Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

NURS 611 PATHO EXAM ADVANCED PATHOPHYSIOLOGY EXAM QUESTIONS & CORRECT ANSWERS GRADED A, Exams of Pathophysiology

NURS 611 PATHO EXAM ADVANCED PATHOPHYSIOLOGY EXAM QUESTIONS & CORRECT ANSWERS GRADED A

Typology: Exams

2024/2025

Available from 06/20/2025

clara-perez-33
clara-perez-33 🇨🇦

127 documents

1 / 32

Toggle sidebar

This page cannot be seen from the preview

Don't miss anything!

bg1
NURS 611 PATHO EXAM ADVANCED
PATHOPHYSIOLOGY EXAM QUESTIONS
& CORRECT ANSWERS GRADED A
(MARYVILLE UNIVERSITY)
1. What are clinical manifestations of hypothyroidism?
a. Intolerance to heat, tachycardia, and weight loss
b. Oligomenorrhea, fatigue, and warm skin
c. Restlessness, increased appetite, and metrorrhagia
d. Constipation, decreased heat rate, and lethargy
The lower levels of thyroid hormone result in decreased energy metabolism, resulting
in constipation, bradycardia, and lethargy, thus eliminating the remaining options.
2. Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone (TH) and is
inhibited when plasma levels of TH are adequate. This is an example of:
a. Positive feedback
b. Neural regulation
c. Negative feedback
d. Physiologic regulation
Negative feedback. Feedback systems provide precise monitoring and control of the
cellular environment. Negative feedback occurs because the changing chemical, neural,
or endocrine response to a stimulus negates the initiating change that triggered the
release of the hormone. Thyrotropin-releasing hormone (TRH) from the hypothalamus
stimulates TSH secretion from the anterior pituitary. Secretion of TSH stimulates the
synthesis and secretion of THs. Increasing levels of T4 and triiodothyronine (T3) then
generate negative feedback on the pituitary and hypothalamus to inhibit TRH and TSH
synthesis.
3. Lipid-soluble hormone receptors are located:
a. Inside the plasma membrane in the cytoplasm
b. On the outer surface of the plasma membrane
c. Inside the mitochondria
d. On the inner surface of the plasma membrane
Inside the plasma membrane in the cytoplasm. Lipid-soluble hormone receptors are
located inside the plasma membrane and easily diffuse across the plasma membrane to
bind to either cytosolic or nuclear receptors.
4. The releasing hormones that are made in the hypothalamus travel to the anterior
pituitary via the:
a. Vessels of the zona fasciculata
b. Hypophyseal stalk
c. Infundibular stem
d. Portal hypophyseal blood vessels
Portal hypophyseal blood vessels. Releasing and inhibitory hormones are synthesized in
the hypothalamus and are secreted into the portal blood vessels through which they
travel to the anterior pituitary hormones.
5. Which mineral is needed for thyroid-stimulating hormone (TSH) to stimulate the
secretion of thyroid hormone (TH)?
a. Iron
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff
pf12
pf13
pf14
pf15
pf16
pf17
pf18
pf19
pf1a
pf1b
pf1c
pf1d
pf1e
pf1f
pf20

Partial preview of the text

Download NURS 611 PATHO EXAM ADVANCED PATHOPHYSIOLOGY EXAM QUESTIONS & CORRECT ANSWERS GRADED A and more Exams Pathophysiology in PDF only on Docsity!

NURS 611 PATHO EXAM ADVANCED

PATHOPHYSIOLOGY EXAM QUESTIONS

& CORRECT ANSWERS GRADED A

(MARYVILLE UNIVERSITY)

