Ch. 2-4
Which of the following clients would be an example of cellular atrophy?
A.) A middle-aged female experiencing menopause due to loss of estrogen stimulation
B.) A postnephrectomy client whose remaining kidney enlarges to compensate for the loss
C. ) A hypertensive, noncompliant client who has developed a progressive increase in left ventricular mass
D.) A female client with the change in uterine size as a result of pregnancy
A.) A middle-aged female experiencing menopause due to loss of estrogen stimulation
In women, the loss of estrogen stimulation during menopause results in atrophic changes in the reproductive organs. Compensatory hypertrophy is the enlargement of a remaining organ or tissue after a portion has been surgically removed or rendered inactive. For instance, if one kidney is removed, the remaining kidney enlarges to compensate for the loss. In hypertension, for example, the increased workload required to pump blood against an elevated arterial pressure results in a progressive increase in left ventricular muscle mass and need for coronary blood flow. The pregnant uterus undergoes both hypertrophy and hyperplasia as a result of estrogen stimulation.
What is metaplasia and give one example
One cell type is replaced by another, it is reversible
A smokers trachea due to irritation or inflammation
A client with diabetes and severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. The client asks, “How this can happen?” Which of the following pathophysiologic processes should the nurse explain to this client? “More than likely, your gangrene is caused by:
A.) Inappropriate activation of apoptosis, which means death of your cells.”
B.) Bacterial invasion into the foot and toe.”
C.) Impaired arterial blood supply to your toe.”
D.) Metaplastic cellular changes in your toe.”
C.) Impaired arterial blood supply to your toe.”
Dry gangrene is often a result of impaired arterial blood supply to the extremities. A bacterial etiology is more common in wet gangrene, whereas neither metaplasia nor activation of apoptosis is implicated in cases of dry gangrene.
Fay and Dan have recently visited a genetic counselor. The counselor told them that they were both carriers for an autosomal recessive genetic disorder. What are the chances that their child could express the disease?
A.) 0%
B.) 25%
C.) 50%
D.) 100%
B.) 25%
To have an autosomal recessive disorder, you inherit two mutated genes, one from each parent. These disorders are usually passed on by two carriers. Their health is rarely affected, but they have one mutated gene (recessive gene) and one normal gene (dominant gene) for the condition. With each pregnancy, two carriers have a 25 percent chance of having an unaffected child with two normal genes (left), a 50 percent chance of having an unaffected child who is also a carrier (middle), and a 25 percent chance of having an affected child with two recessive genes
The most reliable method for measuring body water or fluid volume increase is by assessing:
A.) Tissue turgor
B.) Intake and output
C.) Body weight change
D.)Serum sodium levels
C.) Body weight change
Daily weights are a reliable index of water volume gain (1 L of water weighs 2.2 pounds). Daily weight measurements taken at the same time each day with the same amount of clothing provide a useful index of water gain due to edema. When an unbalanced distribution of body water exists in the tissues and organs, assessment of surface skin tissue turgor will be inaccurate. Measurement of renal output is unreliable because fluid retention may be a compensatory response, or the renal system may be dysfunctional. Serum sodium levels are affected by multiple variables other than body water volume.
A client has experienced significant decreases in mobility and stamina during a 3-week hospital stay for the treatment of a femoral head fracture. Which of the following phenomena most likely accounts for the client's decrease in muscle function?
A.) Impaired muscle cell metabolism resulting from metaplasia
B.) Dysplasia as a consequence of inflammation during bone remodeling
C.) Disuse atrophy of muscle cells during a prolonged period of immobility
D.) Ischemic atrophy resulting from vascular changes while on bedrest
C. Disuse atrophy of muscle cells during a prolonged period of immobility
Disuse atrophy frequently occurs as a consequence of prolonged periods of muscle inactivity. Metaplasia and dysplasia are not common consequences of immobility and muscle disuse. Similarly, infrequent muscle use does not typically cause vascular changes that result in ischemic atrophy.
A client has an abscess in the mouth with a profuse amount of thick creamy white exudate. The nurse knows that this wound with necrotic cells is classified as:
A.) Serous
B.) Fibrinous
C.) Suppurative
D.) Membranous
D.) Membranous
Membranous or pseudomembranous exudates develop on mucous membrane surfaces. It is an acute inflammatory response to a powerful necrotizing toxin with formation on a mucosal surface, of a false membrane composed of precipitated fibrin, necrotic epithelium, and inflammatory white cells. Serous exudate is a watery fluid. Fibrinous exudates contain fibrinogen and form a thick sticky meshwork. Suppurative exudate contains pus.
A diabetic client has injured his foot while walking barefoot on the lawn. On admission, which of the following assessment findings would be considered a localized cardinal sign of acute inflammation?
A.) Temperature of 101°F
B.) Fatigue with listlessness
C.) Redness and edema at the injured site
D.) Urine output of less than 500 mL/24 hours (low)
C.) Redness and edema at the injured site
Localized manifestations include redness, swelling, and heat. Fever and fatigue are systemic manifestations of acute inflammation. Low urine output is not a localized sign but could be a systemic manifestation if the client goes into septic shock.
When a male child inherits an X-linked disorder from his heterozygous carrier mother:
A.) His sons will be carriers.
B.) His father has the disorder.
C.) Some of his sisters will be carriers.
D.) His daughters will have the disorder.
C.) Some of his sisters will be carriers.
A male who has a recessive X-linked disorder will have daughters who are carriers and sons who are unaffected. Male children of a carrier mother have a 50% risk of having the disorder and cannot be carriers. Female children of a carrier mother have a 50% risk of being carriers and are not affected by the disorder.
What is the normal level of Sodium?
