CHAPTERS 1-6 REVIEW WITH ANSWERS

PATHOPHYSIOLOGY
Chapter: Chapter 01 - Quiz
Multiple Choice

1. In contrast to malignant tumors, benign tumors:

A) are well differentiated but have lost their ability to control cell replication.
B) are more likely to undergo degenerative changes than malignant tumors.
C) do not cause pressure damage to surrounding tissues, as do malignant tumors.
D) are unable to effect alterations in body function through the elaboration of hormones or other chemicals.
Ans: A

2. The staging TNM system for classifying cancers is used to describe:

A) the etiologic factors associated with the disease.
B) the microscopic nature of the cancer.
C) the clinical spread of the disease.
D) the location of the cancer.
Ans: C

3. A mother of a 6-month-old infant presents to the clinic for a wellness visit. The mother had an uncomplicated pregnancy and delivery. No fetal issues were
identified at birth. The nurse practitioner notes the following while conducting the child's history and physical examination: infant not meeting milestones, muscular
rigidity, and some questionable seizure activity. Which of the following would be most beneficial for the nurse practitioner to include in the assessment to assist in
diagnosing this child’s possible condition?
A) Maternal age
B) Maternal tobacco use
C) Maternal drug abuse during pregnancy
D) Maternal ethnic heritage
Ans: D

4. What involves an example of cellular adaptation?

A) Formation of pancreatic cancer
B) Muscular hypertrophy with regular weight lifting
C) Mutation of nuclear DNA
D) Immune destruction of precancerous cells
Ans: B

5. What is a major factor leading to increased occurrence of cancer in the elderly?

A) Cumulative exposure to carcinogens
B) Widespread vascular degeneration
C) Increased immune surveillance
D) Hereditary factors
Ans: A

6. A child is noted to have a very short stature, webbed neck, droopy eyelids, and recurrent infections. The nurse will expect which of the following diagnoses?
A) Turner syndrome
B) Down syndrome
C) Marfan syndrome
D) Klinefelter syndrome
Ans: A

7. Which of the following is true of congenital disorders?

A) Always diagnosed by clinical signs at birth
B) Also called a developmental defect
C) The same as a genetic disorder
D) Present at birth but not always apparent
Ans: D

8. Following shift report on an oncology unit, which patient would the nurse assess first?
A) 47-year-old male diagnosed with prostatic cancer admitted for chemotherapy
B) 89-year-old female diagnosed with metastatic breast cancer complaining of pain of 7 on a scale of 1 to 10
C) 68-year-old male diagnosed with late-stage lung cancer complaining of difficulty breathing
D) 57-year-old female diagnosed with cervical cancer admitted for radiation
Ans: C

9. Which of the following assessment findings is most concerning to the nurse and would require immediate action?
A) 5-mm bluish-black mole with asymmetrical edges
B) Multiple raised flesh-toned skin lesions on a patient diagnosed with neurofibromatosis
C) Patient complaining of fatigue after receiving chemotherapy
D) Simian crease in a patient diagnosed with Down syndrome
Ans: A

Multiple Response
1. Warning signs of possible cancer would include which of the following? (Select all that apply.)
A) Persistent, unusual bleeding
B) Sudden development of fever, nausea, and diarrhea
C) A change in shape, color, or surface of a skin lesion
D) Increased appetite
E) A change in bowel habits
Ans: A, C, E

Chapter: Chapter 02 - Quiz

Multiple Choice

1. The nurse is teaching a patient who has recently given birth about immunity that has been passed to the baby in utero. Which statement by the patient indicates
that additional teaching is needed?
A) “My baby received some antibodies from me before birth, and I will give him more when I breastfeed.”
B) “I had chickenpox and am immune to it, so my baby will not need to have the chickenpox vaccine.”
C) “I had the measles, so my baby will be protected against it until he is old enough to receive the MMR vaccine.”
D) “Only certain antibodies were able to cross the placenta to protect my baby.”
Ans: B

2. Which kind of innate immunity usually involves swelling of tissues?

A) Barriers
B) Inflammatory response
C) Pyrogens
D) Interferons
Ans: B

3. A 2-day post-op heart transplant patient begins to have fever and signs and symptoms of heart failure. The patient is more than likely experiencing which of the
following?
A) Type I, IgE-mediated hypersensitivity
B) Type III, immune complex-mediated hypersensitivity
C) Graft-versus-host disease
D) Host-versus-graft disease
Ans: D