  1. What are clinical manifestations of hypothyroidism? a. Intolerance to heat, tachycardia, and weight loss b. Oligomenorrhea, fatigue, and warm skin c. Restlessness, increased appetite, and metrorrhagia d. Constipation, decreased heat rate, and lethargy The lower levels of thyroid hormone result in decreased energy metabolism, resulting in constipation, bradycardia, and lethargy, thus eliminating the remaining options.
  2. Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone (TH) and is inhibited when plasma levels of TH are adequate. This is an example of: a. Positive feedback b. Neural regulation c. Negative feedback d. Physiologic regulation Negative feedback. Feedback systems provide precise monitoring and control of the cellular environment. Negative feedback occurs because the changing chemical, neural, or endocrine response to a stimulus negates the initiating change that triggered the release of the hormone. Thyrotropin-releasing hormone (TRH) from the hypothalamus stimulates TSH secretion from the anterior pituitary. Secretion of TSH stimulates the synthesis and secretion of THs. Increasing levels of T 4 and triiodothyronine (T 3 ) then generate negative feedback on the pituitary and hypothalamus to inhibit TRH and TSH synthesis.
  3. Lipid-soluble hormone receptors are located: a. Inside the plasma membrane in the cytoplasm b. On the outer surface of the plasma membrane c. Inside the mitochondria d. On the inner surface of the plasma membrane Inside the plasma membrane in the cytoplasm. Lipid-soluble hormone receptors are located inside the plasma membrane and easily diffuse across the plasma membrane to bind to either cytosolic or nuclear receptors.
  4. The releasing hormones that are made in the hypothalamus travel to the anterior pituitary via the: a. Vessels of the zona fasciculata b. Hypophyseal stalk c. Infundibular stem d. Portal hypophyseal blood vessels Portal hypophyseal blood vessels. Releasing and inhibitory hormones are synthesized in the hypothalamus and are secreted into the portal blood vessels through which they travel to the anterior pituitary hormones.
  5. Which mineral is needed for thyroid-stimulating hormone (TSH) to stimulate the secretion of thyroid hormone (TH)? a. Iron

b. Iodide c. Zinc

d. Testosterone Angiotensin II. Ca++^ is considered an important second messenger that facilitates the binding of a hormone (e.g., norepinephrine, angiotensin II) to a surface receptor, activating the enzyme phospholipase C through a G protein inside the plasma membrane.

  1. The control of calcium in cells is important because it: a. Is controlled by the calcium negative-feedback loop. b. Is continuously synthesized. c. Acts as a second messenger. d. Carries lipid-soluble hormones in the bloodstream. Acts as a second messenger. In addition to being an important ion that participates in a multitude of cellular actions, Ca++^ is considered an important second messenger.
  2. Where is antidiuretic hormone (ADH) synthesized, and where does it act? a. Hypothalamus; renal tubular cells b. Anterior pituitary; posterior pituitary c. Renal tubules; renal collecting ducts d. Posterior pituitary; loop of Henle Hypothalamus; renal tubular cells. Once synthesized in the hypothalamus, ADH acts on the vasopressin 2 (V2) receptors of the renal duct cells to increase their permeability.
  3. How does a faulty negative-feedback mechanism result in a hormonal imbalance? a. Hormones are not synthesized in response to cellular and tissue activities. b. Decreased hormonal secretion is a response to rising hormone levels. c. Too little hormone production is initiated. d. Excessive hormone production results from a failure to turn of the system. Excessive hormone production results from a failure to turn off the system. Negative- feedback systems are important in maintaining hormones within physiologic ranges. The lack of negative-feedback inhibition on hormonal release often results in pathologic conditions. Excessive hormone production, which is the result of the failure to turn of the system, can cause various hormonal imbalances and related conditions.
  4. A deficiency of which chemical may result in hypothyroidism? a. Iron b. Zinc c. Iodine d. Magnesium Iodine. The only cause of hypothyroidism from among the provided options is a deficiency of endemic iodine.
  5. What imbalance lessens the rate of secretion of parathyroid hormone a. Increased serum calcium levels b. Decreased serum magnesium levels c. Decreased levels of thyroid-stimulating hormone d. Increased levels of thyroid-stimulating hormone The overall effect of parathyroid hormone (PTH)is to increase serum calcium and to decrease serum phosphate concentration.
  6. Which condition may result from pressure exerted by a pituitary tumor?

a. Hypothyroidism b. Diabetes insipidus c. Hypercortisolism d. Insulin hyposecretion Hypothyroidism. If the tumor exerts sufficient pressure, then thyroid and adrenal hypofunction may occur because of lack of thyroid-stimulating hormone (TSH) and adrenocorticotropic hormone (ACTH). These result in the symptoms of hypothyroidism and hypocortisolism.

