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Patho 4,5,6,7

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Which of the following clients would be considered a good candidate for hyperbaric oxygen therapy? A. fifth grade student who fell on the playground and broke his femur and developed large hematoma over the injured leg B. A motorcycle accident client with lots of “road rash” requiring scrubbing of the wounds with a brush to remove all the debris C. A middle-aged adult who got in a fight and received a laceration above the eye D. An older adult with history of diabetes and intermittent claudication (poor circulation in the legs) who received a laceration while on the lawnmower.
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an older adult with a history of diabetes and intermittent claudication (poor circulation in the legs) who received a laceration while on the lawnmower Hyperbaric oxygen therapy delivers 100% oxygen at two to three times the normal atmospheric pressure at sea level. The goal of hyperbaric oxygen therapy is to increase oxygen delivery to tissues by increasing the partial pressure of oxygen dissolved in the plasma. Hyperbaric oxygen is currently reserved for the treatment of problem wounds in which hypoxia and infection interfere with healing.
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Epithelialization, the first component of the proliferative phase of wound healing, is delayed in open wounds until what tissue has formed?
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Granulation tissue Epithelialization cannot occur until granulation tissue has formed in the wound area. Collagen is part of the remodeling phase, after epithelialization is complete. Fibroblasts are active during the remodeling phase, to synthesize collagen. New capillaries are not formed as part of the wound-healing process.
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Which of the following clients, who have undergone a major surgery to repair a “leaking” colon with associated peritonitis, is most likely to experience enhanced wound healing as a result of his or her presurgery diet history? A client who A. Is receiving total parenteral nutrition due to recurrent nausea B. Eats a high-calorie diet and large amounts of red meat C. Is a vegetarian and who eats organic foods when possible D. Practices carefully calorie control and who avoids animal fats
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eats a high calorie diet and red meat protein is important for many aspects of wound healing including control of the inflammatory phase, fibroblast function, collagen and protein matrix synthesis, angiogenesis, and wound remodeling. A diet that is high in both calories and protein is known to enhance wound healing
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splicing of mRNA during processing permits a cell to
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Form different proteins Splicing permits a cell to produce a variety of mRNA molecules from a single gene, thus reducing how much DNA must be contained in the genome. Stop codes signal the end of a protein molecule, and RNA strands are then processed. Processing involves addition of certain nucleic acids to the RNA; splicing involves removing segments of RNA
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A physiology instructor asks the students about the purpose of the promoter region on a DNA strand. Which student response is most accurate? Answers: A. Location for protein-coding regions of the mRNA sequences B. Contains amino acids that the RNA polymerase recognized and binds to, thus starting the replication process C. Reverses redundant base pairs D. Delivers activated amino acids to begin mitosis
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contains amino acids that the RNA polymerase recognized and binds to thus starting the replication process During transcription, RNA polymerase recognizes the start sequence of a gene and attaches to the DNA. It is initiated by the assembly of a transcription complex composed of RNA polymerase and other associated factors. This complex binds to the double-stranded DNA at a specific site called the promoter region. Within the promoter region is the so-called “TATA box,” which contains the crucial thymine-adenine-thymine-adenine sequence that RNA polymerase recognizes and binds to, starting the replication process. Exons are RNA sequences retained on the original RNA during splicing. tRNA delivers activated amino acids to proteins in the ribosome. When several triplet codons encode the same amino acid, the genetic code is said to be redundant.
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A client diagnosed with a cancer has been prescribed monoclonal antibodies as a treatment option. He asks the health care provider, “What are you talking about? I’ve never heard of this treatment. Is it experimental?” The health care provider explains somatic cell hybridization to the client by explaining that: Answers: A. The restrictive fragments of DNA can often be replicated through insertion into a unicellular organism, such as a bacterium. B. Researchers inject mice with an antigen from human cancer cells. They then harvest the antibody-producing cells from the mice and individually fuse them with a cancerous cell. C. Short sequences of base pairs can be synthesized, radioactively labeled, and subsequently used to identify their complementary sequence. D. The DNA molecule is cut apart using a bacterial enzyme, called a restriction enzyme, that binds to DNA wherever a particular short sequence of base pairs is found and cleaves the molecule at a specific nucleotide site
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Researchers inject mice with an antigen from human cancer cells. They then harvest the antibody-producing cells from the mice and individually fuse them with a cancerous cell. Somatic cell hybridization involves the fusion of human somatic cells with those of a different species (typically, the mouse) to yield a cell containing the chromosomes of both species. Because these hybrid cells are unstable, they begin to lose chromosomes of both species during subsequent cell divisions. In situ hybridization involves the use of specific sequences of DNA or RNA to locate genes that do not express themselves in cell culture. DNA and RNA can be chemically tagged with radioactive or fluorescent markers. Gene mapping that is performed using dosage studies involves measuring enzyme activity. The restrictive fragments of DNA can often be replicated through insertion into a unicellular organism, such as a bacterium. In cloning, the restrictive fragments of DNA can often be replicated through insertion into a unicellular organism, such as a bacterium.
