Test Bank Understanding Pathophysiology 5th Edition, Huether
Chapter 01: Cellular Biology
1. A student is observing a cell under the microscope. It is observed to have supercoiled DNA with histones. Which of the following would also be observed by the student?
a. A single circular chromosome
b. A nucleus
c. Free-floating nuclear material
d. No organelles
2. A nurse is instructing the staff about cellular functions. Which cellular function is the nurse describing when an isolated cell absorbs oxygen and uses it to transform nutrients to energy?
a. Metabolic absorption
3. A eukaryotic cell is undergoing DNA replication. In which region of the cell would most of the genetic information be contained?
4. The fluid mosaic model for biologic membranes describes membrane behavior. According to this model, which of the following float singly or as aggregates in the fluid lipid bilayer?
a. Peripheral membrane proteins
b. Integral membrane proteins
d. Cell adhesion molecules
5. Which of the following can bind to plasma membrane receptors?
c. Amphipathic lipids
6. A nurse is reviewing a report from a patient with metastatic cancer. What finding would support the diagnosis of metastatic cancer? Alterations in extracellular matrix that include:
a. Decreased fibronectin
b. Increased collagen
c. Decreased elastin
d. Increased glycoproteins
7. Which form of cell communication is used to relate to other cells in direct physical contact?
a. Cell junction
b. Gap junction
d. Tight junctions
8. Pancreatic beta cells secrete insulin, which inhibits secretion of glucagon from neighboring alpha cells. This action is an example of which of the following signaling types?
9. In cellular metabolism, each enzyme has a high affinity for a:
10. An athlete runs a marathon, after which his muscles feel fatigued and unable to contract. The athlete asks the nurse why this happened. How should the nurse respond? A deficiency in ________ can cause impaired muscle contraction.
Chapter 02: Genes and Genetic Diseases
1. A nurse recalls the basic components of DNA are:
a. Pentose sugars and four phosphate bases
b. A phosphate molecule, deoxyribose, and four nitrogenous bases
c. Adenine, guanine, and purine
d. Codons, oxygen, and cytosine
2. Which of the following mutations have the most significant effect on protein synthesis?
a. Base pair substitutions
b. Silent mutations
c. Intron mutations
d. Frameshift mutations
3. The base components of DNA are:
a. A, G, C, and U
b. P, G, C, and T
c. A, G, C, and T
d. X, XX, XY, and YY
4. A DNA strand has a region with the sequence ATCGGAT. Which of the following would be a complementary strand?
5. A biologist is explaining how RNA directs the synthesis of protein. Which process is the biologist describing?
6. When homologous chromosomes fail to separate during meiosis, which of the following occurs?
d. Conjoined twins
7. A cell that does not contain a multiple of 23 chromosomes is called a _____ cell.
8. A 20-year-old pregnant female gives birth to a stillborn child. Autopsy reveals that the fetus has 92 chromosomes. What term may be on the autopsy report to describe this condition?
9. The condition in which an extra portion of a chromosome is present in each cell is called:
a. Reciprocal translocation
b. Partial trisomy
d. Down syndrome
10. After a geneticist talks to the patient about being a chromosomal mosaic, the patient asks the nurse what that means. How should the nurse respond? You may _____ genetic disease(s).
a. Only be a carrier of the
b. Have a mild form of the
c. Have two
d. Be sterile as a result of the
Chapter 03: Altered Cellular and Tissue Biology
1. A report comes back indicating that muscular atrophy has occurred. A nurse recalls that muscular atrophy involves a decrease in muscle cell:
2. During childhood, the thymus decreases in size, and this is referred to as _____ atrophy.
3. When planning care for a cardiac patient, the nurse knows that in response to an increased workload, cardiac myocardial cells will:
a. Increase in size
b. Decrease in length
c. Increase in excitability
d. Increase in number
4. A 55-year-old male with a 30-year history of smoking is examined for respiratory disturbance. Examination of his airway (bronchial) reveals that stratified squamous epithelial cells have replaced the normal columnar ciliated cells. This type of cellular adaptation is called:
5. When planning care for the pregnant patient, the nurse will recall that the mammary glands enlarge as a consequence of:
a. Compensatory hyperplasia
b. Hormonal hyperplasia
c. Hormonal anaplasia
d. Compensatory anaplasia
6. A 24-year-old female presents with excessive menstrual bleeding. The physician identified endometrial changes that are due to hormonal imbalances. These cellular changes would be referred to as:
b. Pathologic dysplasia
d. Pathologic hyperplasia
7. A 55-year-old male is diagnosed with hepatocellular cancer secondary to hepatitis C. If the cancerous region of the liver were removed, the remaining cells would undergo:
a. Pathologic hyperplasia
b. Pathologic metaplasia
c. Compensatory hyperplasia
d. Compensatory aplasia
8. A 40-year-old female is diagnosed with cervical cancer after a Pap smear. Which of the following cellular changes would the nurse most likely see on the report?
