PATHOPHYSIOLOGY PRE-EXAM
QUESTIONS AND ANSWERS
A 70-year-old male client has been admitted to a hospital for the treatment of a recent
hemorrhagic stroke that has left him with numerous motor and sensory deficits. These
deficits are most likely the result of which of the following mechanisms of cell injury?
Select one:
a. Free radical injury
b. Impaired calcium homeostasis
c. Hypoxia and ATP depletion
d. Interference with DNA synthesis - ANSWER -c. Hypoxia and ATP depletion
Stroke is characterized by impaired cerebral circulation and consequent death of
neurons from cellular hypoxia. Free radical injury, abnormal DNA synthesis, and
impaired calcium homeostasis are not direct consequences of lack of blood flow to body
cells.
A 48-year-old male client, who normally enjoys good health, has been admitted to the
hospital for the treatment of polycythemia vera. The nurse who is providing care for the
client should prioritize assessments aimed at the early identification of which of the
following health problems?
Select one:
a. Thromboembolism
b. Hyperventilation
c. Vasculitis
d. Orthostatic hypotension - ANSWER -a. Thromboembolism
The increased blood viscosity that accompanies primary polycythemia creates a
significant risk of thromboembolism. Hypertension, not hypotension, is also a common
sign. Vasculitis and hyperventilation are unlikely to result directly from polycythemia
vera.
A 59-year-old woman with a recent diagnosis of breast cancer has begun a course of
hormone therapy. What is the goal of this pharmacologic treatment?
Select one:
a. Increasing serum hormone levels to promote tumor cell lysis
b. Blocking effects of estrogen on the growth of malignant cells
c. Blocking the entry of malignant cells into the axillary lymph nodes
d. Blocking the effects of progesterone on tumor growth - ANSWER -b. Blocking effects
of estrogen on the growth of malignant cells
Hormone therapy is used to block the effects of estrogen on the growth of breast cancer
cells. Among the most common drugs used for hormone therapy is tamoxifen, a
nonsteroidal antiestrogen that binds to estrogen receptors and blocks the effects of
,estrogens on the growth of malignant cells in the breast. Such drugs do not directly
block axillary node involvement or induce tumor cell lysis.
A 41-year-old woman has made the recent decision to start a family and is eager to
undergo testing to mitigate the possibility of having a child with Down syndrome. Which
of the following tests is most likely to provide the data the woman seeks?
Select one:
a. Ultrasonography
b. Genetic testing of the woman
c. Prenatal blood tests
d. Genetic testing of the woman and the father - ANSWER -c. Prenatal blood tests
Down syndrome is a result of chromosomal abnormality and is not a single-gene
disorder. As a result, genetic testing of the mother and/or father is not relevant.
Ultrasonography does not have predicative value for Down syndrome, but blood tests
such as α-fetoprotein, human chorionic gonadotropin (HCG), unconjugated estriol,
inhibin A, and pregnancy-associated plasma protein A have helped ascertain the risks.
Which one of the following skin disorders seen in elderly persons is considered a
premalignant lesion?
Select one:
a. Cherry angiomas
b. Actinic keratosis
c. Solar lentigines
d. Telangiectases - ANSWER -b. Actinic keratosis
Actinic keratoses are the most common premalignant skin lesions that develop on sun-
exposed areas. Solar lentigines are tan to brown, benign spots on sun-exposed areas.
They are commonly referred to as liver spots. Senile angiomas (cherry angiomas) are
smooth, cherry-red or purple, dome-shaped papules, usually found on the trunk.
Telangiectases are single dilated blood vessels, capillaries, or terminal arteries that
appear on areas exposed to sun or harsh weather, such as the cheeks and the nose.
An obese, male client with a history of gout and a sedentary lifestyle has been advised
by his primary care provider to avoid organ meats, certain fish, and other foods that are
high in purines. The care provider is demonstrating an awareness of the client's
susceptibility to which of the following types of kidney stones?
Select one:
a. Cystine stones
b. Calcium stones
c. Magnesium ammonium phosphate stones
d. Uric acid stones - ANSWER -d. Uric acid stones
Uric acid stones develop in conditions of gout and when high concentrations of uric acid
in the urine. Unlike radiopaque calcium stones, uric acid stones are not visible on x-ray
films. According to Table 25-2, these stones develop in clients who eat a high-purine
diet like Atkins.
