(Test Bank) Understanding Pathophysiology

Huether,McCance, 7

Physiology

Test Bank

7th Edition

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Test Bank for Understanding Pathophysiology, The downloadable file consists of 777 pages, and the total size of the file is 4.04 MB. Purchase now only for highly discounted price.

Author(s): Huether, McCance

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TEST BANK FOR UNDERSTANDING PATHOPHYSIOLOGY 7TH EDITION BY SUE HUETHER AND KATHRYN MCGANCE GRADED A Table of Contents Chapter 1. Cellular Biology ................................ ................................ ................................ ................................ ................ 3 MULTIPLE CHOICE ................................ ................................ ................................ ................................ ......................... 3 Chapter 2. Genes and Gene tic Diseas es ................................ ................................ ................................ .......................... 22 Chapter 3. Epigen etics and Disease ................................ ................................ ................................ ................................ . 40 Chapter 4. Alt ered C ellular and Tissue Biology ................................ ................................ ................................ ................ 45 Chapter 5. Flu ids and Electrolytes, Acids and Bases ................................ ................................ ................................ ........ 64 Chapter 6. Inn ate Immunity: Inflamm ation and Wound H ealing ................................ ................................ .................... 86 Chapter 7. Adaptive Immunity ................................ ................................ ................................ ................................ ...... 106 Chapter 8. Alterations in Im munity ................................ ................................ ................................ ............................... 124 Chapter 9. Infection and Defects in Mechanisms of Defense ................................ ................................ ....................... 129 Chapter 10. Stress and Dise ase ................................ ................................ ................................ ................................ ..... 152 Chapter 11. Biology of Cancer ................................ ................................ ................................ ................................ ....... 162 Chapter 12. Cancer Epide miology ................................ ................................ ................................ ................................ . 173 Chapter 13. Cancer in Children and Adoles cents ................................ ................................ ................................ .......... 183 Chapter 14. Structure a nd Funct ion of the Neurologic System ................................ ................................ ..................... 189 Chapter 15. Pain, Te mperature, Sl eep, and Senso ry Funct ion ................................ ................................ ...................... 212 Chapter 16. Alterations in Cognit ive Syste ms, Cerebral He modyna mics, and Mo tor Funct ion ................................ .... 236 Chapter 17. Disorde rs of the Centr al and Peripheral Ne rvous Syste ms and Neuro muscular ................................ ....... 260 Junc tion ................................ ................................ ................................ ................................ ................................ ......... 260 Chapte r 18. Alt erations of Neuro logic Function in Child ren ................................ ................................ ......................... 287 Chapter 19. Mech anisms of Hormonal Regu lation................................ ................................ ................................ ........ 305 Chapter 20. Alt eratio ns of Hormonal Regu lation ................................ ................................ ................................ .......... 321 Chapter 21. Obesi ty and Disorde rs of Nutrition ................................ ................................ ................................ ............ 347 Chapter 22. Structure a nd Funct ion of the H ematologic Syst em ................................ ................................ .................. 352 Chapter 23. Alt erations of Hematologic Function ................................ ................................ ................................ ......... 369 Chapter 24. Alt erations of Hematologic Function in Chi ldren ................................ ................................ ....................... 401 2 Chapter 25. Structure a nd Funct ion of the Cardiovascu lar and Lymphat ic Syste ms ................................ .................... 421 Chapter 26. Alt erations of Card iovas cular Function ................................ ................................ ................................ ...... 440 Chapter 27. Alterations of Cardiovascular Function in Children ................................ ................................ ................... 460 Chapter 28. Structure a nd Funct ion of the Pul monary System ................................ ................................ ..................... 475 Chapter 29. Alterations of Pulmonary Funct ion ................................ ................................ ................................ ............ 495 Chapter 30. Alt erations of Pulmonary Funct ion in Child ren ................................ ................................ ......................... 521 Chapter 31. Structure a nd Funct ion of the Renal and Urologic Systems ................................ ................................ ...... 537 Chapter 32. Alt erations of Renal and Ur inary Tract Fu nction ................................ ................................ ....................... 555 Chapter 33. Alt erations of Renal and Ur inary Tract Function in Child ren ................................ ................................ ..... 575 Chapter 34. Structure a nd Funct ion of the Reproduc tive Syst ems ................................ ................................ ............... 587 Chapter 35. Alt erations of the Fe male Reprodu ctive System ................................ ................................ ....................... 608 Chapter 36. Alt erations of the Male Repr oduc tive System ................................ ................................ ........................... 623 Chapter 37. Structure a nd Funct ion of the Diges tive System ................................ ................................ ....................... 635 Chapter 38. Alt erations of Diges tive Funct ion ................................ ................................ ................................ ............... 653 Chapter 39. Alt erations of Diges tive Funct ion in Child ren ................................ ................................ ............................ 677 Chapter 40. Structure a nd Funct ion of the Musculoske letal System ................................ ................................ ............ 696 Chapter 41. Alt erations of Muscu loskeletal Fun ction ................................ ................................ ................................ ... 715 Chapter 42. Alt erations of Muscu loskeletal Fun ction in Ch ildren ................................ ................................ ................. 738 Chapter 43. Structure, Funct ion, and Disorde rs of the In tegument ................................ ................................ .............. 751 Chapter 44. Alterations of the Integument in Children ................................ ................................ ................................ . 767 Understanding Pathophysiology 7th edition by Huether, McCance Test Bank Chapter 1. Cellular Biology MULTIPLE CHOICE 1. A student is ob serving a cell und er the microscope. It is observed to have supercoiled DNA with h istones. Which of the fol lowing would al so be observ ed by the student? a. A sing le circular chromosome b. A nucleus c. Free-floating nucl ear material d. No organe lles ANS: B Rationale The ce ll described is a eukaryotic cell, so it has histones and a supercoiled DNA with in its nucleus; thus, the nucleus should be observed. A sing le circular chromosome is characteristic of prokaryotic cells, which do not have histones. Free-floating nucl ear material describes a pro karyotic cell, which wo uld not have a dist inct nucleus. Eukaryo tic cells have membrane bounded cellular components called o rganelles. No organ elles describes a prokaryotic ce ll. 2. A nurse is instructing the staff about cellular functions. Which cellular function is the nurse describing when an isola ted cell ab sorbs oxygen and uses it to transform nutrients to energy? a. Metabolic absorpt ion b. Communication c. Secretion d. Respi ration 4 ANS: D The ab ility of the ce ll to absorb oxy gen refers to the cells funct ion of respiration. The ab ility of the ce ll to funct ion w ithin a society of cel ls refers to its function of communication. The ab ility of the ce ll to take in nutr ients refers to the cells function of metabolic absorpt ion. The ab ility of the ce ll to synthesize new subst ances and secrete these else where refers to the cells function of sec retion. 