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NURS 617 ADVANCED PATHOPHYSIOLOGY EXAM 1 2025 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH EXPLANATIONS
GRADED A+
A direct result of anaerobic metabolism during hypoxic cell injury is:
a. increased ATP
b. metabolic acidosis
c. tissue ischemia
d. all of the above.
b. metabolic acidosis
Rationale: When oxygen is not available, cells switch to anaerobic metabolism, which yields an acid called lactate, or lactic acid.
Accumulation of which of the following molecules results in irreversible cell injury?
a. Calcium
b. Melanin
c. Lipids
d. Water
a. Calcium
Rationale: The accumulation of calcium causes irreversible mitochondrial injury.
Adaptive cellular mechanisms function to:
a. speed up cellular death.
b. prevent cellular aging.
c. treat disease.
d. protect cells from injury.
d.protect cells from injury.
An individual with damage to the spinal cord may experience atrophy of which of the following organs?
a. Skeletal muscles
b. Skin
c. Liver
d. Brain
a. Skeletal muscles
Rationale: Lack of nerve stimulation to skeletal muscles results in muscle atrophy.
Chronic infection of the cervix by the human papillomavirus results in cervical:
a. hormonal hyperplasia.
b. atrophy.
c. dysplasia.
In response to an increased workload, such as that caused by high blood pressure (hypertension), myocardial cells in the left ventricle will adapt through the process of:
a. hyperplasia.
b. hypertrophy.
c. atrophy.
d. dysplasia.
b. hypertrophy.
Rationale: In response to the increased workload of hypertension, myocardial cells will hypertrophy in order to pump harder.
Injury to the endoplasmic reticulum due to hypoxic injury results in:
a. sodium accumulation.
b. a decrease in protein synthesis.
c. the release of enzymes.
d. lactic acid production.
b. a decrease in protein synthesis.
Rationale: Ribosomes are the primary site for protein synthesis. Hypoxic injury and cellular swelling result in dilation of the rough endoplasmic reticulum, causing the ribosomes to detach. Loss of the site for protein synthesis results in decreased protein production.
Lead poisoning affects nervous system function by which of the following mechanisms?
a. Lead blocks oxygen delivery to the brain by binding with hemoglobin.
b. Lead interferes with neurotransmitter release.
c. Lead inhibits fatty acid oxidation in the brainstem.
d. Lead causes nervous tissue necrosis.
b. Lead interferes with neurotransmitter release.
Lysosomal rupture during hypoxic injury leads to:
a. autodigestion of cells.
b. cellular acidosis.
c. sodium influx.
d. cellular adaptation
a. autodigestion of cells.
Rationale: Lysosomal enzyme release during hypoxic injury causes autodigestion of cells.
Metaplasia involves the replacement of normal cells by:
a. cancer cells.
b. scar tissue.
c. abnormal cells of the same tissue type.
d. another type of cell.
d.another type of cell.
The most common cause of hypoxic injury is:
a. chemical toxicity.
b. free radicals.
c. malnutrition.
d. ischemia.
d. ischemia.
Rationale: Hypoxic injury results from a lack of oxygen. The most common cause of this type of cell injury is ischemia, a decrease in blood flow to the tissue.
The process of muscle hypertrophy involves an increase in:
a. cell division.
b. plasma membrane thickness.
c. protein synthesis.
d. water accumulation.
c. protein synthesis.
Rationale: The process of muscle hypertrophy involves an increase in protein synthesis to produce larger, stronger muscle cells.
Tissue ischemia and a decrease in mitochondrial oxygenation result in:
a. cellular dehydration.
b. calcium accumulation outside the cell.
c. decreased ATP production.
d. increased protein synthesis.
c. decreased ATP production.
Rationale: A decrease in oxygen delivery results in a decrease in ATP production.
Vitamin E, vitamin C, and beta-carotene are molecules in food that act as:
a. receptor blockers.
b. antioxidants.
c. poisons.
d. free radicals.
b. antioxidants.
Rationale: Vitamin E, vitamin C, and beta-carotene are antioxidants that attract and neutralize unpaired electrons to protect against free radical injury.
Which of the following molecules is likely to accumulate in any dead or dying tissues?
a. Calcium
b. Uric acid
c. Melanin
d. Protein
a. Calcium
c. Injury to the endoplasmic reticulum and Golgi apparatus
d. Decrease in ATP production and sodium movement into the cell
d. Decrease in ATP production and sodium movement into the cell
Pathologic hyperplasia can lead to:
a. phagocytosis.
b. stem cell activation.
c. enlargement of the uterus.
d. metaplasia.
d. metaplasia.
Which of the following is a form of metaplasia that can occur in the human body?
a. Epithelial cells of the bronchial lining are replaced with collagenous connective tissue.
b. Adipose cells are replaced by cells that cannot store lipids.
c. Squamous epithelial cells of the esophageal lining are replaced by glandular cells similar to those lining the stomach.
d. Liver cells are replaced by squamous epithelial cells.
c. Squamous epithelial cells of the esophageal lining are replaced by glandular cells similar to those lining the stomach.
Free radicals directly injure cells by each of the following mechanisms except:
a. DNA fragmentation.
b. lipid peroxidation.
c. activation of lysosomal enzymes.
d. alteration of proteins.
c. activation of lysosomal enzymes.
Restoration of oxygen to oxygen-deprived tissues results in:
a. chemical injury.
b. establishment of normal cell metabolism.
c. reperfusion injury.
d. hypoxic injury.
c. reperfusion injury.
