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Fundamentals of Pathology: Pathoma Testbank/StudyguideChapter 1:GrowthAdaptations,CellularInjury and Death1.Ischemiaandothertoxicinjuriesincreasetheaccumulationofintracellularcalciumasaresultof:A)releaseofstoredcalciumfromthemitochondria.B)improvedintracellularvolumeregulation.C)decreasedinfluxacrossthecellmembrane.D)attractionofcalciumtofattyinfiltrates.2.Thepatientisfoundtohaveliverdisease,resultingintheremovalofalobeofhisliver.Adaptationtothereducedsizeoftheliverleadsto___________oftheremaininglivercells.A)metaplasiaB)organatrophyC)compensatoryhyperplasiaD)physiologichypertrophy3.Apersoneatingpeanutsstartschokingandcollapses.Hisairwayobstructionispartiallycleared,butheremainshypoxicuntilhereachesthehospital.Theprolongedcellhypoxiacausedacerebralinfarctionandresulting__________inthebrain.A)caspaseactivationB)coagulationnecrosisC)rapidphagocytosisD)proteinp53deficiency4.Bacteriaandvirusescausecelldamageby_______,whichisuniquefromtheintracellulardamagecausedbyotherinjuriousagents.A)disruptingthesodium/potassiumATPasepumpB)interruptingoxidativemetabolismprocessesC)replicatingandproducingcontinuedinjuryD)decreasingproteinsynthesisandfunction5.Thepatienthasaprolongedinterruptioninarterialbloodflowtohisleftkidney,causinghypoxiccellinjuryandthereleaseoffreeradicals.Freeradicalsdamagecellsby:A)destroyingphospholipidsinthecellmembrane.B)alteringtheimmuneresponseofthecell.C)disruptingcalciumstorageinthecell.D)inactivationofenzymesandmitochondria.6.Injuredcellshaveimpairedflowofsubstancesthroughthecellmembraneasaresultof:

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A)increasedfatload.B)alteredpermeability.C)alteredglucoseutilization.D)increasedsurfacereceptors.7.Reversibleadaptiveintracellularresponsesareinitiatedby:A)stimulusoverload.B)geneticmutations.C)chemicalmessengers.D)mitochondrialDNA.8.Injuredcellsbecomeveryswollenasaresultof:A)increasedcellproteinsynthesis.B)alteredcellvolumeregulation.C)passiveentryofpotassiumintothecell.D)blebformationintheplasmamembrane.9.Adiabeticpatienthasimpairedsensation,circulation,andoxygenationofhisfeet.Hestepsonapieceofglass,thewounddoesnotheal,andtheareatissuebecomesnecrotic.Thenecroticcelldeathischaracterizedby:A)rapidapoptosis.B)cellularrupture.C)shrinkageandcollapse.D)chronicinflammation.10.A99-year-oldwomanhasexperiencedthedeclineofcellfunctionassociatedwithage.Agroupoftheoriesofcellularagingfocusonprogrammed:A)changeswithgeneticinfluences.B)eliminationofcellreceptorsites.C)insufficienttelomeraseenzyme.D)DNAmutationorfaultyrepair.11.An89-year-oldfemalepatienthasexperiencedsignificantdecreasesinhermobilityandstaminaduringa3-weekhospitalstayforthetreatmentofafemoralheadfracture.Whichofthefollowingphenomenamostlikelyaccountsforthepatientsdecreaseinmusclefunctionthatunderliesherreducedmobility?A)ImpairedmusclecellmetabolismresultingfrommetaplasiaB)DysplasiaasaconsequenceofinflammationduringboneremodelingC)DisuseatrophyofmusclecellsduringaprolongedperiodofimmobilityD)Ischemicatrophyresultingfromvascularchangeswhileonbedrest

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12.A20-year-oldcollegestudenthaspresentedtohercampusmedicalclinicforascheduledPapanicolaou(Pap)smear.Theclinicianwhowillinterpretthesmearwillexaminecellsamplesforevidenceof:A)changesincellshape,size,andorganization.B)thepresenceofunexpectedcelltypes.C)ischemicchangesincellsamples.D)abnormallyhighnumbersofcellsinaspecifiedfield.13.Whichofthefollowingpathophysiologicprocessesismostlikelytoresultinmetastaticcalcification?A)BenignprostatichyperplasiaB)LivercirrhosisC)ImpairedglycogenmetabolismD)Hyperparathyroidism14.Despitethelowlevelsofradiationusedincontemporaryradiologicimaging,aradiologytechnicianisawareoftheneedtominimizeherexposuretoionizingradiation.Whatistheprimaryrationaleforthetechniciansprecautions?A)Radiationstimulatespathologiccellhypertrophyandhyperplasia.B)Radiationresultsintheaccumulationofendogenouswasteproductsinthecytoplasm.C)RadiationinterfereswithDNAsynthesisandmitosis.D)Radiationdecreasestheactionpotentialofrapidlydividingcells.15.Theparentsofa4-year-oldgirlhavesoughtcarebecausetheirdaughterhasadmittedtochewingandswallowingimportedtoyfigurinesthathavebeendeterminedtobemadeoflead.Whichofthefollowingbloodtestsshouldthecareteamprioritize?A)WhitebloodcelllevelswithdifferentialB)RedbloodcelllevelsandmorphologyC)UreaandcreatininelevelsD)Liverfunctionpanel16.A70-year-oldmalepatienthasbeenadmittedtoahospitalforthetreatmentofarecenthemorrhagicstrokethathaslefthimwithnumerousmotorandsensorydeficits.Thesedeficitsaremostlikelytheresultofwhichofthefollowingmechanismsofcellinjury?A)FreeradicalinjuryB)HypoxiaandATPdepletionC)InterferencewithDNAsynthesisD)Impairedcalciumhomeostasis17.Whichofthefollowingprocessesassociatedwithcellularinjuryismostlikelytobereversible?

