TEST BANK For Robbins & Kumar Basic Pathology, 11th Edition by Vinay Kumar, Abul K. Abba, Verified Chapters 1 - 24, Complete Newest Version

1. Test Bank for Robbins Basic Pathology
11th Edition
by Vinay Kumar, Abul K. Abba
Chapters 1 - 24

2. Table of Content
Chapter 1. The Cell as a Unit of Health and Disease
Chapter 2. Cell Injury, Cell Death, and
Adaptations Chapter 3. Inflammation and Repair
Chapter 4. Hemodynamic Disorders, Thromboembolism, and Shock
Chapter 5. Diseases of the Immune System
Chapter 6. Neoplasia
Chapter 7. Genetic and Pediatric Diseases
Chapter 8. Environmental and Nutritional
Diseases Chapter 9. General Pathology of
Infectious Diseases Chapter 10. Blood Vessels
Chapter 11. Heart
Chapter 12. Hematopoietic and Lymphoid Systems
Chapter 13. Lung
Chapter 14. Kidney and Its Collecting System
Chapter 15. Oral Cavities and Gastrointestinal Tract
Chapter 16. Liver and Gallbladder

3. Chapter 17. Pancreas
Chapter 18. Male Genital System and Lower Urinary Tract
Chapter 19. Female Genital System and Breast
Chapter 20. Endocrine System
Chapter 21. Bones, Joints, and Soft Tissue Tumors
Chapter 22. Peripheral Nerves and Muscles
Chapter 23. Central Nervous System
Chapter 24. Skin

4. Robbins Basic Pathology 11th Edition Kymar Abbas Test Bank
Chapter 1. The Cell as a Unit of Health and Disease
1 The nucleus , which is essential for function
and survival of the cell.
A
)
is the site of protein
synthesis
B) contains the genetic code
C) transforms cellular
energy
D) initiates aerobic metabolism
2 Although energy is not made in mitochondria, they are
known as the power plants of the cell because they:
A
)
contain RNA for protein
synthesis.
B) utilize glycolysis for oxidative energy.
C) extract energy from organic
compounds.
D) store calcium bonds for muscle contractions.
3 Although the basic structure of the cell plasma
membrane is formed by a lipid bilayer, most of the
specific membrane functions are carried out by:
A
)
bound and transmembrane
proteins.
B) complex, long carbohydratechains.
C) surface antigens and hormone
receptors.
D) a gating system of selective ion channels.
4 To effectively relay signals, cell-to-cell
communication utilizes chemical messenger
systems that:
A
)
displace surface receptor
proteins.
B) accumulate within cell gap junctions.

5. C
)
bind to contractile
microfilaments.
D) release secretions into extracellular fluid.
5 Aerobic metabolism, also known as oxidative
metabolism, provides energy by:
A
)
removingthe phosphate bonds from
ATP.
B) combining hydrogen and oxygen to
form water.
C
)
activating pyruvate stored in the
cytoplasm.
D) breaking down glucose to form lactic acid.
6 Exocytosis, the reverse of endocytosis, is important in
into the extracellular fluid.
A
)
Engulfing and ingesting fluid and
proteins for
transpo
rt
B) Killing, degrading, and dissolving
harmful microorganisms
C
)
Removing cellular debris and
releasing
synthesized
substances
D) Destruction of particles by lysosomal
enzymes for secretion
7 The process responsible for generating and
conducting membrane potentials is:
A
)
diffusion of current-carrying
ions.
B) millivoltage of electrical potential.
C
)
polarization of charged
particles.
D) ion channel neurotransmission.
8 Epithelial tissues are classified according to the shape
of the cells and the number of layers. Which of the
following is a correctly matched description and type
of epithelial tissue?

6. A) Simple epithelium: cells in contact
with intercellular matrix; some do not
extend to surface
B) Stratified epithelium: single layer of cells;
all cells rest on basement membrane
C) Glandular epithelium: arise from
surface epithelia and underlying
connective tissue
D) Pseudostratified epithelium: multiple
layers of cells; deepest layer rests on
basement membrane
9 Connective tissue contains fibroblasts that are responsible
for:
A) providing a fibrous framework for capillaries.
B) synthesis of collagen, elastin, and
reticular fibers.
C) forming tendons and the fascia that
covers muscles.
D) filling spaces between tissues to keep
organs in place.
10 Although all muscle tissue cells have some
similarities, smooth muscle (also known as
involuntary muscle) differs by:
A) having dense bodies attached to
actin filaments.
B) containing sarcomeres between Z lines
and M bands.
C) having rapid contractions and abundant
cross- striations.
D) contracting in response to
increased intracellular calcium.

7. 11 Which of the following aspects of the function of the
nucleus is performed by ribosomal RNA (rRNA)?
A
)
Copying and carrying DNAinstructions
for
protein
synthesis
B) Carrying amino acids to the site of
protein synthesis
C) Providing the site where protein
synthesis
occur
s
D) Regulating and controlling protein synthesis
12 Breakdown and removal of foreign substances and
worn-out cell parts are performed by which of the
following organelles?
A
)
Lysosomes
B) Golgiapparatus
C) Ribosome
s
D) Endoplasmicreticulum(ER)
13 Impairment in the function of peroxisomes would result in:
A
)
inadequate sites for protein
synthesis.
B) an inability to transport cellular
products across the cell membrane.
C) insufficient energy production within a
cell.
D) accumulation of free radicals in the
cytoplasm.
14 After several months of trying to conceive, a couple is
undergoing fertility testing. Semen analysis indicates
that the mans sperm have decreased motility, a finding
that is thought to underlie the couples inability to
become pregnant. Which of the following cellular
components may be defective within the mans sperm?
A
)
Ribosome
s
B) Microtubules

