Pathophysiology Exam 2

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Elseiver Questions

A public health nurse is teaching the community about health promotion. Which information should the nurse include for innate immunity? Innate immunity is gained:

At Birth

Which statement indicates teaching was successful regarding collectins? Collectins are produced by the


A 20 year old male received a knife wound to the arm during an altercation. Which of the following types of immunity was compromised?

Innate Immunity

Biochemical Secretions that trap and kill microorganisms include:


A 25 Year old female presents to her primary care provider reporting vaginal discharge of a white, viscous, and foul-smelling substance. She reports that she has been taking antibiotics for the past 6 months. Which finding will the nurse most likely see on the microorganism report?

Decreased Lactobacillus

When an aide asks the nurse what is a purpose of the inflammatory process, how should the nurse respond?

To prevent infection of the injured tissue

A child fell off the swing and scraped the right knee. The injured area becomes painful. What else will the nurse observe upon assessment?

Edema at the injured site

A nurse recalls the mast cell, a major activator of inflammation, initiates the inflammatory response through the process of?


Which of the following individuals would be at greatest risk for an opportunistic infection?

a 24-year old who is immunocompromised

The directional magration of leukocytes along a chemical gradient is termed


A 20-year-old male shoots his hand with a nail gun while replacing roofing shingles. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?


The predominant phagocyte of early inflammation is the?


A 25-year-old female experiences a headache and takes aspirin for relief. A nurse recalls aspirin relieves the headache by:

Decreasing prostaglandin production

Which factor will help the nurse differentiate leukotrienes from histamine?

Time of release

A 25-year-old male is in a car accident and sustains a fracture to his left femur with extensive soft tissue injury. The pain associated with the injury is related to:

Kinins and prostaglandins

The complement, clotting, and kinin systems share which of the following characteristics?

Activation of proenzymes

Which statement indicates teaching was successful regarding the classic pathway of the complement system? The classic pathway of the complement system is activated by:

Antigen-antibody complexes

A patient has researched bradykinin on the internet. Which information indicates the patient understands the functions of bradykinin. Bradykinin is involved in:

Increasing vascular permeability

After teaching the staff about the clotting system, which statement indicates teaching was successful? The end product of the clotting system is:


A 5 year old male is diagnosed with a bacterial infection. Cultures of the bacteria revealed lipopolysaccharides on the bacterial cell surface. Which of the complement pathways would be activated in this case?

Alternative Pathway

An 8 year old female presents with edema of the cutaneous and mucosal tissue layers. Her mother reports that the condition is recurrent and seems to occur more often during stressful situations. The child is diagnosed with hereditary angioedema. Which of the following is deficient in this club?

C1 esterase inhibitor

A nurse is preparing to teach on the subject of opsonins. Which of information should the nurse include? Opsonins are molecules that:

Enhance Phagocytosis

A 10-year-old male is diagnosed with a parasite. Which lab result should the nurse check for a response to the parasite?


a 65 year old female is diagnosed with metastatic breast cancer. She has developed muscle wasting. Which of the following substances would be produced in large quantities to eliminate the tumor cells and cause muscle wasting?

tumor necrosis factor

When phagocytes begin to stick avidly to capillary walls, which process is occurring?


An infant develops a fever secondary to a bacterial infection. Which of the following most likely triggered the fever?


a 54 year old male intravenous drug user is diagnosed with chronic hepatitis C. Testing revealed that he is a candidate for treatment. Which of the following could be used to treat his condition?


A 35 year old male is diagnosed with lobar pneumonia (lung infection). Which of the following exudates would be present in highest concentration at the site of this advanced inflammatory response?


During inflammation, the liver is stimulated to release plasma proteins, collectively known as:

acute phase reactants

A 3 year old is making play cakes in a sandbox and is eating the play cakes. The sand was also being used by cats as a litter box and was contaminated with toxoplasmosis. Which of the following would most likely also be present?

Granuloma formation

A 12 year old male is fighting with another child when he receives a puncture wound from a pencil. The school nurse cleans and bandages the wound. After about 1 week, the wound would be in which phase of healing?