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A)CelldamageresultingfromaccumulationoffatinthecytoplasmB)CellularchangesasaresultofionizingradiationC)CelldamagefromaccumulationoffreeradicalsD)Apoptosis18.Theextrinsicpathwayofapoptosiscanbeinitiatedby:A)damagetocellularDNA.B)decreasedATPlevels.C)activationofthep53protein.D)activationofdeathreceptorsonthecellsurface.19.Apatientwithsevereperipheralvasculardiseasehasdevelopedsignsofdrygangreneonthegreattoeofonefoot.Whichofthefollowingpathophysiologicprocessesmostlikelycontributedtothisdiagnosis?A)InappropriateactivationofapoptosisB)BacterialinvasionC)ImpairedarterialbloodsupplyD)Metaplasticcellularchanges20.Whichofthefollowingfactsunderliestheconceptofreplicativesenescence?A)Genescontrollinglongevityarepresentorabsentinvaryingquantitiesamongdifferentindividuals.B)Telomeresbecomeprogressivelyshorterinsuccessivegenerationsofacell.C)Thedamaginginfluenceoffreeradicalsincreasesexponentiallyinlatergenerationsofacell.D)AgingproducesmutationsinDNAanddeficitsinDNArepair.AnswerKey1.A2.C3.B4.C5.A6.B7.C8.B9.B10.A

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11.C12.A13.D14.C15.B16.B17.A18.D19.C20.B

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Chapter 2:Inflammation, Inflammatory Disorders, andWound HealingMULTIPLECHOICE1.Tears are considered to be part of the:1. first line of defense.2. second line of defense.3. third line of defense.4. specific defenses.5. nonspecific defenses.a.1, 4b.1, 5c.3, 4d.2, 5ANS: B2.A specific defense for the body is:a.phagocytosis.b.sensitized T lymphocytes.c.the inflammatory response.d.intact skin and mucous membranes.ANS: B3.The inflammatory response is a nonspecificresponse to:a.phagocytosis of foreign material.b.local vasodilation.c.any tissue injury.d.formation of purulent exudates.ANS: C4.Chemical mediators released during the inflammatory response include:a.albumin and fibrinogen.b.growth factors and cell enzymes.c.macrophages and neutrophils.d.histamine and prostaglandins.ANS: D5.Which of the following result directly from the release of chemical mediators following amoderate burn injury?1. Pain2. Localvasoconstriction3. Increased capillary permeability4. Pallora.1, 2

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b.1, 3c.2, 3d.2, 4ANS: B 6.Granulation tissue is best described as:a.highly vascular, very fragile, and very susceptible to infection.b.an erosion through the wall ofviscera, leading to complications.c.a type of adhesion with no vascularization.d.a form of stenosis, in a duct, that is extremely tough and resists attack by microbes.ANS: A7.Edema associated with inflammation results directly from:a.increased fluid and protein in the interstitial compartment.b.increased phagocytes in the affected area.c.decreased capillary permeability.d.general vasoconstriction.ANS: A8.The warmth and redness related to the inflammatory response resultsfrom:a.increased interstitial fluid.b.production of complement.c.a large number of white blood cells (WBCs) entering the area.d.increased blood flow into the area.ANS: D9.What is the correct order of the following events in theinflammatory response immediatelyafter tissue injury?1. Increased permeability of blood vessels2. Dilation of blood vessels3. Transient vasoconstriction4. Migration of leukocytes to the area5. Hyperemiaa.5, 3, 2, 1, 4b.1, 2, 4, 5, 3c.2, 3,5, 4, 1d.3, 2, 5, 1, 4ANS: D10.The process of phagocytosis involves the:a.ingestion of foreign material and cell debris by leukocytes.b.shift of fluid and protein out of capillaries.c.formation of a fibrin mesh around the infectedarea.

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d.movement of erythrocytes through the capillary wall.ANS: A11.Systemic effects of severe inflammation include:a.erythema and warmth.b.loss of movement at the affected joint.c.fatigue, anorexia, and mild fever.d.abscessformation.ANS: C12.The termleukocytosismeans:a.increased white blood cells (WBCs) in the blood.b.decreased WBCs in the blood.c.increased number of immature circulating leukocytes.d.significant change in the proportions of WBCs.ANS: A13.Which of the following statements applies to fever?a.Viral infection is usually present.b.Heat-loss mechanisms have been stimulated.c.It is caused by a signal to the thalamus.d.It results from release of pyrogens into thecirculation.ANS: D14.Mechanisms to bring an elevated body temperature down to the normal level include:a.general cutaneous vasodilation.b.generalized shivering.c.increased heart rate.d.increased metabolic rate.ANS: A15.Replacement of damaged tissue by similar functional cells is termed:a.fibrosis.b.regeneration.c.resolution.d.repair by scar tissue.ANS: B16.Scar tissue consists primarily of:a.granulation tissue.b.epithelial cells.c.collagen fibers.

