurse recognizes a newborn baby has epicanthal folds, a low nasal bridge, and flat, low set ears. The nurse suspects that the baby has:
Trisomy 21
Fragile X syndrome
Cystic fibrosis
Cri du chat syndrome
With regard to chromosome abnormalities, nurses should be aware that:
Chromosomal abnormalities are always fatal
Chromosomal abnormalities are the leading cause of intellectual disabilities
Down syndrome is a result of an abnormal chromosome structure
Unbalanced translocation results in a mild abnormality that the child will outgrow
A female patient born with short stature, webbing of the neck, sparse body hair, and narrowing of the aorta is likely exhibiting symptomatology of:
Turner syndrome
Fetal alcohol syndrome
Klinefelter syndrome
Huntington's Disease
A genetics nurse is discussing the concept of epigenetic modifications with a friend who is not in the medical field. The nurse would be correct in explaining that epigenetic modifications:
Alter gene expression by modifying DNA
Can be influenced by diet and lifestyle
Occur only at the time of birth
At best, only involve benign processes
All of the following events are part of the process of metastasis, EXCEPT:
Gaining access to the lymph system or a blood vessel
Growing and establishing a blood supply
Losing cellular adhesion
Apoptosis
A nurse is caring for a patient with newly diagnosed breast cancer staged T2N1M1. The nurse knows this means:
Tumor >3cm, local lymph involvement, distant metastasis present.
Tumor <3cm, distant lymph involvement, no metastasis present.
Tumor >7cm, no lymph involvement, no metastasis present.
Tumor <7cm, distant lymph involvement, distant metastasis present
A patient has developed a paraneoplastic syndrome. What hormone/substance secretion and corresponding clinical manifestations could it be associated with? Select all that apply.
Adrenocorticotropic hormone (ACTH) → Cushing’s syndrome
Antidiuretic hormone (ADH) → Syndrome of inappropriate antidiuretic hormone (SIADH)
Erythropoietin → Polycythemia
Glucagon → Hyperglycemia
Parathyroid hormone related protein (PTHRP) → Hypercalcemia
A patient newly diagnosed with cancer asks their nurse: “My doctor says my cancer is called Sarcoma. What does that mean? Where in my body is the cancer?” The nurse’s best response is:
“The cancer is in your blood.”
“The cancer is in your connective tissue.”
“The cancer is in your glandular tissue.”
“The cancer is in your lymphatic tissue.”
The parents of a child who has been diagnosed with sickle cell anemia should be aware that their child is at significant risk for which of the following health problems?
Acute chest syndrome, fractures, hypoxia
Autoimmune diseases, hypoxia, stroke
Hypoxia, stroke, fractures
Acute chest syndrome, hypoxia, stroke
A patient presents to the ED having a diagnosis of folic acid deficiency anemia. What are some signs and symptoms that would be observed in this patient?
Pallor, stomatitis, fatigue
Neurological complications, stomatitis, fatigue
Pallor, stomatitis, koilonychia
Fatigue, pallor, abdominal pain
A student nurse is being oriented to the oncology unit. What statement by the student nurse shows an understanding of the pathophysiology of chronic myelocytic leukemia?
Slow development of fully differentiated lymphocytes in blood and bone marrow
Rapid proliferation of fully differentiated granulocytes/ monocytes
Rapid development of neutrophil precursors in blood and bone marrow
Slow proliferation of fully differentiated granulocytes/ monocytes
Fibrinolysis occurs as a result of:
Plasminogen converting to plasmin, which in turn digests the fibrin from the clot
Plasmin converting to plasminogen, which in turn digests the fibrin from the clot
Platelets releasing mediators, which help dissolve the clot
Both A and C
Both B and C
A patient diagnosed with Immune Thrombocytopenia Purpura (ITP) presents to the ED. Which of the following would be most accurate in explaining to this patient what ITP is?
ITP is an autoimmune disorder that primarily destroys platelets
ITP is an autoimmune disorder that primarily destroys factor VIII
ITP is an allergic disorder that primarily destroys platelets
ITP is an allergic disorder that primarily destroys factor VIII
A patient with Non-Hodgkins Lymphoma is admitted into the clinic. This form of cancer is characterized by:
Malignant proliferation of Reed-Sternberg cells that spread to adjacent nodes
Chromosomal abnormalities leading to activation of oncogenes and inactivation of tumor suppressor genes
Excessive proliferation of plasma cells producing high amounts of M protein
Chromosomal abnormalities leading to over-expression of proto-oncogenes
Which of the following mechanism pathways for someone experiencing disseminated intravascular coagulation (DIC) is correct?
