chronic myelogenous leukemia
Question 1
A 70-year-old woman has received a diagnosis of chronic myelogenous leukemia (CML) after a clinical investigation sparked by the presence of leukocytosis in her routine blood work. What clinical course should her care provider tell her to expect?
Answers:
A. “It’s likely that this will give you chronic fatigue and malaise for the rest of your life, but that will probably be the extent of your symptoms.”
B. “Unfortunately, your leukemia will likely enter a crisis mode within a few weeks if we don’t treat it immediately.”
C. “You could remain the chronic stage of CML for several years before it accelerates and culminates in a crisis.”
D. “You can expect your blood results, fatigue, and susceptibility to infection to gradually worsen over a few years.”
Question 2
Following an injury resulting in a small cut from a knife, the first cells to go to the area of the cut would be the
Answers:
A. erythrocytes.
B. basophils.
C. neutrophils.
D. albumin.
Question 3
Which of the following diagnostic findings is likely to result in the most serious brain insult?
Answers:
A. Moderate decrease in brain tissue volume secondary to a brain tumor removal
B. High intracellular concentration of glutamate
C. Increased ICP accompanied by hyperventilation
D. Mean arterial pressure (MAP) that equals intracranial pressure (ICP)
Question 4
Which of the following patients would be most likely to be experiencing an increase in renal erythropoietin production?
Answers:
A. A 70-year-old woman admitted with dehydration secondary to an overdose of her potassium-wasting diuretic
B. A 21-year-old man with acute blood loss secondary to a motor vehicle accident 3 hours prior
C. A 68-year-old man with a long-standing diagnosis of polycythemia vera
D. A 71-year-old smoker admitted to hospital with exacerbation of his chronic obstructive pulmonary disease (COPD)
Question 5
A college student has been experiencing frequent headaches that he describes as throbbing and complaining of difficulty concentrating while studying. Upon cerebral angiography, he is found to have an arteriovenous malformation. Which of the following pathophysiological concepts is likely responsible for his symptoms?
Answers:
A. Localized ischemia with areas of necrosis noted on CT angiography
B. High pressure and local hemorrhage of the venous system
C. Hydrocephalus and protein in the cerebral spinal fluid
D. Increased tissue perfusion at the site of the malformation
Question 6
A group of nursing students were studying for their pathophysiology exam by quizzing each other about disorders of WBCs and lymphoid tissue. When asked what the first chromosomal abnormality that identified cancer was, one student correctly answered
Answers:
A. interleukin cells.
B. Philadelphia.
C. PSA.
D. BRCA-1.
Question 7
A 47-year-old woman was diagnosed with amyotrophic lateral sclerosis 3 years ago and has experienced a progressive onset and severity of complications. She has been admitted to a palliative care unit due to her poor prognosis? What assessments and interventions should the nursing staff of the unit prioritize in their care?
Answers:
A. Regular pain assessment and administration of opioid analgesics as needed
B. Cardiac monitoring and administration of inotropic medications
C. Assessment and documentation of cognitive changes, including confusion and restlessness
D. Assessment of swallowing ability and respiratory status
Question 8
A 53-year-old man presents with inability to concentrate, itching in his fingers and toes, elevated blood pressure, and unexplained weight loss. He is diagnosed with primary polycythemia. What will be the primary goal of his treatment?
Answers:
A. To increase the amount of oxygen distributed by his red blood cells
B. To reduce the viscosity of his blood
C. To reduce the mean size of his red cells
D. To control his hypertension
Question 9
During a late night study session, a pathophysiology student reaches out to turn the page of her textbook. Which of the following components of her nervous system contains the highest level of control of her arm and hand action?
Answers:
A. Thalamus
B. Cerebellum
C. Frontal lobe
D. Basal ganglia
Question 10
The family members of an elderly patient are wondering why his “blood counts” are not rising after his last GI bleed. They state, “He has always bounced back after one of these episodes, but this time it isn’t happening. Do you know why?” The nurse will respond based on which of the following pathophysiological principles?
Answers:
A. “Don’t worry about it. We can always give him more blood.”
B. “Due to stress, the red blood cells of older adults are not replaced as promptly as younger people.”
C. “Everything slows down when you get older. You just have to wait and see what happens.”
D. “The doctor may start looking for another cause of his anemia, maybe cancer of the bone.”
Question 11
A 44-year-old female patient presents to the emergency department with abnormal bleeding and abdominal pain that is later attributed to gallbladder disease. Which of the following diagnoses would the medical team be most justified in suspecting as a cause of the patient’s bleeding?