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d.new capillaries and smooth muscle fibers.ANS: C17.Which of the following promotes rapid healing?a.Closely approximated edges of a woundb.Presence of foreign materialc.Exposure to radiationd.Vasoconstriction in the involved areaANS: A18.Glucocorticoids are used to treat inflammation because they directly:a.promote the release of prostaglandins at the site.b.decrease capillary permeability.c.mobilize lymphocytes andneutrophils.d.prevent infection.ANS: B19.Patients taking glucocorticoids for long periods of time are likely to develop all of thefollowing EXCEPT:a.decreased bone density.b.wasting of skeletal muscle.c.opportunistic infections.d.increased leukocyte production.ANS: D20.Which of the following drugs relieves fever and some types of pain but is NOT an anti-inflammatory agent?a.Acetaminophenb.Prednisonec.Aspirind.IbuprofenANS: A21.A burn area in which theepidermis and part of the dermis is destroyed is classified as:a.full-thickness.b.deep partial-thickness.c.superficial partial-thickness.d.first-degree.ANS: B22.A woman has burns on the anterior surfaces of her right arm, chest, andright leg. Thepercentage of body surface area burned is approximately:a.13.5%.

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b.18%.c.22.5%.d.31.5%.ANS: C23.The characteristic appearance of a full-thickness burn is:a.painful with multiple blisters.b.heavy bleeding.c.red withsome swelling.d.dry, firm, charred, or hard white surface.ANS: D24.A typical source of infection in burn areas is:a.the skin grafts.b.microbes surviving in the hair follicles in the burn area.c.circulating blood bringing microbes to theburn wound.d.opportunistic virus in digestive tract.ANS: B25.A large burn area predisposes to decreased blood pressure because:a.bleeding occurs under the burn surface.b.the heart is damaged by toxic materials from the burn.c.fluid andprotein shift out of the blood.d.vasoconstriction occurs in the burn area.ANS: C26.During an inflammatory response, hyperemia is caused by:a.increased blood flow in the area.b.increased capillary permeability.c.irritation of sensorynerve endings by histamine.d.increased leukocytes in the area.ANS: A27.The advantages of applying a biosynthetic skin substitute to a large area of full-thicknessburns include:1. reduced risk of infection.2. decreased loss of plasmaprotein and fluid.3. developing stronger fibrous scar tissue.4. more rapid healing.5. regeneration of all glands, nerves, and hair follicles.a.1, 3b.4, 5c.1, 2, 4

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d.2, 3, 5ANS: C28.Purulent exudates usually contain:a.smallamounts of plasma protein & histamine in water.b.red blood cells & all types of white blood cells.c.numerous leukocytes, bacteria, and cell debris.d.large amounts of water containing a few cells.ANS: C29.Isoenzymes in thecirculating blood:a.are a type of plasma protein normally present in the circulating blood.b.often indicate the precise location of an inflammatory response.c.are normally released from leukocytes during the inflammatory response.d.arepyrogens, causing low-grade fever.ANS: B30.A serous exudate is best described as a:a.thin, watery, colorless exudate.b.thick, sticky, cloudy secretion.c.thick, greenish material containing microbes.d.brownish, clotted material.ANS: A31.Systemic manifestations of an inflammatory response include:a.edema and erythema.b.area of necrosis and loss of function.c.pain and tenderness.d.fever and malaise.ANS: D32.Some local effects of a general inflammatoryresponse would include:a.high, spiking fever and chills.b.redness, warmth, and swelling.c.leukopenia and reduced erythrocyte sedimentation rate (ESR).d.anorexia and headaches.ANS: B33.Prolonged administration ofglucocorticoids such as prednisone may cause:1. atrophy of lymphoid tissue.2. increased resistance to infection.3. thrombocytopenia.4. decreased protein synthesis.a.1, 2

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b.1, 3c.1, 4d.2, 4ANS: C34.Application of ice to an injuredknee reduces edema by:a.promoting return of lymph fluid.b.causing local vasoconstriction.c.increasing the rate of tissue repair.d.causing systemic vasodilation.ANS: B35.Healing of large areas of skin loss (including dermis andepidermis) would be mostsuccessful through:a.rapid mitosis and regeneration of skin layers.b.resolution of damaged cells in the area.c.covering the area with biosynthetic skin substitute.d.graft of fibrous tissue to the area.ANS: C36.Prostaglandins are produced from ___________ and cause ___________.a.activated plasma protein; increased capillary permeabilityb.mast cells; vasodilation and painc.platelets; attraction of neutrophils, chemotaxisd.mast cell granules; activation of histamines and kininsANS: B37.The number of neutrophils in the blood is increased significantly:a.during allergic reactions.b.during chronic inflammation.c.to produce antibodies.d.in order to promote phagocytosis.ANS: D38.An abscess contains:a.serous exudate.b.purulent exudate.c.fibrinous exudate.d.hemorrhagic exudate.ANS: B39.Nonspecific agents that protect uninfected cells against viruses are called:a.neutrophils.