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Genetic disorders that involve a single gene trait are characterized by
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Mendelian patterns of transmission Single-gene disorders are characterized by patterns of transmission that follow the Mendelian patterns of inheritance. Multifactorial inheritance involves more than one gene mutation, rearrangement of groups of genes, and uneven numbers of some chromosomes in each cell.
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In one family, a son was born with polydactyly toes while his sister had polydactyly fingers. in explaining this phenomenon in genetic terms to the parents, which concept should be addressed?
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variable expressivity of a gene Autosomal dominant disorders are characterized by variable gene penetrance (degree to which the trait is displayed) and expression (differences in how the trait is displayed). Aneuploidy is not a single-gene disorder and does not follow the Mendelian pattern of inheritance. Deficiencies of enzyme synthesis are common in autosomal recessive disorders. X-linked inheritance can be dominant or recessive, but it is not autosomal
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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? Tay Sachs, Cystic fibrosis, Phenylketonuria (PKU), Neurofibromatosis
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neurofibromatosis Neurofibromatosis is an autosomal dominant genetic disorder with a consequent 50% chance of passing the disease to offspring. Tay-Sachs disease, PKU, and cystic fibrosis are autosomal recessive disorders and are manifested only when both members of the gene pair are affected.
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Paraneoplastic syndromes are manifestations of cancer that often result from
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inappropriate hormone release Paraneoplastic syndromes are manifestations in sites that are not directly affected by the disease; many are caused by excessive or inappropriate peptide hormone synthesis and release by cancer cells. Radiation and chemotherapy are cancer treatments that cause side effects unrelated to the paraneoplastic syndromes. Area vessel compression is a direct result of the tumor’s location; area tissue necrosis is a direct result of area tissue destruction and death of healthy cells.
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Genetic screening may be indicated for individuals who have a family history of which of the following neoplasms? breast cancer, liver cancer, leukemia, multiple myeloma
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breasts cancer The hereditary component of cancer is well identified although it is implicated in varying degrees in different types of cancer. Breast cancer has an identified genetic component and screening is often recommended for women with a family history of breast cancer
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A 5-year-old girl’s diagnosis of bone cancer required an aggressive treatment regimen. The client immediately receives doxorubicin chemotherapy. The nurse administering this medication should perform a detailed assessment of which body system that has been greatly affected by this drug?
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cardiac there are numerous multisystemic sequelae of chemotherapy and radiation that are required in childhood. vital organs such as the heart and lungs may be affected by cancer treatment. children who received anthracyclines (doxorubicin or daunorubicin) may be at risk for developing cardiomyopathy and congestive heart failure.
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T/F: stem cells are undifferentiated cells that have the capacity to generate multiple cell types
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true
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T/F: The inflammatory phase of wound healing prepares the wound environment for the healing process
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true
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T/F: RNA and DNA have the same general structure
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false
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T/F: the genetic information for protein synthesis in encoded in the DNA contained in the cell nucleus
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true
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a teratogenic agent is an environmental agent that produces abnormalities only during the first 4 weeks of embryonic development
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false
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autosomal recessive disorders are manifested even if only one member of the gene pair is affected
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false
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Benign neoplasms are less differentiated tumors that grow in a crab-like manner to invade surrounding tissues, have cells that break loose and travel to distant sites to form metastases, and inevitably cause suffering and death unless their growth can be controlled through treatment.
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false
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the papanicolaou test is a cytologic method used to detect cancer cells
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true
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A client has arrived in the emergency department with massive blood loss from a lacerated liver. Knowing the physiological principles behind the capacity for cells to regenerate, the client’s body will likely: A. Activate the tissue cells to start producing stem cells B. Pull fluid from the tissues to maintain a reasonable blood pressure C. Stimulate rapid proliferation of RBCs by the blood-forming progenitor cells of the bone marrow D. Begin a cell cycle so stem cells can undergo numerous mitotic division
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stimulate rapid proliferation of RBCs Continuously dividing tissues are those in which the cells continue to divide and replicate throughout life, replacing cells that are continually being destroyed. These tissues can readily regenerate after injury as long as a pool of stem cells is preserved. Bleeding, for example, stimulates the rapid proliferation of replacement cells by the blood-forming progenitor cells of the bone marrow. Another type of tissue cell, called a stem cell, remains incompletely differentiated throughout life. As mature cells die, the tissue is replenished by the differentiation of cells generated from stem cells.