9. A 75-year-old male presents with chest pain on exertion. The chest pain is most likely due to hypoxic injury secondary to:
b. Free radicals
d. Chemical toxicity
10. A patient has a heart attack that leads to progressive cell injury that causes cell death with severe cell swelling and breakdown of organelles. What term would the nurse use to define this process?
b. Pathologic calcification
Chapter 04: Fluids and Electrolytes, Acids and Bases
1. A nurse is reviewing lab reports. The nurse recalls blood plasma is located in which of the following fluid compartments?
a. Intracellular fluid (ICF)
b. Extracellular fluid (ECF)
c. Interstitial fluid
d. Intravascular fluid
2. A 35-year-old male weighs 70 kg. Approximately how much of this weight is ICF?
a. 5 L
b. 10 L
c. 28 L
d. 42 L
3. While planning care for elderly individuals, the nurse remembers the elderly are at a higher risk for developing dehydration because they have a(n):
a. Higher total body water volume
b. Decreased muscle mass
c. Increase in thirst
d. Increased tendency towards developing edema
4. Which of the following patients should the nurse assess for a decreased oncotic pressure in the capillaries? A patient with:
a. A high-protein diet
b. Liver failure
c. Low blood pressure
d. Low blood glucose
5. Water movement between the ICF and ECF compartments is determined by:
a. Osmotic forces
b. Plasma oncotic pressure
c. Antidiuretic hormone
d. Buffer systems
6. An experiment was designed to test the effects of the Starling forces on fluid movement. Which of the following alterations would result in fluid moving into the interstitial space?
a. Increased capillary oncotic pressure
b. Increased interstitial hydrostatic pressure
c. Decreased capillary hydrostatic pressure
d. Increased interstitial oncotic pressure
7. When planning care for a dehydrated patient, the nurse remembers the principle of water balance is closely related to _____ balance.
8. A 70-year-old male with chronic renal failure presents with edema. Which of the following is the most likely cause of this condition?
a. Increased capillary oncotic pressure
b. Decreased interstitial oncotic pressure
c. Increased capillary hydrostatic pressure
d. Increased interstitial hydrostatic pressure
9. A 10-year-old male is brought to the emergency room (ER) because he is incoherent and semiconscious. CT scan reveals that he is suffering from cerebral edema. This type of edema is referred to as:
a. Localized edema
b. Generalized edema
c. Pitting edema
10. A nurse is teaching the staff about antidiuretic hormone (ADH). Which information should the nurse include? Secretion of ADH is stimulated by:
a. Increased serum potassium
b. Increased plasma osmolality
c. Decreased renal blood flow
d. Generalized edema
Chapter 05: Innate Immunity: Inflammation and Wound Healing
1. A public health nurse is teaching the community about health promotion. Which information should the nurse include for innate immunity? Innate immunity is gained:
a. Following an illness
b. At birth
c. Via injection of specific antibodies
d. In adulthood
2. Which statement indicates teaching was successful regarding collectins? Collectins are produced by the:
3. A 20-year-old male received a knife wound to the arm during an altercation. Which of the following types of immunity was compromised?
a. Innate immunity
b. Inflammatory response
c. Adaptive immunity
d. Specific immunity
4. Biochemical secretions that trap and kill microorganisms include:
d. Gastric acid
5. A 25-year-old female presents to her primary care provider reporting vaginal discharge of a white, viscous, and foul-smelling substance. She reports that she has been taking antibiotics for the past 6 months. Which finding will the nurse most likely see on the microorganism report?
a. Clostridium difficile overgrowth
b. Decreased Lactobacillus
c. Streptococcus overgrowth
d. Decreased Candida albicans
6. When an aide asks the nurse what is a purpose of the inflammatory process, how should the nurse respond?
a. To provide specific responses toward antigens
b. To lyse cell membranes of microorganisms
c. To prevent infection of the injured tissue
d. To create immunity against subsequent tissue injury
7. A child fell off the swing and scraped the right knee. The injured area becomes painful. What else will the nurse observe upon assessment?
a. Vasoconstriction at injured site
b. Decreased RBC concentration at injured site
c. Pale skin at injured site
d. Edema at injured site
8. A nurse recalls the mast cell, a major activator of inflammation, initiates the inflammatory response through the process of:
9. Which of the following individuals would be at greatest risk for an opportunistic infection?
a. 18-year-old with diabetes
b. 70-year-old with congestive heart failure
c. 24-year-old who is immunocompromised
d. 30-year-old with pneumonia
10. The directional migration of leukocytes along a chemical gradient is termed:
Chapter 06: Adaptive Immunity
1. Which of the following is responsible for initiating clonal selection?
a. T cells
b. B cells
2. After teaching the students about B cells, which statement indicates teaching was successful? B cells are originally derived from cells of the:
a. Bone marrow
b. Lymph nodes
c. Gut-associated lymphoid tissue
3. A 6-year-old female is diagnosed with a bacterial infection of the respiratory system. Which of the following will most likely try to fight the antigen?
b. Cytotoxic T cells
d. Helper T cells
4. When the immunoglobulin crosses the placenta, what type of immunity does the fetus receive?
5. An immunologist has isolated a molecule from the human body to study. It is found to react with antibodies on B cells. Further testing reveals that the molecule is large and chemically diverse. What type of molecule is the immunologist studying?