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b.macrophages.c.interferons.d.pyrogens.ANS: C40.Causes of inflammation include:a.direct physical damage such as cuts and sprains.b.allergic reactions.c.infection.d.All the aboveANS: D41.In normal capillary exchange, what is nethydrostatic pressure based on?a.The difference between the hydrostatic pressure within the capillary, as compared with the hydrostaticpressure of the interstitial fluidb.The relative osmotic pressures in the blood and the interstitial fluidc.The difference between the hydrostatic pressure and osmotic pressure within the capillaryd.The difference between the concentrations of blood cells, plasma proteins, and dissolved substances inthe blood and the interstitial fluidANS: A42.Thecardinal signs of inflammation include all of the following EXCEPT:a.redness.b.loss of function.c.nausea.d.swelling.ANS: C43.Drugs that have anti-inflammatory, analgesic, and antipyretic activities include:1. COX-2 inhibitors(NSAIDs).2. glucocorticoids (e.g., prednisone).3. ibuprofen (NSAID).4. acetaminophen.5. aspirin (ASA).a.1, 2b.2, 4c.1, 3, 5d.1, 4, 5ANS: C 44.Aspirin (ASA) is discouraged for treatment of viral infection in children because of:a.decreased bone growth after puberty.b.frequent production of blood clots.c.formation of a granuloma filled with virus.

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d.the risk of developing Reyes syndrome.ANS: D45.Systemic manifestations of inflammation include all EXCEPT:a.pyrexia.b.malaise.c.local swelling.d.anorexia.ANS: C46.Which of the following cellular elements found in the inflammatory response are responsiblefor phagocytosis?a.Macrophagesb.Basophilsc.B lymphocytesd.T lymphocytese.EosinophilsANS: A47.Which chemical mediator is involved in prolonging the inflammatory response?a.Bradykininb.Histaminec.Leukotrienesd.Chemotactic factorsANS: C48.Potential complications after healing by scar formation include allthe following EXCEPT:a.lack of sensory function in the area.b.contractures and adhesions.c.increased hair growth.d.keloid formation.ANS: C49.All of the following are correct statements regarding wound healing EXCEPT:a.Resolutionoccurs where there is minimal tissue damage and the cells can recover.b.Granulation tissue forms a permanent replacement for damaged tissue.c.Regeneration occurs where the cells are capable of mitosis.d.Scar tissue forms where the surrounding cells are incapable of mitosis.ANS: B50.Which of the following statements regarding inflammation is incorrect?a.Inflammation caused by an allergen or a burn will typically produce a serous exudate.b.Infection is one cause ofinflammation.

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c.Inflammation is the bodys nonspecific response to tissue injury.d.Disorders are named using the ending-sarcomato indicate inflammation.ANS: D51.Which of the following helps to localize and wall off the foreign materialduring aninflammatory response?a.Lymphocytesb.Increased fluidc.Fibrinogend.AntibodiesANS: C52.Why is an application of cold recommended as part of the RICE first aid measuresimmediately following an inflammatory response due toinjury?a.It improves circulation in the area removing chemical mediators.b.It causes local vasoconstriction to reduce local edema.c.It draws more phagocytic cells to the area to remove debris.d.It promotes immediate healing.ANS: B53.One goal for current research in tissue engineering is to:a.create a functional replacement tissue when regeneration is not possible.b.adapt cells from the injured organ to produce replacement tissue.c.design a nonliving syntheticreplacement tissue.d.use stem cells as a temporary covering for damaged tissue.ANS: A54.Identify the proper sequence in the healing process.a.A blood clot forms; granulation tissue grows into the gap; new blood vessels develop;phagocytosis offoreign material and cell debris occurs; and collagen fibers form a tight, strong scar.b.A blood clot forms; phagocytes remove foreign material and cell debris; granulation tissue grows into thgap; new blood vessels form; and collagenfibers promote formation of a tight, strong scar.c.Collagen fibers form in the damaged area; a blood clot forms; granulation tissue grows into the gap;angiogenesis takes place; and foreign material and cell debris are removed by phagocytes.d.Foreignmaterial and cell debris are removed by phagocytes; a blood clot forms; granulation tissue growinto the gap; new blood vessels form; and collagen fibers grow and cross-link.ANS: B55.All of the following are factors that promote healing EXCEPT:a.good nutrition: protein, vitamins A and C.b.a clean, undisturbed wound.c.effective circulation.d.advanced age.

