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PATHO HESI EXIT LATEST ACTUAL EXAM TEST BANK
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PATHO HESI EXIT LATEST ACTUAL EXAM TEST BANKFollowing routine colonoscopy screening, a client is told that he had several polyps
removed. The client began crying stating, "I just can't deal with cancer. I'm too
young." The nurse responds:
A) "Don't worry. We have some great cancer doctors on staff. I'm sure chemo will
help you fight it."
B) "Maybe if you're lucky, they have stopped it from metastasizing to your liver."
C) "A simple intestinal surgery will cure you."
D) "Most colon polyps are not cancerous. The biopsy results will direct your care." -
ANSWER: Ans: D
Feedback:A polyp is a growth that projects from a mucosal surface, such as the
intestine. Although the term usually implies a benign neoplasm, some malignant
tumors also appear as polyps. Adenomatous polyps are considered precursors to
adenocarcinomas of the colon.
A lung biopsy and magnetic resonance imaging have confirmed the presence of a
benign lung tumor in a client. Which of the following characteristics is associated
with this client's neoplasm?
A) The tumor will grow by expansion and is likely encapsulated.
B) The cells that constitute the tumor are undifferentiated, with atypical structure.
C) If left untreated, the client's tumor is likely to metastasize.
D) The tumor is likely to infiltrate the lung tissue that presently surrounds it. -
ANSWER: Ans: A
A polyp is a growth that projects from
Feedback:
Benign neoplasms typically grow by expansion rather than invasion. As well, they are
usually contained within a fibrous capsule. Malignant tumors are associated with
undifferentiated cells, metastasis, and infiltration of surrounding tissue.
A newly diagnosed lung cancer client asks how his tumor spread (metastasized) so
fast without displaying many signs/symptoms. The nurse responds that malignant
tumors affect area tissues by:
A) Increasing tissue blood flow
B) Providing essential nutrients
C) Liberating enzymes and toxins
Ans: C Feedback: Malignant tumors affect area tissues by liberating enzymes and
toxins that destroy tumor tissue and normal tissue. In addition, the malignant cells
compress area vessels, causing ischemia and tissue necrosis. The high metabolic rate
of tumor growth causes the tumor to deprive the normal tissues of essential
nutrients.D) Forming fibrous membranes - ANSWER: Ans: C
Feedback: Malignant tumors affect area tissues by liberating enzymes and toxins that
destroy tumor tissue and normal tissue. In addition, the malignant cells compress
,area vessels, causing ischemia and tissue necrosis. The high metabolic rate of tumor
growth causes the tumor to deprive the normal tissues of essential nutrients.
A client had a positive Pap smear. The surgeon diagnosed "cancer in situ of the
cervix." The client asks, "What does this mean?" From the following statements,
which is most appropriate in response to this question? The tumor has:
A) Been walled off within a strong fibrous capsule
B) Developed a distant infiltration
C) Not crossed the basement membrane, so it can be surgically removed with little
chance of growing back
D) Grown undifferentiated cells that no longer look like the tissue from which it
arose - ANSWER: Ans: C
Feedback: Cancer in situ is a localized preinvasive lesion. As an example, in breast
ductal carcinoma, in situ the cells have not crossed the basement membrane.
Depending on its location, an in situ lesion usually can be removed surgically or
treated so that the chances of recurrence are small. For example, cancer in situ of
the cervix is essentially 100% curable
While studying to become chemo-certified, the nurse reviews some basic concepts
about cancer cells. When a client asks about why the tumor grows so fast, the nurse
will respond based on which of the following physiological principles? Select all that
apply.
A) Cancer cells have shorter cell cycle times than normal cells.
B) Cancer cells do not die when they are programmed to die.
C) Growth factors prevents cancer cells from entering resting (G0) cell cycle phase.
D) Cancer cells will reach a balance between cell birth and cell death rate.
E) Cancer cells never reach a flattened growth rate. - ANSWER: Ans: B, C
Feedback: One of the reasons cancerous tumors often seem to grow so rapidly
relates to the size of the cell pool that is actively engaged in cycling. It has been
shown that the cell cycle time of cancerous tissue cells is not necessarily shorter than
that of normal cells. Rather, cancer cells do not die on schedule, and growth factors
prevent cells from exiting the cell cycle and entering the G0 or noncycling phase. The
ratio of dividing cells to resting cells in a tissue mass is called the growth fraction.
The doubling time is the length of time it takes for the total mass of cells in a tumor
to double. As the growth fraction increases, the doubling time decreases. When
normal tissues reach their adult size, an equilibrium between cell birth and cell death
is reached. Cancer cells, however, continue to divide until limitations in blood supply
and nutrients inhibit their growth. When this occurs, the doubling time for cancer
cells decreases. The initial growth rate is exponential and then tends to decrease or
flatten out over time.