6. Which statement indicates a correct understanding of antibodies? The most abundant class of antibody in the serum is:
7. The predominant antibody of a typical primary immune response is:
8. An immunology nurse is caring for a patient. While planning care, which principle will the nurse remember? The primary role of IgA1 is to prevent infections in the:
d. Mucous membranes
9. A 23-year-old pregnant female visits her primary care provider for her final prenatal checkup. The primary care provider determines that the fetus has developed an infection in utero. Which of the following would be increased in the fetus at birth?
10. Which portion of the antibody is responsible for the biologic functions of antibodies?
a. Heavy chain
b. Variable region
c. Fc portion
Chapter 07: Infection and Defects in Mechanisms of Defense
1. When a patient asks the nurse what hypersensitivity is, how should the nurse respond? Hypersensitivity is best defined as:
a. A reduced immune response found in most pathologic states
b. A normal immune response to an infectious agent
c. An excessive or inappropriate response of the immune system to a sensitizing antigen
d. Antigenic desensitization
2. A 5-year-old female takes a hike through the woods during a school field trip. Upon returning home, she hugs her father, and he later develops poison ivy. Which of the following immune reactions is he experiencing?
b. Tissue specific
c. Immune complex
3. When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs?
4. While planning care, a nurse recalls seasonal allergic rhinitis is expressed through:
a. IgE-mediated reactions
b. Tissue-specific reactions
c. Antigen-antibody complexes
d. Type II hypersensitivity reactions
5. A patient presents with poison ivy on the extremities, face, and buttocks. This condition is an example of:
b. Serum sickness
c. Delayed hypersensitivity
d. Viral disease
6. A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pain, swelling, redness, and respiratory difficulties. He is suffering from:
d. Tissue-specific hypersensitivity
7. When a patient presents at the emergency department for an allergic reaction, the nurse recognizes the most severe consequence of a type I hypersensitivity reaction is:
d. Antibody-dependent cell-mediated cytotoxicity (ADCC)
8. When histamine is released in the body, which of the following responses would the nurse expect?
a. Bronchial dilation
9. Which information would indicate more teaching is needed regarding hypersensitivity reactions? Type _______ hypersensitivity reactions involve an antibody response.
10. A 10-year-old male presents to his primary care provider reporting wheezing and difficulty breathing. History reveals that both of the child’s parents suffer from allergies. Which of the following terms would be used to classify the child?
Chapter 08: Stress and Disease
1. After teaching about stress, which information indicates a correct understanding of stress?
a. It worsens but does not cause disease.
b. It can be viewed as transactional.
c. It is a psychologic, rather than biologic, event.
d. It is a passive event.
2. Selye reported several structural changes in rats exposed to repeated stressors. These included:
a. Hypertrophy of the thymus gland
b. Ulceration in the gastrointestinal system
c. Atrophy of the cortex in the adrenal gland
d. Fight or flight response
3. A female student is driving to school when another driver nearly hits her. Her heart begins beating harder and faster as she becomes aroused and scared. Which of the following stages of the general adaptation syndrome is she experiencing?
a. Alarm stage
b. Stage of resistance
4. Exhaustion occurs if stress continues and _____ is not successful.
a. Fight or flight
5. A male student arrives at school to find that he has an exam for which he is unprepared. Which of the following would be expected?
a. Decreased lipolysis
c. Decreased cortisol release
d. Increased glucagon release
6. A 10-year-old female is arriving at a national spelling bee contest. Her heart starts beating faster and harder, and she begins to sweat. Which of the following is she experiencing?
a. Anticipatory response
c. Reactive response
d. Exhaustion stage
7. Which of the following hormones activates adrenergic receptors?
8. A 35-year-old male is diagnosed with a hormone-secreting tumor of the adrenal medulla. He experiences elevated blood pressure, pupil dilation, “goose bumps,” and increased anxiety. Which of the following hormones is the predominant one released by the tumor?