  1. Which substance is a water-soluble protein hormone? a. Thyroxine b. Follicle-stimulating hormone c. Aldosterone d. Insulin Insulin. Peptide or protein hormones, such as insulin, pituitary, hypothalamic, and parathyroid, are water soluble and circulate in free (unbound) forms.
  2. Which of the following is a lipid-soluble hormone? a. Cortisol b. Epinephrine c. Oxytocin d. Growth hormone Cortisol. Cortisol and adrenal androgens are lipid-soluble hormones and are primarily bound to a carrier or transport protein in circulation.
  3. Most protein hormones are transported in the bloodstream and are: a. Bound to a lipid-soluble carrier b. Free in an unbound, water-soluble form c. Bound to a water soluble–binding protein d. Free because of their lipid-soluble chemistry Free in an unbound, water-soluble form. Peptide or protein hormones, such as insulin, pituitary, hypothalamic, and parathyroid, are water soluble and circulate in free (unbound) forms.
  4. When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an example of what type of effect by a hormone? a. Pharmacologic b. Synergistic c. Permissive d. Direct Direct. Direct effects are the obvious changes in cell function that specifically result from the stimulation by a particular hormone.
  5. Graves disease develops from a(n): a. Viral infection of the thyroid gland that causes overproduction of thyroid hormone. b. Autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue.

Dilution & water retention

  1. The common cause of elevated levels of antidiuretic hormone (ADH) secretion is: a. Ectopically produced ADH b. Posterior pituitary tumor c. Inflammation of the hypothalamus d. Inflammation of the nephrons Ectopically produced ADH
  2. Which laboratory value would the nurse expect to find if a person is experiencing syndrome of inappropriate antidiuretic hormone (SIADH)? a. Hypernatremia and urine hypo-osmolality b. Serum potassium (K+) level of 5 mEq/L and urine hyper-osmolality c. Serum sodium (Na+) level of 120 mEq/L and serum hypo-osmolality d. Hypokalemia and serum hyper-osmolality Serum Na level of 120 and serum hypo-osmolatlity. A diagnosis of SIADH requires a serum sodium level of less than 135 mEq/L, serum hypo-osmolality less than 280 mOsm/kg, and urine hyper-osmolarity. Potassium levels are not considered a factor.
  3. A patient who is diagnosed with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits, but his antidiuretic hormone (ADH) level is low. Although he has had no intake for 4 hours, no change in his polyuria level has occurred. These symptoms support a diagnosis of: a. Neurogenic diabetes insipidus b. Syndrome of inappropriate antidiuretic hormone c. Psychogenic polydipsia d. Osmotically induced diuresis Neurogenic diabetes insipidus. Remember, sodium has to be below 135 to meet the requirement for SIADH.
  4. Diabetes insipidus, diabetes mellitus, and syndrome of inappropriate antidiuretic hormone all exhibit which symptom? a. Polyuria b. Vomiting c. Edema d. Thirst Thirst, is the only symptom in common.
  5. The cause of neurogenic diabetes insipidus (DI) is related to an organic a. Anterior pituitary b. Posterior pituitary c. Thalamus d. Renal tubules Posterior pituitary. Neurogenic DI is a result of dysfunctional antidiuretic hormone synthesis, caused by a lesion of the posterior pituitary, hypothalamus, or pituitary stalk.
  6. Which form of diabetic insipidus (DI) will result if the target cells for antidiuretic hormone (ADH) in the renal collecting tubules demonstrate insensitivity? a. Neurogenic b. Nephrogenic

c. Psychogenic d. Ischemic Nephrogenic. Only nephrogenic DI is associated with an insensitivity of the renal collecting tubules to ADH.

  1. Which laboratory value is consistently low in a patient with diabetes insipidus (DI)? a. Urine-specific gravity b. Urine protein c. Serum sodium d. Serum total protein Urine-specific gravity. The basic criteria for diagnosing DI include a low urine-specific gravity while sodium levels are high. Protein levels are not considered.
  2. Which form of diabetes insipidus (DI) is treatable with exogenous antidiuretic hormone (ADH)? a. Neurogenic b. Nephrogenic c. Psychogenic d. Ischemic Neurogenic DI is treated with ADH replacement therapy.
  3. The term used to describe a person who experiences a lack of all hormones associated with the anterior pituitary is: a. Panhypopituitarism b. Hypopituitarism c. Adrenocorticotropic hormone deficiency Panhypopituitarism is the only available term that is correctly associated with the lack of all anterior pituitary hormones.
  4. Diabetes insipidus is a result of: a. Antidiuretic hormone hyposecretion b. Insulin hyposecretion c. Antidiuretic hormone hypersecretion d. Insulin hypersecretion ADH hyposecretion
  5. Visual disturbances are a result of a pituitary adenoma because of the: a. Liberation of anterior pituitary hormones into the optic chiasm b. Pituitary hormones clouding the lens of the eyes c. Pressure of the tumor on the optic chiasm d. Pressure of the tumor on the optic and oculomotor cranial nerves Pressure on the optic chiasm is the only cause for visual disturbances resulting from a pituitary adenoma.
  6. Which hormone is involved in the regulation of serum calcium levels? a. Parathyroid hormone (PTH) b. Thyroxine (T 4 ) c. Adrenocorticotropic hormone (ACTH) d. Triiodothyronine (T 3 ) The parathyroid glands produce PTH, a regulator of serum calcium.

