Understanding Pathophysiology 7th Edition Test Bank
Table ofContents Chapter 1. Cellular Biology
... [Show More] .............................................................................................................. 2
Chapter 2. Genes and Genetic Diseases .......................................................................................... 19 Chapter 3. Epigenetics and Disease ............................................................................................... 35 Chapter 4. Altered Cellular and Tissue Biology .............................................................................. 39 Chapter 5. Fluids and Electrolytes, Acids and Bases ....................................................................... 56 Chapter 6. Innate Immunity: Inflammation and Wound Healing ..................................................... 75 Chapter 7. Adaptive Immunity ...................................................................................................... 91 Chapter 9. Infection and Defects in Mechanisms of Defense ......................................................... 111 Chapter 10. Stress and Disease .................................................................................................... 131 Chapter 11. Biology of Cancer ..................................................................................................... 139 Chapter 12. Cancer Epidemiology ................................................................................................ 149 Chapter 13. Cancer in Children and Adolescents .......................................................................... 157 Chapter 14. Structure and Function of the Neurologic System...................................................... 163 Chapter 15. Pain, Temperature, Sleep, and Sensory Function ....................................................... 183 Chapter 16. Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function ........ 204
Chapter 17. Disorders of the Central and Peripheral Nervous Systems and NeuromuscularJunction .................................................................................................................................................. 224 Chapter 18. Alterations of Neurologic Function in Children ......................................................... 246 Chapter 19. Mechanisms of Hormonal Regulation ........................................................................ 261 Chapter 20. Alterations of Hormonal Regulation .......................................................................... 275 Chapter 21. Obesity and Disorders of Nutrition ........................................................................... 298 Chapter 22. Structure and Function of the Hematologic System ................................................... 303 Chapter 23. Alterations of Hematologic Function ......................................................................... 317 Chapter 24. Alterations of Hematologic Function in Children ....................................................... 345 Chapter 25. Structure and Function of the Cardiovascular and Lymphatic Systems ...................... 362 Chapter 26. Alterations of Cardiovascular Function ..................................................................... 379 Chapter 27. Alterations of Cardiovascular Function in Children ................................................... 396 Chapter 28. Structure and Function of the Pulmonary System ..................................................... 409 Chapter 29. Alterations of Pulmonary Function ........................................................................... 427 Chapter 30. Alterations of Pulmonary Function in Children ......................................................... 449 Chapter 31. Structure and Function of the Renal and Urologic Systems ........................................ 463 Chapter 32. Alterations of Renal and Urinary Tract Function ....................................................... 478 Chapter 33. Alterations of Renal and Urinary Tract Function in Children ..................................... 495 Chapter 34. Structure and Function of the Reproductive Systems ................................................ 505 Chapter 35. Alterations of the Female Reproductive System ........................................................ 524
1 | P a g eChapter 36. Alterations of the Male Reproductive System ............................................................ 536
Chapter 37. Structure and Function of the Digestive System ........................................................ 547
Chapter 38. Alterations of Digestive Function .............................................................................. 562
Chapter 39. Alterations of Digestive Function in Children ............................................................ 582
Chapter 40. Structure and Function of the Musculoskeletal System .............................................. 599
Chapter 41. Alterations of Musculoskeletal Function .................................................................... 615
Chapter 42. Alterations of Musculoskeletal Function in Children .................................................. 635
Chapter 43. Structure, Function, and Disorders of the Integument ............................................... 646
Chapter 44. Alterations of the Integument in Children ................................................................. 660
Chapter 1. Cellular Biology
MULTIPLE CHOICE
1. A student is observing a cell under the microscope. It is observed to have supercoiled DNA
with histones. Which of the following would also be observed by the student?
a. A single circular chromosome
b. A nucleus
c. Free-floating nuclear material
d. No organelles
ANS: B
The cell described is a eukaryotic cell, so it has histones and a supercoiled DNA within its
nucleus; thus, the nucleus should be observed.
A single circular chromosome is characteristic of prokaryotic cells, which do not have histones.
Free-floating nuclear material describes a prokaryotic cell, which would not have a distinct
nucleus.
