MSN 570 Advanced Pathophysiology (MSN) Exam Questions And Answers

When a child inherits a disease that is autosomal recessive, it is inherited from whom? A. father B. mother C. both parents D. grandparent - C. both parents A patient has a serum sodium level of 165 mEq/L. The healthcare professional explains that the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma are caused by what mechanism? A. high sodium in the blood vessels pulls water out of the brain cells into the blood vessels, causing brain cells to shrink. B. high sodium in the brain cells pulls water out of the blood vessels into the brain cells, causing them to swell. C. low sodium in the blood vessels pulls potassium out of the brain cells, which slows the synapses in the brain. D. low sodium in the blood vessels draws chloride into the brain cells followed by water, causing the brain cells to swell. - A. high sodium in the blood vessels pulls water out of the brain cells into the blood vessels, causing brain cells to shrink. What is the role of reverse transcriptase in HIV infection? A. reverse transcriptase converts single-stranded DNA into double-stranded DNA. B. it is needed to produce integrase. C. it transports the RNA into the cell nucleus. D. it converts RNA into double-stranded DNA. - D. it converts RNA into double-stranded DNA. How many months does it take for the newborn to be sufficiently protected by antibodies produced by its own B cells? A. 1 to 2 B. 4 to 5 C. 6 to 8 D. 10 to 12 - C. 6 to 8 What is dysplasia? A. abnormal increase in the number of a specific cell type B. true adaptive process at the cellular level. C. modification in the shape of a specific cell type. D. lack of oxygen at the cellular level. - C. modification in the shape of a specific cell type. What is the vascular effect of histamine released from mast cells? A. platelet adhesion B. initiation of the clotting cascade C. vasodilation D. increased endothelial adhesiveness - C. vasodilation Which action is a purpose of the inflammatory process? 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 - C. to prevent infection of the injured tissue Which are cancers that cluster strongly in families? (select all that apply.) A. breast B. colon C. ovarian D. lung E. brain - A, B, C (Breast, colon, ovarian) Carcinoma in situ is characterized by which changes? A. cells have broken through the local basement membrane B. cells have invaded immediate surrounding tissue C. cells remain localized in the glandular or squamous cells D. cellular and tissue alterations indicate dysplasia - C. cells remain localized in the glandular or squamous cells When are childhood cancers most often diagnosed? A. during infancy B. at peak times of physical growth C. after diagnosis of a chronic illness D. after an acute illness - B. at peak times of physical growth Considering the hypothalamus, what is a fever produced by? A. endogenous pyrogens acting directly on the hypothalamus B. exogenous pyrogens acting directly on the hypothalamus C. immune complexes acting indirectly on the hypothalamus D. cytokines acting indirectly on the hypothalamus - A. endogenous pyrogens acting directly on the hypothalamus The World Health Organization (WHO) defines grade 1 (overweight) as which BMI range? A. 18.5 to 24.9 B. 25 to 29.9 C. 30 to 39.9 D. 40 to 50.9 - B. 25 to 29.9 Stress-induced sympathetic stimulation of the adrenal medulla causes the secretion of what? A. epinephrine and aldosterone B. norepinephrine and cortisol C. epinephrine and norepinephrine D. acetylcholine and cortisol - C. epinephrine and norepinephrine The movement of fluid across the arterial end of capillary membranes into the interstitial fluid surrounding the capillary is an example of which fluid movement process? A. hydrostatic pressure B. osmosis C. diffusion D. active transport - A. hydrostatic pressure How do free radicals cause cell damage? A. stealing the cell's oxygen to stabilize the electron, thus causing hypoxia B. stimulating the release of lysosomal enzymes that digest the cell membranes C. transferring one of its charged, stabilized atoms to the cell membrane, which causes lysis D. giving up an electron, which causes injury to the chemical bonds of the cell membrane - D. giving up an electron, which causes injury to the chemical bonds of the cell membrane It has been determined that a patient's tumor is in stage 2. How does the healthcare professional describe this finding to the patient? A. cancer is confined to the organ of origin. B. cancer has