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ANS: D56.Identify the correct statement about burns:a.The severity of the burn depends on the temperature, duration, andextent of the burn.b.Young children are less likely to suffer severe burns from immersion in excessively hot water.c.Burns to the palms of the hands are more damaging than burns on the face.d.With a major burn, excessive bleeding usually causes shock.ANS: A57.Which statement applies to the recommended emergency care for burns?a.Drop and lie completely still on your back.b.Call a neighbor for help if the burn appears to be extensive.c.Apply lotion and cover burn tightly with asheet or towel.d.Cover the burn area with clean, cool, or tepid water and remove nonsticking clothing.ANS: D58.Inhalation of carbon monoxide is a threat for many burn patients because this gas:a.causes swelling in the trachea.b.quicklyreduces the available oxygen in the blood.c.prevents full expansion of the lungs.d.is toxic to the nervous system.ANS: B59.How does scar tissue usually cause obstructions to develop in tube-like structures?a.Scar tissue continues to growand spread, causing a blockage.b.Scar tissue does not stretch, but rather shrinks in time, causing narrowing.c.Scar tissue twists and forms knots as it develops.d.Scar tissue attaches to nearby normal tissue, causing obstruction.ANS: B60.Which of the following is a serious potential complication found only with the anti-inflammatory COX-2 inhibitor drugs?a.Increased risk of infection at the site of inflammationb.Reyes syndrome developing in children and young adultsc.Increasedincidence of heart attacksd.Greatly delayed blood clottingANS: CChapter 3: Principles of NeoplasiaMULTIPLECHOICE1.What is a benign neoplasm originating from adipose tissue called?a.Adenoma

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b.Lipomac.Fibrosarcomad.AdenocarcinomaANS: B2.What are malignant neoplasms arising from connective tissue cells called?a.Carcinomasb.Sarcomasc.Melanomasd.FibromasANS: B3.Which of the following is a characteristic of a benign tumor?a.It isunencapsulated and invasive.b.It consists of undifferentiated cells.c.It exerts systemic effects.d.Cells appear relatively normal.ANS: D4.Which factor provides the basis for the grading of newly diagnosed malignant tumors?a.Size of thetumorb.Number of metastasesc.Degree of differentiation of the cellsd.Number of lymph nodes involvedANS: C5.A warning sign of possible cancer would be any of the following EXCEPT:a.persistent, unusual bleeding.b.a change in bowelhabits.c.sudden development of fever, nausea, and diarrhea.d.a change in shape, color, or surface of a skin lesion.ANS: C6.The common local effects of an expanding tumor mass include:1. obstruction of a tube or duct.2. anemia and weightloss.3. cell necrosis and ulceration.4. tumor markers in the circulation.a.1, 2b.1, 3c.2, 4d.3, 4

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ANS: B7.Which of the following doesparaneoplasticsyndromerefer to?a.The effects of substances such as hormones secreted by thetumor cellsb.Severe weight loss and cachexia associated with advanced cancerc.The decreased resistance to infection resulting from malignant tumorsd.The effects of multiple metastatic tumorsANS: A8.Which term refers to the spread ofmalignant cells through blood and lymph to distant sites?a.Invasivenessb.Seedingc.Metastasisd.Systemic effectANS: C9.One reason for staging a malignant tumor at the time of diagnosis is to:a.identify the original cell from which thetumor developed.b.locate and identify the primary tumor.c.decide the initiating factor for a particular tumor.d.determine the best treatment and prognosis.ANS: D10.The process of carcinogenesis usually begins with:a.exposure topromoters causing dysplasia.b.development of defective genes.c.an irreversible change in the cell DNA.d.a single exposure to a known risk factor causing temporary cell damage.ANS: C11.What would be an external source of ionizingradiation?a.A needle containing a radioisotope implanted beside the tumorb.Gamma rays delivered by a cobalt machinec.A dose of a radioactive drug to be ingestedd.A fluid containing radioactive material instilled in a body cavityANS: B12.Radiation therapy destroys:a.all cells in the tumor at one time.b.the cells in the center of the tumor.c.primarily rapidly dividing cells.d.radioresistant cells.ANS: C

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13.The most critical adverse effects of chemotherapy andradiation therapy are:a.thrombocytopenia and leucopenia.b.headache and lethargy.c.nausea and constipation.d.alopecia and weight loss.ANS: A14.Chemotherapy usually involves a combination of drugs in order to:1. reduce the adverseeffects.2. guarantee that all cancer cells are destroyed.3. be effective in more phases of the cell cycle.4. totally block the mitotic stage.a.1, 3b.1, 4c.2, 3d.3, 4ANS: A15.Why does ovarian cancer have a poor prognosis?a.Theovaries are inaccessible for examination.b.Specific signs rarely appear until after secondary tumors have developed.c.The same tumor markers are present with many types of cancer.d.No effective treatment is available.ANS: B16.Select thecorrect pair representing a malignant tumor and its marker:a.colon cancer: carcinoembryonic antigen (CEA)b.hepatic cancer: CA125, AFPc.prostate cancer: human chorionic gonadotropin (hCG)d.testicular cancer: Philadelphia chromosomeANS: A17.Antiangiogenesis drugs act on a malignant tumor by:a.promoting the immune response and removal of abnormal tumor cells.b.blocking hormonal stimulation of tumor cells.c.reducing blood flow and nutrient supply to tumor cells.d.transporting radioisotopes into the tumor.ANS: C18.The development of neutropenia during chemotherapy for cancer means:a.the cancer cells are being destroyed quickly.b.the patient is likely to hemorrhage.