Eukaryotic cells have membrane bounded cellular components called organelles. No organelles
describes a prokaryotic cell.
2. A nurse is instructing the staff about cellular functions. Which cellular function is the nurse
describing when an isolated cell absorbs oxygen and uses it to transform nutrients to energy?
a. Metabolic absorption
2 | P a g eb. Communication
c. Secretion
d. Respiration
ANS: D
The ability of the cell to absorb oxygen refers to the cells function of respiration.
The ability of the cell to function within a society of cells refers to its function of
communication.
The ability of the cell to take in nutrients refers to the cells function of metabolic absorption.
The ability of the cell to synthesize new substances and secrete these elsewhere refers to the cells
function of secretion.
3. A eukaryotic cell is undergoing DNA replication. In which region of the cell would most of
the genetic information be contained?
a. Mitochondria
b. Ribosome
c. Nucleolus
d. Nucleus
ANS: C
The region of the cell that contains genetic material, including a large amount of ribonucleic
acid, most of the DNA, and DNA-binding proteins, is the nucleolus.
The mitochondria is the site of cellular respiration.
The ribosomes are involved in manufacturing of proteins within the cell.
The nucleus contains the nucleolus, and it is the nucleolus that contains genetic material.
4. The fluid mosaic model for biologic membranes describes membrane behavior. According to
this model, which of the following float singly or as aggregates in the fluid lipid bilayer?
a. Peripheral membrane proteins
b. Integral membrane proteins
c. Glycoproteins
d. Cell adhesion molecules
3 | P a g eANS: B
Integral membrane proteins float freely in the fluid lipid bilayer.
Peripheral membrane proteins are not embedded in the layer, but reside at the
surface.Glycoproteins act as cell surface markers.
Cell adhesion molecules are on the outside of the membrane and allow cells to hook together.
5. Which of the following can bind to plasma membrane receptors?
a. Oxygen
b. Ribosomes
c. Amphipathic lipids
d. Ligands
ANS: D
Ligands are specific molecules that can bind with receptors on the cell membrane.
Oxygen moves by diffusion; it does not bind to receptors.
Ribosomes make proteins and are not involved in binding.
Amphipathic lipids are a portion of the cell membrane.
6. A nurse is reviewing a report from a patient with metastatic cancer. What finding would
support the diagnosis ofmetastatic cancer? Alterations in extracellular matrix that include:
a. Decreased fibronectin
b. Increased collagen
c. Decreased elastin
d. Increased glycoproteins
ANS: A
Reduced amounts of fibronectin are found in some types of cancerous cells, allowing cancer
cells to travel, or metastasize.
4 | P a g eCollagen provides strength, and its breakdown is associated with osteoarthritis, not cancer.
Elastin is found in the lungs and allows tissues to stretch; it is not associated with cancerous
cells.
Decreased, not increased, glycoproteins are associated with cancerous cells.
7. Which form of cell communication is used to relate to other cells in direct physical contact?
a. Cell junction
b. Gap junction
c. Desmosomes
d. Tight junctions
ANS: A
Cell junctions hold cells together and permit molecules to pass from cell to cell.
Gap junctions allow communication from the inside of one cell to the inside of another.
Desmosomes are not involved in communication, but allow cells to hold together.
Tight junctions are barriers that prevent movement of some substances and leakages of others.
8. Pancreatic beta cells secrete insulin, which inhibits secretion of glucagon from neighboring
alpha cells. This action is an example of which of the following signaling types?
a. Paracrine
b. Autocrine
c. Neurohormonal
d. Hormonal
ANS: A
Paracrine signaling involves the release of local chemical mediators that are quickly taken up,
destroyed, or immobilized, as in the case of insulin and the inhibition of the secretion of
glucagon.
When cells produce signals that they themselves respond to, autocrine signaling is used.
Neurohormonal signaling involves secretion of hormones into the bloodstream by neurosecretory
hormones.
5 | P a g eHormonal signaling involves specialized endocrine cells that secrete hormone chemicals released
by one set of cells that travel through the tissue through the bloodstream to produce a response
inother sets of cells.