8. C
)
Mitochondri
a
D) Microfilaments
15 Which of the following statements is true of glycolysis?
A
)
Glycolysis requires
oxygen.
B) Glycolysis occurs in cells
without mitochondria.
C
)
Glycolysis provides the majority of the
bodys
energy
needs.
D) Glycolysis produces energy, water,and
carbon dioxide.
16 Which of the following membrane transport
mechanisms requires the greatest amount of
energy?
A
)
Facilitated
diffusion
B) Passivetransport
C
)
Vesicular
transport
D) Simplediffusion
17 A male patient with a diagnosis of type 1 diabetes
mellitus is experiencing hyperglycemia because he lacks
sufficient insulin to increase the availability of glucose
transporters in his cell membranes. Consequently, his
cells lack intracellular glucose and it accumulates in his
blood. Which of the following processes would best
allow glucose to cross his cell membranes?
A
)
Facilitated
diffusion
B) Simplediffusion
C
)
Secondary active
transport
D) Endocytosis

9. 18 Which of the following statements is true of skeletal
muscle cells?
A
)
Skeletal muscle cells each have an
apical,
lateral, and basal
surface.
B) They are closely apposed and are
joined by cell-to-cell adhesion
molecules.
C) Their basal surface is attached to a
basement
membran
e.
D) Skeletal muscle is multinucleated, lacking
true cell boundaries.
19 Which of the following body tissues exhibits the highest
rate of turnover and renewal?
A
)
The squamous epithelial cells of the
skin
B) The connective tissue supporting blood vessels
C) The skeletal muscle that facilitates
movement
D) The nervous tissue that constitutes the
central nervous system
20 A patient with a pathophysiologic condition that
affects the desmosomes is most likely to exhibit:
A
)
impaired contraction of skeletal and
smooth
muscle
.
B) weakness of the collagen and elastin
fibers in the extracellular space.
C) impaired communication between
neurons and
effector
organs.
D) separation at the junctions between
epithelial cells.
Answer Key
1 B
2 C

10. Chapter 2 . Cell Injury, Cell Death, and Adaptations
1 Ischemia and other toxic injuries increase the
accumulation of intracellular calcium as a result of:
A
)
release of stored calcium from
the
mitochondri
a.
B) improved intracellularvolumeregulation.
C
)
decreased influx across the cell
membrane.
D) attraction of calcium to fatty infiltrates.
3 A
5 B
7 A
9 B
10 A
11
12 A
13
14
15 B
16 C
17
18
19 A
20
4 D
6 C
8 C
C
D
B
A
D
D

11. 2 The patient is found to have liver disease, resulting in
the removal of a lobe of his liver. Adaptation to the
reduced size of the liver leads to of the remaining liver
cells.
A
)
metaplasi
a
B) organ atrophy
C) compensatory
hyperplasia
D) physiologichypertrophy
3 A person eating peanuts starts choking and
collapses. His airway obstruction is partially
cleared, but he remains hypoxic until he reaches
the hospital. The prolonged cell hypoxia caused a
cerebral infarction and resulting
in the brain.
A
)
caspase
activation
B) coagulationnecrosis
C) rapid
phagocytosis
D) protein p53 deficiency
4 Bacteria and viruses cause cell damage by , which
is unique from the intracellular damage caused by
other injurious agents.
A
)
disruptingthe sodium/potassiumATPase
pump
B) interruptingoxidative metabolismprocesses
C) replicating and producing continued
injury
D) decreasing protein synthesis and function
5 The patient has a prolonged interruption in arterial
blood flow to his left kidney, causing hypoxic cell injury
and the release of free radicals. Free radicals damage
cells by:
A
)
destroying phospholipids in the
cell
membran
e.
B) altering the immune response of the cell.

12. C
)
disrupting calcium storage in the
cell.
D) inactivation of enzymes and mitochondria.
6 Injured cells have impaired flow of substances
through the cell membrane as a result of:
A
)
increased fat
load.
B) alteredpermeability.
C
)
altered glucose
utilization.
D) increased surface receptors.
7 Reversible adaptive intracellular responses are initiated
by:
A
)
stimulus
overload.
B) genetic mutations.
C
)
chemical
messengers.
D) mitochondrial DNA.
8 Injured cells become very swollen as a result of:
A
)
increased cell protein
synthesis.
B) altered cell volume regulation.
C
)
passive entry of potassium into the
cell.
D) bleb formation in the plasma membrane.
9 A diabetic patient has impaired sensation,
circulation, and oxygenation of his feet. He steps on
a piece of glass, the wound does not heal, and the
area tissue becomes necrotic. The necrotic cell death
is characterized by:
A
)
rapid
apoptosis.
B) cellular rupture.
C
)
shrinkage and
collapse.
D) chronicinflammation.

13. 10 A 99-year-old woman has experienced the decline of
cell function associated with age. A group of theories
of cellular aging focus on programmed:
A
)
changes with genetic
influences.
B) elimination of cell receptor sites.
C) insufficienttelomerase
enzyme.
D) DNA mutation or faulty repair.
11 An 89-year-old female patient has experienced
significant decreases in her mobility and stamina
during a 3-week hospital stay for the treatment of a
femoral head fracture. Which of the following
phenomena most likely accounts for the patients
decrease in muscle function that underlies her reduced
mobility?
A
)
Impaired muscle cell metabolism
resulting
from
metaplasia
B) Dysplasia as a consequence of
inflammation during bone remodeling
C) Disuse atrophy of muscle cells
during a
prolonged period of
immobility
D) Ischemic atrophy resulting from
vascular changes while on bedrest
12 A 20-year-old college student has presented to her
campus medical clinic for a scheduled Papanicolaou
(Pap) smear. The clinician who will interpret the smear
will examine cell samples for evidence of:
A
)
changes in cell shape, size, and
organization.
B) the presence of unexpected cell types.
C) ischemic changes in cell
samples.