a. Antidiuretic hormone
9. Stress induces sympathetic stimulation of the adrenal medulla. This causes the secretion of catecholamines, which include:
a. Epinephrine and aldosterone
b. Norepinephrine and cortisol
c. Epinephrine and norepinephrine
d. Cortisol and aldosterone
10. A nurse recalls stress-induced stimulation of the adrenal cortex causes it to secrete:
c. Parathyroid hormone
d. Adrenocorticotropin hormone (ACTH)
Chapter 09: Biology, Clinical Manifestations, and Treatment of Cancer
1. A patient has a tissue growth that was diagnosed as cancer. Which of the following terms best describes this growth?
2. Which information indicates a nurse understands characteristics of malignant tumors?
a. Grows slowly
b. Has a well-defined capsule
c. Has a high mitotic index
d. Is well-differentiated
3. A nurse is discussing preinvasive epithelial tumors of glandular or squamous cell origin. What is the nurse describing?
a. Tumor in differentiation
c. Cancer in situ
d. Cancer beyond (meta) situ
4. A 25-year-old male develops a tumor of the breast glandular tissue. What type of tumor will be documented on the chart?
5. A 30-year-old female is diagnosed with cancer. Testing reveals that the cancer cells have spread to local lymph nodes. A nurse realizes this cancer would be documented as stage:
6. An oncologist is discussing when a cancer cell loses differentiation. Which of the following is the oncologist describing?
7. A primary care provider is attempting to diagnose cancer and is looking for a tumor marker. Which of the following could be a possible marker?
a. Red blood cells
b. Apoptotic cells
8. A 52-year-old male with hepatitis C recently developed hepatic cancer. Which of the following markers should be increased?
a. Alpha-fetoprotein (AFP)
c. Prostate-specific antigen
d. Homovanillic acid
9. Which information should the nurse include when teaching about angiogenic factors? In cancer, angiogenic factors stimulate:
a. Release of growth factors
b. Tumor regression
d. New blood vessel growth
10. A patient has been researching telomere caps on the Internet. Which statement indicates the patient has a good understanding? Presence of telomere caps gives cancer cells:
a. The ability to divide over and over again
b. Clonal distinction
c. Limited mitosis
d. Mutation abilities
Chapter 10: Cancer Epidemiology
1. Which statement indicates the patient has a good understanding of cancer risk factors? The most important environmental risk factor for cancer is exposure to:
a. Ultraviolet (UV) radiation
d. Cigarette smoke
2. When an oncologist is discussing the degree to which an organism’s development is contingent on its environment, which of the following is the oncologist explaining?
a. Transgenerational inheritance
c. Histone modification
d. Developmental plasticity
3. When a patient asks what types of cancers are associated with tobacco use, how should the nurse respond?
a. Squamous and small cell adenocarcinomas
b. Sarcoma and adenoma
c. Melanoma and lymphoma
d. Basal cell and lipoma
4. Chromosome aberrations and mutations in cells that were not directly irradiated are referred to as:
a. Bystander effects
b. Lethal mutation
c. Delayed reproductive death
d. Genetic instability
5. A 50-year-old female develops skin cancer on her head and neck following years of sunbathing. Which of the following cancers is the most likely?
c. Basal cell carcinoma
6. A 25-year-old male nursing student recently learned how diet can alter the chances of developing cancer. He tries to minimize his risks of developing the disease by ordering his steak:
d. Well done
7. Which of the following compounds has been shown to increase the risk of cancer when used in combination with smoking?
8. A 25-year-old female was diagnosed with cervical cancer. History reveals she had many sexual partners, which she indicates is “too many to count.” Which of the following is most likely to have caused her cancer?
9. A nurse recalls physical activity was shown to reduce the risk of which of the following types of cancer?
10. A 65-year-old male was recently diagnosed with cancer. He is retired from construction work. Which of the following cancers is he likely to develop secondary to occupational hazards?
b. Bladder cancer
c. Prostate cancer
d. Bone cancer
Chapter 11: Cancer in Children
1. While planning care for children with cancer, which information should the nurse remember? Most childhood cancers originate from the:
c. Mesodermal germ layer
d. Neural tube
2. A child was recently diagnosed with cancer. The diagnosis suggests it is an embryonic tumor. Which of the following characterizes this type of cancer?
a. Commonly occurring
b. Often seen in adults
c. Composed of mature, differentiated cells
d. Usually manifested around age 5
3. A nurse is preparing to teach the most common malignancy in children. Which malignancy should the nurse discuss?
c. Wilms tumor
4. A 3-year-old female was diagnosed with Wilms tumor. This disease is a tumor of the:
c. Bone marrow
5. A couple brings their child to his primary care provider for a checkup. The child has Down syndrome, and the couple is concerned about other diseases that could afflict the child. The primary care provider explains that young children with Down syndrome are at higher risk for developing:
6. A newborn male is born with heart failure. Three weeks later he receives a heart transplant. Which of the following is he at the highest risk for developing?