9. In cellular metabolism, each enzyme has a high affinity for a:
a. Solute
b. Substrate
c. Receptor
d. Ribosome
ANS: B
Each enzyme has a high affinity for a substrate, a specific substance converted to a product of the
reaction.
Solutes are small particles that pass through the cell membrane.
A receptor is a site on the cell wall that allows transport into the cell.
Ribosomes are located inside the cell and are not related to the work of enzymes.
10. An athlete runs a marathon, after which his muscles feel fatigued and unable to contract. The
athlete asks the nurse why this happened. How should the nurse respond? A deficiency in
can cause impaired muscle contraction.
a. GTP
b. AMP
c. ATP
d. GMP
ANS: C
The cell uses ATP for muscle contraction. when it is deficient, impaired muscle contraction
results.
GTP is involved in cell signaling, not muscle contraction.
AMP is not involved in muscle contraction.
GMP is not involved in muscle contraction.
6 | P a g e11. Which phase of catabolism produces the most ATP?
a. Digestion
b. Glycolysis
c. Oxidation
d. Citric acid cycle
ANS: D
Most of the ATP is generated during the citric acid cycle.
Larger molecules are broken down into smaller units during digestion; no ATP is produced
during this cycle.
During glycolysis, two molecules of ATP are produced from each glucose molecule, but the
most ATP is produced during the citric acid cycle.
Oxidation is part of the glycolysis process and ATP is produced, but more ATP is produced
during the citric acid cycle.
12. A nurse is teaching the staff about the three phases of cellular catabolism. Which of the
following should the nurse include?
a. Digestion, glycolysis and oxidation, and the citric acid cycle
b. Diffusion, osmosis, and mediated transport
c. S phase, G phase, and M phase
d. Metabolic absorption, respiration, and excretion
ANS: A
Digestion, glycolysis and oxidation, and the citric acid cycle are the three phases of cellular
catabolism.
Diffusion, osmosis, and mediated transport are parts of the movement of fluids in and out of
cells.
The S, G, and M phases are phases of cellular division, not catabolism.
Metabolic absorption, respiration, and excretion are functions of the cell.
7 | P a g e13. A runner has depleted all the oxygen available for muscle energy. Which of the following
will facilitate his continued muscle performance?
a. Electron-transport chain
b. Aerobic glycolysis
c. Anaerobic glycolysis
d. Oxidative phosphorylation
ANS: C
When no oxygen is available, anaerobic glycolysis occurs.
The electron-transport chain is part of the citric acid cycle.
Aerobic glycolysis involves the presence of oxygen.
Oxidative phosphorylation is the mechanism by which the energy produced from carbohydrates,
fats, and proteins is transferred to ATP. It is not part of muscle performance.
14. The faculty member asked the student to identify the appropriate term for the movement
ofsmall, electrically uncharged molecules through a semipermeable barrier. Which answer
indicates the nursing student understood the teaching?
a. Osmosis
b. Diffusion
c. Hydrostatic pressure
d. Active transport
ANS: B
Diffusion is the movement of a solute molecule from an area of greater solute concentration to an
area of lesser solute concentration.
Osmosis is the movement of water across a semipermeable membrane from a region of higher
water concentration to one of lower concentration.
Hydrostatic pressure is the force of fluid against a cell membrane. Within the vascular system,
this pressure is the blood pressure.
8 | P a g eIn active transport, molecules move up a concentration gradient. This process requires energy.
15. A nurse is teaching a patient about fluid and electrolytes. Which of the following indicates
the teaching was successful regarding electrolytes? Electrolytes are:
a. Small lipid-soluble molecules
b. Large protein molecules
c. Micronutrients used to produce ATP
d. Electrically charged molecules
ANS: D
Electrolytes are electrically charged molecules.
Electrolytes are not lipid soluble.
Electrolytes are not made up of protein.
Electrolytes do not have a role in the production of ATP.