3. A euka ryotic cell is undergoing DNA replication. In which region of t he cell would most of the g enetic information be con tained? a. Mitochon dria b. Riboso me c. Nucleolus d. Nucleus ANS: C The reg ion of the ce ll that contains genet ic material, including a large amount of r ibonucleic acid, most of the D NA, and D NA-binding prote ins, is the nucleolus. The mitochond ria is the site of cellu lar respiration. The r iboso mes are involved in manufacturing of proteins wit hin the cell. The nucl eus contains the nucl eolus, and it is the nucleolus that contains genetic material. 4. The fluid mosaic model for b iologic membranes describes membrane behav ior. According to this model, whi ch of the following float singly or as agg regates in the fluid lipid bilaye r? a. Peripheral membrane proteins b. Integral membrane p roteins c. Glycop roteins d. Cell adhesion molecules ANS: B Integral membrane p roteins float fr eely in the fl uid lipid bila yer. Peripheral membrane proteins are not embedded in the lay er, but reside at the surfa ce. Glycop roteins act as cell surface markers. Cell adhesion molecules are on the outside of the membrane and a llow c ells to ho ok togeth er. 5. Which of the fol lowing can b ind to pla sma membrane receptors? a. Oxygen b. Riboso mes c. Amphipa thic lipids d. Ligands ANS: D Ligands are specific molecules that can bind wi th receptors on the cell membrane. Oxygen moves by d iffusion; it do es not b ind to receptors. Riboso mes make p roteins and are not involved in bind ing. Amphipa thic lipids are a portion of the cell membrane. 6. A nurse is reviewing a report from a patient with metastatic canc er. What find ing would support the diagno sis of metastatic cancer? Alterations in extr acellular matrix that include: a. Decre ased f ibronectin b. Increased c ollagen c. Decre ased elastin 6 d. Increased glycopro teins ANS: A Reduced amounts of fibronec tin are found in so me typ es of c ancerous cells, allowing cancer cells to travel, or metastasiz e. Collag en provides strength, and its breakdown is associat ed with osteoarthrit is, not cancer. Elastin is f ound in the lungs and allows ti ssues to stretch; it is not associated with c ancerous cells. Decre ased, not increased, gly coproteins are ass ociated with cancerous cells. 7. Which form of cell com munication is used to relate to oth er cells in direct physic al contact? a. Cell junction b. Gap junc tion c. Desmosomes d. Tight junctions ANS: A Cell junctions ho ld cells together and permit molecules to pass from cell to cell. Gap junc tions allow c omm unication from the inside of one ce ll to the inside of anothe r. Desmosomes are not in volved in comm unication, but allow cells to ho ld together. Tigh t junctions are bar riers that pre vent movement of s ome substan ces and leakages of other s. 8. Panc reatic beta cells secrete insulin, which inhibi ts secreti on of glucagon from neighbo ring alpha cells. This a ction is an example of which of the following sig naling type s? a. Paracrine b. Autoc rine c. Neurohor monal 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 ce lls produce s ignals that they the mselves respond to, autocrine signaling is used. Neurohor monal signal ing invo lves secretion of hor mones into the bloodstr eam by neu rosecre tory hormones. Hormonal signaling involves specialized endo crine cells that secrete hor mone che micals released by one set of cells that t ravel through the ti ssue through the bloodstream to produce a response in other sets of ce lls. 9. In cellular metabolism, each enzyme has a high affinity for a: a. Solute b. Subst rate c. Recep tor d. Riboso me ANS: B Each enzyme has a high affinity for a sub strate, a spec ific su bstance converted to a product of the reaction. Solutes are small particles that pass through the cell membrane. A recep tor is a site on t he cell wall t hat allows t ranspo rt into the cell. Riboso mes are located inside the cell and are not related to t he work of enzy mes. 8 10. An athlete runs a marathon, after which h is muscles feel fatigued a nd unable to contract. The athlete asks the nu rse why this hap pened. How should the nu rse respon d? A de ficiency in can c ause impai red muscle contraction. a. G TP b. AMP c. A TP d. GMP ANS: C The ce ll uses ATP for muscle contraction. when it is deficient, impaired muscle contra ction results. GTP is involved in cell signaling, n ot muscle contra ction. AMP is not involved in muscle contra ction. GMP is not involved in muscle contra ction. 