Pathophysiology Exam 1: Rasmussen 2024-2025, Exams of Nursing

Download Pathophysiology Exam 1: Rasmussen 2024-2025 and more Exams Nursing in PDF only on Docsity! 1 | P a g e Pathophysiology Exam 1 Rasmussen 2024-2025 UPDATE (100%correct Questions and Answers) Graded A An ordered photographic display of a set of chromosomes from a single cell is a(n): A) metaphase spread. B) autosomal spread. C) karyotype. D) anaphase spread. c An error in which homologous chromosomes fail to separate during meiosis is termed: A) aneuploidy. B) nondisjunction. C) polyploidy. D) anaplasia. b A somatic cell that does not contain a multiple of 23 chromosomes is called: A) an aneuploid cell. B) a euploid cell. C) a polyploidy cell. D) a haploid cell. a A 20-year-old pregnant female gives birth to a stillborn child. Autopsy reveals that the fetus has 92 chromosomes. Which of the following describes this condition? A) Euploidy B) Triploidy C) Tetraploidy D) Aneuploidy c If a person is a chromosomal mosaic, the person may: A) be a carrier of the genetic disease. B) have a mild form of the genetic disease. C) have two genetic diseases. D) be sterile as a result of the genetic disease. 2 | P a g e b The most common cause of Down syndrome is: A) paternal nondisjunction. B) maternal translocations. C) maternal nondisjunction. D) paternal translocations. c Risk factors for Down syndrome include: A) fetal exposure to mutagens in the uterus. B) increased paternal age. C) family history of Down syndrome. D) pregnancy in women over age 35. d A 13-year-old girl has a karyotype that reveals an absent homologous X chromosome with only a single X chromosome present. Her condition is called: A) Down syndrome. B) Cri du chat syndrome. C) Turner syndrome. D) Edward syndrome c A child is diagnosed with cystic fibrosis. History reveals that the child's parents are first cousins. Cystic fibrosis was most likely the result of: A) X inactivation. B) genomic imprinting. C) consanguinity. D) obligate carriers. c Joey, age 9, is admitted to a pediatric unit with Duchenne muscular dystrophy. He inherited this condition through a: A) sex-linked dominant trait. B) sex-influenced trait. C) sex-limited trait. D) sex-linked recessive trait. d 5 | P a g e Which of the following types of genetic disorders is the most common cause of miscarriage? A) Autosomal dominant B) Autosomal recessive C) X-linked recessive D) Chromosomal d Which of the following is an accurate characteristic of an autosomal recessive pedigree? A) On average, 50% of the children will have the autosomal recessive disease if one parent has the disease. B) Males are affected more than females. C) On average, 25% of the children are affected by the autosomal recessive disease if both parents are carriers. D) There is a decreased risk of disease with consanguinity. c Which of the following is an accurate characterization of an X-linked recessive pedigree? A) Disease is seen more often in males than females. B) A pattern of skipped generations is rare. C) Males are gene carriers. D) Mothers usually transmit the disease to their daughters. a The process by which RNA directs the synthesis of protein is called: A) termination. B) transcription. C) promotion. D) translation. d A 15-year-old female is diagnosed with Prader-Willi syndrome. This condition is an example of: A) gene imprinting. B) an autosomal recessive trait. C) an autosomal dominant trait. D) a sex-linked trait. a Adaptive cellular mechanisms function to: A) treat disease. 6 | P a g e B) protect cells from injury. C) prevent cellular aging. D) speed up cellular death. b Cellular atrophy involves: A) an increase in cell size. B) a decrease in cell size. C) an increase in the number of cells. D) a decrease in the number of cells. b The process of cellular atrophy is accomplished through which of the following processes? A) Loss of fluid B) Decreased cell division C) Inhibition of enzyme formation D) Formation of autophagic vacuoles d In compensatory hyperplasia, growth factors stimulate cell division in response to: A) tissue loss. B) decreased hormonal stimulation. C) ischemia. D) puberty. a Pathologic hyperplasia can lead to: A) neoplasia (cancer). B) dysplasia. C) metaplasia. D) all of the above. d In response to an increased workload, such as that caused by high blood pressure (hypertension), myocardial cells in the left ventricle will adapt through the process of: A) atrophy. B) hypertrophy. C) hyperplasia. D) dsyplasia. b 7 | P a g e The process of muscle hypertrophy involves an increase in: A) cell division. B) water accumulation. C) protein synthesis. D) plasma membrane thickness. c Chronic infection of the cervix by the human papillomavirus results in cervical: A) atrophy. B) dysplasia. C) metaplasia. D) hormonal hyperplasia. b Metaplasia involves the replacement of normal cells by: A) another type of cell. B) abnormal cells of the same tissue type. C) scar tissue. D) cancer cells. a The most common cause of hypoxic injury is: A) free radicals. B) malnutrition. C) chemical toxicity. D) ischemia. d Tissue ischemia and a decrease in mitochondrial oxygenation result in: A) cellular dehydration. B) decreased ATP production. C) calcium accumulation outside the cell. D) increased protein synthesis. b Lysosomal rupture during hypoxic injury leads to: A) cellular acidosis. B) sodium influx. C) cellular adaptation. D) autodigestion of cells. 