14. D) abnormally high numbers of cells
in a specified field.
13 Which of the following pathophysiologic processes is
most likely to result in metastatic calcification?
A
)
Benign prostatic
hyperplasia
B) Liver cirrhosis
C) Impaired glycogen
metabolism
D) Hyperparathyroidism
14 Despite the low levels of radiation used in
contemporary radiologic imaging, a radiology
technician is aware of the need to minimize her
exposure to ionizing radiation. What is the primary
rationale for the technicians precautions?
A
)
Radiation stimulates pathologic
cell
hypertrophy and
hyperplasia.
B) Radiation results in the accumulation of
endogenous waste products in the
cytoplasm.
C) Radiation interferes with DNA synthesis
and
mitosis
.
D) Radiation decreases the action
potential of rapidly dividing cells.
15 The parents of a 4-year-old girl have sought care
because their daughter has admitted to chewing and
swallowing imported toy figurines that have been
determined to be made of lead. Which of the following
blood tests should the care team prioritize?
A
)
White blood cell levels with
differential
B) Red blood cell levels and morphology
C) Urea and creatinine
levels
D) Liver function panel

15. 16 A 70-year-old male patient has been admitted to a
hospital for the treatment of a recent hemorrhagic
stroke that has left him with numerous motor and
sensory deficits. These deficits are most likely the result
of which of the following mechanisms of cell injury?
A
)
Free radical
injury
B) Hypoxiaand ATP depletion
C) Interference with DNA
synthesis
D) Impaired calciumhomeostasis
17 Which of the following processes associated with
cellular injury is most likely to be reversible?
A
)
Cell damage resulting from
accumulation of
fat in the
cytoplasm
B) Cellular changes as a result of
ionizing radiation
C) Cell damage from accumulation of
free
radical
s
D) Apoptosis
18 The extrinsic pathway of apoptosis can be initiated by:
A
)
damage to cellular
DNA.
B) decreased ATP levels.
C) activation of the p53
protein.
D) activation of death receptors on the
cell surface.
19 A patient with severe peripheral vascular disease has
developed signs of dry gangrene on the great toe of
one foot. Which of the following pathophysiologic
processes most likely contributed to this diagnosis?
A
)
Inappropriate activation of
apoptosis

16. B) Bacterial invasion
C) Impaired arterial blood supply
D) Metaplastic cellular changes
20 Which of the following facts underlies the
concept of replicative senescence?
A) Genes controlling longevity are present
or absent in varying quantities among
different individuals.
B) Telomeres become progressively
shorter in successive generations of a
cell.
C) The damaging influence of free radicals
increases exponentially in later
generations of a cell.
D) Aging produces mutations in DNAand
deficits in DNA repair.
Answer Key
1 A
2 C
3 B
4 C
5 A
6 B
7 C
8 B
9 B
10 A
11 C
12 A

17. 13 D
14 C
15 B
16 B
17 A
18 D
19 C
2
0
B
Chapter 3. Inflammation and Repair
1 The characteristic, localized cardinal signs of
acute inflammation include:
A
)
fever
.
B) fatigue.
C
)
redness
.
D) granuloma.
2 The vascular, hemodynamic stage of acute
inflammation is initiated by momentary
vasoconstriction followed by vasodilation that causes
localized:
A
)
bleedin
g.
B) congestion.
C
)
pale
skin.
D) coolness.
3 The cellular stage of acute inflammation is marked by
the movement of leukocytes into the area. Which of the
following cells arrives early in great numbers?
A
)
Basophil
s
B) Lymphocytes

18. C
)
Neutrophi
ls
D) Platelets
4 The phagocytosis process involves three distinct steps.
What is the initial step in the process?
A
)
Engulfme
nt
B) Intracellularkilling
C
)
Antigen
margination
D) Recognition and adherence
5 Which of the following mediators of inflammation
causes increased capillary permeability and pain?
A
)
Serotoni
n
B) Histamine
C
)
Bradykini
n
D) Nitric oxide
6 Inflammatory exudates are a combination of several
types. Which of the following exudates is composed
of enmeshed necrotic cells?
A
)
Serou
s
B) Fibrinous
C
)
Suppurati
ve
D) Membranous
7 The acute-phase systemic response usually begins
within hours of the onset of inflammation and
includes:
A
)
fever and
lethargy.
B) decreased C-reactive protein.
C
)
positive nitrogen
balance.
D) low erythrocyte sedimentation rate.

19. 8 In contrast to acute inflammation, chronic
inflammation is characterized by which of the
following phenomena?
A
)
Profusefibrinous
exudation
B) A shift to the left of granulocytes
C) Metabolic and respiratory
alkalosis
D) Lymphocytosis and activated macrophages
9 Exogenous pyrogens (interleukin-1) and the
presence of bacteria in the blood lead to the
release of endogenous pyrogens that:
A
)
stabilize thermal control in the
brain.
B) produce leukocytosis and anorexia.
C) block viral replication in
cells.
D) inhibitprostaglandin release.
10 An older adult patient has just sheared the skin on her
elbow while attempted to boost herself up in bed, an
event that has precipitated acute inflammation in the
region surrounding the wound. Which of the following
events will occur during the vascular stage of the
patients inflammation?
A
)
Outpouring of exudate into interstitial
spaces
B) Chemotaxis
C) Accumulation of leukocytes along
the
epitheliu
m
D) Phagocytosis of cellular debris
11 Which of the following individuals most likely has
the highest risk of experiencing chronic
inflammation?
A
)
A patient who has recently been
diagnosed
with type 2
diabetes