Answers:
A. Hemophilia B
B. Vitamin K deficiency
C. Excess calcium
D. Idiopathic immune thrombocytopenic purpura (ITP)
Question 12
Your ESRD patient is receiving 2 units of packed red blood cells for anemia (Hgb of 8.2). Twenty minutes into the first transfusion, the nurse observes the patient has a flushed face, hives over upper body trunk, and is complaining of pain in lower back. His vital signs include pulse rate of 110 and BP drop to 95/56.What is the nurse’s priority action?
Answers:
A. Recheck the type of blood infusing with the chart documentation of patient’s blood type.
B. Discontinue the transfusion and begin an infusion of normal saline.
C. Slow the rate of the blood infusion to 50 mL/hour.
D. Document the assessment as the only action.
Question 13
A 5th grade elementary student asks the school nurse how much blood is in an entire body. The nurse should respond that the average grown-up adult has
Answers:
A. 2 to 4 cups of blood in his or her body.
B. 5 to 6 L of blood throughout his or her body.
C. 3 pints of blood in total.
D. 3 to 4 quarts of blood in his or her body.
Question 14
The geriatrician providing care for a 74-year-old man with diagnosis of Parkinson disease has recently changed the client’s medication regimen. What is the most likely focus of the pharmacologic treatment of the man’s health problem?
Answers:
A. Preventing demyelination of the efferent cerebellar pathways
B. Preventing axonal degradation of motor neurons
C. Maximizing acetylcholine release from synaptic vesicles at neuromuscular junctions
D. Increasing the functional ability of the underactive dopaminergic system
Question 15
A student makes the statement to a colleague, “Blood plasma is essentially just a carrier for the formed elements like red blood cells and white blood cells.”What would be the most accurate response to this statement?
Answers:
A. “Not really. Plasma also contributes to the processes of protein synthesis and hematopoiesis.”
B. “Actually, plasma plays a significant role in nutrient and waste transport.”
C. “Actually, plasma is integral to the proper function of the liver and maintenance of acid–base balance.”
D. “That’s not really true. Plasma is crucial in the immune and inflammatory responses.”
Question 16
Several months ago, a 20-year-old male suffered a spinal cord injury brought about by a snowboard trick gone wrong. The lasting effects of his injury include a flaccid bowel and bladder and the inability to obtain an erection. While sensation has been completely preserved in his legs and feet, his motor function is significantly impaired. What type of incomplete spinal cord injury has the man most likely experienced?
Answers:
A. Central cord syndrome
B. Conus medullaris syndrome
C. Brown-Séquard syndrome
D. Anterior cord syndrome
Question 17
A client with a gastrointestinal bleed secondary to alcohol abuse and a hemoglobin level of 5.8 g/dL has been ordered a transfusion of packed red blood cells. The client possesses type B antibodies but lacks type D antigens on his red cells. Transfusion of which of the following blood types would be least likely to produce a transfusion reaction?
Answers:
A. A–
B. A+
C. B–
D. B+
Question 18
Which of the following clients’ signs and symptoms would allow a clinician to be most justified in ruling out stroke as a cause? An adult
Answers:
A. has vomited and complained of a severe headache.
B. states that his left arm and leg are numb, and gait is consequently unsteady.
C. has experienced a sudden loss of balance and slurred speech.
D. has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days.
Question 19
Amniocentesis has suggested that a couple’s first child will be born with sickle cell disease. The parents are unfamiliar with the health problem, and their caregiver is explaining the complexities. Which of the following statements by the parents would suggest a need for further teaching or clarification?
Answers:
A. “Our baby’s red cells are prone to early destruction because of his or her weak membranes.”
B. “Our son or daughter likely won’t show the effects of sickling until he or she is school-aged because of the different hemoglobin in babies.”
C. “Not all of his or her red cells will be sickled, but low oxygen levels can cause them to become so.”
D. “Sickled cells can block his or her blood vessels, especially in the abdomen, chest, and bones.”
Question 20
During science class, a student asks, “What’s the difference between plasma and serum in the blood?” The nurse responds that the primary difference between plasma and serum is that plasma contains
Answers:
A. hydrogen ions.
B. heparin.