b. Liver cancer
c. Pancreatic cancer
d. Burkitt lymphoma
7. A 40-year-old female developed adenocarcinoma of the vagina. Which of the following is the most likely cause of her cancer?
a. Rb gene mutation
b. Prenatal exposure to diethylstilbestrol (DES)
c. Prenatal exposure to solvents
d. Prenatal exposure to radiation
8. A 16-year-old male with aspirations of becoming a bodybuilder spends 3 hours a day in the gym. Five years later he develops hepatocellular carcinoma. Which of the following is the most likely cause of the cancer?
a. Immunosuppressive agents
b. Cytotoxic agents
c. Anabolic steroids
d. A viral infection
9. The most common tissue type of cancer occurring after adolescence is:
b. Squamous cell
Chapter 12: Structure and Function of the Neurologic System
1. When a patient asks what the somatic nervous system controls, how should the nurse respond? It controls:
a. The heart
b. The spinal cord
c. Skeletal muscle
d. Smooth muscle organs
2. A nurse is preparing to teach about nerves. Which information should the nurse include? The axon leaves the cell body at the:
a. Axon hillock
b. Nissl body
c. Node of Ranvier
d. Myelin sheath
3. When a student asks in which region of the neuron do nerve impulses travel the fastest, how should the nurse respond? The:
a. Large axon
b. Axon hillock
c. Cell body
4. A neurologist is teaching the staff about motor neurons. Which information should be included? Motor neurons are structurally classified as _____ neurons.
5. An experiment looking at an isolated neuron revealed a sensory nerve with one process containing a dendritic portion extending away from the CNS and an axon extending toward the CNS. Which of the following classifications would this neuron fall into?
6. A cell was isolated from the CNS. A researcher revealed that its main function was to clear cellular debris. What type of cell is the researcher studying?
b. Ependymal cell
d. Schwann cell
7. Which answer indicates a nurse understands regeneration of neurons? Neurons that have the capacity for regeneration include:
a. Unmyelinated neurons in the brain
b. Myelinated neurons in the spinal cord
c. Myelinated peripheral neurons
d. Postganglionic motor neurons
8. When a presynaptic neuron is stimulated in a patient’s body by an electrical current, neurotransmitters are released from the:
b. Synaptic bouton
c. Synaptic cleft
9. An aide asks a nurse what neurotransmitters interact with. Which response is the nurse’s best answer? Neurotransmitters interact with the postsynaptic membrane by binding to a:
b. Nissl body
c. Glial cell
10. If a neuron’s membrane potential is held as close to the threshold potential by excitatory postsynaptic potentials (EPSPs), the neuron is said to be:
Chapter 13: Pain, Temperature, Sleep, and Sensory Function
1. A patient asks the nurse where nociceptors can be found. How should the nurse respond? One location in which nociceptors can be found is the:
b. Spinal cord
c. Efferent pathways
2. A nurse is discussing an individual’s conditioned or learned approach or avoidance behavior in response to pain. Which system is the nurse describing?
a. Sensory-discriminative system
b. Affective-motivational system
c. Sensory-motivational system
d. Cognitive-evaluative system
3. When a neurologist explains how pricking a finger with a needle provides minimal pain while cutting the finger with a knife provides more severe pain, what theory is being described?
a. Gate control theory
b. Neuromatrix theory
c. Specificity theory
4. A 5-year-old female breaks her leg after falling from a merry-go-round. Which of the following would be released from the midbrain to modulate her pain?
5. A 15-year-old female scrapes her knee while playing soccer and complains of sharp and well-localized pain. Which of the following should the nurse document to most accurately characterize her pain?
a. Chronic pain
b. Referred pain
c. Somatic pain
d. Visceral pain
6. A nurse should document on the chart that chronic pain is occurring when the patient reports the pain has lasted longer than:
a. 1 month
b. 3 to 6 months
c. 1 year
d. 2 to 3 years
7. A 50-year-old male cut his hand off while working in a sawmill. Several years later he still sporadically feels pain in the absent hand. What type of pain should the nurse document in the chart?
a. Neuropathic pain
b. Visceral pain
c. Phantom limb pain
d. Chronic pain
8. When planning care for a child in pain, which principle should the nurse remember? The pain threshold in children is _____ that of adults.
a. Higher than
b. Lower than
c. The same as
d. Not related to
9. When the nurse is taking a patient’s temperature, which principle should the nurse remember? Regulation of body temperature primarily occurs in the:
d. Pituitary gland
10. When the nurse is discussing the patient’s cyclical temperature fluctuation occurring on a daily basis, what term should the nurse use?