20. B) A patient who is a carrier of an
antibiotic- resistant organism
C
)
A patient who is taking oral antibiotics
for an
upper respiratory
infection
D) A patient who is morbidly obese and who
has a sedentary lifestyle
12 Which of the following core body temperatures is
within normal range?
A
)
35.9C
(96.6F)
B) 38.0C (100.4F)
C
)
35.5C
(95.9F)
D) 37.3C (99.1F)
13 A postsurgical patient who is recovering in the
postanesthetic recovery unit states that she is freezing
cold. Which of the following measures is likely to be
initiated in the patients hypothalamus in an effort to
reduce heat loss?
A
)
Opening of arteriovenous (AV)
shunts
B) Reduced exhalation of warmed air
C
)
Contraction of pilomotor
muscles
D) Decreased urine production
14 An elderly patient is dressed only in a hospital gown
and complains of a draft in her room. Consequently,
she has requested a warm blanket while she sits in
her wheelchair. Which of the following mechanisms
of heat loss is most likely the primary cause of her
request?
A
)
Evaporation and
conduction
B) Radiation and convection
C
)
Conduction and
convection
D) Convection and evaporation

21. 15 Which of the following pathophysiologic processes
are capable of inducing the production of pyrogens?
Select all that apply.
A
)
Acute
inflammation
B) Obesity
C
)
Myocardial
infarction
D) Malignancy
E
)
Renal
failure
16 Which of the following patients is most likely
to be susceptible to developing a neurogenic
fever?
A
)
Apatient who has stage II Alzheimer
disease
B) A patient who has sustained a head
injury in a bicycle crash
C
)
A patient who has become delirious
after the
administration of a
benzodiazepine
D) A patient who has begun taking a
selective serotonin-reuptake inhibitor
(SSRI) for the treatment of depression
17 Patients are commonly administered antipyretics
when their oral temperature exceeds 37.5C (99.5F).
Which of the following statements related to the
rationale for this action is most accurate?
A
)
Temperatures in excess of 37.5C (99.5F)
can
result in seizure
activity.
B) Lower temperatures inhibit the
protein synthesis of bacteria.
C
)
There is little empirical evidence for
this
treatment
modality.
D) Most common antipyretics have been
shown to have little effect on core
temperature.

22. 18 A patient has sought care because of recent malaise and
high fever. Upon assessment, the patient states that his
current fever began two days earlier, although he
states that for the last 2 weeks he is in a cycle of high
fever for a couple of days followed by a day or two of
normal temperature. Which of the following fever
patterns is this patient experiencing?
A
)
Recurrent
fever
B) Remittentfever
C) Sustained
fever
D) Intermittentfever
19 A febrile, 3-week-old infant has been brought to the
emergency department by his parents and is currently
undergoing a diagnostic workup to determine the cause
of his fever. Which of the following statements best
conveys the rationale for this careful examination?
A
)
The immature hypothalamus is
unable to
perform normal
thermoregulation.
B) Infants are susceptible to serious
infections because of their decreased
immune function.
C) Commonly used antipyretics often have no
effect on the core temperature of
infants.
D) Fever in neonates is often evidence of a
congenital disorder rather than an
infection.
20 An 84-year-old patients blood cultures have come
back positive, despite the fact that his oral
temperature has remained within normal range.
Which of the following phenomena underlies the
alterations in fever response that occur in the
elderly?
A
)
Disturbance in the functioning of
the
thermoregulatory
center
B) Increased heat loss by evaporation

23. C
)
The presence of comorbidities that
are
associated with lowered core
temperature
D) Persistent closure of arteriovenous shunts
Answer Key
Chapter 4. Hemodynamic Disorders, Thromboembolism, and Shock
1 With the exception of the first two steps, what is required in
all steps of the clotting process?
1 C
3 C
D
5 C
D
7 A
D
9 B
10 A
11 D
12 D
13 C
14
15 A, C, D
16
17 C
18 D
19 B
20 A
2 B
4
6
8
B
B

24. A
)
Calciu
m
B) Prothrombin
C) Tissue
factor
D) Plasminogen
2 The first step of hemostasis occurs as a:
A
)
fibrin
clot.
B) platelet plug.
C) clot
retraction.
D) vessel spasm.
3 To form a platelet plug, platelets are attracted to the
damaged vessel, and then platelet occurs.
A
)
adhesio
n
B) fibrinolysis
C) thrombos
is
D) thromboxaneA2
4 Blood coagulation is initiated by either of two
pathways. The intrinsic pathway requires circulating
to begin
the step-wise coagulation cascade.
A
)
protein
C
B) thrombin
C) factor
XII
D) tissue factor
5 Increased platelet function, and
consequent hypercoagulability, can be
caused by:
A
)
factor V
mutation.
B) plateletinsensitivity.
C) vascular wall
damage.

25. D) decreased platelet numbers.
6 Immune thrombocytopenia purpura (ITP) is a/an
disorder that destroys .
A
)
allergic;
fibrinogen
B) alloimmune; factor VIII
C
)
autoimmune;
platelets
D) immunoglobulin; Bcells
7 Thrombotic thrombocytopenic purpura (TTP) causes
which of the following manifestations? Select all that
apply.
A
)
Purpu
ra
B) Jaundice
C
)
Petechi
ae
D) Erythema
E
)
Confusion
8 Hemophilia A is a hereditary blood disorder
caused by inadequate activity or absent:
A
)
factor
VIII.
B) prothrombin.
C
)
vWF
complex.
D) intrinsicfactor.
9 Disseminated intravascular coagulation (DIC) is
characterized by:
A
)
headache
s.
B) platelet loss.
C
)
hypertensio
n.
D) hemorrhage.