4. Which of the following is a complication of chronic stress?

A) Renal disease
B) Diabetes mellitus
C) Pathological fractures
D) Increased susceptibility to illness
Ans: D

5. Within minutes after receiving an injection of penicillin, the patient complains of shortness of breath and chest pain. The nurse notifies the patient's healthcare
provider because this patient is most likely experiencing which type of hypersensitivity?
A) Type I
B) Type II
C) Type III
D) Type IV
Ans: A

6. During which of the following stages of the general adaptation syndrome (GAS) have the body’s coping methods been completely utilized?
A) Alarm
B) Resistance
C) Transference
D) Exhaustion
Ans: D

7. Which of the following is a chemical released from the sympathetic nervous system by the adrenal medulla that is responsible for many of the physiological
symptoms of the “fight or flight” response?
A) Insulin
B) Cortisol
C) Epinephrine
D) Corticotropin
Ans: B

8. What disease state results from an inability to differentiate self from non-self?
A) Immunodeficiency
B) Hypersensitivity
C) Autoimmunity
D) Anaphylaxis
Ans: C

9. Which of the following patients is at the greatest risk for impaired immune function?
A) 23-year-old female who is 5% above her ideal body weight
B) 79-year-old male with poorly controlled diabetes mellitus
C) 89-year-old male with controlled hypertension
D) 45-year-old female who is recently widowed
Ans: B

Multiple Response

1. The nurse is teaching a community health class about the immune system. The nurse asks the class to list various functions of B cells in immunity. Which
responses by students are correct? (Select all that apply.)
A) “They are the first to arrive at the scene of infection.”
B) “They make all sorts of antibodies.”
C) “They eat up bacteria, viruses, and parasites.”
D) “They turn into memory cells that keep the person immune.”
E) “They release chemicals to stop inflammation when healing is done.”
Ans: B, D

Chapter: Chapter 03 - Quiz

Multiple Choice

1. Which of the following patients would be most likely to develop disseminated intravascular coagulation (DIC)?
A) 28-year-old male diagnosed with hemophilia A
B) 47-year-old female diagnosed with sepsis
C) 50-year-old male diagnosed with hypertension and diabetes mellitus
D) 78-year-old female smoker diagnosed with Alzheimer's disease
Ans: B

2. Which information is most important for the nurse to provide to the patient to prevent sickle cell crisis?
A) “Avoid exercising.”
B) “Maintain a diet high in iron.”
C) “Eat a diet low in iron.”
D) “Maintain an oral fluid intake of at least 4500 mL/day.”
Ans: D

3. Which instruction will the nurse include in the discharge teaching plan of a patient who was recently diagnosed with thrombocytopenia?
A) “Avoid high-fat foods.”
B) “Increase red meat in your diet.”
C) “Use a soft-bristled toothbrush.”
D) “Avoid green leafy vegetables.”
Ans: C

4. Which of these patients should the nurse assess first?

A) A 32-year-old with pernicious anemia who needs to receive a vitamin B12 injection
B) A 40-year-old with iron deficiency anemia who needs a Z-track iron injection
C) A 67-year-old with acute myelocytic leukemia who has petechiae on the legs
D) An 81-year-old with thrombocytopenia and an increase in waist circumference
Ans: D

5. Why do vascular occlusions and infarcts occur frequently with sickle cell anemia?
A) Increased hemolysis of erythrocytes
B) The inability of hemoglobin S to transport oxygen
C) The damaged membranes of many red blood cells
D) The change in shape of erythrocytes clogging vessels
Ans: D

6. In the course of infectious mononucleosis, the Epstein-Barr virus invades:

A) B lymphocytes.
B) T lymphocytes.
C) macrophages.
D) marrow stem cells.
Ans: A

7. Multiple myeloma is a malignancy of the:

A) lymphatic system.
B) T lymphocytes.
C) granulocytes.
D) plasma cells.
Ans: D

8. When making a differential diagnosis between Hodgkin's and non-Hodgkin's disease, the nurse understands that Hodgkin's disease would have which of the
following present?
A) Felty syndrome
B) Epstein-Barr virus
C) Bence Jones proteins
D) Reed-Sternberg cells
Ans: D

9. While in the hospital for management of an acute leukemia, J.B.'s neutrophil count is 175. The most appropriate action for this condition would be:
A) anticoagulant therapy.
B) minimizing visitors.
C) chemotherapy.
D) iron supplements.
Ans: B