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c.higher doses ofchemotherapy could be tolerated by this patient.d.the patient is at high risk for infection.ANS: D19.Malignant brain tumors:a.metastasize quickly to all parts of the body.b.spread first to lungs and bone.c.spread to other parts of CNS.d.do not metastasize anywhere at any time.ANS: C20.Identify the common dose-limiting factor for chemotherapy:a.Alopeciab.Bone marrow depressionc.Nausea and vomitingd.Weight lossANS: B21.Glucocorticoids are often prescribed during acourse of chemotherapy and radiation because:a.glucocorticoids greatly potentiate the effect of chemotherapy.b.the immune system is stimulated.c.skeletal muscle atrophy will be decreased.d.inflammation around the tumor may be reduced.ANS: D22.Vomiting frequently follows a chemotherapy treatment because:a.the gastrointestinal tract is irritated.b.the chemicals stimulate the emetic center.c.the drugs have an unpleasant odor.d.A and BANS: D23.What type of normalcells are often damaged during chemotherapy and radiation treatments?a.Epithelial cellsb.Skeletal muscle cellsc.Nerve tissued.Collagen and fibrous tissueANS: A24.Remission for cancer is generally defined as a period in which:a.chemotherapy cannot be used.b.signs and symptoms are absent.

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c.complications are evident.d.metastases occur.ANS: B25.All of the following are correct statements about skin cancers EXCEPT:a.They are difficult to diagnose and treat.b.They usually develop slowly on the head, neck, or back of individuals with fair skin.c.The number of skin cancer cases is increasing.d.Basal cell carcinoma is the most common form of skin cancer.ANS: A26.High risk factors for cancer include:1.human papilloma virus.2. chronic irritation and inflammation.3. repeated sun exposure.4. high family incidence.a.1, 3b.3, 4c.1, 2, 4d.1, 2, 3, 4ANS: D27.The termapoptosisrefers to:a.programmed cell death.b.abnormal orimmature cells.c.degree of differentiation of cells.d.the development of new capillaries in a tumor.ANS: A28.The warning signs for cancer include:a.unusual bleeding.b.change in a wart or mole (e.g., color).c.a new solid lump, oftenpainless.d.All the aboveANS: D29.A classification process that applies to a specific malignant tumor and describes the extent ofthe disease at a given time is called:a.seeding.b.mutation.c.staging.d.grading.

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ANS: C30.Benign tumors can often be differentiated from malignant tumors because benign tumors:a.often have systemic effects.b.contain cells showing increased mitosis and atypical rapid growth.c.are encapsulated and slow-growing.d.can metastasize orinvade nearby tissue.ANS: C31.Benign tumors in the brain are often life-threatening because they:a.metastasize early in their development.b.create excessive pressure within the skull.c.cannot be removed.d.cause serious systemiceffects.ANS: B32.Drugs or agents that augment the natural immune response in the body to improveidentification and removal of abnormal cells are called:a.biological response modifiers.b.angiogenesis stimulators.c.analgesiccomplements.d.targeted receptor modifiers.ANS: A33.The method that can be used as an alternative to surgical removal of a tumor by using heatgenerated by a needle inserted into the tumor is referred to as:a.radiation therapy.b.thermolysis intervention.c.brachytherapy.d.radiofrequency ablation.ANS: D34.Staging systems used to classify a malignant tumor at the time of diagnosis are based onwhich of the following factors?a.Size of the tumor, involvement of lymphnodes, metastasesb.Location of tumor, size, type of cellular abnormalityc.Size, encapsulated or non-encapsulated, invasion into neighboring tissued.Type of cellular abnormality, size of secondary tumors, location/tissue affectedANS: AChapter 4: Hemostasis and Related Disorders1.Withtheexceptionofthefirsttwosteps,whatisrequiredinallstepsoftheclottingprocess?

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A)CalciumB)ProthrombinC)TissuefactorD)Plasminogen2.Thefirststepofhemostasisoccursasa:A)fibrinclot.B)plateletplug.C)clotretraction.D)vesselspasm.3.Toformaplateletplug,plateletsareattractedtothedamagedvessel,andthenplatelet___________occurs.A)adhesionB)fibrinolysisC)thrombosisD)thromboxaneA24.Bloodcoagulationisinitiatedbyeitheroftwopathways.Theintrinsicpathwayrequirescirculating________tobeginthestep-wisecoagulationcascade.A)proteinCB)thrombinC)factorXIID)tissuefactor5.Increasedplateletfunction,andconsequenthypercoagulability,canbecausedby:A)factorVmutation.B)plateletinsensitivity.C)vascularwalldamage.D)decreasedplateletnumbers.6.Immunethrombocytopeniapurpura(ITP)isa/an________disorderthatdestroys________.A)allergic;fibrinogenB)alloimmune;factorVIIIC)autoimmune;plateletsD)immunoglobulin;Bcells7.Thromboticthrombocytopenicpurpura(TTP)causeswhichofthefollowingmanifestations?Selectallthatapply.A)Purpura