Decreased glucose causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis, which have resulted in the symptoms listed in the question.

  1. Polyuria occurs with diabetes mellitus because of the: a. Formation of ketones b. Elevation in serum glucose c. Chronic insulin resistance d. Increase in antidiuretic hormone Elevation of serum glucose. Glucose accumulates in the blood and appears in the urine as the renal threshold for glucose is exceeded, producing an osmotic diuresis and the symptoms of polyuria and thirst.
  2. Type 2 diabetes mellitus is best described as a(an): a. Resistance to insulin by insulin-sensitive tissues b. Need for lispro instead of regular insulin c. Increase of glucagon secretion from α cells of the pancreas d. Presence of insulin autoantibodies that destroy β cells in the pancreas Resistance to insulin by insulin-sensitive tissues. One of the basic pathophysiologic characteristics of type 2 diabetes is the development of insulin-resistant tissue cells.
  3. A person diagnosed with type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The most probable cause of these symptoms is: a. Hyperglycemia caused by incorrect insulin administration b. Dawn phenomenon from eating a snack before bedtime c. Hypoglycemia caused by increased exercise d. Somogyi effect from insulin sensitivity Hypoglycemia caused by increased exercise. The most likely cause of these symptoms is hypoglycemia, which is often caused by a lack of systemic glucose as a result of muscular activity.
  4. When comparing the clinical manifestations of both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS), which condition is associated with only DKA? a. Fluid loss b. Increased serum glucose c. Weight loss d. Kussmaul respirations Kussmaul respirations are only observed in those with DKA and is that “air hunger” or rapid deep labored breathing.
  5. Hypoglycemia, followed by rebound hyperglycemia, is observed in those with: a. The Somogyi effect b. The dawn phenomenon c. Diabetic ketoacidosis d. Hyperosmolar hyperglycemic non-ketotic syndrome Hypoglycemia, followed by rebound hyperglycemia, is observed only in the Somogyi effect.
  1. The first laboratory test that indicates type 1 diabetes is causing the development of diabetic nephropathy is: a. Dipstick test for urine ketones b. Increase in serum creatinine and blood urea nitrogen c. Protein on urinalysis d. Cloudy urine on the urinalysis Protein on urinalysis. Microalbuminuria is the first manifestation of this form of renal failure. Although the other options may develop, they occur after protein is found in the urine.
  2. Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake? a. Biguanide (metformin) b. Meglitinides (glinides) c. Sulfonylureas (glyburide) d. α-Glycosidase inhibitor (miglitol) Biguanides (metformin). Only biguanides decrease hepatic glucose production and increase insulin sensitivity and peripheral glucose uptake.
  3. What causes the microvascular complications in patients with diabetes mellitus? a. The capillaries contain plaques of lipids that obstruct blood flow. b. Pressure in capillaries increase as a result of the elevated glucose attracting water. c. The capillary basement membranes thicken, and cell hyperplasia develops. d. Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries. Capillary basement membranes thicken and cell hyperplasia develops. Microvascular complications are a result of capillary basement membranes thickening and endothelial cell hyperplasia.
  4. Retinopathy develops in patients with diabetes mellitus because: a. Plaques of lipids develop in the retinal vessels. b. Pressure in the retinal vessels increase as a result of increased osmotic pressure. c. Ketones cause microaneurysms in the retinal vessels. d. Retinal ischemia and red blood cell aggregation occur. Retinal ischemia and RBC aggregation occur. Retinopathy appears to be a response to retinal ischemia and red blood cell aggregation.
  5. Which disorder is caused by hypersecretion of the growth hormone (GH) a. Cushing syndrome b. Giantism c. Acromegaly d. Myxedema Acromegaly is a term for adults who have been exposed to continuously high levels of GH, whereas the term giantism is reserved for children and adolescents.
  6. Which disorder is considered a co-morbid condition of acromegaly? a. Hypotension b. Brain cancer