11. Which ph ase of ca tabolism produ ces the most ATP? a. Diges tion b. Glycoly sis c. Oxidat ion d. Citric acid cycle ANS: D Most of the ATP is gen erated during the citric acid cycle. Larg er molecules are broken do wn into smaller units during digestion; no ATP is p roduced during this cycle. During g lycolysis, two molecules of ATP are p roduced from each g lucose molecule, but the most ATP is p roduced during the c itric acid cyc le. Oxidat ion is part of the glyco lysis process and ATP is produ ced, but more A TP is produced during the c itric acid cycle. 12. A nurse is teaching the staff about the three phases of c ellular cataboli sm. Which of the following shou ld the nu rse include? a. Diges tion, glycolysis and oxidation, and the citric acid cycle b. Diffusion, osmosis, and mediated transport c. S phase, G phas e, and M phase d. Metabolic absorpt ion, respi ration, a nd exc retion ANS: A Diges tion, glycolysis and oxidation, and the citric acid cycle are the three phases of cel lular catabolism. Diffusion, osmosis, and mediated transport are parts of the movement of fluids in and out of cells. The S, G, and M pha ses are phases of cellular di vision, not cataboli sm. Metabolic absorpt ion, respi ration, a nd exc retion are functions of the cell. 13. A runner has deplet ed all the oxygen available for muscle energy. Which of the fol lowing will facilitate his continued muscle performance? a. Electro n-transport chain b. Aerob ic glycolys is c. Anaerob ic glycolysis d. Oxidat ive phosphorylat ion ANS: C 10 When no o xygen is available, anaerobic g lycolysis occurs. The e lectron-transport chain is part of the citric acid cy cle. Aerob ic glycolys is involves the pre sence of oxygen. Oxidat ive phosphorylat ion is the mechan ism by which the energy produced from carbohydr ates, fats, and p roteins is tr ansferred to ATP. It is not part of muscle performance. 14. The faculty member ask ed the s tudent to identify the appropr iate term for the movement of small, electrically unch arged molecules through a semipermeable barrier. Which answer indicates the nursing st udent und erstood the tea ching? a. Osmosis b. Diffusion c. Hydrostatic pressure d. Active transport ANS: B Diffusion is the movement of a solu te molecule from an area of grea ter solute concentration to an area of less er solute con centration. 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 f luid against a cell membrane. Within the vas cular sys tem, this pressure is the blood pressure. In active tr ansport, molecules move up a concentration gra dient. This p rocess requires energy. 15. A nurse is teaching a pat ient about fluid and electrolytes. Which of the fol lowing indicates the teaching was succ essful reg arding electrolytes? Electrolytes are: a. Small lipid-solubl e molecules b. Large protein molecules c. Micronut rients used to produce ATP d. Electr ically charged molecules ANS: D Electro lytes are electrically charged molecules. Electro lytes are not lipid soluble. Electro lytes are not made up of pro tein. Electro lytes do not h ave a role in the produ ction of ATP. 16. A nurse is reading a chart and sees the term oncot ic pressure. The nurse recalls that on cotic pressure ( colloid os motic pr essure) is dete rmined by: a. Concen tration of sodium b. Plasma pro teins c. Hydrostatic pressure d. Avail ability of membrane transporter proteins ANS: B Oncot ic pre ssure is determined by the ef fect of collo ids or plas ma proteins. The concentration of sodium plays a role in tonicity. Hydrostatic pressure is the for ce within a v essel. Membrane transporter proteins are involv ed in active t ransport within a concentration gradi ent. 17. A pati ent has a body fluid of 300 mOsm/kg. This lab result is measuring: a. Osmolality b. Osmolarity c. Osmotic pressure 12 d. Oncot ic pre ssure ANS: A Osmolality measures the number of milliosmoles per kilogram of wa ter, or the co ncentration of molecules per weight of wate r. Osmolarity measures the number of milliosmoles per liter of solu tion, or the conc entration of molecules per volume of solut ion. Osmotic pressure is the amount of hydrostatic p ressure required to oppose the os motic movement of wate r. Oncot ic pre ssure is from plasma prote ins, not b ody fluids. 