, Which of the following pathophysiologic phenomena may result in a diagnosis of
Cushing disease?
Select one:
a. Autoimmune destruction of the adrenal cortex
b. Excess ACTH production by a pituitary tumor
c. Malfunction of the HPA system
d. Hypopituitarism - ANSWER -b. Excess ACTH production by a pituitary tumor
Three important forms of Cushing syndrome result from excess glucocorticoid
production by the body. One is a pituitary form, which results from excessive production
of ACTH by a tumor of the pituitary gland. Hypopituitarism and destruction of the
adrenal cortex are associated with Addison disease. Disruption of the HPA system is
not implicated in the etiology of Cushing disease.
A genetic test result returns noting that the specimen (client) has inclusion bodies in the
sample. The health care provider can associate this result with the development of
which pathologic disease process? Select all that apply.
Select one or more:
a. Myasthenia gravis
b. Parkinson disease
c. Alzheimer disease
d. Multiple myeloma - ANSWER -b. Parkinson disease
c. Alzheimer disease
Disruption of chaperoning mechanisms causes intracellular molecules to become
denatured and insoluble. These denatured proteins tend to stick to one another,
precipitate, and form inclusion bodies. The development of inclusion bodies is a
common pathologic process in Parkinson, Alzheimer, and Huntington diseases.
Which body tissue exhibits the highest rate of turnover and renewal?
Select one:
a. The nervous tissue that constitutes the central nervous system
b. The skeletal muscle that facilitates movement
c. The squamous epithelial cells of the skin
d. The connective tissue supporting blood vessels - ANSWER -c. The squamous
epithelial cells of the skin
Cells making up the epithelial tissues generally exhibit a high rate of turnover, which is
related to their location and function. Renewal of connective and muscle tissue takes
place at a much slower pace, whereas nervous tissue is incapable of postnatal
regeneration.
A client presents to a STI clinic. Her primary complaint is related to purulent exudate
and bleeding after intercourse. The health care worker will primarily focus on the
diagnosis of which STI?
QUESTIONS AND ANSWERS
A 70-year-old male client has been admitted to a hospital for the treatment of a recent
hemorrhagic stroke that has left him with numerous motor and sensory deficits. These
deficits are most likely the result of which of the following mechanisms of cell injury?
Select one:
a. Free radical injury
b. Impaired calcium homeostasis
c. Hypoxia and ATP depletion
d. Interference with DNA synthesis - ANSWER -c. Hypoxia and ATP depletion
Stroke is characterized by impaired cerebral circulation and consequent death of
neurons from cellular hypoxia. Free radical injury, abnormal DNA synthesis, and
impaired calcium homeostasis are not direct consequences of lack of blood flow to body
cells.
A 48-year-old male client, who normally enjoys good health, has been admitted to the
hospital for the treatment of polycythemia vera. The nurse who is providing care for the
client should prioritize assessments aimed at the early identification of which of the
following health problems?
Select one:
a. Thromboembolism
b. Hyperventilation
c. Vasculitis
d. Orthostatic hypotension - ANSWER -a. Thromboembolism
The increased blood viscosity that accompanies primary polycythemia creates a
significant risk of thromboembolism. Hypertension, not hypotension, is also a common
sign. Vasculitis and hyperventilation are unlikely to result directly from polycythemia
vera.
A 59-year-old woman with a recent diagnosis of breast cancer has begun a course of
hormone therapy. What is the goal of this pharmacologic treatment?
Select one:
a. Increasing serum hormone levels to promote tumor cell lysis
b. Blocking effects of estrogen on the growth of malignant cells
c. Blocking the entry of malignant cells into the axillary lymph nodes
d. Blocking the effects of progesterone on tumor growth - ANSWER -b. Blocking effects
of estrogen on the growth of malignant cells
Hormone therapy is used to block the effects of estrogen on the growth of breast cancer
cells. Among the most common drugs used for hormone therapy is tamoxifen, a
nonsteroidal antiestrogen that binds to estrogen receptors and blocks the effects of
,estrogens on the growth of malignant cells in the breast. Such drugs do not directly
block axillary node involvement or induce tumor cell lysis.