The macrophage secretion that stimulates procollagen synthesis and secretion is:

Transforming growth factor-beta

A 30 year old male was involved in a motor vehicle in a motor accident. The glass from the shattered window cut his face and neck. The scar, however, was raised and extended beyond the original boundries of the wound. This pattern of scarring is caused by impaired:

Collagen synthesis

The nurse is reviewing a lab data of newly admitted patient. the nurse notes the patient had an erythrocyte sedimentation done, and the results are quite elevated. The nurse would focus the care plan on which of the following conditions?


Healing by secondary intention would occur in which of the following patients? A patient with a:

Stage IV pressure ulcer

The post-surgical patient is experiencing delayed wound healing. The dietician believes the delay is related to nutritional intake. A deficiency in which of the following substances could directly affect healing?

Ascorbic Acid

A nurse remembers the primary actions of the complement cascade include (select all that apply)

Increased vascular permeability
Cell Killing

The nurse is assessing a patient with a diagnosis of inflammation. The nurse would expect to find which of the following signs and symptoms consistent with acute inflammation?

Heat, Erythema, Pain, Swelling, Loss of function

The nurse identified each of the following clinical manifestations of inflammation. Which would the nurse classify as a local response?

redness, swelling, heat, pain

Physical barriers that offer the body protection from damage and infection are located in the:

Gastrointestinal tract
Genitourinary tract
Respiratory tract

Which of the following is responsible for initiating clonal selection?


After teaching the students about B cells, which statement indicates teaching was successful? B cells originally derived form cells of the

bone marrow

A 6-year-old female is diagnosed with a bacterial infection of the respiratory system. What of the following will most likely try to fight the antigen?


When the immunoglobulin crosses the placenta, what type of immunity does the fetus receive?


An immunologist has isolated a molecule from the human body to study. It is found to react with antibodies on B cells. Further testing reveals that the molecule is large and chemically diverse. What type of molecule is the immunologist studying?


Which statement indicates a correct understanding of antibodies? The most abundant class of antibody in the serum is:


THe predominant antibody of a typical primary immune response is:


An immunology nurse is caring for a patient. While planning care, which principle will the nurse remember? The primary role of IgA1 is to prevent infections in the:


A 23-year old pregnant female visits her primary care provider for her final prenatal checkup. The primary care provider determines that the fetus has developed an infection in utero. Which of the following would be increased in the fetus at birth?


Which portion of the antibody is responsible for the biologic functions of antibodies?

Fc portion

An experiment is carried out to characterized newly discovered immunoglobulins. Specificity of the amino acids within the immunoglobulin could be determined by studying the:

Complementary-Determining Region (CDR)

A 20 year old female is applying for nursing school and is required to be tested for immunity against several illnesses. Testing that looks at which of the following would be the best to determine immunity?


A 10 year old male is stung by a bee while playing in the yard. He experiences a severe allergic reaction and has to go to the ER. The nurse providing care realized this reaction is the result of:


A 25 year old female has sexual relations with her boyfriend. Later she is told that the boyfriend is infected with Neisseria Gonorrheoeae. Testing reveals that she does not have the disease. How is it possible that she did not contract the disease?

Antibodies covered sites of attachment

Which of the following characteristics is shared by both the secretory and systemic immune systems?

Neutralization following antigen-antibody binding

A patient has done research on monoclonal antibodies on the internet. Which statement indicates a correct understanding? Pure monoclonal antibodies are produced by?


An experiment is designed to determine specific cell types involved in cell-mediated immune response. The experimenter is interested in finding cells that attack cells that have specific antigens. Which cells should be isolated?

Cytotoxic T cells

Which of the following statements indicates more teaching is needed regarding secondary lymph organs? ______ is/are the secondary lymph organ/

The liver

After a patient is exposed to a specific antigen, B cells will differentiate into:

Plasma cells

A macrophage was isolated and analyzed for major histocompatibility complex. Which of the following would be expected?

MHC I and II

A cell that is produced in the thymus and interacts with MHC class II molecules would have which of the following surface proteins?


A 6 month old infant is brought to the pediatrician for recurrent colds. The child is fed formula, and the other family members have not been ill. The primary care provider tells the mother that the child's immune system is no yet competent, but will be about 60% of an adult system around age _____ months.


A 5 month old child is admitted to the hospital with recurring respiratory infections. A possible cause of this condition is:

Immune insufficiency

Which patient will develop active immunity?

