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