nerve impulse. This creates tetany manifested as muscle spasms, hyperreflexia, tonic- clonic convulsions, laryngeal spasms, and, in severe cases, death from asphyxiation.

60. A chronic complication of diabetes mellitus is likely to result in microvascular complications in which areas? (Select all that apply.) a. Eyes x b. Coronary arteries c. Renal system x d. Peripheral vascular system e. Nerves x The areas most often affected are the retina, kidneys, and nerves.

  1. Which compound or hormone is secreted by the adrenal medulla? a. Cortisol b. Androgens c. Epinephrine d. Aldosterone Epinephrine
  2. The secretion of adrenocorticotropic-stimulating hormone (ACTH) will result in the increased level of which hormone? a. Thyroxine b. Cortisol c. Insulin d. Antidiuretic hormone Cortisol. Psychologic and physiologic stress (e.g., hypoxia, hypoglycemia, hyperthermia, exercise) increases ACTH secretion, leading to increased cortisol levels. Only cortisol describes the appropriate feedback loop.
  3. Aldosterone directly increases the reabsorption of: a. Magnesium b. Sodium c. Calcium d. Water Sodium. In the kidney, aldosterone primarily acts on the epithelial cells of the nephron- collecting duct to increase sodium ion reabsorption.
  4. Which is an expected hormonal change in an older patient? a. Thyroid-stimulating hormone secretion below normal b. Triiodothyronine level below normal c. Cortisol level below normal d. Adrenocorticotropic hormone level above normal Thyroid-stimulating hormone secretion below normal. Aging causes overall thyroid- stimulating hormone secretion to diminish but does not bring about the other changes. 65. What are actions of glucocorticoids? (Select all that apply.) a. Decreasing muscle cell reuptake of glucose b. Fat storage c. Decreased blood glucose d. Carbohydrate metabolism

e. Liver gluconeogenesis Decreasing muscle cell reuptake of glucose, carbohydrate metabolism, and liver gluconeogenesis. The term glucocorticoid refers to those steroidal hormones that have direct effects on carbohydrate metabolism. These hormones increase blood glucose concentration by promoting gluconeogenesis in the liver and by decreasing uptake of glucose into muscle cells, adipose cells, and lymphatic cells. Glucocorticoids are not capable of fat storage.