A patient who has natural exposure to an antigen or receives an immunization

A 16 year old is bitten by a rabid dog while jogging in the park. Upon admission to the emergency department, the nurse will administer which of the following to help prevent infection?

immune globulin

self antigens do not meet the requirements for immunogenicity because they lack which of the following?


A patient has a disease state that results from the secretion of toxins by bacteria. Which medical diagnosis will the nurse see documented on the chart?


While planning care for an elderly patient, the nurse remembers that increased age is associated with:

decreased immune function
Decreased number of circulating immune complexes
decreased ability to fight infection

When a patient asks about secondary lymph organs, how should the nurse respond? Secondary lymph organs include:

peyers patches

Direct effects of antibodies include


When a patient asks the nurse what hypersensitivity is, how should the nurse respond? Hypersensitivity is best defined as:

An excessive or inappropriate response of the immune system to a sensitizing antigen

a 5-year old female takes a hike through the woods during a school field trip. Upon returning home, she hugs her father, and he later develops poison ivy. Which of the following immune reactions is he experiencing?


When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs?


While planning care, a nurse recalls seasonal allergic rhinitis is expressed through:

IgE-mediated reactions

A patient presents with poison ivy on extremities, face, and buttocks. This condition is an example of:

Delayed hypersensitivity

A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pain, swelling, redness, and respiratory difficulties. He is suffering from:


When a patient presents at the emergency department for an allergic reaction, the nurse recognizes the most severe consequences of a type I hypersensitivity reaction is:


When histamine is released in the body, which of the following responses would the nurse expect?


Which information would indicate more teaching is needed regarding hypersensitivity reactions? Type ___ hypersensitivity reactions involve an antibody response.


A 10 year old male presents to his primary care provider reporting wheezing and difficulty breathing. History reveals that both of the child's parents suffer from allergies. Which of the following terms would be used to classify the child?


a 30 year old female presents to her primary care provider reporting fatigue, excessive sweating and increased appetite. Physical examination reveals protruding eyes, and laboratory testing receals hyperthyroidism secondary to autoantibody production. This disorder falls into the category of type __ hypersensitivity.


A 30 year old male is having difficulty breathing and has been spitting blood. He reports that he began experiencing this reaction after cleaning his pigeons' cages. Testing reveals he is suffering from allergic alveolitis. Which of the following is he experiencing?

Arthus Reaction

A nurse recalls an example of an immune-complex-mediated disease is:

serum sickness

Several prisoners are experiencing symptoms of tuberculosis. A tuberculin reaction test was ordered. This test is an example of type __ hypersensitivity.


When a nurse cares for a patient with systemic lupus erythemotosus (SLE), the nurse remembers this disease is an example of:


A 30-year old female complains of fatigue, arthritis, rash and changes in urine color. Laboratory testing reveals anemia, lymphopenia, and kidney inflammation. Assuming a siagnosis of SLE, which of the following is also likely to be present?

antinuclear antibodies

A 40-year-old female is diagnosed with SLE. Which of the following findings would be considered a symptom of this disease?


What is the chance that two siblings share both HLA haplotypes, making them a good match for an organ transplant from one to the other?


When a nurse notices that a patient has type O blood, the nurse realizes that anti-____ antivodies are present in the patient's body.

A and B

In addition to matching ABO antigens, a blood transfusion must also be matched for:

Rh antigen

a 15 year old male suffers from severe hemorrhage following a motor vehicle accident. He is given a blood transfusion, but shortly afterward the red blood cells are destroyed by agglutination and lysis. Which of the following blood type-transfusions type matches would cause this?


When an immunologist teaches about the relationship that benefits the organism but causes no harm to the host, the immunologist is describing which of the following?


The microorganisms that makes up for the normal human flora are important for:

Preventing the colonization and multiplication of pathogens

When bacterial pathogens enter a patient's body, they can defend themselves from an immune response by:

producing capsules

A person is given an attenuated antigen as a vaccine. When the person asks what was given in the vaccine, how should the nurse respond? The antigen is:

Alive, but less infectious

An immunologist is discussing endotoxin production. Which information should the immunologist include? Endotoxins are produced by:

Gram-negative bacteria

a 5-year old male becomes ill with a severe cough. Histologic examination reveals a bacterial infection and further laboratory testing reveals cell membrane damage and decreased protein synthesis. Which of the following is the most likely cause of this illness?