26. 10 In persons with a bleeding disorder caused by
vascular defects, laboratory tests will most often
reveal:
A
)
normal
values.
B) hypocalcemia.
C) polycythemi
a.
D) thrombocytopenia.
11 Removal of a patients peripheral intravenous catheter
resulted in brief bleeding and the loss of a small
amount of blood.
Which of the following processes occurred during the
formation of the platelet plug that helped to stop
blood flow?
A
)
Activation of factor
X
B) Conversion of prothrombin to thrombin
C) Release of von Willebrand factor from
the
epitheliu
m
D) Conversion of fibrinogen to fibrin threads
12 A 69-year-old patient who is obese and has a
diagnosis of angina pectoris has been prescribed
clopidogrel (Plavix) by his primary care provider. The
patients medication achieves its therapeutic effect in
which of the following ways?
A
)
Prevention of platelet
aggregation
B) Activation of plasminogen
C) Inhibition of the intrinsic clotting
pathway
D) Deactivation of factor X
13 A public health nurse is conducting a health promotion
campaign under the auspices of the local community
center. Which of the following measures that the nurse
is promoting are likely to influence the participants
risk of hypercoagulability disorders? Select all that
apply.
A
)
Smoking
cessation

27. B) Blood glucose screening
C
)
Weight
management
D) Cholesterol screening and management
E) Blood pressure screening and
management
14 During a patients admission assessment prior to
reduction mammoplasty surgery, the nurse notes a
reference to a Leiden mutation in the patients history.
The nurse would recognize the patients increased risk
for
A
)
Hemorrha
ge
B) Myocardial infarction
C
)
HemophiliaA or
B
D) Deep vein thrombosis
15 The most recent blood work of a patient with a
diagnosis of acute myelogenous leukemia (AML)
reveals thrombocytopenia. Where is the patient most
likely to experience abnormal bleeding as a result of
low platelets?
A
)
In the
brain
B) Skin and mucous membranes
C
)
Sclerae of the
eyes
D) Nephrons and ureters
16 A patient was started on a protocol for the prevention
of deep vein thrombosis shortly after admission, and
has been receiving 5000 units of heparin twice daily for
the last 5 days. An immune response to this treatment
may increase the patients chance of developing which
health problem?
A
)
Antiphospholipid
syndrome
B) Disseminatedintravascularcoagulation
(DIC)
C
)
Von Willebrand
disease

28. D) Thrombocytopenia
17 In light of the presence of numerous risk factors for
coronary artery disease, a patients primary care
provider has recommended that he take low-dose
aspirin once daily. Doing so will reduce the patients risk
of myocardial infarction by altering which of the
following stages of hemostasis?
A
)
Vessel
spasm
B) Platelet plug formation
C) Blood
coagulation
D) Clot lysis
18 A 23-year-old female patient has been diagnosed with
von Willebrand disease following a long history of
heavy periods and occasional nosebleeds. Which of the
patients following statements demonstrates a sound
understanding of her new diagnosis?
A
)
Im really disappointed that I wont be
able to
do sports
anymore.
B) I read on a website that I might have
to get blood transfusions from time to
time.
C) Ill make sure to take Tylenol instead of
aspirin
when I get aches and
pains.
D) I hope my insurance covers the injections
that Ill need to help my blood clot.
19 Which of the following patients likely faces the
highest risk of an acquired hypocoagulation disorder
and vitamin K deficiency?
A
)
A patient who has a diagnosis of liver
failure
secondary to alcohol
abuse
B) A patient who has chronic renal failure
as a result of type 1 diabetes mellitus

29. Answer Key
C
)
A patient who is immunocompromised
as a
result of radiation therapy for the
treatment of lung cancer
D) Apatient with dehydration and
hypokalemia that have resulted from
Clostridium difficileassociateddiarrhea
20 Ahealthy, primiparous (first-time) mother delivered a
healthy infant several hours ago, but the mother has
experienced postpartum hemorrhage. Which of the
following disorders is most likely to underlie the
patients excessive bleeding after delivery?
A
)
Disseminated intravascular
coagulation
B) Hemophilia A
C
)
Von Willebrand
disease
D) Thromboticthrombocytopenicpurpura(TTP)
1 A
2 D
3 A
4 C
5 C
6 C
7 A, C, E
8 A
9 D
10 A
11 C
12 A

30. Chapter 5 . Diseases of the Immune System
13 A, B, C, D, E
14 D
15 B
16 D
17 B
18 C
19 A
2
0
A
1 The mediators involved in type I hypersensitivity
allergic responses are released from:
A
)
mast
cells.
B) plasmacells.
C
)
monocyte
s.
D) arachidonicacid.
2 A genetically determined hypersensitivity to common
environmental allergens causes reactions,
such as:
A
)
atopic;
urticaria.
B) autoimmune; diarrhea.
C
)
IgM-mediated;
infections.
D) delayed; poison ivy rash:
3 Mismatched blood transfusion reaction with
hemolysis of blood cells is an example of type II,
mediated
hypersensitivityreaction.
A
)
T-cell
B) antibody

31. C
)
leukotrie
ne
D) complement
4 Type III hypersensitivity immune responses can be
harmful when immune complex deposits in tissue
activate
that can directly damage area tissues.
A
)
inflammati
on
B) autoantibodies
C
)
cytotoxic
cells
D) immunoglobulins
5 The mechanism by which humans recognize self-cells
from non-self (antigens)-cells is .
A
)
autoimmuni
ty
B) self-tolerance
C
)
non-self
anergy
D) immunocompatibility
6 Organ rejection is a complication of organ
transplantation caused by recipient immune cells:
A
)
destroying the host T
cells.
B) attack on the donor cells.
C
)
combining with grafts
HLA.
D) being recognized as foreign.
7 The leading cause of death for people with
HIV is opportunistic .
A
)
leukemi
a
B) tuberculosis
C
)
pneumoni
a
D) toxoplasmosis

32. 8 Wasting syndrome, an AIDS-defining illness, is
characterized by involuntary weight loss of at least 10%
of baseline body weight in the presence of:
A
)
diarrhe
a.
B) hypermetabolism.
C) weakness and
fever.
D) glucoseintolerance.
9 The window period of HIV infection refers to the
period of time between infection and:
A
)
transmissio
n.
B) seroconversion.
C) initial
symptoms.
D) antibodyscreening.
10 HIV-positive persons thatdisplay manifestations of
laboratory category 3 or clinical category C are
considered to have:
A
)
zero viral
load.
B) seroconversion.
C) complete
remission.
D) AIDS-definingillnesses.
11 Contact with poison ivy has resulted in intense
pruritus, erythema, and weeping on a patients
forearm. Which of the following processes resulted in
the patients signs and symptoms?
A
)
IgE-mediated mast cell
degranulation
B) Formation of antigen-antibody complexes
C) Cytokine release by sensitized T
cells
D) Formation of antibodies against cell
surface antigens