a. Thermogenesis cycle
b. Thermoconductive phases
c. Adaptive pattern
d. Circadian rhythm
Chapter 14: Alterations in Cognitive Systems, Cerebral Hemodynamics and Motor Function
1. A neurologists explains that arousal is mediated by the:
a. Cerebral cortex
b. Medulla oblongata
c. Reticular activating system
d. Cingulate gyrus
2. A 20-year-old male suffers a severe closed head injury in a motor vehicle accident. He remains in a vegetative state (VS) 1 month after the accident. Which of the following structures is most likely keeping him in a vegetative state?
a. Cerebral cortex
c. Spinal cord
3. A 16-year-old male took a recreational drug that altered his level of arousal. Physical exam revealed a negative Babinski sign, equal and reactive pupils, and roving eye movements. Which of the following diagnosis will the nurse most likely see on the chart?
a. Psychogenic arousal alteration
b. Metabolically induced coma
c. Structurally induced coma
d. Structural arousal alteration
4. The breathing pattern that reflects respirations based primarily on carbon dioxide (CO2) levels in the blood is:
c. Central neurogenic
5. A 45-year-old female presents to the emergency room (ER) reporting excessive vomiting. A CT scan of the brain reveals a mass in the:
a. Skull fractures
c. Medulla oblongata
d. Frontal lobe
6. A teenage boy sustains a severe closed head injury following an all-terrain vehicle (ATV) accident. He is in a state of deep sleep that requires vigorous stimulation to elicit eye opening. How should the nurse document this in the chart?
7. A 50-year-old male suffers a severe head injury when his motorcycle hits a tree. His breathing becomes deep and rapid but with normal pattern. What term should the nurse use for this condition?
b. Ataxic breathing
d. Central neurogenic hyperventilation
8. When a student asks what can cause dilated, fixed pupils, what is the nurse’s best response? Dilated fixed pupils can be caused by:
a. Brainstem hypoxia
b. Cerebral contusions
c. Compression of the hypothalamus
d. Spinal shock
9. An attorney spoke to the nurses regarding brain death. Which statement indicates the nurses understood brain death? For legal purposes, brain death is defined as:
a. Cessation of brain function
b. Lack of cortical function
c. A VS
d. Death of the brainstem
10. When thought content and arousal level are intact but a patient cannot communicate, the patient has:
a. Cerebral death
b. Locked-in syndrome
d. Cerebellar motor syndrome
Chapter 15: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction
1. A neurologist is teaching about brain injuries. Which information should the neurologist include? The most severe diffuse brain injury caused by rotational acceleration is most likely to be located _____ the brainstem.
a. More peripheral to
b. In the central portion of
d. Distal to
2. A nurse is preparing to teach staff about the most common type of traumatic brain injury. Which type of traumatic brain injury should the nurse discuss?
a. Penetrating trauma
b. Diffuse axonal injury
c. Focal brain injury
3. A 15-year-old male suffered diffuse brain injury after wrecking an all-terrain vehicle. He had momentary confusion and retrograde amnesia after 5 to 10 minutes. His injury could be categorized as:
a. Grade I
b. Grade II
c. Grade III
d. A mild concussion
4. A 25-year-old male was in an automobile accident. At impact, his forehead struck the windshield. In this situation, a nurse recalls the coup injury would occur in the _____ region.
5. While planning care for a patient with an extradural hematoma, which principle should the nurse remember? The main source of bleeding in extradural (epidural) hematomas is:
6. A 69-year-old male with a history of alcohol abuse presents to the emergency room (ER) after a month-long episode of headaches and confusion. Based on his alcoholism, a likely cause of his neurologic symptoms is:
b. Chronic subdural hematoma
c. Epidural hematoma
d. Subacute subdural hematoma
7. A 15-year-old male was struck by a motor vehicle and suffered a traumatic brain injury. Paramedics found him unconscious at the scene of the accident. During the ambulance ride, he regained consciousness and was able to maintain a conversation with the medical staff. Upon arrival to hospital, he was alert and oriented. Physical exam reveals confusion and impaired responsiveness. What is the probable nature of his brain injury based on this history?
a. Mild concussion
b. Subdural hematoma
c. Extradural (epidural) hematoma
d. Mild diffuse axonal injury
8. Which assessment finding by the nurse characterizes a mild concussion?
a. A brief loss of consciousness
b. Significant behavioral changes
c. Retrograde amnesia
d. Permanent confusion
9. A 39-year-old male suffers a severe brain injury when he falls off a building while working. CT scan reveals that he has a basilar skull fracture. Based upon his injuries, what major complication should the nurse observe for in this patient?
a. Hematoma formation
b. Meningeal infection
c. Increased intracranial pressure (ICP)
d. Cognitive deficits
10. A 65-year-old female loses her balance while walking in the woods, causing her to fall and hit her head. She loses consciousness and is in a coma for 5 days. She is diagnosed as having diffuse brain injury. Which of the following would most likely occur in this patient?
a. Complete loss of vision
c. Blunted affect
d. Meningitis infection
Chapter 16: Alterations of Neurologic Function in Children
1. The nurse is assessing a 2-month-old infant. Which reflex of infancy will disappear first?
c. Palmar grasp
d. Moro reflex
2. A 10-month-old infant presents for a well-baby visit. Which of the following reflexes should be present at this age?
d. Palmar grasp
3. The parents ask, “During infancy, what is the fastest growing part of the body?” How should the nurse respond?
a. Spinal cord
b. Limb bones
d. Vertebral column
4. A nurse is preparing to teach about the most common defects of neural tube closure. Which one should the nurse discuss?