A 50 year old female experiences decreased blood pressure, deceased oxygen delivery, cardiovascular shock, and subsequent death. A complication of endotoxic shock is suspected. Which of the following is the most likely cause?

Gram-negative bacteria

After studying about viruses, which information indicates the student has a good understanding of viruses? VIruses:

Replicate their genetic material inside host cells

A patient has chicken pox. How does the varicella replicate?

In the cytoplasm

A 25-year old female reports having unprotected sexual intercourse with several men. Blood tests reveal that she is positive for human papilloma virus. What else should the nurse assess for?


After studying about fungi, which information indicates a correct understanding of fungi? Fungi causing deep or systemic infections:

are commonly opportunistic

When trying to distinguish between an infectious disease and noninfectious disease, what is the hallmark symptom for most infectious diseases?


Which information indicates a correct understanding of viral vaccines? Most viral vaccines contain:

attenuated viruses

Which information indicates a good understanding of bacterial vaccines? Most bacterial vaccines contain:

Dead bacteria

A nurse recalls bacteria become resistant to antimicrobials by:


What common symptom should be assessed in individuals with immunodeficiency?

Recurrent infections

A 5 year old male presents with low-set ears, a fish shaped mouth and involuntary rapid muscular contraction. Laboratory testing reveals decreased calcium levels. Which of the following diagnosis is most likely?

T-lymphocyte deficiency

A 22 year old was recently diagnosed with acquired immunodeficiency syndrome (AIDS). Which decreased lab finding would be expected to accompany this virus?

CD4 T-helper

Which of the following is a characteristic of the human immunodeficiency virus (HIV), which causes AIDS?

HIV is a retrovirus

A 30 year old male was diagnosed with HIV. Which of the following treatments would be most effective?

Highly active antiretroviral therapy (HAART)

When the immunologist says that pathogens possess infectivity, what is the immunologist explaining? Inactivity allows pathogens to:

invade and multiply in the host

When the immunologist says that pathogens possess virulence, what does virulence mean?

Causes diseases

The nurse would correctly respond that the etiology of a congenital immune deficiency is due to a(n):

Genetic defect

An infant is experiencing hemolytic disease of the newborn. Which of the following would the nurse expect to find in the infant's history and physical?

The baby is Rh positive

A nurse is discussing endocrine system dysfunction with a patient. Which statement indicates the patient understood? Endocrine system dysfunction can result from hyposecretion, hypersecretion, or from:

abnormal receptor activity

An aide asks the nurse what is the most common cause of elevated levels of antidiuretic hormone (ADH) secretion. How should the nurse respond?


A 54-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which of the following electrolyte imbalances would be expected in this patient?


A 44-year old patient with pulmonary tuberculosis (lung infection) is evaluated for SIADH. Which of the following assessment findings would be expected in this patient?

concentrated urine

A nurse is caring for a patient with SIADH. What severe complication should the nurse assess for?

neurologic damage

A 22-year old male is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident. The injury has caused severe damage to the posterior pituitary. Which of the following complications should the nurse anticipate?

dehydration from polyuria

While planning care for a patient from general anesthesia, which principle should the nurse remember? A side effect of some general anesthetic agents is ____ diabetes insipidus.


Diabetes insipidus, diabetes mellitus (DM) and SIADH share which of the following assessment manifestations?


A 50 year old male patient presents with polyuria and extreme thirst. He was given exogenous ADH. For which of the following conditions would this treatment be effective?

neurogenic diabetes insipidus

A 25 year old male presents with fatigue, constipation, and sexual dysfunction. Tests reveal all pituitary hormones are normal and no masses are present. The nurse suspects the most likely cause of his symptoms is a dysfunction in the:

pituitary stalk

A 15 year old female presents with breast discharge, dysmenorrhea, and excessive excitability. Tests reveal that all her pituitary hormones are elevated. What does the nurse suspect as the most likely cause for these assessment findings?

A pituitary adenoma

What common neurologic disturbances should the nurse assess for in a patient with a pituitary adenoma?