spread to regional structures C. cancer is locally invasive D. cancer has spread to distant sites - C. cancer is locally invasive After ovulation, the uterine endometrial cells divide under the influence of estrogen. This process is an example of what hormonal process? A. hyperplasia B. dysplasia C. hypertrophy D. Anaplasia - A. hyperplasia What type of immunity is produced when an immunoglobulin crosses the placenta? A. passive-acquired immunity B. active-acquired immunity C. passive-innate immunity D. active-innate immunity - A. passive-acquired immunity What effect of increased secretions of epinephrine, glucagon, and growth hormone would the healthcare professional assess for? A. hyperglycemia B. hypertension C. bronchodilation D. pupil dilation - A. hyperglycemia A patient's blood gases reveal the following findings: pH 7.3; bicarbonate (HCO3) 27 mEq/L; carbon dioxide (CO2) 58 mm Hg. What is the interpretation of these gases? A. respiratory alkalosis B. metabolic acidosis C. respiratory acidosis D. metabolic alkalosis - C. respiratory acidosis Regarding the endothelium, what is the difference between healthy vessel walls and those that promote clot formation? A. inflammation and roughening of the endothelium of the artery are present. B. Hypertrophy and vasoconstriction of the endothelium of the artery are present. C. Excessive clot formation and liquid accumulation in the endothelium of the artery are present. D. Evidence of age-related changes that weaken the endothelium of the artery is present. - A. inflammation and roughening of the endothelium of the artery are present. A parent asks the healthcare professional to explain why a child diagnosed with Tetralogy of Fallot squats frequently. What explanation by the professional is best? a. Reduces the chest pain b. Controls dizziness c. Relieves hypoxia d. Improves headache - c. Relieves hypoxia A patient in the clinic reports fever, arthralgia, a rash, and nosebleeds. What other information should the healthcare professional elicit from this parent? A. family history of Marfan's disease B. history of a recent bacterial infection C. history of any recent chest trauma D. any illnesses in family members - B. history of a recent bacterial infection A patient reports sudden onset of severe chest pain that radiates to the back and worsens with breathing and when lying down. What action by the healthcare professional is most appropriate? A. prepare to assist with an immediate pericardiocentesis B. inform the patient about the side effects of diuretics C. facilitate the patient getting an immediate ECG D. teach the patient about a course of antiinflammatory medications - D. teach the patient about a course of antiinflammatory medications A patient is diagnosed with chronic obstructive pulmonary disease (COPD) and has elevated pulmonary vascular resistance. Which complication would the health care professional assess the patient for? A. right heart failure B. left heart failure C. restrictive cardiomyopathy D. hypertrophic cardiomyopathy - A. right heart failure What is the initiating event that leads to the development of atherosclerosis? A. release of the inflammatory cytokines B. macrophages adhere to vessel walls C. injury to the endothelial cells that line the artery wall D. release of the platelet-deprived growth factor - C. injury to the endothelial cells that line the artery wall A person wishes to reduce the risk of developing coronary artery disease. This person has a normal lipid panel. What risk factor reduction would the healthcare professional advise for this person? A. eating a low-fat diet B. controlling the blood pressure C. avoiding air pollution D. moderate alcohol use - B. controlling the blood pressure What is an expected change in the cardiovascular system that occurs with aging? A. arterial stiffening B. decreased left ventricular wall tension C. decreased aortic wall thickness D. arteriosclerosis - A. arterial stiffening A person with diabetes mellitus does not realize that this disease contributes to coronary artery disease and asks the healthcare professional to explain. What information does the professional provide? (select all that apply) A. "high blood glucose directly attacks the heart cells." B. "diabetes is associated with impaired lipid metabolism." C. "it can lead to more vasoconstriction in the blood vessels." D. "diabetes can damage the inside of your blood vessel." E. "it causes inflammation and cells to clump together in the vessels." - (B, C, D, E) B. "diabetes