The process of cellular atrophy may be accomplished through which of the following processes?
a. Decreased cell division
b. Loss of fluid
c. Formation of autophagic vacuoles
d. Inhibition of enzyme formation
c. Formation of autophagic vacuoles
Rationale: This child has Trisomy 21, also known as Down syndrome. These children typically present with IQs ranging from 25 to 70. The facial appearance is distinctive and exhibits a low nasal bridge, epicanthal folds, protruding tongue, and flay, low-set ears. Widely spaced nipples and edema of the newborn's feet are characteristic of Turner syndrome. The high-pitched voice and gynecomastia are characteristic of Klinefelter syndrome.
What is the most common cause of Down syndrome?
a. Paternal nondisjunction
b. Maternal nondisjunction
c. Paternal translocation
d. Maternal translocations
b. Maternal nondisjunction
Rationale: Nondisjunction during the formation of one of the parent's gametes or during early embryonic development occurs in approximately 97% of infants born with Down syndrome. In approximately 90% to 95% of infants, the nondisjunction occurs in the formation of the mother's egg cell. Down syndrome is rarely caused by paternal nondisjunction. Robertsonian translocations are responsible for 3% to 5% of cases of Down syndrome. A high-pitched voice and gynecomastia are characteristic of Klinefelter syndrome.
A person with 47, XXY karyotype has the genetic disorder resulting in which syndrome?
a. Fragile X
b. Turner
c. Down
d. Klinefelter
d. Klinefelter
Rationale: A disorder in the chromosome (47, XXY karyotype) results in a disorder known as Klinefelter syndrome. Turner syndrome has a karyotype of 45, X. Down syndrome is caused by Trisomy 21. Fragile X syndrome is caused by microscopically observable breaks and gaps in the X chromosome.
Cystic fibrosis is caused by what type of gene?
a. Autosomal dominant
b. X-linked dominant
c. Autosomal recessive
d.X-linked recessive
c. Autosomal recessive
Rationale: Cystic fibrosis is the most common lethal autosomal recessive disease in white children. It is not X linked of dominant.
Males, having only one X chromosome, are said to be what?
a. Heterozygous
b. Homozygous
c. Hemizygous
d. Ambizygous
c. Hemizygous
Which risk factor for hypertension is influenced by genetic factors and lifestyle?
a. Physical inactivity
b. Obesity
c. Psychosocial stress
d.Sodium intake
b. Obesity
Rationale: The most important environmental risk factors for hypertension are increased sodium intake, decreased physical activity, psychosocial stress, and obesity. However, obesity is, itself, influenced by genes and the environment.
Studies have identified several genes that play a role in the prevention of obesity by affecting what?
a. Absorption of fat
b. Metabolizing of fat
c. Regulation of appetite
d. Altering the sense of satiety
c. Regulation of appetite
Rationale: clinical trials using recombinant leptin have demonstrated moderate weight loss in a subset of obese individuals. In addition, leptin participates in important interactions with other components of appetite control, such as neuropeptide Y and a-melanocyte-stimulating hormone and its receptor, the melanocortin-4 receptor (MC4R).
The BRCA1 and BRCA2 mutations increase the risk of which cancer in women?
a. Ovarian
b. Pancreatic
c. Uterine
d. Lung
a. Ovarian
Rationale: BRCA1 mutations increase the risk of ovarian cancer among women (20% to 50% lifetime risk), and BRCA2 mutations also confer an increased risk of ovarian cancer (10% to 20% lifetime prevalence). BRCA1 and BRCA2 mutations are not currently believed to be linked with risks of lung, uterine, or pancreatic cancers.
Traits caused by the combined effects of multiple genes are referred to by which term?
a. Modifiable
b. Polygenic
c. Involuntary
d. Multifocal
b. Polygenic
Rationale: Traits in which variation is thought to be caused by the combined effects of multiple genes are polygenic, meaning many genes. Multifocal means relating to or arising from many points. Modifiable refers to the changeability of something. Involuntary suggests being out of the control of someone or something.
What genetic process is likely responsible for the occurrence of asthma in only one of a pair of identical twins?
a. Transgenerational inheritance
b. Genomic imprinting
c. Epigenetic modifications
d. Methylation
c. Epigenetic modifications
Rationale: Epigenetic modifications can cause individuals with the same DNA sequences (such as identical twins) to have different disease profiles. Imprinting means that wither the copy of the gene inherited through the sperm or the copy inherited through the egg is inactivated and remains in this inactive state in all of the somatic cells of the individual. The heritable transmission to future generations of epigenetic modifications is called transgenerational inheritance. DNA methylation is called transgenerational inheritance. DNA methylation occurs through the attachment of methyl group to the carbon-5 position of a cytosine.
Prader-Willi syndrome causes a chromosomal defect that is what?
a. Initiated by postnatal exposure to a virus
b. Inherited from the father
c. Related to maternal alcohol abuse
d. Transferred from mother to child
b. Inherited from the father
Rationale: Prader-Willi syndrome can be caused by a 4 Mb deletion of chromosome 15q when inherited from the father. This disorder is not caused by a virus, or related to maternal alcohol abuse. The same gene deletion causes Angelman syndrome when inherited from the mother.
What can a malfunction in DNA methylation lead to?
a. Hypothyroidism
b. Cancer
c. Blindness
d. Diabetes mellitus
b. Cancer
Rationale: Aberrant methylation can lead to silencing of tumor-suppressor genes in the development of cancer.
What is the difference between DNA sequence mutations and epigenetic modifications?
a. Epigenetic modifications potentially can be reversed
b. Leukemia is a result of only DNA sequence mutation
c. DNA sequence mutations can be directly altered.
d. No known drug therapies are available for epigenetic modifications.
a. Epigenetic modifications potentially can be reversed
Rationale: Unlike DNA sequence mutations, which cannot be directly altered, epigenetic modifications can be reversed.
Which term refers to the silenced gene of a gene pair?