Triggering event → activation of clotting cascade → depletion of clotting factors/platelets → uncontrolled thrombin formation → hemorrhage
Triggering event → uncontrolled thrombin formation → depletion of clotting factors/platelets → activation of clotting cascade → hemorrhage
Triggering event → activation of clotting cascade → uncontrolled thrombin formation → depletion of clotting factors/platelets → hemorrhage
Activation of clotting cascade → triggering event → uncontrolled thrombin formation → depletion of clotting factors/platelets → hemorrhage
Hemophilia A is due to _____ while Hemophilia B is due to ______. Both disorders are ______?
Factor VIII deficiency; factor IX deficiency; X-linked recessive
Factor VIII sufficiency; factor IX sufficiency; X-linked recessive
Factor IX deficiency; factor VIII deficiency; X-linked recessive
Factor VIII deficiency; factor IX deficiency; X-linked dominant
A male patient has been brought to the ED by his family. Routine lab work reveals that the patient has a hemoglobin level of 12.6 g/dL. While taking a detailed history, which of the following statements by the patient could validate a potential diagnosis of anemia? Select all that apply.
“I notice that I have been gaining weight”
“Every now and then, my big toe gets swollen, red, and painful”
“When I go shopping, I have to sit down and rest after one or two aisles”
“I seem to get dizzy more frequently”
“I get up to the bathroom two or three times a night”
To form a platelet plug, platelets must adhere to the endothelium. For this to occur, which protein molecule is required?
Fibrin
Plasminogen
Von Willebrand factor
Fibrinogen
T helper cells can recognize an antigen when:
It is displayed on the cells surface by MHC I and activated by cytokines
It circulates in the blood or lymph
It displayed on the cell surface by MHC II and is activated by cytokines
It is bound to antibody
Your patient has a cyst; you notice large amounts of pus, grey color, and it’s malodorous. You would characterize this inflammatory exudate as:
Serous
Hemorrhagic
Fibrinous
Purulent
Your patient comes in and reports pain in their ankle from a fall. What are other local manifestations of inflammation? Select all that apply.
Heat
Fever
Redness
Swelling
Leukocytosis
A child comes into the ED with anaphylaxis after being exposed to tree nuts. What occurs in the initial exposure phase of type I hypersensitivity disorders?
Basophils and mast cells display IgE on their surfaces
Histamine and other cell mediators (prostaglandins, leukotrienes, etc.) are released
IgG or IgM are secreted against target antigen
Allergen binds to cell-bound IgE
The malaise and fever that occur with inflammation are attributed to:
Activated complement system
Interleukins and tumor necrosis factor (TNF)
Bacterial toxins
Neutrophils
All of the following are examples of active immunity, EXCEPT:
Response to a disease
Response to a MMR vaccination
Response to an oral vaccine
Response to a gamma-globulin injection
A patient tells you, “The doctor told me my neutrophil level is elevated. I do not know what that means.” What is the best response to the patient?
“Neutrophils are the first responders of your inflammation system.”
“Neutrophils are primarily released in an allergic reaction.”
“Neutrophils will help your body induce a fever.”
“Neutrophils are programmed to kill infected cells.”
You examine your patient’s wound and note that they are in the proliferative phase of wound healing. This phase is characterized by which of the following?
Vasoconstriction followed by vasodilation
Fibroblasts create granulation tissue, collagen, and ECM
Influx of neutrophils and macrophages
Occurs 3 weeks after injury
A 48 year old cis-male is experiencing an acute transplant rejection. What is the first step of transplant rejection?
Host APCs process the antigen from the donor tissue
CD4+ helper T cells release enzymes and kill foreign tissue
The antigen needs to be processed
Antibodies are created to target the donor tissue
A client is suspected of having systemic lupus erythematosus. The nurse monitors the client for which of the following clinical manifestations?
Liver disease
Bradycardia
Joint pain
Edema