16. A nurse is reading a chart and sees the term oncotic pressure. The nurse recalls that
oncoticpressure (colloid osmotic pressure) is determined by:
a. Concentration of sodium
b. Plasma proteins
c. Hydrostatic pressure
d. Availability of membrane transporter proteins
ANS: B
Oncotic pressure is determined by the effect of colloids or plasma proteins.
The concentration of sodium plays a role in tonicity.
Hydrostatic pressure is the force within a vessel.
Membrane transporter proteins are involved in active transport within a concentration gradient.
17. A patient has a body fluid of 300 mOsm/kg. This lab result is measuring:
a. Osmolality
9 | P a g eb. Osmolarity
c. Osmotic pressure
d. Oncotic pressure
ANS: A
Osmolality measures the number of milliosmoles per kilogram of water, or the concentration of
molecules per weight of water.
Osmolarity measures the number of milliosmoles per liter of solution, or the concentration
of molecules per volume of solution.
Osmotic pressure is the amount of hydrostatic pressure required to oppose the
osmoticmovement of water.
Oncotic pressure is from plasma proteins, not body fluids.
18. In teaching a patient with cirrhosis, which information should the nurse include regarding
cholesterol?
a. Cholesterol decreases the membrane fluidity of the erythrocyte, which reduces its
ability to carry oxygen.
b. Cholesterol decreases the membrane fluidity of erythrocytes, which reduces its
ability to carry hemoglobin.
c. Cholesterol increases the membrane fluidity of erythrocytes, which allows
binding of excess glucose.
d. Cholesterol increases the membrane fluidity of erythrocytes, which prolongs its
life span beyond 120 days.
ANS: A
In cirrhosis, the cholesterol content of the red blood cells plasma membrane increases, causing a
decrease in membrane fluidity that seriously affects the cells ability to transport oxygen.
In cirrhosis, for example, the cholesterol content of the red blood cells plasma membrane
increases, causing a decrease in membrane fluidity that seriously affects the cells ability to
transport oxygen, not hemoglobin; the hemoglobin carries the oxygen.
In cirrhosis, for example, the cholesterol content of the red blood cells plasma membrane
increases, causing a decrease in membrane fluidity that seriously affects the cells ability to
transport oxygen; it does not bind excess glucose.
10 | P a g eIn cirrhosis, for example, the cholesterol content of the red blood cells plasma membrane
increases, causing a decrease in membrane fluidity that seriously affects the cells ability to
transport oxygen. It does not prolong the life of the RBC and could decrease it.
19. A nurse is discussing the movement of fluid across the arterial end of capillary membranes
into the interstitial fluid surrounding the capillary. Which process of fluid movement is the nurse
describing?
a. Hydrostatic pressure
b. Osmosis
c. Diffusion
d. Active transport
ANS: A
Blood reaching the capillary bed has a hydrostatic pressure of 25 to 30 mm Hg, which is
sufficient force to push water across the thin capillary membranes into the interstitial space.
Osmosis involves the movement of fluid from an area of higher concentration to an area of lower
concentration. It does not involve pressure or force. It is related to hydrostatic pressure.
Diffusion is the passive movement of a solute from an area of higher solute concentration to an
area of lower solute concentration.
Active transport involves movement up a concentration gradient.
20. A patient who has diarrhea receives a hypertonic saline solution intravenously to replace the
sodium and chloride lost in the stool. What effect will this fluid replacement have on cells?
a. Cells will become hydrated.
b. Cells will swell or burst.
c. Cells will shrink.
d. Cells will divide.
ANS: C
The hypertonic saline will cause fluid to leave the intracellular space and enter the vascular
space, causing cells to shrink.
11 | P a g eIntravenous hypertonic solutions lead to cell dehydration.
Intravenous hypertonic solutions cause fluid to leave cells; thus, they would shrink, not swell.
Intravenous hypertonic solutions do not affect cellular division.
21. A nurse is teaching a patient with diabetes how glucose is transported from the blood to
thecell. What type of transport system should the nurse discuss with the patient?
a. Active-mediated transport (active transport)
b. Active diffusion
c. Passive osmosis
d. Passive-mediated transport (facilitated diffusion)
ANS: D
A well-known passive-mediated transport system is that for glucose in erythrocytes (red blood
cells).