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Which of the following clients is most likely to experience impaired wound healing? Answers: A. A client with persistent hypertension who takes a β-adrenergic blocker and a potassium-wasting diuretic daily B. A child whose severe cleft lip and palate have required a series of surgeries over several months C. A client with a diagnosis of type 1 diabetes and a history of poor blood sugar control D. A client who takes nebulized bronchodilators several times daily to treat chronic obstructive pulmonary disease
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type 1 diabetes and history of poor blood sugar Diabetes mellitus is a significant barrier to wound healing. Serial surgeries COPD hypertension and related medications are not directly linked to impaired wound healing
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A 12-year-old boy’s severe wound that he received from a dog bite has begun to heal and currently shows no signs of infection. Which of the following processes occurred first during this process of repair by connective tissue deposition? A. Emigration of fibroblasts to the wound site B. Reorganization of fibrous tissue C. Deposition of the extracellular matrix D. Angiogenesis
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angiogenesis during the process of tissue repair by CT deposition angiogenesis precede the emigration of fibroblasts, deposition of ECM and reorganization of the fibrous tissue
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A pregnant female has been told she is a carrier for fragile X syndrome. She asks, “What does that mean?” The health care provider explains that she is heterozygous for fragile X recessive trait, but this will only be a problem if: Answers: A. She does not receive a blood transfusion from a non-fragile X donor prior to pregnancy. B. Her mate also is a carrier of the recessive fragile X trait. C. The expressed pairing switches to a dominant trait. D. The expressed pairing becomes homozygous.
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homozygous Offspring in whom the two alleles of a given pair are the same are called homozygotes. For example, a plant may have two alleles for wrinkled peas. Heterozygotes have different alleles at a gene locus. All offspring with a dominant allele manifest that trait. In human genetics, a carrier is a person who is heterozygous for a recessive trait and does not manifest the trait. For example, the gene for the genetic disorder cystic fibrosis is recessive. Therefore, only persons with a genotype having two alleles for cystic fibrosis have the disease. In most cases, neither parent manifests the disease; however, both must be carriers. A blood transfusion will not fix the problem.
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Which of the following is an application of recombinant DNA technology? Answers: A. DNA fingerprinting B. Gene dosage studies C. Somatic cell hybridization D. Production of human insulin
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production of human insulin recombinant dan technology can be used to direct cells to produce proteins they would not otherwise produce such as human insulin. gene dosage and somatic cell hybridization are genetic mapping methods`
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A newly pregnant female is worried about her baby. She recently returned from a mission trip to Africa. She was told there was a rubella outbreak in the next village. She has been given a TORCH screening test. If she has exposed her fetus to rubella, the nurse would expect the infant to display which of the following possible birth defects? Answers: A. Hydrocephalus B. Missing limbs C. Blindness D. Encephalitis
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blindness The acronym TORCH stands for toxoplasmosis, other, rubella (i.e., German measles), cytomegalovirus, and herpes, which are the agents most frequently implicated in fetal anomalies. The TORCH screening test examines the infant’s serum for the presence of antibodies to these agents. Although rubella has virtually been eliminated, it remains endemic in many developing countries, where it is the major preventable cause of hearing impairment, blindness, and adverse neurodevelopmental outcome.
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A 16-year-old male presents to the clinic complaining of headaches, trouble hearing the teacher in the front of the classroom, and ringing in the ears. He also revealed that every time he goes swimming underwater, he gets disorientated (which never happened when he was younger). Given these manifestations, the health care provider is going to start testing for: Answers: A. Deafness B. Fragile X syndrome C. Tay-Sachs disease D. Neurofibromas
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neurofibromas NF-2, which is characterized by tumors of the acoustic nerve and multiple meningiomas, is much less common than NF-1. The disorder is often asymptomatic through the first 15 years of life. The most frequent symptoms are headaches, hearing loss, and tinnitus.
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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 nurse’s following statements to the parent’s best conveys the probable cause of the infant’s cleft lip
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“Your child’s cleft lip likely results from the interplay between environment and genes.” A cleft lip is considered to be a multifactorial disorder, in which both environment and genes contribute to the condition. It does not depend solely on Mendelian patterns of inheritance and is not known to result from teratogenic drug
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the angiogenesis process which allows tumors to develop new blood vessels is triggered and regulated by tumor secreted
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growth factors Many tumors secrete growth factors, which trigger and regulate the angiogenesis process. Tumor cells express various cell surface attachment factors, for anchoring. Tumor cells secrete proteolytic enzymes to degrade the basement membrane and migrate into surrounding tissue. Cancer cells may produce procoagulant materials that affect clotting mechanisms.
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A 51-year-old client has been diagnosed with stage IV breast cancer with lung metastases. The oncologist sits down with the client/family to explain treatment options. The nurse knows that which of the following treatment options will be discussed for her cancers? Answers: A. Radiation therapy B. Chemotherapy C. Surgery D. Hormone therapy
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chemotherapy it can treat cancer both at primary site and at sites of metastasis
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a large surface wound is likely to heal by the process of primary intention
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false
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formation of granulation tissue involves the creation of new capillaries
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true
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there are 6 bases that make up the alphabet of the genetic code
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false
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messenger rna carries the instructions for protein synthesis
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true
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most genetic disorders are caused by alteration in DNA sequences that alter the synthesis of a single gene product
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true