Question 1

A newborn male is diagnosed with albinism based on skin, eye, and hair appearance.Which finding will support this diagnosis?

Accepted Answer

The person with albinism is unable to convert tyrosine to DOPA, an intermediate in melanin biosynthesis.An increase in melanin would cause skin to be darker.Hemoprotein accumulations in cells are caused by excessive storage of iron, which is transferred to the cells from the bloodstream.An inability to convert bile to bilirubin would not lead to albinism.

Question 2

A group of prison inmates developed tuberculosis following exposure to an infected inmate.On examination, tissues were soft and granular (like clumped cheese).Which of the following is the most likely cause?

Accepted Answer

Caseous necrosis results from tuberculosis pulmonary infection.Coagulative necrosis occurs primarily in the kidneys, heart, and adrenal glands, and commonly results from hypoxia.Liquefactive necrosis results from ischemic injury to neurons and glial cells in the brain.Autonecrosis is a process of cellular self-digestion and is not due to infection such as tuberculosis.

Question 3

A 35-year-old female is diagnosed with multiple myeloma.Biopsy of the tumor reveals Russell bodies, and laboratory testing reveals kidney dysfunction.Which substance should the nurse monitor as it is accumulating in the patient's body?

Accepted Answer

Russell bodies occur due to excess aggregates of protein.Excess glycogen would affect blood glucose.Increased pigment would not lead to kidney dysfunction.Melanin accumulates in epithelial cells (keratinocytes)of the skin and retina.

Question 4

When a nurse observes muscle stiffening occurring within 6-14 hours after death, the nurse should document this finding as the presence of:

Accepted Answer

Rigor mortis occurs within 6 hours after death and is evidenced by muscle stiffening.Livor mortis is a purple discoloration.Gangrene refers to death of tissue and results from severe hypoxic injury and does not lead to stiffening.Algor mortis is postmortem reduction of body temperature.

Question 5

A 50-year-old male intravenous drug user is diagnosed with hepatitis C.Examination of the liver reveals cell death secondary to:

Accepted Answer

With hepatitis C, the liver will demonstrate apoptosis that is a result of the viral infection.Fat necrosis occurs with enzymatic action due to lipases.Apoptosis is not a normal physiological process.Pyknosis occurs when the nucleus shrinks and becomes a small, dense mass of genetic material.

Question 6

When a nurse is checking a urinalysis, the finding that would alert the nurse to cellular injury is the presence of:

Accepted Answer

The presence of protein in the urine in significant amounts indicates cellular injury and altered cellular function.Neither glucose nor blood is normally present in the urine, but its presence is not indicative of altered cellular function.Urea is an expected substance in the kidney.

Question 7

Confirmation of somatic death is based on:

Accepted Answer

The most notable manifestations are complete cessation of respiration and circulation.Algor mortis is postmortem reduction of body temperature and is not confirmation of somatic death.Livor mortis is muscle stiffening and is not confirmation of somatic death.Change in skin color to pale yellow does occur, but complete cessation of respiration and circulation confirms somatic death.

Question 8

Liquefactive necrosis occurs in the brain because:

Accepted Answer

Liquefactive necrosis is due to enzymatic action and because cells of the brain are rich in enzymes.Protein denaturation occurs primarily in the kidneys.Liquefactive necrosis is due to enzymatic reaction and not to hypoxia or hydrolases.

Question 9

An 86-year-old female patient has the wasting syndrome of aging, making her vulnerable to falls, functional decline, disease, and death.The nurse knows this patient is experiencing:

Accepted Answer

Frailty leaves the individual vulnerable to falls, disease, and death.Sarcopenia is loss of muscle mass.It is associated with aging but is not as severe as frailty.Somatic death is death of the whole person.Cellular aging occurs at the cellular level and is characteristic of aging, including cell atrophy, decreased function, and loss of cells.

Question 10

A 23-year-old male develops a black eye following a fight.When the aide asks the nurse why this occurred, the nurse's best response is that the bruising is due to an accumulation of:

Accepted Answer

Hemosiderin is responsible for the color changes in a black eye.Transferrin is a transport protein responsible for iron transport.Bilirubin is the normal, yellow-to-green pigment of bile derived from the porphyrin structure of hemoglobin.Albumin is the protein in the serum, responsible for cellular integrity.

Question 11

A 2-year-old swallowed watch batteries.Following ingestion, kidney function was impaired, and the heart began to fail.Which of the following was the most likely cause?

Accepted Answer

Coagulative necrosis occurs primarily in the kidneys, heart, and adrenal glands and commonly results from hypoxia.Karyorrhexis means fragmentation of the nucleus into smaller particles or "nuclear dust." Ammonia accumulation is not associated with this toxicity.Caseous necrosis results from tuberculosis pulmonary infection.

Question 12

A patient has been reading on the Internet that light to moderate intake of alcohol is cardioprotective.When the patient asks the nurse what this means, the nurse should respond that the heart is protected by which of the following mechanisms? (select all that apply)

Accepted Answer

The suggested mechanisms for cardioprotection by low to moderate alcohol intake include increased levels of high-density lipoprotein cholesterol (HDL-c), prevention of clot formation, reduction in platelet aggregation, and decrease in blood pressure.Increased collateral circulation is not a benefit of alcohol.Alcohol consumption can decrease folate absorption, which can lead to a nutritional deficient.

Question 13

A 50-year-old female became infected with Clostridium bacteria and died a week later.Examination of her red blood cells revealed lysis of membranes.Which of the following was the most likely cause of her death?

Accepted Answer

Gas gangrene is a special type of gangrene caused by infection of injured tissue by one of many species of Clostridium.Fat necrosis is cellular dissolution caused by powerful enzymes, called lipases, that occur in the breast, pancreas, and other abdominal structures.Wet gangrene develops when neutrophils invade the site, causing liquefactive necrosis.Gangrenous necrosis is due to death of tissue and results from severe hypoxic injury.

Question 14

What principle should the nurse remember when trying to distinguish aging from diseases?

Accepted Answer

It is difficult to differentiate between aging and disease because both occur secondary to cellular aging.It is not easy to differentiate normal processes from abnormal because aging appears as a normal process.Disease and aging have a possible genetic component.Aging is a time-dependent loss of structure and function that proceeds slowly and in such small increments that it appears to be the result of the accumulation of small, imperceptible injuries.It is not a time period outside of life expectancy.

Question 15

After ingestion of lead, what organ systems should the nurse monitor because they are the most sensitive to the effects of lead? (select all that apply)

Accepted Answer

The organ systems primarily affected by lead ingestion include the nervous system (brain), the hematopoietic system (tissues that produce blood cells), and the kidneys.The heart, liver, and lungs are not affected.

Question 16

While reading a textbook, a student reads the term apoptosis.The student recalls that apoptosis is a condition in which cells program themselves to:

Accepted Answer

In apoptosis, cells are programmed to die.Apoptosis is not associated with cell atrophy, regeneration, or aging.

Quiz 4: Altered Cellular and Tissue Biology