5. An infant has an anterior midline defect of neural tube closure. What term will the nurse observe written on the chart?
6. What nutrient should the nurse encourage a woman in the early stages of pregnancy to consume to prevent neural tube defects?
c. Vitamin D
d. Folic acid
7. A newborn child has a herniation of brain and meninges through a defect in the occipital area of the skull. What will the pediatrician call this condition?
8. A newborn child has a hernial protrusion of a saclike cyst through a defect in the posterior arch of a vertebra. This condition is referred to as:
9. A 19-month-old boy developed a premature closure of one or more of the cranial sutures. Which diagnosis will the nurse observe on the chart?
b. Congential hydrocephalus
10. A baby is stillborn after 6 hours of labor. Autopsy reveals hydrocephalus caused by cystic dilation of the fourth ventricle and aqueductal compression. Which of the following is the most likely diagnosis?
a. Congenital hydrocephalus
c. Dandy-Walker deformity
d. Macewen sign
Chapter 17: Mechanisms of Hormonal Regulation
1. A nurse recalls direct stimulation of the insulin-secreting cells of the pancreas by the autonomic nervous system is an example of _____ control.
a. Negative feedback
b. Positive feedback
d. Substrate-level dependent
2. A nurse is teaching staff about protein hormones. Which information should the nurse include? One of the protein hormones is:
a. Thyroxine (T4)
3. A 45-year-old female has elevated thyroxine production. Which of the following would accompany this condition?
a. Increased thyroid-releasing hormone (TRH)
b. Increased anterior pituitary stimulation
c. Decreased T4
d. Decreased thyroid-stimulating hormone (TSH)
4. An endocrinologist isolated a new hormone and found it to be a water-soluble amine. Which of the following is most like this new hormone?
a. Growth hormone (GH)
b. Luteinizing hormone (LH)
c. Antidiuretic hormone (ADH)
5. When insulin binds to its receptors on muscle cells, an increase in glucose uptake by the muscle cells occurs. This is an example of a _____ effect by a hormone.
6. A 30-year-old male was diagnosed with hypothyroidism. Synthesis of which of the following would decrease in this patient?
a. Corticosteroid B globulin
b. Sex hormone-binding globulin
c. Thyroid-binding globulin
7. A patient has high levels of hormones. To adapt to the high hormone concentrations, the patient’s target cells have the capacity for:
a. Negative feedback
b. Positive feedback
8. A patient has researched lipid-soluble hormones on the Internet. Which information indicates the patient has a good understanding? Lipid-soluble hormone receptors cross the plasma membrane by:
c. Active transport
9. When a patient asks about target cell receptors, which is the nurse’s best response? Target cell receptors for most water-soluble hormones are located in the:
b. Cell membrane
c. Endoplasmic reticulum
10. When the endocrinologist asks the staff how the releasing hormones that are made in the hypothalamus travel to the anterior pituitary, how should the staff reply? Via the:
a. Vessels of the zona fasciculata
c. Median eminence
d. Hypophysial portal system
Chapter 18: Alterations of Hormonal Regulation
1. A nurse is discussing endocrine system dysfunction with a patient. Which statement indicates the patient understood? Endocrine system dysfunction can result from hyposecretion, hypersecretion, or from:
a. Abnormal receptor activity
b. Abnormal hormone levels
c. Increased synthesis of second messengers
d. Extracellular electrolyte alterations
2. An aide asks the nurse what is the most common cause of elevated levels of antidiuretic hormone (ADH) secretion. How should the nurse respond?
a. Autoimmune disease
d. Heart failure
3. A 54-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which of the following electrolyte imbalances would be expected in this patient?
4. A 44-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for SIADH. Which of the following assessment findings would be expected in this patient?
a. Peripheral edema
c. Low blood pressure
d. Concentrated urine
5. A nurse is caring for a patient with SIADH. What severe complication should the nurse assess for?
b. Diabetes insipidus
c. Neurologic damage
d. Renal failure
6. A 22-year-old male is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident. The injury has caused severe damage to the posterior pituitary. Which of the following complications should the nurse anticipate?
a. Dilutional hyponatremia
b. Dehydration from polyuria
c. Cardiac arrest from hyperkalemia
d. Metabolic acidosis
7. While planning care for a patient from general anesthesia, which principle should the nurse remember? A side effect of some general anesthetic agents is _____ diabetes insipidus.