  1. What is the most abundant class of plasma protein? a. Globulin b. Clotting factors c. Albumin d. Complement proteins Albumin. Albumin (approximately 60% of total plasma protein at a concentration of about 4 g/dl) is the most abundant plasma protein.
  2. What is the effect of low plasma albumin? a. Clotting factors decrease, thus increasing the chance of prolonged bleeding. b. Fewer immunoglobulins are synthesized, thus impairing the immune function. c. Less iron is stored, thus increasing the incidence of iron deficiency anemia. d. Osmotic pressure decreases, thus water moves from the capillaries to the interstitium. In the case of decreased production (e.g., cirrhosis, other diffuse liver diseases, protein malnutrition) or excessive loss of albumin (e.g., certain kidney diseases, extensive burns), the reduced oncotic pressure leads to excessive movement of fluid and solutes into the tissues and decreased blood volume.
  3. The absence of parietal cells would prevent the absorption of an essential nutrient necessary to prevent which type of anemia? a. Iron deficiency b. Folic acid deficiency anemia c. Pernicious anemia d. Aplastic anemia Pernicious anemia. Dietary vitamin B 12 is a large molecule that requires a protein secreted by parietal cells into the stomach (intrinsic factor [IF]) to transport across the ileum. Defects in IF production lead to decreased B 12 absorption and pernicious anemia.
  4. Which nutrients are necessary for the synthesis of DNA and the maturation of erythrocytes? a. Protein and niacin b. Cobalamin (vitamin B 12 ) and folate c. Iron and vitamin B 6 (pyridoxine) d. Pantothenic acid and vitamin C Cobalamin and folate are necessary for the synthesis of DNA and for the maturation of erythrocytes.
  5. Which substance is used to correct the chronic anemia associated with chronic renal failure? a. Iron
  1. Which of the following is classified as a megaloblastic anemia? a. Iron deficiency b. Sideroblastic c. Pernicious d. Hemolytic Pernicious anemia is the most common type of megaloblastic anemia.
  2. Deficiencies in folate and vitamin B 12 alter the synthesis of which of the following? a. RNA b. DNA c. Cell membrane d. Mitochondria DNA
  3. Which condition resulting from untreated pernicious anemia (PA) is fatal? a. Brain hypoxia b. Heart failure c. Liver hypoxia d. Renal failure Heart failure
  4. Considering sideroblastic anemia, what would be the expected effect on the plasma iron levels? a. Plasma iron levels would be high. b. Levels would be low. c. Levels would be normal. d. Levels would be only minimally affected. Plasmin iron levels would be high.
  5. In aplastic anemia (AA), pancytopenia develops as a result of which of the following? a. Suppression of erythropoietin to produce adequate amounts of erythrocytes b. Suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes c. Lack of DNA to form sufficient quantities of erythrocytes, leukocytes, and thrombocytes d. Lack of stem cells to form sufficient quantities of leukocytes Suppression of the bone marrow to produce adequate amounts of erythrocytes, leukocytes, and thrombocytes. AA is a critical condition characterized by pancytopenia, which is a reduction or absence of all three blood cell types, resulting from the failure or suppression of bone marrow to produce adequate amounts of blood cells.
  6. What is the most common pathophysiologic process that triggers aplastic anemia (AA)? a. Autoimmune disease against hematopoiesis by activated cytotoxic T (Tc) cells. b. Malignancy of the bone marrow in which unregulated proliferation of erythrocytes crowd out other blood cells. c. Autoimmune disease against hematopoiesis by activated immunoglobulins. d. Inherited genetic disorder with recessive X-linked transmission. Answer is A. Most cases of AA result from an autoimmune disease directed against hematopoietic stem cells. Tc cells appear to be the main culprits.
  1. When considering hemolytic anemia, which statement is true regarding the occurrence of jaundice? a. Erythrocytes are destroyed in the spleen. b. Heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin. c. The patient has elevations in aspartate transaminase (AST) and alanine transaminase (ALT). d. The erythrocytes are coated with an immunoglobulin. Heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin. Jaundice (icterus) is present when heme destruction exceeds the liver’s ability to conjugate and excrete bilirubin. This selection is the only option that accurately describes the process that affects the occurrence of hemolytic anemia–related jaundice.
  2. Which statement is true regarding the physical manifestations of vitamin B 12 deficiency anemia? a. Vitamin B 12 deficiency anemia seldom results in neurologic symptoms. b. The chances of a cure are good with appropriate treatment. c. The condition is reversible in 75% of the cases. d. Symptoms are a result of demyelination. Symptoms are a result of demyelination. The neurologic manifestations characteristic of vitamin B 12 deficiency anemia result from nerve demyelination that may produce neuronal death. These complications pose a serious threat because they are not reversible, even with appropriate treatment. 83. A 2000 ml blood loss will produce which assessment finding? (Select all that apply.) a. Air hunger b. Normal blood pressure in the supine position c. Rapid thready pulse d. Cold clammy skin e. lactic acidosis A, C, D. With a 2000 ml loss of blood, central venous pressure, cardiac output, and arterial blood pressure are below normal, even when at rest and in the supine position. The person commonly has air hunger; a rapid, thready pulse; and cold, clammy skin. With a 1500 ml loss of blood, supine blood pressure and pulse can still be normal. Lactic acidosis is observed with a blood loss of 2500 ml or more.
  3. Which conditions are generally included in the symptoms of pernicious anemia (PA)? (Select all that apply.) a. Weakness b. Weight gain c. Low hemoglobin d. Paresthesias e. Low hematocrit A, C, D, E. When the hemoglobin and hematocrit levels in the blood have significantly decreased, the individual experiences the classic symptoms of PA—weakness, fatigue, paresthesias of the feet and fingers, difficulty in walking, loss of appetite, abdominal pains, and weight loss. 85. What are the clinical manifestations of folate deficiency anemia? (Select all that apply.)

c. Platelets d. Erythrocytes Platelets (thrombocytes) are not true cells but are disk-shaped cytoplasmic fragments that are essential for blood coagulation and control of bleeding.