10 | P a g e The process by which cells program themselves to die is called: A) karyolysis. B) apoptosis. C) pyknosis. D) necrosis. b Osmosis describes the movement of: A) electrolytes. B) glucose. C) water. D) blood. c Which of the following electrolytes is found in the highest concentrations in the intracellular fluid (ICF)? A) Sodium B) Calcium C) Magnesium D) Potassium d Capillary oncotic pressure is primarily determined by which of the following molecules? A) Glucose B) Sodium C) Albumin D) Water c Edema can result from all of the following alterations except: A) decreased capillary hydrostatic pressure. B) decreased capillary oncotic pressure. C) lymphatic obstruction. D) increased capillary membrane permeability. a Symptoms of dehydration include: A) decreased urine output. B) increased skin turgor. 11 | P a g e C) increased blood pressure. D) edema. a What is the purpose of vasodilatation and increased vascular permeability during inflammation? A) To bring white blood cells to the area of injury B) To transport inflammatory chemicals to the area of injury C) To dilute toxins D) All of the above d The first cell to react to tissue injury is the: A) macrophage. B) mast cell. C) fibroblast. D) neutrophil b Which of the following stimuli are known to induce mast cell degranulation? A) Thermal injury B) The presence of toxins C) Immunologic tissue injury D) All of the above d The process of a phagocyte squeezing through retracted endothelial cells to enter into the tissues is called: A) fusion. B) diapedesis. C) phagocytosis. D) margination. b Prior to engulfment of a bacterium during phagocytosis, which of the following events must occur? A) Release of lysosomal enzymes B) Fusion C) Recognition and adherence D) Formation of a phagolysosome 12 | P a g e c In addition to phagocytosis, which of the following functions are also performed by macrophages? A) Release of growth factors and stimulating new blood vessel growth B) Destroying circulating antibodies C) Inhibiting inflammation D) Promotion of blood clotting a A monocyte is a circulating white blood cell that transforms into which of the following cells once it enters the tissue during an inflammatory response? A) Neutrophil B) Macrophage C) Mast cell D) Fibroblast b Cells defend against viral invasion through the production and secretion of: A) histamine. B) interferon. C) growth factors. D) prostaglandins. b Opsonization promotes the process of: A) phagocytosis. B) vasodilation. C) increased vascular permeability. D) clotting. a Warmth and redness of the skin are indicators of inflammation. Which of the following processes is responsible for this clinical manifestation? A) Increased vascular permeability B) Phagocytosis C) Vasoconstriction D) Vasodilation d 15 | P a g e The primary cell of immunity is the: A) mast cell. B) macrophage. C) neutrophil. D) lymphocyte. d Humoral immunity is generated through the process of: A) direct cell lysis. B) stimulating an inflammatory response. C) producing antibodies. D) secreting toxic molecules. c If a person has resistance to a disease from natural exposure to an antigen, the person has which form of immunity? A) Natural B) Innate C) Passive acquired D) Active naturally acquired d Molecules that are capable of inducing an immune response are called: A) lymphocytes. B) haptens. C) antigens. D) antibodies. c Which of the following is an example of an endogenous antigen? A) Poison ivy B) Injected medications C) Pollen D) The body's own tissue d The condition in which the immune cells attack the individual's own tissues as if they were invaders is called: A) alloimmunity. B) autoimmunity. 16 | P a g e C) hypersensitivity. D) graft rejection. b Immune cells distinguish "self" from "nonself" by recognizing: A) cellular RNA. B) major histocompatibility antigens. C) different types of phospholipids in a cell's membrane. D) "nonself" enzymes secreted by foreign cells. b Major histocompatibility class I (MHC I) antigens are found on which of the following cells? A) Red blood cells B) B lymphocytes and macrophages only C) All body cells except for red blood cells D) Liver, heart, and bone marrow cells only c Which of the following cells has the capacity to produce antibodies during an immune response? A) Plasma cells B) T cells C) Memory cells D) Pluripotent cells a Which cell ingests microorganisms for the purposes of presenting their antigen