Although growth rate is variable among types of bacteria, the growth of bacteria is
dependent on:
A) Biofilm communication
B) Availability of nutrients
,C) An intact protein capsid
D) Individual cell motility - ANSWER: Ans: B
Feedback:
Bacterial growth is dependent upon the availability of nutrients and physical growth
conditions. Bacteria prefer to colonize as biofilm and communicate with other
bacteria within the biofilm, but biofilm is not necessary for growth. Viruses (not
bacteria) form a capsid. Although some bacteria have projections for motility, these
are not necessary for growth.
Which of the following outpatients are at a greater risk for developing Treponema
pallidum, the cause of syphilis? Select all that apply.
A) A homeless adolescent female performing oral sex for money
B) A male who frequents clubs catering to exotic dancers and sexual favors
C) A homosexual male couple who have had a monogamous relationship for the past
20 years
D) An older adult female living in a condominium who regularly has sex with three to
four different men/week - ANSWER: Ans: A, B, D
Feedback:
Treponema pallidum is a sexually transmitted infection that is spread by direct
physical contact. The Borrelia type of spirochete is spread from animals to humans
through lice or tick bites. Leptospira spirochetes spread from animals to humans
through contact with infected animal urine. Spirochetes are anaerobic; therefore,
they would not invade the host through oxygen-filled aerobic lungs.
Chlamydiaceae have characteristics of both viruses and bacteria and are a rather
common sexually transmitted infectious organism. After entry into the host, they
transform into a reticulate body. The health care provider should monitor which of
the following clients for this possible infection? Select all that apply.
A) An adult male who raises a number of exotic birds in his home
B) A drug abuser looking to share needles/syringes
C) A newborn with a noticeable eye infection
D) A teenager who swims in the lake regularly - ANSWER: Ans: A, B, C
Feedback:
Chlamydiaceae are in the form of an elementary body when infectious and outside
of the host cell. Once an organism enters the cell, it transforms into a large reticulate
body. This undergoes active replication into multiple elementary bodies, which are
then shed into the extracellular environment to initiate another infectious cycle.
Chlamydial diseases of humans include sexually transmitted genital infections
(Chlamydophila trachomatis); ocular infections and pneumonia of newborns (C.
trachomatis); upper and lower respiratory tract infections in children, adolescents,
and young adults (Chlamydophila pneumoniae); and respiratory disease acquired
from infected birds (Chlamydophila psittaci).
A client has been diagnosed with Coxiella burnetii infection. She asked the health
care provider how she could have gotten this disease. The health care provider's best
response is:
, A) "Probably while walking outside without your shoes on."
B) "While swimming in an unsanitary pond."
C) "Drinking contaminated milk."
D) "Eating undercooked fish." - ANSWER: Ans: C
Feedback:
In humans, Coxiella infection produces a disease called Q fever, characterized by a
nonspecific febrile illness often accompanied by headache, chills, arthralgias, and
mild pneumonia. The organism produces a highly resistant sporelike stage that is
transmitted to humans when contaminated animal tissue is aerosolized (e.g., during
meat processing) or by ingestion of contaminated milk.
A teenage male develops a severe case of "athlete's foot." He asks, "How did I get
this?" The health care worker explains that certain fungi become infectious (called
dermatophytes) and exhibit which of the following characteristics?
A) Prefer to grow in warm environments like shoes/socks
B) Like a moist environment
C) Limited to cooler cutaneous surfaces
D) Need higher blood flow to survive - ANSWER: Ans: C
Feedback:
Dermatophytes are not able to grow at core body temperature, preferring the cooler
surface skin areas instead of moist skin folds. Diseases caused by these organisms,
including ringworm, athlete's foot, and jock itch, are collectively called superficial
mycoses.
A male client with a history of angina has presented to the emergency department
with uncharacteristic chest pain, and his subsequent ECG reveals T-wave elevation.
This finding suggests an abnormality with which of the following aspects of the
cardiac cycle?
A) Atrial depolarization
B) Ventricular depolarization
C) Ventricular repolarization
D) Depolarization of the AV node - ANSWER: Ans: C
Feedback:
The T wave on electrocardiography (ECG) corresponds to ventricular repolarization.
Atrial depolarization is represented by the P wave and ventricular depolarization by
the QRS complex. The isoelectric or zero line between the P wave and the Q wave
represents depolarization of the AV node, bundle branches, and Purkinje system.
During ventricular systole, closure of the atrioventricular (AV) valves coincides with:
A) Atrial chamber filling
B) Aortic valve opening
C) Isovolumetric contraction
D) Semilunar valves opening - ANSWER: Ans: C
Feedback:
Ventricular systole is divided into two parts: isovolumetric contraction when the AV
valves close and ventricles fill; and the ejection period, when the semilunar valves
open and blood is ejected through the aortic valve into circulation. Immediately after
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