  1. What is the life span of platelets (in days)? a. 10 b. 90 c. 30 d. 120 A platelet circulates for approximately 10 days and ages. Macrophages of the mononuclear phagocyte system, mostly in the spleen, remove platelets.
  2. Which blood cells are the chief phagocytes involved in the early inflammation process? a. Neutrophils b. Eosinophils c. Monocytes d. Erythrocytes Neutrophils are the chief phagocytes of early inflammation.
  3. Which blood cells are biconcave in shape and have the capacity to be reversibly deformed? a. Neutrophils b. Eosinophils c. Monocytes d. Erythrocytes The erythrocyte’s size and shape are ideally suited to its function as a gas carrier. A red blood cell (RBC) is a small disk with two unique properties: (1) a biconcave shape and (2) the capacity to be reversibly deformed.
  4. What is the life span of an erythrocyte (in days)? a. 20 to 30 b. 100 to 120 c. 60 to 90 d. 200 to 240 Because it cannot undergo mitotic division, the erythrocyte has a limited life span of approximately 120 days.
  5. Local signs and symptoms of Hodgkin disease–related lymphadenopathy are a result of which of the following? a. Pressure and ischemia b. Inflammation and ischemia c. Pressure and obstruction d. Inflammation and pressure Pressure and obstruction. Local symptoms caused by pressure and obstruction of the lymph nodes are the result of lymphadenopathy.
  6. Which statement best describes heparin-induced thrombocytopenia (HIT)? a. Immunoglobulin G immune–mediated adverse drug reaction that reduces circulating platelets

b. Hematologic reaction to heparin in which the bone marrow is unable to produce sufficient platelets to meet the body’s needs c. Immunoglobulin E–mediated allergic drug reaction that reduces circulating platelets d. Cell-mediated drug reaction in which macrophages process the heparin and platelet complexes that are then destroyed by activated cytotoxic T cells. Answer is A. Heparin is a common cause of drug-induced thrombocytopenia. HIT is an immune-mediated, adverse drug reaction caused by immunoglobulin G antibodies that leads to increased platelet consumption and a decrease in platelet counts.

  1. Vitamin is required for normal clotting factor synthesis by the? a. K; kidneys b. K; liver c. D; kidneys d. D; liver K;liver. Vitamin K, a fat-soluble vitamin, is necessary for the synthesis and regulation of prothrombin, procoagulant factors (VII, IX, X), and anticoagulant regulators (proteins C and S) in the liver.
  2. Which disorder is described as an unregulated release of thrombin with subsequent fibrin formation and accelerated fibrinolysis? a. Disseminated intravascular coagulation (DIC) b. Immune thrombocytopenic purpura (ITP) c. Heparin-induced thrombocytopenia (HIT) d. Essential thrombocythemia (ET) DIC is an acquired clinical syndrome characterized by widespread activation of coagulation resulting in the formation of fibrin clots in medium and small vessels throughout the body.
  3. In disseminated intravascular coagulation (DIC), what activates the coagulation cascade? a. Cytokines, such as platelet-activating factor (PAF), and tumor necrosis factor- alpha (TNF-α). b. Thromboxane A, causing platelets to aggregate and consume clotting factors. c. Tissue factor (TF) located in the endothelial layer of blood vessels and subcutaneous tissue. d. Endotoxins from gram-negative and gram-positive bacteria circulating in the bloodstream. C. Direct tissue damage (ischemia and necrosis, surgical manipulation, crushing injury) causes the endothelium to release TF. The common pathway for DIC appears to be excessive and widespread exposure of TF.
  4. Which proinflammatory cytokines are responsible for the development and maintenance of disseminated intravascular coagulation (DIC)? a. Granulocyte colony-stimulating factor (G-CSF); interleukin (IL)–2, IL-4, and IL-10; and tumor necrosis factor-gamma (IFN-γ). b. Granulocyte-macrophage colony-stimulating factor (GM-CSF); and IL-3, IL-5, IL-9, and IFN-γ. c. Macrophage colony-stimulating factor (M-CSF); IL-7, IL-11, and IL-14; and PAF.