The transport of glucose does not require energy, so active-mediated transport is not
correct.The transport of glucose does not require energy, so active diffusion is not correct.
Osmosis involves the movement of water.
22. How are potassium and sodium transported across plasma membranes?
a. By passive electrolyte channels
b. By coupled channels
c. By adenosine triphosphate enzyme (ATPase)
d. By diffusion
ANS: C
A carrier mechanism in the plasma membrane mediates the transport of ions and nutrients.
Thebest-known pump is the Na+-K+dependent ATPase pump.
Electrolyte movements require energy and do not move passively.
Enzymes, not electrolytes, are passed via coupled channels.
12 | P a g eElectrolytes are not transported by diffusion.
23. Why is potassium able to diffuse easily in and out of cells?
a. Because potassium has a greater concentration in the intracellular fluid (ICF)
b. Because sodium has a greater concentration in the extracellular fluid (ECF)
c. Because the resting plasma membrane is more permeable to potassium
d. Because there is an excess of anions inside the cell
ANS: C
The resting membrane is more permeable to potassium because potassium is more easily
transported inward.
Potassium is greater in concentration in the ICF, but this is not why it is transported more easily.
Sodium does have a greater concentration, but this is not why potassium moves easily when the
membrane potential is at rest.
It is cations, not anions, that are involved in membrane potential activity.
24. The ion transporter that moves Na+ and Ca2+ simultaneously in the same direction is an
example of which of the following types of transport?
a. Biport
b. Uniport
c. Antiport
d. Symport
ANS: D
When ions are transported in one direction, it is termed
symport.There is no such term as biport.
Uniport refers to the movement of a single molecule.
Antiport refers to movement of molecules in the opposite direction.
25. During which process can lysosomal enzymes be released to degrade engulfed particles?
a. Endocytosis
b. Pinocytosis
13 | P a g ec. Phagocytosis
d. Exocytosis
ANS: C
Engulfment of particles occurs by phagocytosis.
Endocytosis involves the formation of vesicles to facilitate movement into the cell.
Pinocytosis is a type of endocytosis in which fluids and solute molecules are ingested through
formation of small vesicles.
Exocytosis occurs when coated pits invaginate and internalize ligand-receptor complexes in
coated vesicles.
26. A nurse is teaching the staff about cholesterol. Which information should be taught? The
cellular uptake of cholesterol depends on:
a. Active-mediated transport
b. The antiport system
c. Receptor-mediated endocytosis
d. Passive transport
ANS: C
The cellular uptake of cholesterol depends on receptor-mediated endocytosis.
The cellular uptake of cholesterol depends on receptor-mediated endocytosis; it is not dependent
on active-mediated transport.
The cellular uptake of cholesterol depends on receptor-mediated endocytosis; it is not a part of
the antiport system.
The cellular uptake of cholesterol depends on receptor-mediated endocytosis; it requires energy
and is not passive in transport.
27. Some cancer drugs work during the cell cycle phase where nuclear and cytoplasmic division
occurs. What is this cell cycle phase called?
a. G1
b. S
14 | P a g ec. M
d. G2
ANS: C
The M phase includes both nuclear and cytoplasmic division.
The G1 phase includes the period between the M phase and the start of DNA synthesis.
The S phase include synthesis of DNA in the cell nucleus.
The G2 phase includes RNA and protein synthesis.
28. What causes the rapid change in the resting membrane potential that initiates an
actionpotential?
a. Potassium gates open, and potassium rushes into the cell, changing the membrane
potential from negative to positive.
b. Sodium gates open, and sodium rushes into the cell, changing the membrane
potential from negative to positive.
c. Sodium gates close, allowing potassium into the cell to change the membrane
potential from positive to negative.
d. Potassium gates close, allowing sodium into the cell to change the membrane
potential from positive to negative.
ANS: B
When the threshold is reached, the cell will continue to depolarize with no further stimulation.
The sodium gates open, and sodium rushes into the cell, causing the membrane potential to
reduce to zero and then become positive (depolarization).