33. 12 A patient with a long history of hay fever has recently
begun a series of immunotherapy (allergy shots). How
will this treatment potentially achieve a therapeutic
effect?
A
)
By blocking cytokine release from
sensitized
mast
cells
B) By preventing mast cells from
becoming sensitized
C) By causing T cells to be sequestered in
the
thymus for longer
periods
D) By stimulating production of IgG to
combine with antigens
13 A patient with a diagnosis of cirrhosis has experienced
an acute rejection of a donor liver. Which of the
following cells is central to the rejection of the patients
transplanted organ?
A
)
Natural killer
cells
B) Mast cells
C) T cells
D) Neutrophils
14 A patient with a diagnosis of aplastic anemia has
undergone allogenic bone marrow transplantation.
Which of the following signs and symptoms would most
clearly suggest the existence of graft-versus-host disease
(GVHD)?
A
)
Shortness of breath, audible crackles,
and
decreasing
PaO2
B) Presence of a pruritic rash that has
begun to slough off
C) Development of metabolic
acidosis
D) Diaphoresis, fever, and anxiety

34. 15 A patient has developed pericarditis after developing
acute glomerulonephritis, a development that may be
attributable to the presence of similar epitopes on
group A, b-hemolytic streptococci and the antigens in
the patients heart tissue.
Which of the following has most likely accounted for
this patients autoimmune response?
A
)
Breakdown of T-cell
anergy
B) Release of sequestered antigens
C) Superantige
ns
D) Molecularmimicry
16 A 70-year-old female patient has had her mobility
and independence significantly reduced by
rheumatoid arthritis. Which of the following
processes likely contributed to the development of
her health problem?
A
)
Delayed-typehypersensitivity(DTH)
reaction
B) Proliferation of cytotoxic Tcells
C) Failure of normal self-
tolerance
D) Deletion of autoreactive B cells
17 Which of the following would constitute a normal
assessment finding in a neonate?
A
)
Minimal or absent levels of IgA and
IgM
B) Absence of plasma cells in the lymph
nodes and spleen
C) Undetectable levels of all
immunoglobulins
D) Absence of mature B cells with normal T-
cell levels and function
18 A patient was diagnosed as HIV positive several years
ago. Which of the following blood tests is most
clinically useful for determining the stage and
severity of her disease?

35. A
)
Plasma
levels
B) CD4+ cell counts
C) Viral
load
D) White blood cell count with differential
19 A patient has been admitted to the hospital for the
treatment of HIV infection, which has recently
progressed to overt AIDS. Which of the following
nursing actions should the nurse prioritize when
providing care for this patient?
A
)
Frequent neurologic vital signs and
thorough
skin
care
B) Hemodynamic monitoring and
physical therapy
C) Careful monitoring of fluid balance
and
neurologic
status
D) Astute infection control and
respiratory assessments
20 Shortly after being diagnosed with HIV, a patient has
begun highly active antiretroviral therapy (HAART).
What is the primary goal of the patients drug
regimen?
A
)
To limit the latent period of
HIV
B) To slow the progression of the disease
C) To minimize opportunities for
transmission
D) Topreventseroconversion
Answer Key
1 A
2 A
3 B
4 A
5 B

36. Chapter 6 . Neoplasia
6 B
7 B
8 A
9 B
10 D
11 C
12 D
13 C
14 B
15 D
16 C
17 A
18 B
19 D
20 B
1 Unlike the tissue growth that occurs with
hypertrophy and hyperplasia, the growth of a
malignancy is:
A
)
adaptiv
e.
B) specialized.
C) predictabl
e.
D) autonomous.
2 In contrast to malignancies, benign tumors are
characterized by:
A
)
a fibrous
capsule.
B) distantinfiltration.

37. C) rapid replication.
D) undifferentiated cells.
3 Because of their rapid growth, malignant tumors
affect area tissues by:
A) increasing tissue blood flow.
B) providing essential nutrients.
C) liberating enzymes and toxins.
D) formingfibrous membranes.
4 The metastatic spread of tumor cells is facilitated by
that enables invasion and movement to distant tissues.
A) cell cohesiveness
B) enzymesecretion
C) contactinhibition
D) cell-to-cell signaling
5 The angiogenesis process, which allows tumors to
develop new blood vessels, is triggered and
regulated by tumor- secreted:
A) procoagulants.
B) growth factors.
C) attachmentfactors.
D) proteolyticenzymes.
6 Cancerous transformation of a cell requires the activation of:
A) cell cycle apoptosis.
B) multiplemutations.
C) a single gene mutation.
D) tumor suppressor genes.

38. 7 Although clinical manifestations vary with the type of
cancer and organs involved, abnormal tumor growth
causes general manifestations that include:
A
)
copious lymph
flow.
B) sleepdisturbances.
C) involuntary weight
gain.
D) visceral organ expansion.
8 Paraneoplastic syndromes are manifestations of
cancer that often result from:
A
)
radiation and
chemotherapy.
B) compression of area vessels.
C) tumor-related tissue
necrosis.
D) inappropriatehormonerelease.
9 Although both grading and staging are methods for
classifying cancer and selecting a treatment plan,
staging is used to determine the:
A
)
number of
mitoses.
B) tissuecharacteristics.
C) level of
differentiation.
D) extent of disease spread.
10 Early diagnosis of childhood cancers is often difficult
because the signs and symptoms are:
A
)
already present at
birth.
B) absent until the late stage.
C) similar to those of other childhood
diseases.
D) seen as developmental delays.