10. A 52-year-old man presents to the clinic complaining of back pain. X-rays reveal multiple areas of reduced bone density and a compression fracture of the
vertebra. His lab work revealed elevated serum calcium levels. Which of the following diseases is most consistent with these findings?
A) Leukemia
B) Lymphoma
C) Multiple myeloma
D) Hodgkin lymphoma
Ans: C

Chapter: Chapter 04 - Quiz

Multiple Choice

1. Your patient has hypertension and asks you how this can lead to heart failure. What is the best response?
A) “Hypertension causes resistance in your carotids, or afterload, so your heart works harder and weakens.”
B) “Hypertension causes resistance in your blood vessels, or afterload, so your heart works harder and weakens.”
C) “Hypertension limits the amount of blood entering your left ventricle, or afterload, so your heart works harder and weakens.”
D) “Hypertension limits the ability of your heart to stretch before emptying, or afterload, so your heart works harder and weakens.”
Ans: B

2. You are providing group education about lipids to patients who have been diagnosed with dyslipidemia. What does the best instruction include?
A) High-density lipoprotein (HDL) is called good cholesterol because it increases the oxygen content in the arteries and stabilizes plaque build-up.
B) HDL is called good cholesterol because it removes cholesterol from your body and gets rid of it in your liver.
C) HDL is called good cholesterol because it deceases cardiac workload by decreasing oxygen consumption by your heart.
D) HDL decreases low-density lipoprotein (LDL) and prevents it from converting to very low-density lipoprotein (VDRL), which is the worst kind of cholesterol in the
body.
Ans: B

3. Which breakfast food recommendations are most appropriate for a patient who has been placed on a low-cholesterol diet?
A) Eggs, skim milk, whole wheat toast, decaffeinated coffee
B) Skim milk, oatmeal, banana, decaffeinated coffee
C) Toast, margarine, one slice of bacon, coffee
D) Blueberry muffin, orange juice, coffee
Ans: B

4. A nurse is caring for a patient with newly diagnosed hypertension. Which dietary teaching will be included in the plan of care for this patient?
A) “Completely avoid drinking any alcohol products.”
B) “Use fresh herbs and spices for cooking.”
C) “You may use salt substitutes freely for flavoring.”
D) “You may cook with salt, but do not add additional salt when your food is served.”
Ans: B

5. Which statement made by a patient would alert the nurse to the possibility of right-sided heart failure?
A) “My shoes fit really tight.”
B) “I sleep with four pillows at night.”
C) “I wake up coughing every night.”
D) “I have trouble catching my breath.”
Ans: A

6. A young adult presents with a fever, petechiae, and a murmur. Which additional data will the nurse obtain?
A) Personal history of dyslipidemia
B) Family history of coronary artery disease
C) Whether the patient is responsible for cleaning pet litter boxes
D) History of any systemic infection or dental work within the past month
Ans: D

7. Which of the following patients is at highest risk for thrombus formation?

A) 80-year-old female with anemia
B) 56-year-old 1-day post-op cardiac bypass surgery
C) 78-year-old female 1-week post-op hip replacement receiving physical therapy
D) 36-year-old male admitted 2 days ago with idiopathic thrombocytopenic purpura
Ans: B

8. The patient has all the following clinical manifestations. Which assessment finding alerts the nurse to the probability of anaphylactic shock as opposed to other
types of shock?
A) Hypotension
B) Pale, clammy skin
C) Anxiety and confusion
D) Difficulty breathing
Ans: D

9. Which of the following orders would the nurse prioritize for the patient suspected to be experiencing an acute myocardial infarction?
A) Demerol 50-mg intravenous push
B) Nitroglycerin spray sublingual
C) Chew one extra-strength Tylenol
D) Order a low-cholesterol diet
Ans: B

Multiple Response

1. Which of the following factors or conditions are associated with an increased risk of coronary artery disease? (Select all that apply.)
A) Low dietary intake of saturated fats and cholesterol
B) High blood pressure
C) High dietary fiber intake
D) Cigarette smoking
E) Obesity
Ans: B, D, E

Chapter: Chapter 05 - Quiz

Multiple Choice

1. The nurse assesses which patient for nosocomial pneumonia?

A) The patient receiving mechanical ventilation
B) The patient with acquired immunodeficiency syndrome (AIDS)
C) The patient in traction for a fractured femur who also has a cold
D) The patient with type 2 diabetes who has a 50-pack-per-year smoking history
Ans: A

2. Which of the following accurately describes the pathophysiology of chronic obstructive pulmonary disease (COPD)?
A) Obstruction of the trachea and larynx
B) Obstructed air flow in the bronchi during inspiration
C) Excess fluid compressing the lung, limiting expansion
D) Inflammation leading to lung fibrosis and a loss of elasticity
Ans: D

