Cells and Tissue Flashcards
(40 cards)
A stable patient arrives at the intensive care unit in diabetic ketoacidosis and is placed on an insulin and D5W drip. When placed on cardiac monitoring, the nurse notices U- waves appear. What would be the nurses next step?
A. Increase insulin drip rate
B. Contact the provider to order a BMP
C. Check the patients blood sugar level
D. Decrease the D5w rate
Contact the provider to order a BMP.
This is correct, as U waves can appear on cardiac monitoring for patients in hypokalemia (Rogers & Brash, 2023, pp. 120-121). Given the patient is on an insulin drip, this will deplete levels quickly, so the nurse should check out their electrolyte levels to determine if replacement is warranted.
A patient arrives at your outpatient clinic, and a BMP shows they have hypophosphatemia. Which response by the patient would prompt further education?
A. I will make sure to cut back my alcohol drinking during the week
B. I’ll make sure to add Vitamin D Supplements to my morning medications, to make sure I take them
C. I can try alternative methods to relieve my heartburn, rather than always taking antacids
D. I need to make sure I’m adding more calcium to my diet
I need to make sure I’m adding more calcium into my diet
This statement means the patient needs more education as phosporous and calcium have an inverse relationship (p.125). therefore if calcium levels are increased, then phosphorous level will decrease
While caring for an intubated patient, the lab calls, and reports from an arterial blood gas that the patient’s pH came back at 7.5, and their PaCO2 is 30 mmHg, and their HCO3 is 27 mmol/L. What would the nurse anticipate the provider ordering?
A. Decrease respirations (on ventilator)
B. repeat ABG
C. Give a dose of Bicarbonate
D. COntinue to monitor
Decrease respirations– pt is currently in respiratory alkalosis and requires respirations to decrease so the patient can retain more CO2 (p. 136)
During rounds, the medical provider notifies the bedside nurse that the team will be ordering a blood test that could help to indicate or rule out heart failure in their patient. The provider goes on to explain that the blood test will check for the presence of hormones released by the myocardium in response to increased left ventricular tension to help reduce the workload on the heart by :
A) preventing urinary sodium excretion
B) promoting urinary sodium excretion
C) preventing a drop in blood pressure
D) promoting vasoconstriction
promoting urinary sodium excretion
B-Type Natriuretic Peptide (BNP) is produced by the myocardium of the cardiac ventricles in response to increased volume, pressure, or tension on the ventricular walls. Serum BNP is measured to assist in the preliminary diagnosis of heart failure. The function of natriuretic peptides is to reduce cardiac workload by reducing blood pressure. BNP reduces blood pressure by promoting vasodilation, sodium and water excretion by the kidneys
Which of the following actions would constitute a disruption in the first layer of defense in human immunity?
A) Peripheral venous blood draw
B) chronic inflammation
C) oral antihistamine therapy
D) chemotherapy induced neutropenia
peripheral venous blood draw
When describing the causes of an inherited trait, the term multifactorial inheritance is used when ________ is/ are thought to be involved.
A) multiple gene diseases
B) environmental factors
C) when both members of a set of identical twins are afflicted similarly
D) single gene diseases
environmental factors
The term multifactorial inheritance is used when it is believed that there are non-genetic causes for an inherited trait or disease
A patient with a partial small bowel obstruction has been admitted to the medical unit with symptoms of abdominal pain, nausea, and vomiting. An X-ray shows a largely distended stomach. An NG tube was inserted, 800 mL of green fluid was removed, and continuous suction was ordered. Morning lab results reveal a potassium level of 2.7 mEq/L. Which of the following symptoms is the patient most likely experiencing?
A. ECG changes such as T wave decreases, ST depression, and/or U wave
B. Depression
C. Chvostek and Trousseau signs
D. Kidney stones
ECG changes such as T wave decreases, ST depression, and/or U wave
Which of the following statements correctly explains a cellular response in inflammation?
A. Eosinophils are the most important phagocytes in the cellular response to inflammation and arrive early at the scene in large numbers.
B. All pathogens can be destroyed by phagocytosis using pattern recognition receptors (PRRs) that recognize pathogen-associated molecular patterns (PAMPs) on microorganisms.