Sodium is involved in creating the action potential, not potassium.The
sodium gate must be open, not closed.
The sodium channel must be open; this is not affected by a change in the potassium gate.
29. A cell is isolated, and electrophysiology studies reveal that the resting membrane potential is
70 millivolts. The predominant intracellular ion is Na+, and the predominant extracellular ion is
K+. With voltage change, which of the following would result in an action potential?
a. K+ rushing into the cell
15 | P a g eb. Na+ rushing into the cell
c. Na+ rushing out of the cell
d. K+ rushing out of the cell
ANS: A
With voltage change, potassium rushes into the cell.
Potassium, not sodium, rushes into the cell.
Potassium, not sodium, is involved in the process, and potassium moves into the cells, not out.
Potassium rushes into the cell, not out.
30. A nurse is teaching the staff about platelet-derived growth factor. Which information should
the nurse include? Platelet-derived growth factor (PDGF) stimulates the production of:
a. Platelets
b. Epidermal cells
c. Connective tissue cells
d. Fibroblast cells
ANS: C
Different types of cells require different growth factors; for example, PDGF stimulates the
production of connective tissue cells.
The factor stimulates the production of connective tissue, not platelets.
The factor stimulates the production of connective tissue, not epidermal cells.
The factor stimulates the production of connective tissue, not fibroblast cells.
31. The phase of the cell cycle during which the centromeres split and the sister chromatids are
pulled apart is referred to as:
a. Anaphase
b. Telophase
c. Prophase
d. Metaphase
16 | P a g eANS: A
Anaphase begins when the centromeres split and the sister chromatids are pulled apart.
During telophase, the final stage, a new nuclear membrane is formed around each group of 46
chromosomes, the spindle fibers disappear, and the chromosomes begin to uncoil.
During prophase, the first appearance of chromosomes occurs.
Metaphase occurs when two centrioles located at opposite poles of the cell pull the chromosomes
to opposite sides of the cell.
32. What is the role of cytokines in cell reproduction?
a. Provide growth factor for tissue growth and development
b. Block progress of cell reproduction through the cell cycle
c. Restrain cell growth and development
d. Provide nutrients for cell growth and development
ANS: A
Cytokines play a major role in the regulation of tissue growth and development.
Cytokines help overcome intracellular braking mechanisms that restrain cell growth.
Cytokines promote cell growth, not restrain it.
Cytokines regulate growth; they do not provide nutrients.
33. A biopsy of the lung bronchi revealed ciliated epithelial cells that are capable of secretion
and absorption. These cells are called
columnar epithelium.
a. Simple
b. Ciliated simple
c. Stratified
d. Pseudostratified ciliated
ANS: B
Ciliated simple columnar epithelium are found in the lungs.
Simple columnar epithelium are found from the stomach to the anus.
Stratified columnar epithelium are found in the linings of epiglottis, part of pharynx, anus, and
17 | P a g emale urethra.
Pseudostratified ciliate columnar epithelium is found in the linings of large ducts of some glands
(parotid, salivary), male urethra, respiratory passages, and eustachian tubes of ears.
34. The nurse would be correct in identifying the predominant extracellular cation as:
a. Sodium
b. Potassium
c. Chloride
d. Glucose
ANS: A
The predominant extracellular cation is sodium.
Potassium is the predominant intracellular cation.
Chloride is an anion. Urea is a nonelectrolyte.
Glucose is a nonelectrolyte.
35. The student is reviewing functions of the cell. The student would be correct in identifying the
primary function of the nerve cell as:
a. Sensory interpretation
b. Conductivity
c. Maintenance of homeostasis
d. Communication
ANS: B
Conduction as a response to a stimulus is manifested by a wave of excitation; an electrical
potential that passes along the surface of the cell to reach its other parts. Conductivity is the chief
function of nerve cells.
Nerve cells assist with sensory interpretation, but their primary function is conductivity.
Nerve cells assist with maintenance of homeostasis, but their primary function is conductivity.
18 | P a g eNerve cells assist with communication, but their [Show Less]