A 41-year-old woman has made the recent decision to start a family and is eager to
undergo testing to mitigate the possibility of having a child with Down syndrome. Which
of the following tests is most likely to provide the data the woman seeks?
Select one:
a. Ultrasonography
b. Genetic testing of the woman
c. Prenatal blood tests
d. Genetic testing of the woman and the father - ANSWER -c. Prenatal blood tests
Down syndrome is a result of chromosomal abnormality and is not a single-gene
disorder. As a result, genetic testing of the mother and/or father is not relevant.
Ultrasonography does not have predicative value for Down syndrome, but blood tests
such as α-fetoprotein, human chorionic gonadotropin (HCG), unconjugated estriol,
inhibin A, and pregnancy-associated plasma protein A have helped ascertain the risks.
Which one of the following skin disorders seen in elderly persons is considered a
premalignant lesion?
Select one:
a. Cherry angiomas
b. Actinic keratosis
c. Solar lentigines
d. Telangiectases - ANSWER -b. Actinic keratosis
Actinic keratoses are the most common premalignant skin lesions that develop on sun-
exposed areas. Solar lentigines are tan to brown, benign spots on sun-exposed areas.
They are commonly referred to as liver spots. Senile angiomas (cherry angiomas) are
smooth, cherry-red or purple, dome-shaped papules, usually found on the trunk.
Telangiectases are single dilated blood vessels, capillaries, or terminal arteries that
appear on areas exposed to sun or harsh weather, such as the cheeks and the nose.
An obese, male client with a history of gout and a sedentary lifestyle has been advised
by his primary care provider to avoid organ meats, certain fish, and other foods that are
high in purines. The care provider is demonstrating an awareness of the client's
susceptibility to which of the following types of kidney stones?
Select one:
a. Cystine stones
b. Calcium stones
c. Magnesium ammonium phosphate stones
d. Uric acid stones - ANSWER -d. Uric acid stones
Uric acid stones develop in conditions of gout and when high concentrations of uric acid
in the urine. Unlike radiopaque calcium stones, uric acid stones are not visible on x-ray
films. According to Table 25-2, these stones develop in clients who eat a high-purine
diet like Atkins.
, Which of the following pathophysiologic phenomena may result in a diagnosis of
Cushing disease?
Select one:
a. Autoimmune destruction of the adrenal cortex
b. Excess ACTH production by a pituitary tumor
c. Malfunction of the HPA system
d. Hypopituitarism - ANSWER -b. Excess ACTH production by a pituitary tumor
Three important forms of Cushing syndrome result from excess glucocorticoid
production by the body. One is a pituitary form, which results from excessive production
of ACTH by a tumor of the pituitary gland. Hypopituitarism and destruction of the
adrenal cortex are associated with Addison disease. Disruption of the HPA system is
not implicated in the etiology of Cushing disease.
A genetic test result returns noting that the specimen (client) has inclusion bodies in the
sample. The health care provider can associate this result with the development of
which pathologic disease process? Select all that apply.
Select one or more:
a. Myasthenia gravis
b. Parkinson disease
c. Alzheimer disease
d. Multiple myeloma - ANSWER -b. Parkinson disease
c. Alzheimer disease
Disruption of chaperoning mechanisms causes intracellular molecules to become
denatured and insoluble. These denatured proteins tend to stick to one another,
precipitate, and form inclusion bodies. The development of inclusion bodies is a
common pathologic process in Parkinson, Alzheimer, and Huntington diseases.
Which body tissue exhibits the highest rate of turnover and renewal?
Select one:
a. The nervous tissue that constitutes the central nervous system
b. The skeletal muscle that facilitates movement
c. The squamous epithelial cells of the skin
d. The connective tissue supporting blood vessels - ANSWER -c. The squamous
epithelial cells of the skin
Cells making up the epithelial tissues generally exhibit a high rate of turnover, which is
related to their location and function. Renewal of connective and muscle tissue takes
place at a much slower pace, whereas nervous tissue is incapable of postnatal
regeneration.
A client presents to a STI clinic. Her primary complaint is related to purulent exudate
and bleeding after intercourse. The health care worker will primarily focus on the
diagnosis of which STI?