C. Phagocytes detect chemotactic factors (chemokines), including bacterial products, complement fragments C3a and C5a, and other chemokines, and migrate toward the highest concentration of these factors.
D. Dying phagocytes do not cause tissue damage at the site of inflammation and are absorbed by the vascular system.
Phagocytes detect chemotactic factors (chemokines), including bacterial products, complement fragments C3a and C5a, and other chemokines, and migrate toward the highest concentration of these factors.
Which of the following is a good example of active immunity?
A. An adult does not contract measles after childhood because they were previously infected and recovered.
B. Neonates do not develop an infection because they have maternal antibodies received through breast milk.
C. A cancer patient is given monoclonal antibodies against a cancer antigen.
D. Adults do not develop an infection because they receive rabies immune globulin, which provides immediate protection against the rabies virus.
An adult does not contract measles after childhood because they were previously infected and recovered.
Active immunity occurs when the immune system generates its own antibodies in response to an infection or vaccination, leading to long-term protection.
A patient presents post unilateral nephrectomy with normal kidney function. What is the type of cellular adaptation responsible for maintaining the patient’s kidney function post nephrectomy?
Physiologic hypertrophy
Pathologic hypertrophy
Hormonal hyperplasia
Compensatory hyperplasia
Physiologic hypertrophy occurs when the cells increase in size but maintain their functionality. In physiologic hypertrophy there is no alteration in the structure or function. This is due to increased demand and there is no pathology occurring to alter function. (Gray et al., 2024, pp. 44)
A 25 year old patient with no past medical or surgical history presents with altered mental status, lethargy and new onset of seizure activity. Assessment shows very dry mucous membranes and tenting skin turgor. Upon collecting a history from the patient mother present at the bedside she states that the patient has had 1 week of vomiting with poor PO intake. The collection of a comprehensive metabolic panel shows a serum sodium level of 125 mEq/L. What is the likely type of hyponatremia?
Isovolemic Hypernatremia
Hypertonic Hyponatremia
Hypovolemic Hyponatremia
Dilutional Hyponatremia
Hypovolemic Hyponatremia
Correct. Due to the loss of fluid through vomiting and no past medical history this is the most likely form of hyponatremia. The extracellular fluid volume is decreased causing an increased concentration of sodium in the blood serum.
During the inflammatory response mast cells act as activators containing biochemical mediators responsible for initiating different responses to stimuli. Of these mediators, which is responsible for the increased vascular permeability, neutrophil chemotaxis and pain produced by the action of cyclooxygenase (COX)?
Vascular endothelial growth factor (VEGF)
Prostaglandins
Leukotrienes
Platelet-activating factor
Prostaglandins
Correct. Prostaglandins are mediators produced by mast cells causing above symptoms. They are produced by the action of COX in two forms, COX- 1 and COX - 2. This is why NSAIDs are useful in counteracting these symptoms depending on the COX type. They counteract the prostaglandins reducing inflammation and pain produced by the prostaglandin. (Brasher, 2024, pp. 212)
In regards to cellular function, atrophy, hypertrophy, hyperplasia, metaplasia, and dysplasia are all examples of:
A. Cellular reactivity
B. Cellular adaptation
C. Cellular malfunction
D. Cellular injury/death
Cellular adaptation is the “reversible response involving structural and functional modifications to accommodate physiologic and pathologic conditions” ( Gray et al, 2023, p.44). Cellular Adaptation response to stressors are as listed in the question. Cellular injury occurs when the cell is unable to maintain homeostasis (normal or adaptive steady state) Rodgers, 2023, p 47)
A patient with Kussmaul respirations is showing compensatory mechanisms of?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Kussmaul (deep and rapid) respirations are the bodies attempt to compensate and achieve homeostasis during metabolic acidosis, often associated diabetic keto acidosis. The patients ph is acidic, less than 7.35 and bicarb is low <22 mEq/L
Your patient is complaining of burning and pressure along the sternum and belching after eating acidic food. As the nurse you know stimulation of which histamine receptor is responsible for these symptoms?