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B)JaundiceC)PetechiaeD)ErythemaE)Confusion8.HemophiliaAisahereditaryblooddisordercausedbyinadequateactivityorabsent:A)factorVIII.B)prothrombin.C)vWFcomplex.D)intrinsicfactor.9.Disseminatedintravascularcoagulation(DIC)ischaracterizedby:A)headaches.B)plateletloss.C)hypertension.D)hemorrhage.10.Inpersonswithableedingdisordercausedbyvasculardefects,laboratorytestswillmostoftenreveal:A)normalvalues.B)hypocalcemia.C)polycythemia.D)thrombocytopenia.11.Removalofapatientsperipheralintravenouscatheterresultedinbriefbleedingandthelossofasmallamountofblood.Whichofthefollowingprocessesoccurredduringtheformationoftheplateletplugthathelpedtostopbloodflow?A)ActivationoffactorXB)ConversionofprothrombintothrombinC)ReleaseofvonWillebrandfactorfromtheepitheliumD)Conversionoffibrinogentofibrinthreads12.A69-year-oldpatientwhoisobeseandhasadiagnosisofanginapectorishasbeenprescribedclopidogrel(Plavix)byhisprimarycareprovider.Thepatientsmedicationachievesitstherapeuticeffectinwhichofthefollowingways?A)PreventionofplateletaggregationB)ActivationofplasminogenC)InhibitionoftheintrinsicclottingpathwayD)DeactivationoffactorX

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13.Apublichealthnurseisconductingahealthpromotioncampaignundertheauspicesofthelocalcommunitycenter.Whichofthefollowingmeasuresthatthenurseispromotingarelikelytoinfluencetheparticipantsriskofhypercoagulabilitydisorders?Selectallthatapply.A)SmokingcessationB)BloodglucosescreeningC)WeightmanagementD)CholesterolscreeningandmanagementE)Bloodpressurescreeningandmanagement14.Duringapatientsadmissionassessmentpriortoreductionmammoplastysurgery,thenursenotesareferencetoaLeidenmutationinthepatientshistory.ThenursewouldrecognizethepatientsincreasedriskforA)HemorrhageB)MyocardialinfarctionC)HemophiliaAorBD)Deepveinthrombosis15.Themostrecentbloodworkofapatientwithadiagnosisofacutemyelogenousleukemia(AML)revealsthrombocytopenia.Whereisthepatientmostlikelytoexperienceabnormalbleedingasaresultoflowplatelets?A)InthebrainB)SkinandmucousmembranesC)ScleraeoftheeyesD)Nephronsandureters16.Apatientwasstartedonaprotocolforthepreventionofdeepveinthrombosisshortlyafteradmission,andhasbeenreceiving5000unitsofheparintwicedailyforthelast5days.Animmuneresponsetothistreatmentmayincreasethepatientschanceofdevelopingwhichhealthproblem?A)AntiphospholipidsyndromeB)Disseminatedintravascularcoagulation(DIC)C)VonWillebranddiseaseD)Thrombocytopenia17.Inlightofthepresenceofnumerousriskfactorsforcoronaryarterydisease,apatientsprimarycareproviderhasrecommendedthathetakelow-doseaspirinoncedaily.Doingsowillreducethepatientsriskofmyocardialinfarctionbyalteringwhichofthefollowingstagesofhemostasis?A)VesselspasmB)Plateletplugformation

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C)BloodcoagulationD)Clotlysis18.A23-year-oldfemalepatienthasbeendiagnosedwithvonWillebranddiseasefollowingalonghistoryofheavyperiodsandoccasionalnosebleeds.Whichofthepatientsfollowingstatementsdemonstratesasoundunderstandingofhernewdiagnosis?A)ImreallydisappointedthatIwontbeabletodosportsanymore.B)IreadonawebsitethatImighthavetogetbloodtransfusionsfromtimetotime.C)IllmakesuretotakeTylenolinsteadofaspirinwhenIgetachesandpains.D)IhopemyinsurancecoverstheinjectionsthatIllneedtohelpmybloodclot.19.WhichofthefollowingpatientslikelyfacesthehighestriskofanacquiredhypocoagulationdisorderandvitaminKdeficiency?A)ApatientwhohasadiagnosisofliverfailuresecondarytoalcoholabuseB)Apatientwhohaschronicrenalfailureasaresultoftype1diabetesmellitusC)ApatientwhoisimmunocompromisedasaresultofradiationtherapyforthetreatmentoflungcancerD)ApatientwithdehydrationandhypokalemiathathaveresultedfromClostridiumdifficileassociateddiarrhea20.Ahealthy,primiparous(first-time)motherdeliveredahealthyinfantseveralhoursago,butthemotherhasexperiencedpostpartumhemorrhage.Whichofthefollowingdisordersismostlikelytounderliethepatientsexcessivebleedingafterdelivery?A)DisseminatedintravascularcoagulationB)HemophiliaAC)VonWillebranddiseaseD)Thromboticthrombocytopenicpurpura(TTP)AnswerKey1.A2.D3.A4.C5.C6.C7.A,C,E8.A9.D10.A

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11.C12.A13.A,B,C,D,E14.D15.B16.D17.B18.C19.A20.AChapter 5: Red Blood CellDisorders