Visual disturbances

A 35 year old female with Graves disease is admitted to a medical-surgical unit. While the nurse is reviewing the lab tests, which results would the nurse expect to find?

High levels of circulating thyroid-stimulating antibodies

While checking the lab results for a patient with Graves disease, the nurse would check the T3 level to be abnormally:


A 35 year old female with graves disease is admitted to a medical-surgical unit. Which of the following symptoms would the nurse expect to find before treatment?

Skin hot and moist, rapid heart rate

Visual disturbances are a common occurrence in patients with untreated Graves disease. The endocrinologist explains to the patient that the main cause of these complications is:

Orbital edema and protrusino of the eyeball

A 25 year old female with Graves disease is admitted to a medical-surgical unit. Palpation of her neck would most likely reveal:

Diffuse thyroid enlargement

A 22-year old female has a low level of TSH. What condition does the nurse expect the patient is experiencing?

secondary hypothyriodism

While planning care for a patient with hypothyroidism, which principle should the nurse remember? The basal metabolic rate is unusually ________ with hypothyroidism.


A 3 year old male was diagnosed with congenital hypothryoidism. The parent asks the nurse, if left untreated what will happen? What is the nurse's best response? If left untreated, the child would have:

mental retardation and stunted growth

A 30 year old male was diagnosed with thyroid carcinoma. The lab tests the nurse would most likely find are ____ T3 and T4 levels.


What problem should the nurse assess for in a patient with chronic hyperparathyroidism?

osteoporosis and pathologic fractures

A 45 year old female with Graves disease underwent surgical removal of her thyroid gland. During the postoperative period, her serum calcium was low. The most probable reason for her low serum calcium is:

Hypoparathyroidism caused by surgical injury to the parathyroid gland

A 30-year-old female with Graves disease is admitted to a hospital unit for the surgical removal of her thyroid gland. During the postoperative period, the nurse notes that the patient's serum calcium is low. The nurse should observe the patient for which of the following signs/symptoms?

Laryngeal spasms and hyperreflexia

When a patient wants to know what most commonly causes hypoparathyroidism, how should the nurse reply? It is most commonly caused by:

Parathyroid gland injury

A 25-year-old male presents to his primary care provider reporting changes in facial features. CT scan reveals a mass on the anterior pituitary, and lab tests reveal severely elevated growth hormone (GH). Which of the following would the nurse also expect to find?

Sexual dysfunction

A 30-year-old male presents to his primary care provider reporting visual disturbances. CT reveals a pituitary tumor and lab tests reveal elevated prolactin. He is diagnosed with prolactinoma. Which of the following treatments would the nurse help implement? Administering:

Dopaminergic agaonists

A 12-year-old female is newly diagnosed with type 1 DM. When the parents ask what causes this, what is the nurse's best response?

Immune destruction of the pancreas

A 12-year-old male is newly diagnosed with type 1 DM. Which of the following tests should the nurse prepare the patient to best confirm the diagnosis?

Fasting plasma glucose levels

An 11-year-old male is newly diagnosed with type 1 DM. Which classic symptoms should the nurse assess the patient for?

polydipsia, polyuria, polyphagia, and weight loss

A 19-year-old female with type 1 DM was admitted to the hospital with altered consciousness and the following lab values: serum glucose 500 mg/dl (high) and serum K+ 2 (low). Her parents state that she has been sick with the "flu" for a week. The diagnosis is hyperosmolar hyperglycemia nonketotic syndrome (HHNKS). What relationship do these values have with her insulin deficiency?

Decreased insulin causes hyperglycemia and osmotic diuresis

A nurse is reviewing lab results for glycosylated hemoglobin (hemoglobin A1c) levels. A nurse recalls the purpose of this test is to

Monitor long-term serum glucose control

When a patient asks what causes hyperglycemia in type 2 DM, how should the nurse respond? Hyperglycemia is a result of


A 19-year-old female with type 1 DM was admitted to the hospital with the following lab values: serum glucose 500 mg/dl (high), urine glucose and ketones 4+ (high), and arterial pH 7.20 (low). Her parents state that she has been sick with the "flu" for a week. Which of the following statements best explains her acidotic state?

insulin deficiency promotes lipid metabolism and ketone formation

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