to the immune system and activating an immune response? A) Helper T cell B) Mast cell C) Neutrophil D) Macrophage d Which cell stimulates both the cell-mediated and humoral immune responses? A) Plasma cells B) Cytotoxic T cells C) B lymphocytes D) Helper T cells 17 | P a g e d CD4 receptors that bind to the surface of macrophages and B cells are found on: A) helper T cells. B) cytotoxic T cells. C) plasma cells. D) the human immunodeficiency virus (HIV). a Which process confers long-lasting immunity against a specific organism? A) Production of memory cells B) Activation of macrophages C) Activation of cytotoxic T cells D) Activation of the inflammatory response a The predominant antibody of a typical secondary immune response is: A) IgG. B) IgM. C) IgE. D) IgA. a If a person is exposed to antigen X and is later exposed to antigen X again, which of the following immune responses will occur? A) Primary B) Secondary C) Determinant D) Immunosuppressive b What type of immunity is conferred when an individual is given a vaccine? A) Natural immunity B) Passive acquired immunity C) Active acquired immunity D) Alloimmunity c Which of the following is not a function of antibodies? A) Neutralizing bacterial toxins B) Preventing viruses from entering tissue cells 20 | P a g e In type II hypersensitivity, tissue injury is caused by: A) autoantibody activation of complement and subsequent destruction of target cells. B) autoantibody stimulation of NK cells that destroy target cells. C) autoantibody opsonization of target cells and subsequent phagocytosis. D) all of the above. d Which of the following hypersensitivity reactions involves the formation of antigen- antibody (immune) complexes that get deposited on vessel walls or in extravascular tissue? A) Type I B) Type II C) Type III D) Type IV c A positive tuberculin skin test for detecting the presence of tuberculosis is indicative of which type of hypersensitivity reaction? A) Type I B) Type II C) Type III D) Type IV d What is the effect of repeated exposure to an allergen in an atopic individual? A) The allergic response gets worse. B) Antibody production is suppressed. C) Antibody formation remains constant. D) Tc cell activity increases significantly. a Desensitization therapy improves allergies by which of the following mechanisms? A) Producing antibodies that prevent the allergen from binding to IgE B) Decreasing the amount of IgE in the body C) Decreasing the amount of antigen in the bloodstream D) Decreasing the responsiveness of the bronchi and blood vessels to histamine a Which of the following features is characteristic of a type IV hypersensitivity? A) Antibody-dependent cell-mediated toxicity B) Delayed response 21 | P a g e C) Usually life-threatening D) Mediated by the complement system b Type IV hypersensitivities, such as poison ivy reactions, are initiated by: A) B cells that release IgD 24 to 48 hours after exposure. B) the release of neutrophil chemotactic factor. C) the stimulation of cytotoxic T cells. D) the release of large quantities of IgE. c What type of reaction occurs when the body mounts an aggressive response against an organ transplanted from another person? A) Type I hypersensitivity B) Autoimmune C) Alloimmune D) Immunosuppressive c Autoimmunity can result from all of the following hypersensitivities except: A) type I. B) type II. C) type III. D) type IV. a Manifestations of the autoimmune disease SLE include: A) wheezing, eczema, and itching. B) pulmonary edema, leg swelling, and vein distention. C) arthritic joint pain, pleuritic chest pain, and rash. D) nasal polyps, headache, and rhinorrhea. c A person with type O blood has which of the following antigens present on their red blood cells? A) A and B B) Rh C) O D) None of the above d 22 | P a g e Transfusion of A-negative blood to an O-positive individual will have which of the following results? A) Improved red blood cell count B) Clumping and lysis of red blood cells C) Production of anti-B antibodies D) An Rh incompatibility reaction b Individuals with immunodeficiencies are at risk for: A) hypersensitivity reactions. B) fungal infections only. C) opportunistic infections. D) autoimmune diseases. c The microorganism that causes acquired immunodeficiency syndrome (AIDS) is a: A) gram-negative bacterium. B) gram-positive bacterium. C) retrovirus. D) protozoan. c The microorganism that causes AIDS can be transmitted through: A) heterosexual intercourse. B) breast milk. C) blood transfusions. D) all of the above. d HIV inserts its genetic material by binding to the _____ on the helper T cell. A) gp 120 receptor B) CD8 receptor C) CD4 receptor D) phospholipids c After initial infection with the HIV, most individuals: A) experience severe symptoms of AIDS. B) have mild flu-like symptoms. 