39. 11 A lung biopsy and magnetic resonance imaging have
confirmed the presence of a benign lung tumor in a
patient. Which of the following characteristics are
associated with this patients neoplasm?
A
)
The tumor will grow by expansion
and is
likely
encapsulated.
B) The cells that constitute the tumor
are undifferentiated,withatypical
structure.
C) If left untreated, the patients tumor is
likely to
metastasiz
e.
D) The tumor is likely to infiltrate the lung
tissue that presently surrounds it.
12 Which of the following processes characterizes an
epigenetic contribution to oncogenesis?
A
)
ADNA repair mechanism is
disrupted.
B) A tumor suppressor gene is present, but
it is not expressed.
C) Cells lose their normal contact
inhibition.
D) Regulation of apoptosis in impaired,
resulting in accumulation of cancer cells.
13 A farmers long-term exposure to pesticides has made
the cells in his alveoli and bronchial tree susceptible to
malignancy.
Which of the following processes has taken place
in the farmers lungs?
A
)
Promotio
n
B) Progression
C) Initiatio
n
D) Differentiation

40. 14 Genetic screening may be indicated for individuals who
have a family history of which of the following
neoplasms?
A
)
Liver
cancer
B) Multiple myeloma
C) Leukemi
a
D) Breast cancer
15 A public health nurse has cited a reduction in cancer
risk among the many benefits of maintaining a healthy
body-mass index. Which of the following facts underlies
the relationship between obesity and cancer?
A
)
Obesity can cause inflammation and
hormonal
changes that are associated with
cancer.
B) Adipose tissue is more susceptible to
malignancy than other types of
connective tissue.
C) Increased cardiac workload and tissue
hypoxia
can interfere with normal cell
differentiation.
D) Increased numbers of body cells increase
the statistical chances of neoplastic cell
changes.
16 Which of the following dietary guidelines should a
nurse provide to a group of older adults to possibly
decrease their risks of developing colon cancer?
A
)
As much as possible, try to eat organic foods.
B) Regular vitamin supplements and a
low- carbohydrate diet are
beneficial.
C) Try to minimize fat and maximize fiber
when
youre planning your
meals.
D) Eat enough fiber in your diet that you
have bowel movement at least once
daily.

41. 17 A male patient with a diagnosis of liver cancer has
been recently admitted to a palliative care unit
following his recent development of bone metastases.
Despite his familys encouragement, the patient has
experienced precipitous weight loss in recent weeks.
Which of the following factors may underlie the
patients loss of fat and muscle mass?
A
)
The action of cytokines and
consequent
inflammatio
n
B) Loss of appetite due to fatigue and pain
C) Changes in peptide hormone
levels
D) Production of onconeural
antigens by cancerous cells
18 A 51-year-old patient has been diagnosed with stage IV
breast cancer with lung metastases. Which of the
following treatment options is most likely to treat both
her primary and distant cancer sites?
A
)
Radiation
therapy
B) Chemotherapy
C) Surger
y
D) Hormonetherapy
19 A patients oncologist has presented the possibility of
implementing biotherapy in the treatment of the
patients brain tumor. Which of the following
mechanisms of action provide the therapeutic effects of
biotherapy? Select all that apply.
A
)
Stimulating the immune response to
tumor
cells
B) Inhibiting tumor protein synthesis
C) Reversing
angiogenesis
D) Altering the hormonal environment of
tumor cells

42. Answer Key
E
)
Causing breaks in the DNA of tumor
cells
20 A 5-year-old girls diagnosis of bone cancer required
an aggressive treatment regimen. Which of the
following considerations forms the most significant
threat to her future health?
A
)
Retention of chemotherapeutic drugs
in the
healthy bone
matrix
B) Unwanted effects of chemotherapy
and radiation therapy
C
)
Resistance to chemotherapy and
radiation if
required later in
life
D) Risk for recurrence of the primary
neoplasm after puberty
1 D
2 A
3 C
4 B
5 B
6 B
7 B
8 D
9 D
10 C
11 A
12 B
13 C
14 D

43. 15 A
16 C
17 A
18 B
19 A, B
2
0
B
Chapter 7. Genetic and Pediatric Diseases
1 Genetic disorders that involve a single gene
trait are characterized by:
A
)
multifactorial gene
mutations.
B) chromosomerearrangements.
C
)
Mendelian patterns of
transmission.
D) abnormal numbers of chromosomes.
2 In addition to having a 50% chance of inheriting an
autosomal dominant disorder from an affected parent,
such a disorder is characterized by:
A
)
aneuploidy of genes in all
cells.
B) deficiencies in enzyme synthesis.
C
)
affected X transmission to
daughters.
D) varied gene penetration and expression.
3 Autosomal recessive disorders are characterized by:
A
)
age of onset later in
life.
B) abnormal protein structure.
C
)
inborn errors of
metabolism.
D) one in two risk of a carrier child.
4 When a male child inherits an X-linked disorder
from his heterozygous carrier mother,

44. A
)
his sons will be
carriers.
B) his father has the disorder.
C) some of his sisters will be
carriers.
D) his daughters will have the disorder.
5 Multifactorial inheritance disorders, such as cleft
palate, are often caused byduring fetal
development.
A
)
multiple gene
mutations
B) dominant gene expression
C) X-linked crossover
problem
D) polyploidy of chromosomes
6 The newborn has the distinctive physical features of
trisomy 21, Down syndrome, which includes:
A
)
upward slanting of
eyes.
B) large, protruding ears.
C) thin lips and small
tongue.
D) long fingers with extra creases.
7 Aneuploidy of the X chromosome can result in a
monosomy or polysomy disorder. The manifestations
of monosomy X, Turner syndrome, differ from
polysomy X disorders in numerous ways that include:
A
)
short-staturefemale
individual..
B) mental retardation.
C) enlarged
breasts.
D) early onset puberty.
8 A teratogenic environmental agent can cause birth
defects when:
A
)
inherited as a recessive
trait.