A. Histamine 1
B. Histamine 2
C. Histamine 3
D. Histamine 4
Histamine 2 receptor is generally antiiflammatory, abundant in parietal cells of the stomach where stimulation induces the secretion of gastric acid as normal physiology of the stomach” (Rodgers, 2023, p 211)
Your 45yo male patient presents with complaints of widespread muscle twitching/spasms. You would be concerned about the following electrolyte abnormalities:
Hypercalcemia, hypophosphatemia, hypermagnesemia
Hypernatremia, hypomagnesemia, hypocalcemia
Hypernatremia, hypocalcemia, hypokalemia
Hyperkalemia, hypercalcemia, hyponatremia
Hypernatremia, hypomagnesemia, hypocalcemia
You evaluate a patient who fell and sustained a 1” laceration across their knee. You decide to suture the incision based on the principal of healing by:
Proliferation
Epithelialization
Primary intention
Secondary intention
Primary intention
You are interpreting your patients EKG and notice peaked T waves. You would be concerned about which of the following electrolyte abnormalities:
Hyperkalemia
Hypokalemia
Hypercalcemia
Hypernatremia
Hyperkalemia
Which of the following statements is true about hypertrophy?
Hypertrophy is a compensatory increase in the number of cells that occurs in response to mechanical load or stress
Hypertension causes physiologic hypertrophy of the heart
“Runner’s heart” is a type of pathologic hypertrophy
Physiologic hypertrophy of the heart results from increased demands, but the myocardial matrix is preserved
Physiologic hypertrophy of the heart results from increased demands, but the myocardial matrix is preserved
Physiologic hypertrophy results from increased demands, stimulation hormones and growth factors. Despite the increase in size of the heart, the myocardial matrix is preserved. (Roger, 2023, p. 45)
A 75 year old female presents to her primary care office with the chief complaint of “feeling ill.” She states she has been experiencing flu-like symptoms for the past 5 days, including nausea, vomiting, diarrhea, weakness, and decreased appetite, as well as a 6/10 headache that began 2 days ago. She explains that she has been trying her best to increase her water intake to prevent dehydration. According to her presentation, which electrolyte imbalance is this patient at risk for?
Hyponatremia
Hyperchloremia
Hyperkalemia
Hypomagnesemia
hyponatremia
Innate immunity refers to the defense mechanisms that are present at birth. The immune system provides an initial nonspecific response to protect the body. Which of the follow statements are false about innate immunity?
A first line of defense is the physical barrier of the epithelial cells of the skin
Inflammation is activated as the second line of defense when the guardian cells detect pathogen invasion or tissue damage
Neutrophils and macrophages play an essential role of removing debris and initiating healing by the process of phagocytosis
None of the above
none of the above, these are all true statements
Mark was playing soccer with his local sports club when he fell and injured his left ankle. He presents to the office with swelling surrounding the left ankle joint. Which type of edema would be anticipated that Mark is experiencing based on the presentation of swelling of his left ankle?
a. generalized edema
b. localized edema
c. pitting edema
d. dependent edema
localized edema. Considering the localized swelling of his left ankle, it is likely that Mark is experiencing localized edema, which can be caused by injury such as a sprained joint (Rogers, 2022). Page 110
A 4-year-old child presents with fatigue, irritability, and abdominal pain. The child lives in a house built in the early 1900s and attends a daycare located in an older building. What is the suspected diagnosis for this child’s presentation?
a. fetal alcohol poisoning
b. carbon monoxide exposure
c. lead exposure
d. mercury exposure
lead exposure.
With the prevalence of hand-to-mouth behavior in children and the absence of regulations concerning household materials, such as paint, prior to the 1970s, young children are at an elevated risk of encountering deteriorating paint in older housing and environments. (Rogers, 2022). Pages 57-65
Which of the following terms refers to the reversible change from one cell type to another in response to chronic irritation or inflammation, and tissue damage, repair, and regeneration?
a. metaplasia
b. dysplasia
c. hyperplasia
d. hypertrophy
metaplasia. Metaplasia refers to the reversible change from one type of tissue to another in response to chronic irritation or inflammation (Rogers, 2022). This adaptive change allows the affected tissue better to withstand adverse conditions (Rogers, 2022). For example, in the respiratory tract, chronic exposure to cigarette smoke can lead to the transformation of the normal pseudostratified columnar epithelium into stratified squamous epithelium, a change that is more resistant to damage from the inhaled irritants but not able to secrete mucus nor have cilia which decrease the protective barrier of the tissues (Rogers, 2022). Page 47