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1.Sueisfatiguedandsomebloodtestsaredone.HerresultsincludeHct40%;Hgb8g/dL;WBC8,000;platelets175,000.ThenurseshouldinterpretSuesbloodworkasindicativeof:A)highplatelets/thrombocytosis.B)lowWBCcount/granulocytopenia.C)lowhemoglobin/anemia.D)highhematocrit/polycythemia.2.Manifestationsofanemiathataredirectlyduetothediminishedoxygen-carryingcapacityofhemoglobininclude:A)fatigue.B)bleeding.C)bonepain.D)paleskin.3.WhenanRh-negativemotherhasbeensensitizedandispregnantwithanRh-positivefetus,whathappenstothefetus?A)BilirubindeficiencyB)Nothing,thisisnormalC)PlasmavolumedepletionD)Profoundredcellhemolysis4.Thepatientisanaverage-sizedadultandhasabnormalmicrocytichypochromicredbloodcellsduetoalong-term,chronicdisease.WhichofthefollowingCBCresultsischaracteristicofhertypeofanemia?A)Hematocrit44%B)Reticulocytes1.5%C)Bandcells3,000/mLD)Hemoglobin8g/dL5.MegaloblasticanemiascausedbyfolicacidorvitaminB12deficienciescanseriouslyaffectRBCproduction.Thisisbecausebotharenecessaryfor_______synthesisand_______.A)iron;hemoglobinadhesionB)DNA;redbloodcellmaturationC)thrombin;plateletaggregationD)protein;reticulocytematuration6.Polycythemiadevelopsinpatientswithlungdiseaseasaresultof:A)hyperventilation.B)chronichypoxia.C)decreasedbloodviscosity.

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D)excessiverespiratoryfluidloss.7.Whichofthefollowingtypesandcharacteristicsofanemiaarecorrectlymatched?A)Hemolytic;abnormalironuptakeB)Irondeficiency;earlyRBCdeathC)Folate;decreasederythropoiesisD)Bloodloss;bonemarrowexpansion8.Conditionsthatpredisposetosicklingofhemoglobininpersonswithsicklecellanemiainclude:A)impairedredbloodcellmaturation.B)increasedironcontentofblood.C)decreasedoxygensaturation.D)increasedintravascularvolume.9.Anelevatedlevelofunconjugatedbilirubin,duetohemolysisofRBCs,resultsinahighlevelofironreleasedand:A)diarrhea.B)cyanosis.C)numbness.D)jaundice.10.Hemolyticanemiaischaracterizedbyexcessiveredbloodcelldestructionandcompensatory:A)hypoactivebonemarrow.B)increasederythropoiesis.C)ironretentioninthebody.D)shrinkageofthespleen.11.A48-year-oldmalepatient,whonormallyenjoysgoodhealth,hasbeenadmittedtothehospitalforthetreatmentofpolycythemiavera.Thenursewhoisprovidingcareforthepatientshouldprioritizeassessmentsaimedattheearlyidentificationofwhichofthefollowinghealthproblems?A)OrthostatichypotensionB)HyperventilationandrespiratoryalkalosisC)VasculitisD)Thromboembolism12.Whichofthefollowingpatientsismostsusceptibletoexperiencingtheeffectsofinadequateerythropoiesis?A)Apatientwhohasdevelopedrenalfailureasaresultoflongstandinghypertension

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B)ApatientwhorecentlyexperiencedanischemicstrokeandwhoremainsbedriddenC)ApatientwhoseheavyalcoholusehasculminatedinadiagnosisofpancreatitisD)Apatientwhoseestimatedbloodlossduringrecentsurgerywas700mL.13.A72-year-oldwomanwithcomplaintsofincreasingfatiguehascompletedaseriesoffecaloccultbloodteststhatindicatethepresenceofbloodinherstool.Whichofthefollowinghealthproblemsislikelytoaccompanythispatientsgastrointestinalbleed?A)HemolyticanemiaB)AplasticanemiaC)Iron-deficiencyanemiaD)Megaloblasticanemia14.HemoglobinsolubilityresultsandhemoglobinelectrophoresishaveresultedinadiagnosisofsicklecellanemiainanAfricanAmericaninfant.Theparentsofthechildshouldbeawarethattheirchildisatasignificantriskforwhichofthefollowinghealthproblems?Selectallthatapply.A)AcutepainB)StrokeC)RespiratorydiseaseD)AutoimmunediseasesE)Fractures15.Thepathologiceffectsofthethalassemiasareprimarilyduetowhichofthefollowingpathophysiologicprocesses?A)ImpairedhemoglobinsynthesisB)ImpairedfolicacidabsorptionC)ErythropoietindeficiencyD)Lossofiron16.Whichofthefollowingindividualslikelyfacesthehighestriskofmegaloblasticanemia?A)A69-year-oldwomanwhotakesASAfourtimesdailytotreatherarthritisB)A44-year-oldmanwholostapproximately500mLofbloodinaworkplaceaccidentC)A21-year-oldcollegestudentwholivesaveganlifestyleD)Aninfantwhoisexclusivelyfedcommercialbabyformula17.Forwhichofthefollowinghealthproblemsisstemcelltransplantationlikelytobeoftherapeuticbenefit?A)AplasticanemiaB)b-ThalassemiasC)Chronicdiseaseanemias

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