is associated with impaired lipid metabolism." C. "it can lead to more vasoconstriction int he blood vessels." D. "diabetes can damage the inside of your blood vessel." E. "it causes inflammation and cells to clump together in the vessels." A patient has been diagnosed with Raynaud disease and asks for an explanation. What statement by the healthcare professional is best? A. inflammatory disorder of small- and medium-size arteries in the feet and sometimes in the hands B. neoplastic disorder of the lining of the arteries and veins of the upper extremities C. vasospastic disorder of the small arteries and arterioles of the fingers and, less commonly, of the toes D. autoimmune disorder of the large arteries and veins of the upper and lower extremities - C. vasospastic disorder of the small arteries and arterioles of the fingers and, less commonly, of the toes A healthcare professional is caring for a patient who has a delay in electrical activity reaching the ventricle as seen on ECG. What ECG finding would the healthcare professional associate with this problem? A. a prolong ST interval B. variability in measurement with heart rate C. PR interval measuring 0.28 sec D. a QRS complex measuring 0.08 sec - C. PR interval measuring 0.28 sec Which factor is responsible for the hypertrophy of the myocardium associated with hypertension? A. increased norepinephrine B. adducin C. angiotension II D. insulin resistance - C. angiotension II Amyloidosis, hemochromatosis, or glycogen storage disease usually causes which form of cardiomyopathy? A. infiltrative B. restrictive C. septal D. hypertrophic - B. restrictive Which laboratory test is an indirect measure of atherosclerotic plaque? A. homocysteine B. low-density lipoprotein (LDL) C. erythrocyte sedimentation rate (ESR) D. c-reactive protein (CRP) - D. c-reactive protein (CRP) Nicotine increases atherosclerosis by the release of which neurotransmitter? A. histamine B. nitric oxide C. angiotension II D. epinephrine - D. epinephrine A healthcare professional is caring for four patients. Which patient does the professional assess for pulmonary emboli (PE) as the priority? A. deep vein thrombosis B. endocarditis C. valvular disease D. left heart failure - A. deep vein thrombosis A patient who had a myocardial infarction is going to cardiac rehabilitation where progressive exercise is monitored by health care professionals. When would this patient be most vulnerable to injury and complications? A. between 5 to 9 days B. between 10 to 14 days C. between 15 to 20 days D. between 20 to 30 days - B. between 10 to 14 days Which event triggers congenital heart defects that cause acyanotic congestive heart failure? A. right-to-left shunts B. left-to-right shunts C. obstructive lesions D. mixed lesions - B. left-to-right shunts An infant has a continuous machine-type murmur best heard at the left upper sternal border throughout systole and diastole. The healthcare professional suspects a congenital heart disorder. What other assessment finding is inconsistent with the professional's knowledge about this disorder? A. bounding pulses B. active precordium C. thrill on palpation D. hydronephrosis - D. hydronephrosis A patient reports chest pain that occurs most often during sleep. What treatment does the healthcare professional discuss with the patient? A. treatment of obstructive sleep apnea B. short-acting nitroglycerin tablets C. a low-dose aspirin regimen D. oral calcium channel blockers - D. oral calcium channel blockers A patient is diagnosed with tuberculosis (TB). What does the student know about this condition? (select all that apply.) A. foreign-born people have the highest rate in the United States. B. TB is rapidly becoming resistant to many different antibiotics. C. It is transmitted through contact with patient secretions. D. a positive skin test is the only reliable way to diagnose TB. E. treatment consists of a combination of antibiotics. - (A, B, E) A. foreign-born people have the highest rate in the United States. B. TB is rapidly becoming resistant to many different antibiotics. E. treatment consists of a combination of antibiotics. A patient is having a spirometry measurement done and asks the healthcare professional to explain this test. What response by the professional is best? A. to evaluate the cause of hypoxia B. to measure the volume and flow rate during forced expiration C. to measure the gas diffusion rate at the alveolcapilllary membrane D. to determine pH and oxygen and carbon dioxide concentrations - B. to measure the volume and flow rate during forced expiration Which statement by the healthcare professional accurately describes childhood asthma? A. an obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation B. a pulmonary disease characterized by severe hypoxemia, decreased pulmonary compliance, and diffuse densities on chest x-ray imaging C. a pulmonary disorder involving an abnormal expression of a protein, producing viscous mucus that lines the airways, pancreas, sweat ducts, and van deferens - A. an obstructive airway disease characterized by reversible airflow obstruction, bronchial hyperreactivity, and inflammation What are clinical manifestations of bacterial pneumonia in children? (select all that apply) A. fever with chills B. productive cough C. dyspnea D. respiratory alkalosis E. malaise - (A, B, C) A. fever with chills B. productive cough C. dyspnea A patient has recently been diagnosed with emphysema. What initial step in management of this disease does the healthcare professional discuss with the patient? A. inhaled anticholinergic agents B. beta agonists C. cessation of smoking D. surgical reduction of lung volume - C. cessation of smoking What is the most common predisposing factor to obstructive sleep apnea in children? A. chronic respiratory infections B. adenotonsillar hypertrophy C. obligatory mouth breathing D. paradoxical breathing - B. adenotonsillar hypertrophy What condition is capable of producing alveloar dead space? A. pulmonary edema B. pulmonary emboli C. atelectasis D. pneumonia - B. pulmonary emboli What does the student learn about ventilation? A. hypoventilation causes hypocapnia B. hypoventilation causes alkalosis C. hyperventilation causes hypocapnia D. hyperventilation causes acidosis - C. hyperventilation causes hypocapnia Which condition involves an abnormally enlarged gas-exchange system and the destruction of the lung's alveolar walls? A. transudative effusion B. emphysema C. exudative effusion D. abcess - B. emphysema Why is nasal congestion a serious threat to young infants? A. infants are obligatory nose breathers. B. their nares are small in diameter C. infants come dehydrated when mouth breathing D. their epiglottis is proportionally greater than the epiglottis of an adult's. - A. infants are obligatory nose breathers. Which factor contributes to the production of mucus associated with chronic bronchitis? A. airway injury B. pulmonary infection C. increased goblet cell size D. bronchospasms - C. increased goblet cell size What does the pathophysiology student learn about the respiratory process referred to as remodeling? (select all that apply) A. remodeling involves the vascular walls. B. scarring and thickening occurs during this process. C. remodeling results in a permanent change D. pulmonary artery hypotension results E. remodeling increases blood flow resistance - (A, B, C, E) A. remodeling involves the vascular walls. B. scarring and thickening occurs during this process. C. remodeling results in a permanent change E. remodeling increases blood flow resistance The student asks the professor to explain what characteristic is demonstrated by lungs with decreased compliance? A. difficult deflation B. easy inflation C. stiffness D. inability to diffuse oxygen - C. stiffness A healthcare professional is educating a patient about asthma. The professional states that good control is necessary due to which pathophysiologic process? A. norepinephrine causes bronchial smooth muscle contraction and mucus secretion but it also causes high blood pressure. B. uncontrolled inflammation leads to increased bronchial hyperresponsiveness and eventual scarring. C. the release of epinephrine leads to development of cardiac dysrthymias. D. immunoglobulin G causes smooth muscle contraction which will eventually weaken the respiratory muscles. - B. uncontrolled inflammation leads to increased bronchial hyperresponsiveness and eventual scarring. Which structure(s) in acute respiratory distress syndrome (ARDS) release inflammatory mediators such as proteolytic enzymes, oxygen-free radicals, prostaglandins, leukotrienes, and platelet-activating factor? A. Complement cascade B. Mast cells C. Macrophages D. Neutrophils - D. Neutrophils Hypoventilation that results in the retention of carbon dioxide will stimulate which receptors in an attempt to maintain a normal homeostatic state? A. Irritant receptors B. Central chemoreceptors C. Peripheral chemoreceptors D. Stretch receptors - B. Central chemoreceptors