25 | P a g e o Mediated by T lymphocytes- Don't involve antibody -Destruction of the tissue usually caused by direct killing by toxins from Tc cells - Th1 cells produce cytokines that recruit phagocytes, especially macrophages o Examples: acute graft rejection, skin test for TB, contact allergic reactions (poison ivy), and some autoimmune diseases - diabetes, contact dermatitis (allergy), hashimoto thyroiditis, Rheumatoid arthritis (autoimmune), graft rejection(alloimmune) aneuploid cell variation of chromosomal number that causes a cell to have too many or too few chromosomes; total number of chromosomes is not a multiple of 23 as it is in triploidy or tetraploidy. complementary base pairing the consistent pairing of adenine & thymine and of guanine & cytosine; ensures accurate replication of DNA. Cri du chat syndrome condition caused by deletion on chromosome 5; child has cat-like cry, low birth weight, mental retardation, microcephaly and heart defects Down syndrome trisomy-21; most well known aneuploidy, occurs in about 1:800 live births; characterized by mental retardation, sterility, poor muscle tone, congenital heart defects, characteristic facial features and lowered life expectancy (about 60 years). Duplication excess genetic material; usually less severe than deletions Euploid cells with a normal number of chromosomes (diploid = 46, haploid = 23) Expressivity the extent of variation in a phenotype associated with a particular genotype Klinefelter Syndrome individuals with XXY karyotype, may have moderate mental impairment, male appearance but may have hypogonadism and sterility, high pitched voice and mosaicism (duel XXY & XY karyotypes). Triploidy 26 | P a g e mutation that causes cells to have 3 copies of each chromosome, resulting in 69 chromosomes; incompatible with life Turner Syndrome monoploidy of sex chromosome (karyotype 45, X); may cause learning diabilities, short stature, coarctation of aorta and sterility. abrasion results from removal of the superficial layers of the skin caused by friction between the skin and the injuring object adaptation A reversable, structural, or functional response both to normal (physiologic) conditions and to adverse (pathologic) conditions in order to maintain homeostasis. algor mortis postmortem reduction in body temp asphyxial injury injury caused by failure of cells to receive or use oxygen bilirubin normal yellow-green pigment of bile derived from the porphyrin structure of hemoglobin; excessive levels cause jaundice; unconjugated bilirubin is lipid soluble and can damage cell membranes blunt force injury mechanical injury to body resulting in tearing, shearing, or crushing; most common injury seen in healthcare, caused by blows or impact, MVA, and falls carbon monoxide an odorless, colorless and undetectable gas produced by incomplete combustion of fuels like gasoline; causes hypoxic injury caseous necrosis a combination of coagulative and liquefactive necrosis that usually results from TB infection; the dead cells disintegrate but debris is not fully digested, so tissues resemble soft cheese chopping wound 27 | P a g e heavy edged instruments (axes, hatchets, propeller blades, etc) produce wounds with a combination of sharp and blunt force characteristics. coagulative necrosis occurs primarily in kidneys, heart, and adrenal cells; commonly results from hypoxia/ischemia; caused by protein denaturation (particularly albumin) compensatory hyperplasia an adaptive mechanism that enables certain organs to regenerate; occurs significantly in epidermal and intestinal epithelia, hepatocytes, bone marrow cells, fibroblasts, and some bone, cartilage, and smooth muscle. contusion bruising; bleeding into skin or underlying tissues cyanide chemical asphyxiant that blocks the intracellular use of oxygen; signs are similar to carbon monoxide posioning disuse atrophy atrophy that occurs in skeletal muscles with prolonged periods of non use dry-lung drowning drowning that occurs with little or no water entering lungs due to vagal nerve mediated larynogospasms; occurs in 15% of drownings dysplasia abnormal changes in the size, shape, and organization of mature cels dystrophic calcification calcification of dying and dead tissues that occurs as a reaction to tissue injury; necrosis is one example exit wound gunshot injury; has the same appearance regardless of range of fire; size cannot determine if entrance or exit wound; usually has clean edges fat necrosis 30 | P a g e atrophy that occurs early in development, like with the thymus gland postmortem autolysis postmortem putrification changes that begin to occur 24-48 hours after death; caused by the release of enzymes and lytic dissolution. puncture wound injury caused by instrument or object with sharp points but no sharp edges (such as a nail); prone to infection, have abrasions of edges and can be very deep pyknosis type of nuclear dissolution where the nucleus shrinks and becomes a small, dense mass of genetic material reperfusion injury