135-145
During a lecture on inflammation, the physiology instructor discusses the major cellular components involved in the inflammation response. The instructor asks, “Which of the following cells arrives early in great numbers?” The student with the correct response is:
A.) Basophils
B.) Lymphocytes
C.) Neutrophils
D.) Monocytes
C.) Neutrophils
Neutrophils are the primary early arrival cells and are signified by an elevated neutrophil count that includes mature (PMNs) and immature (bands) cell forms. Basophils respond later. Lymphocytes have a slower arrival and stay longer. The half-life of circulating monocytes is about a day, after which they begin to migrate to the site of injury and mature into larger macrophages, which have a longer half-life and greater phagocytic ability than do blood monocytes.
Characteristics of apoptosis include all of the following except:
A.) Referred to as “cellular suicide”
B.) Can be both a physiologic and pathologic cell response
C.) Occurs as a response to the removal of hormonal signals
D.) Is associated with inflammation
D.) Is associated with inflammation
A client presents for a scheduled Papanicolaou (Pap) smear. The clinician who will interpret the smear will examine cell samples for evidence of:
A.) Changes in cell shape, size, and organization
B.) The presence of unexpected cell types
C.) Ischemic changes in cell samples
D.) Abnormally high numbers of cells in a specified field
A.) Changes in cell shape, size, and organization
A Pap smear is an example of a diagnostic procedure that tests for the presence of cell dysplasia, that is, deranged cell growth of a specific tissue that results in cells that vary in size, shape, and organization. Unexpected cell types are evidence of metaplasia, whereas ischemic changes are associated with cell hypertrophy. Increases in the number of cells are characterized as hyperplasia.
Which of the following is a manifestation of Turner syndrome?
A.) Amenorrhea
B.) Gynecomastia
C.) Tall stature
D.) Testicular atrophy
A.) Amenorrhea
What would cause a positive Trousseau sign
Hypocalcemia
A pregnant client is attending a nutrition class for first-time moms. During the class, the instructor stressed that they should avoid consumption of which food that may cause brain damage from methyl mercury exposure?
A.) Tuna
B.) Raw hamburger
C.) Fresh milk
D.) Beets
A.) Tuna
The main source of methyl mercury exposure is from consumption of long-lived fish, such as tuna and swordfish. Fish concentrate mercury from sediment in the water. Because the developing brain is more susceptible to mercury-induced damage, it is recommended that young children and pregnant and nursing women should avoid consumption of fish known to contain high mercury content. None of the other foods listed pose a threat of mercury toxicity.
When does Translocation of a chromosome occur, does this result in normal or abnormal offspring?
When there are simultaneous breaks in two chromosomes from different pairs, with exchange of chromosome parts. With a balanced reciprocal translocation, no genetic information is lost; therefore, persons with translocations usually are normal
While sponging a client who has a high temperature, the nurse observes the client begins to shiver. At this point, the priority nursing intervention would be to:
A.) Administer an extra dose of aspirin
B.) Stop sponging the client and retake a set of vital signs
C.) Increase the room temperature by turning off the air conditioner and continue sponging the client with warmer water
D.) Place a heated electric blanket on the client's bed
B.) Stop sponging the client and retake a set of vital signs
AVOID OVERCOOLING
Modification of the environment ensures that the environmental temperature facilitates heat transfer away from the body. Sponge baths with cool water or an alcohol solution can be used to increase evaporative heat losses. More profound cooling can be accomplished through the use of a cooling blanket or mattress, which facilitates the conduction of heat from the body into the coolant solution that circulates through the mattress. Care must be taken so that cooling methods do not produce vasoconstriction and shivering that decrease heat loss and increase heat production.
Explain Anchorage independence
Do not need to be attached to grow
If cells are able to adapt to their new environment, then they have probably become anchorage-independent, which is one of the hallmarks of cancer cells. Anoikis resistance and anchorage-independency allow tumor cells to expand and invade adjacent tissues, and to disseminate through the body, giving rise to metastasis.
Anoikis (or cell-detachment-induced apoptosis) is a self-defense strategy that organisms use to eliminate ‘misplaced’ cells
A female client with a history of chronic renal failure has a total serum calcium level of 7.9 mg/dL. While performing an assessment, the nurse should focus on which of the following clinical manifestations associated with this calcium level?
A.) Complaints of shortness of breath on exertion with decreased oxygen saturation levels
B.) Difficulty arousing the client and noticing she is disoriented to time and place
C.) Heart rate of 120 beats/minute associated with diaphoresis (sweaty)
D.) Intermittent muscle spasms and complaints of numbness around her mouth
D.) Intermittent muscle spasms and complaints of numbness around her mouth
Spasms and numbness are characteristic of hypocalcemia. Respiratory effects, tachycardia, and diaphoresis are not associated with low calcium levels, whereas decreased level of consciousness can be indicative of hypercalcemia.
Free radicals damage cells by:
A.) Destroying phospholipids in the cell membrane
B.) Altering the immune response of the cell
C.) Disrupting calcium storage in the cell
D.) Inactivation of enzymes and mitochondria
A.) Destroying phospholipids in the cell membrane
Free radicals are highly reactive and can damage cells in several ways. One way is by destroying lipids, which results in a loss of cell membrane integrity. Free radicals modify proteins but do not affect the immune function, calcium storage, or intracellular enzymes of cells.
What type of cell is less differentiated?
Malignant Cancer cells
What are growth factors and what do they do?
Small signaling proteins that increase cell size and division
Fluid Distribution: Which compartment do the following belong to, and what is the ratio in comparison to the other compartment: Interstitial, plasma, and transcellular
Extracellular (1/3)
vs. Intracellular (2/3)
Hyponatremia causes cells to:
A.). Become hyperresponsive
B.). Remain static
C.) Swell
D.) Shrink
C.) Swell