18. In teaching a patient with cirrhos is, which infor mation sh ould the nu rse include regarding cholesterol? a. Choles terol dec reases the membrane fluid ity of the erythrocyte, whi ch reduces its ability to carry oxygen. b. Choles terol dec reases the membrane fluid ity of erythrocytes, which redu ces its ability to carry he moglob in. c. Choles terol inc reases t he membrane fluid ity of erythrocytes, which a llows binding of excess gluco se. d. Choles terol inc reases t he membrane fluid ity of erythrocytes, which prol ongs its life span be yond 120 days. ANS: A In cirrhos is, the cholesterol content of the red blood cells pla sma membrane in creases, causing a decrease in membrane fluid ity that seriously affects the cells ability to transport oxygen. In cirrhosis, for exa mple, the cholesterol content of the red bl ood cells p lasma membrane increases, causing a dec rease in membrane fluidi ty that seriously affects the cells abili ty to transport oxygen, not he moglob in; the he moglobin c arries the oxygen. In cirrhosis, for exa mple, the cholesterol content of the red bl ood ce lls plasma membrane increases, causing a dec rease in membrane fluidi ty that seriously affects the cells abili ty to transport oxygen; it does not b ind excess glucose. In cirrhosis, for exa mple, the cholesterol content of the red bl ood ce lls pla sma membrane increases, causing a dec rease in membrane fluidi ty that seriously affects the cells abili ty to transport oxygen. It does not pro long the life of the RBC and cou ld decrease it. 19. A nurse is discussing the movement of fluid across the a rterial end of capillary membranes into the interst itial fluid surrounding the capil lary. Which p rocess of fluid movement is the nurse describing? a. Hydrostatic pressure b. Osmosis c. Diffusion d. Active transport ANS: A Blood r eaching the capilla ry bed has a hydrost atic pressure of 25 to 30 mm Hg, which is sufficient force to push water across the thin capillary membranes into the interstitial spac e. Osmosis involves the movement of fluid from an area of hig her concentration to an area of lower concentration. It doe s not involve pressure or for ce. It is related to hyd rostatic pressure. Diffusion is the passive movement of a so lute fr om an area of higher solute conc entration to an area of low er solute con centration. Active transport involv es movement up a conc entration gradient. 20. A pati ent who has diar rhea receives a hyper tonic saline solution intravenous ly to replace the sodium and chloride lost in the stool. What effect will this fluid replace ment h ave on cells? a. Cells will beco me hydrat ed. b. Cells will swell or burst. 14 c. Cells will shrink. d. Cells will divide. ANS: C The hyper tonic saline w ill cause fluid to l eave the intracellu lar space and enter the vascul ar space, causing cells to shrink. Intravenous hype rtonic solu tions le ad to c ell dehydration. Intravenous hype rtonic solu tions ca use flu id to leave cells; t hus, they would sh rink, not swel l. Intravenous hype rtonic solu tions do not af fect cellular division. 21. A nurse is teaching a pat ient with diabetes how glucose is tran sported from the blood to the cell. What type of tr ansport system should the nurse d iscuss with the patient? a. Activ e-mediated tran sport (active transpor t) b. Active diffusion c. Passive os mosis d. Passive-mediated trans port (facilitated di ffusion) ANS: D A well-known passiv e-mediated transport syst em is that for gluco se in eryth rocytes (red blood cells). The t ransport of gluco se does not require energy, so active-mediated tran sport is not correct. The t ransport of gluco se does not require energy, so active di ffusion is not correct. Osmosis involves the movement of water. 22. How are pot assium and sod ium transpo rted a cross p lasma membranes? a. By passive electrolyte channe ls b. By coupled channe ls c. By adenosine triphosph ate enzyme (ATPase) d. By diffusion ANS: C A carrier mechan ism in the pl asma membrane mediates the t ransport of io ns and nu trients. The best-known pump is the Na+-K+dependent ATPase pu mp. Electro lyte movements require en ergy and do not move pas sively. Enzy mes, not electrolytes , are passed via coupled channe ls. Electro lytes are not transported by diffusion. 23. Why is pota ssium able to d iffuse easily in and out of cel ls? a. Because po tassium has a gr eater co ncentration in the intracellular fluid (ICF) b. Because sodium has a greater conc entration in the extracellular fluid (ECF) c. Because the resting pl asma membrane is more pe rmeable to potass ium d. Because there is an excess of anions ins ide the cell ANS: C The re sting membrane is more pe rmeable to po tassium becau se pot assium is more eas ily transported inward. Potassium is greater in concen tration in the ICF, but this is not why it is transported more easily. Sodium does have a gr eater concentration, but this is not why pota ssium moves easily when the membrane potential is at rest. It is cations, not an ions, that are involved in membrane poten tial activity. 24. The ion transporter t hat moves N a+ and Ca2+ simultaneously in the same di rection is an example of which of the following types of transport?