injury that results from the restoration of oxygen following hypoxic event due to oxidative stress which causes further cell membrane damage and mitochondrial calcium overload rigor mortis the stiffening of muscles that occurs after death due to depletion of ATP, causing detachment of myosin from actin in muscle cells stab wound a penetrating sharp force injury that is deep than it is long; wound may be almost closed by tissue pressure, causing little superficial bleeding despite copious internal bleeding ubiquitin Small protein that is linked to other proteins as a way of marking the targeted protein for degradation by proteasomes. ubiquitin-proteosome pathway the primary pathway of protein catabolism vacuolation formation of vacuoles in the cytoplasm and swelling of lysosomes and mitochondria result from damage to the outer membrane if O2 is not restored xenobiotics toxic, mutagenic, and carcinogenic chemicals; bind to lipoproteins and can penetrate lipid bilayer albumin 31 | P a g e protein in plasma that protects cells by binding with unconjugated bilirubin lead The ability to increase intracellular calcium concentrations and affect the nervous and hematopoietic systems is a characteristic of tattooing The appropriate term for fragments of burning or unburned pieces of gunpowder that are embedded in the epidermis is: caseous Tuberculous infections are likely to result in a form of necrosis called: What are causes of atrophy? aging disuse (skeletal tissue) ischemia [restriction in blood supply to tissue] (heart, brain) inadequate nutrition decrease in work load, use, blood supply, hormones, and nervous stimulation Examples of atrophy skeletal muscle: person with cast, spinal cord injury, bed rest patient heart atrophy: no blood supply to part of heart, chamber of heart can atrophy What are causes of hypertrophy? adaptation for loss (kidney) physiological (skeletal muscle) hormone induced (uterus) Examples of hypertrophy loss of kidney: other kidney enlarges utreus in pregnancy heart secondary to hypertension or diseased heart valves How does metaplasia differ from atrophy, hypertrophy, and hyperplasia? reversible replacement of one mature cell by another cell allows for replacement with cells that are better able to tolerate environmental stresses When does metaplasia occur? 32 | P a g e smoking replacement of normal columnar ciliated epithelial cells of the bronchial (airway) lining by stratified squamous epithelial cells replacement of ciliated epithelial cells in trachea with non-ciliated cells, airway not protected Where does dysplasia occur? cervix respiratory tract epithelia tissue of cervix What is dysplasia associated with? malignancy neoplastic growths strong indicator of development of breast cancer often found adjacent to cancerous cells Mechanisms of Cellular Injury hypoxia chemical infectious immunologic & inflammatory nutritional imbalances physical agents What is the most common cause of hypoxia? ischemia: reduction of blood flow caused by arteriosclerosis (narrowing of arteries/harden arteries) or thrombosis (blockage by blood clots) Dry gangrene skin shrinks, dry wrinkled, black to brown skin is atrophied and crackled, occurs in the extremities, looks like prune Wet gangrene 35 | P a g e production of fibrin shields growth & reproduction intracellularly exotoxins very potent proteins that produce specific physiologic effects (good for vaccines) endotoxins not particularly strong antigens that produce non-specific effects and are part of structure of the organism such as the cell membrane granulomas chronic inflammatory lesion that stays relatively localized (not very invasive) and occupies space What is critical in the initiation of immune response? Macrophage- B and T Lymphocytes what immunity response develops when T cells link with and antigen and is recognized as an invader then destroys it? Cell-mediated immunity B lymphocyte Humoral immunity-activated cell becomes and antibody-producing plasma cell or a B memory cell T lymphocyte White blood cells; cell-mediated immunity which lymphocyte acts primarily against bacteria and viruses? B lymphocyte What occurs during the second exposure leading to an allergic reaction? Large amounts of chemical mediators are released from mast cells into the general circulation very quickly Effects of anaphlaxis Vasodilation- lowering of Blood Pressure Nerve endings irritated- itching Constriction of bronchioles, release of mucus- airways obstructed, cough, dyspnea Secondary or Acquired Immunodeficiency 36 | P a g e refers to loss of the immune response resulting from specific causes and may occur at any time during the lifespan 1st exposure to foreign antigens, in an allergic reaction, causes Production of antibodies, sensitization of mast cells Candida Harmless fungus normally present on the skin- common cause of vaginal infection in immunodeficient individuals