8. Diabetes insipidus, diabetes mellitus (DM), and SIADH share which of the following assessment manifestations?
c. Vomiting and abdominal cramping
9. A 50-year-old male patient presents with polyuria and extreme thirst. He was given exogenous ADH. For which of the following conditions would this treatment be effective?
a. Neurogenic diabetes insipidus
b. Psychogenic diabetes insipidus
c. Nephrogenic diabetes insipidus
10. A 25-year-old male presents with fatigue, constipation, and sexual dysfunction. Tests reveal all pituitary hormones are normal and no masses are present. The nurse suspects the most likely cause of his symptoms is a dysfunction in the:
a. Anterior pituitary
b. Posterior pituitary
c. Pars intermedia
d. Pituitary stalk
Chapter 19: Structure and Function of the Hematologic System
1. A primary care provider is talking about plasma proteins synthesized by lymphocytes in the lymph nodes. What is the primary care provider describing?
c. Clotting factors
d. Complement proteins
2. While reviewing lab results, the nurse recalls the most abundant cells in the blood are:
3. An adult patient’s blood sample is analyzed in a laboratory. Assuming a normal sample, which type of white blood cell accounts for the highest percentage?
4. A group of cells isolated in the laboratory have membrane-bound granules in their cytoplasm and they show phagocytic activity. Which of the following cells is most similar?
5. While planning care for a patient with inflammation, which principle will the nurse remember? The predominant phagocyte of early inflammation is the:
6. A patient has researched white blood cells on the Internet. Which statement indicates the patient has a good understanding? _______________ contain preformed granules of vasoactive amines.
7. A nurse recalls that monocytes are blood cells that mature (differentiate) into:
d. Mast cells
8. A nurse is teaching the staff about platelets. Which information should the nurse include? In addition to playing a role in hemostasis, platelets have the ability to:
a. Stimulate bone marrow production of erythrocytes
b. Release biochemical mediators of inflammation
c. Undergo cell division in response to bleeding
d. Activate a humoral response
9. While planning care for a newborn, the pediatric nurse recalls the main site of hematopoiesis in the fetus is the:
a. Bone marrow
c. Lymph nodes
10. A 45-year-old female undergoes a splenectomy to remove a tumor. Which of the following assessment finding is most likely to occur following surgery?
c. Decreased red blood cell count
d. Decreased platelets
Chapter 20: Alterations of Hematologic Function
1. A patient’s anemia is described as having erythrocytes that demonstrate anisocytosis. The nurse would recognize the erythrocytes would be:
a. Pale in color
b. Present in various sizes
c. Able to assume various shapes
d. Live only a few days
2. A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?
a. Iron deficiency anemia
b. Pernicious anemia
c. Sideroblastic anemia
d. Hemolytic anemia
3. When a nurse is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the nurse calls these erythrocytes:
4. A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has?
a. Sideroblastic anemia
b. Hemolytic anemia
c. Pernicious anemia
d. Iron deficiency anemia
5. After initial compensation, what hemodynamic change should the nurse monitor for in a patient who has a reduction in the number of circulating erythrocytes?
a. Increased viscosity of blood
b. Decreased cardiac output
c. Altered coagulation
d. Hyperdynamic circulatory state
6. A 25-year-old female has a heavy menses during which she loses a profuse amount of blood. Which of the following adaptations should the nurse expect?
a. Movement of fluid into the cell
b. Decreased cardiac output
c. Decreased oxygen release from hemoglobin
d. Peripheral vasoconstriction
7. A 60-year-old female emphysema patient experiences a rapid and pounding heart, dizziness, and fatigue with exertion. Which of the following respiratory assessment findings indicate the respiratory system is compensating for the increased oxygen demand?
b. Increased rate and depth of breathing
d. Activation of the renin-angiotensin response
8. A 2-year-old malnourished child has vitamin B12 and folate deficiencies. A blood smear suggests the deficiency is macrocytic and normochromic. The nurse would expect the hemoglobin to be:
9. A 45-year-old male is diagnosed with macrocytic, normochromic anemia. The nurse suspects the most likely cause of this condition is:
a. Defective DNA synthesis
b. Abnormal synthesis of hemoglobin
c. Defective use of vitamin C
d. Blocked protein synthesis
10. When a patient wants to know why vitamin B12 and folate deficiencies cause anemia, how should the nurse respond?
a. Red blood cells are unable to differentiate into erythrocytes.
b. Red blood cells have malformed hemoglobin molecules.
c. Red blood cells have decreased O2-carrying capacity.
d. Red blood cells have a shorter life span.
AND MUCH MORE