45. B) intense exposure occurs at birth.
C
)
disjunction occurs during
meiosis.
D) retained during early pregnancy.
9 Fetal alcohol syndrome (FAS) is unlike other
teratogens in that the harmful effects on the fetus:
A
)
directly result in liver
damage.
B) extend throughoutthe pregnancy.
C
)
is most noticeable in
adulthood.
D) cause death in early childhood.
10 Prenatal diagnosis methods include the use of
ultrasonography for identifying
abnormaliti
es.
A
)
cytogeni
c
B) skeletal
C
)
chromosom
al
D) a-fetoprotein
11 A woman who is a carrier for which of the following
diseases possesses the greatest likelihood of passing the
disease to her future children when heterozygous
pairing exists?
A
)
Phenylketonuria
(PKU)
B) Tay-Sachs disease
C
)
Neurofibromato
sis
D) Cystic fibrosis
12 Which of the following statements is true of
autosomal recessive disorders?
A
)
Onset is typically late in childhood or
early in
adulthoo
d.
B) Symptomatology is less uniform than
with autosomal dominant disorders.

46. C
)
Mitochondrial DNA is normally the site
of
genetic
alteration.
D) Effects are typically the result of
alterations in enzyme function.
13 The parents of a newborn infant are relieved that their
baby was born healthy, with the exception of a cleft lip
that will be surgically corrected in 10 or 12 weeks.
Which of the nurses following statements to the parents
best conveys the probable cause of the infants cleft lip?
A
)
Though you are both healthy, you likely
both
carry the gene for a cleft
lip.
B) Provided one of you had the gene for a
cleft lip, your baby likely faced a 50/50
chance of having one.
C
)
Your childs cleft lip likely results from
the
interplay between environment and
genes.
D) A cleft lip can sometimes result from
taking prescription drugs, even when
theyre taken as ordered.
14 Which of the following practitioners is most likely to
be of assistance in the early care of an infant with a
cleft lip?
A
)
Lactation
consultant
B) Respiratorytherapist
C
)
Occupational
therapist
D) Socialworker
15 A 41-year-old woman has made the recent decision to
start a family, and is eager to undergo testing to
mitigate the possibility of having a child with Down
syndrome. Which of the following tests is most likely to
provide the data the woman seeks?

47. A
)
Genetic testing of the
woman
B) Genetic testing of the woman and the father
C
)
Prenatal blood
tests
D) Ultrasonography
16 Genetic testing has revealed that a male infant has
been born with an extra X chromosome. What are the
most likely implications of this finding?
A
)
The child is unlikely to survive
infancy
B) The child is likely to have no
manifestations of this chromosomal
abnormality
C
)
The child will have significant
neurological
and cognitive
defects
D) The child will be unable to reproduce
17 Which of the following variables determine the
extent of teratogenic drug effects? Select all that
apply.
A
)
Maternal health
history
B) Molecular weight of the drug
C
)
Stage of pregnancy when the drug was
taken
D) Duration of drug exposure
E
)
Fetal blood
type
18 A woman who has just learned that she is pregnant
for the first time has sought advice from her
healthcare provider about the safe use of alcohol
during pregnancy. What advice should the clinician
provide to the woman?
A
)
Its likely best to eliminate alcohol from
your
diet while youre
pregnant.
B) Moderation in alcohol use is critical while
you are pregnant.

48. Answer Key
C
)
You should limit yourself to a
maximum of
one drink daily while youre
pregnant.
D) You should drink no alcohol until you
are in your second trimester.
19 Which of the following health problems may be
identified by a TORCH screening test?
A
)
Rubella and
herpes
B) Tenovaginitis and human papillomavirus
C
)
Rhinovirus and Ormond
disease
D) Chlamydia and rickets
20 Ultrasonography is most likely to detect which
of the following fetal abnormalities?
A
)
Neural tube
defects
B) Skeletalabnormalities
C
)
Chromosomal
defects
D) Single-genedisorders
1 C
2 D
3 C
4 C
5 A
6 A
7 A
8 D
9 B
10 B

49. 11 C
12 D
13 C
14 A
15 C
16 B
17 B, C, D
18 A
19 A
20 B
Chapter 8. Environmental and Nutritional Diseases
1 The adipocytes in adipose tissue not only serve as a
storage sites, they also:
A
)
produce linoleic fatty
acid.
B) synthesizetriglycerides.
C
)
increase glucagon
release.
D) degradefat-solublevitamins.
2 Protein contains nitrogen. Anegative nitrogen
balance represents:
A
)
more protein consumed than
excreted.
B) a reduced need for nitrogen as protein.
C
)
more nitrogen excreted than
consumed.
D) less use of nitrogen for protein synthesis.
3 Natural appetite suppression mechanisms, necessary
for food intake control, include :
A
)
ketoacid
deficiency.

50. B) cholecystokinin storage.
C
)
decreased blood
glucose.
D) leptin receptor stimulation.
4 Body weight should be used in combination with
other measurements to establish if a person is
underweight or overweight. Obesity is indicated
by:
A
)
female body fat of 20% and
30%.
B) body mass index (BMI) of 30 to 40.
C
)
relative body weight of 70% to
100%.
D) abdominal fat/ hip ratio of 0.8 to 1.0.
5 A patient with upper body obesity also has central fat
distribution. This body fat configuration places the
patient at greater risk for than a patient with lower
body obesity.
A
)
osteoporosi
s
B) renal disease
C
)
cardiometabolic
disorders
D) chronic anemia
6 As the problem of childhood and adolescent obesity
increases, an increase in the incidence of is
occurring in this obese population.
A
)
type 2 diabetes
mellitus
B) attention deficit disorder
C
)
juvenilerheumatoid
arthritis
D) antibiotic-resistantbacterialinfections
7 A diet deficient in calories and protein causes
marasmus, which is characterized by:
A
)
discolored
hair.
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