3. While assessing a patient admitted to the hospital for congestive heart failure treatment, the nurse notes decreased breath sounds over the left lobe and
asymmetrical chest expansion. The nurse reports this finding to the physician, who in turns orders a chest X-ray. The chest X-ray revealed an increased collection of
fluid in the pleural cavity. The nurse recognizes that these findings are consistent with:
A) pneumonia.
B) pleural effusion.
C) mediastinal shift.
D) pulmonary edema.
Ans: D

4. Cystic fibrosis is:

A) a restrictive disorder characterized by proteolytic destruction of alveoli.
B) an autosomal recessive disorder affecting exocrine glands.
C) caused by chronic exposure to secondhand smoke.
D) an allergic disorder triggered by specific antigens.
Ans: B

5. A major risk factor for chronic obstructive pulmonary disease (COPD) is:
A) smoking.
B) male sex.
C) genetic predisposition.
D) diet high in saturated fats.
Ans: A

6. Which of the following disease processes involves the thickening of the bronchial walls, which impedes air flow and leaves the individual unable to increase efforts
to maintain blood gases within normal range?
A) Interstitial lung disease
B) Chronic bronchitis
C) Bronchiectasis
D) Emphysema
Ans: C

7. The most common cause of bacterial pneumonia is:

A) Escherichia coli.
B) histoplasmosis.
C) Streptococcus pneumoniae.
D) Neisseria meningitidis.
Ans: C

8. Pulmonary compliance refers to the ease with which:

A) the lungs can be inflated or the amount of pressure needed to change their volume.
B) sputum can be expectorated from the lungs.
C) air can be moved through the airway.
D) air can be exhaled from the lungs.
Ans: A

9. A distinguishing feature of influenza is:

A) abrupt-onset symptoms of fever, chills, and general malaise.
B) sore throat and profuse watery nasal discharge.
C) dry and nonproductive cough.
D) fever and headache.
Ans: A

10. In asthma, airways are narrowed because of:

A) bronchoconstriction.
B) mucous production.
C) smooth muscle hypertrophy.
D) airway wall thickening.
Ans: C

Chapter: Chapter 06 - Quiz

Multiple Choice

1. Which statement by a patient diagnosed with heart failure indicates a correct understanding of prevention and clinical manifestation of hypervolemia?
A) “I must drink a quart of liquids each day.”
B) “I will weigh myself every morning before I eat or drink.”
C) “I will use a seasoning mix such as seasoned salt when preparing and eating my meals.”
D) “I will drink a soda every night before bedtime.”
Ans: B

2. Classify the following arterial blood gas: pH = 7.30, PaCO2 = 55 mm Hg, HCO3– = 24 mEq/L.
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Ans: C

3. The main source of serum bicarbonate is obtained from:

A) the kidneys.
B) dietary intake.
C) synthesis by the liver.
D) medications containing sodium bicarbonate.
Ans: A

4. The major physiologic stimulus for thirst is:

A) polyuria.
B) hyponatremia.
C) hypovolemia.
D) hypoglycemia.
Ans: C

5. The body compensates for metabolic alkalosis by:

A) hypoventilation.
B) hyperventilation.
C) decreasing arterial carbon dioxide.
D) increasing bicarbonate ion excretion.
Ans: A

6. Capillary colloidal pressure is controlled by the:

A) plasma proteins.
B) red blood cells.
C) white blood cells.
D) serum sodium concentration.
Ans: A

7. Hypoventilation, aspiration of foreign bodies, and sleep apnea may cause:

A) metabolic acidosis.
B) metabolic alkalosis.
C) respiratory alkalosis.
D) respiratory acidosis.
Ans: D
8. Decreased neuromuscular excitability can be seen in which two electrolyte disorders?
A) Hypercalcemia and hypermagnesemia
B) Hyponatremia and hyperkalemia
C) Hypocalcemia and hypokalemia
D) Hypernatremia and hypomagnesemia
Ans: A

9. Your renal failure patient on the hospital unit begins having severe diarrhea. You become concerned that your patient may develop which of the following?
A) Metabolic alkalosis
B) Metabolic acidosis
C) Respiratory alkalosis
D) Respiratory acidosis
Ans: B

10. The most appropriate therapy for an individual with hypernatremia is:
A) volume expansion with normal saline.
B) administration of colloids.
C) hypotonic fluids.
D) ACE inhibitors.
Ans: C