TEST BANK
Huether and McCance's Understanding Pathophysiology, Canadian Edition
Kelly Power-Kean, Stephanie Zettel, Mohamed T. El-Hussein, Sue E. Huether, and Kathryn L. McCance
2nd Edition Table of Contents
Chapter 01 Cellular Biology 1
Chapter 02 Genes and Genetic Diseases 11
Chapter 03 Epigenetics and Disease 21
Chapter 04 Altered Cellular and Tissue Biology 25
Chapter 05 Fluids and Electrolytes, Acids and Bases 37
Chapter 06 Innate Immunity Inflammation and Wound Healing 47
Chapter 07 Adaptive Immunity 59
Chapter 08 Infection and Defects in Mechanisms of Defence 65
Chapter 09 Stress and Disease 76
Chapter 10 Biology of Cancer 81
Chapter 11 Cancer Epidemiology 87
Chapter 12 Cancer in Children and Adolescents 91
Chapter 13 Structure and Function of the Neurological System 94
Chapter 14 Pain, Temperature, Sleep, and Sensory Function 105
Chapter 15 Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function 117
Chapter 16 Disorders of the Central and Peripheral Nervous Systems and Neuromuscular Junction 128
Chapter 17 Developmental Alterations of Neurological Function 140
Chapter 18 Mechanisms of Hormonal Regulation 148
Chapter 19 Alterations of Hormonal Regulation 157
Chapter 20 Structure and Function of the Hematological System 171
Chapter 21 Alterations of Hematological Function 178
Chapter 22 Developmental Alterations of Hematological Function 195
Chapter 23 Structure and Function of the Cardiovascular and Lymphatic Systems 203
Chapter 24 Alterations of Cardiovascular Function 214
Chapter 25 Developmental Alterations of Cardiovascular Function 234
Chapter 26 Structure and Function of the Pulmonary System 241
Chapter 27 Alterations of Pulmonary Function 250
Chapter 28 Developmental Alterations of Pulmonary Function 263
Chapter 29 Structure and Function of the Renal and Urological Systems 270
Chapter 30 Alterations of Renal and Urinary Tract Function 278
Chapter 31 Developmental Alterations of Renal and Urinary Tract Function 285
Chapter 32 Structure and Function of the Reproductive Systems 291
Chapter 33 Alterations of the Female Reproductive System 300
Chapter 34 Alterations of the Male Reproductive System 306
Chapter 35 Structure and Function of the Digestive System 311
Chapter 36 Alterations of Digestive Function 319
Chapter 37 Developmental Alterations of Digestive Function 332
Chapter 38 Structure and Function of the Musculoskeletal System 340
Chapter 39 Alterations of Musculoskeletal Function 349 Chapter 40 Developmental Alterations of Musculoskeletal Function 359
Chapter 41 Structure, Function, and Disorders of the Integument 364
Chapter 42 Developmental Alterations of the Integument 374 Chapter 01: Cellular Biology Power-Kean et al: Huether and McCance’s Understandi ng Pathophysiology, Second Canadian Edition MULTIPLE CHOICE 1. A student is observing a cell under the microscope. The student notices it to have supercoiled DNA with histones. What else would the student be e xpected to observe? 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 pr okaryotic cell contains a single circular chromosome and lacks organelles. DIF: Cognitive Level: Remember REF: Nucleus TOP: Ph ysiological Integrity 2. A nurse is instructing the staff about cellular fun ctions. Which cellular function is the nurse describing when an isolated cell absorbs oxygen and uses it to transform nutrients to energy? a. Metabolic absorption b. Communication c. Secretion d. Respiration ANS: D The cell’s ability to produce energy is respiration . Communication involves maintenance of a steady dynamic state, while metabolic absorption pr ovides cellular nutrition, and secretion allows for the delivery or release of new substance s. DIF: Cognitive Level: Remember REF: Cellular Functi ons TOP: Physiological Integrity 3. A eukaryotic cell is undergoing DNA replication. In which region of the cell would most of the genetic information be contained? a. Peroxisomes b. Ribosomes c. The nucleolus d. Suspended in nucleoplasm ANS: D The region of the cell that contains genetic materi al, is the nucleoplasm contained within the nucleus. The nucleolus, contained within the nucleu s, is largely composed of ribosomes. Peroxisomes contain digestive enzymes. DIF: Cognitive Level: Remember REF: Nucleus TOP: Ph ysiological Integrity ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Huether and McCance's Understanding Pathophysiology, Canadian Edition, 2nd Edition (Power-Kean, 2023)
1 | P a g e 4. Which of the following can remove proteins attached to the cell’s bilayer by dissolving the layer itself? a. Peripheral membrane proteins b. Integral membrane proteins c. Glycoproteins d. Cell adhesion molecules ANS: B Proteins directly attached to the membrane bilayer can be removed by the action of integral membrane proteins that dissolve the bilayer. Periph eral membrane proteins reside at the surface while cell adhesion molecules are on the ou tside of the membrane. Glycoproteins act as cell identifiers. DIF: Cognitive Level: Remember REF: Membrane Compos ition TOP: Physiological Integrity 5. Which of the following can bind to plasma membrane receptors? a. Oxygen b. Ribosomes c. Amphipathic lipids d. Ligands ANS: D Ligands are the only specific molecules that can bi nd with receptors on the cell membrane. DIF: Cognitive Level: Remember REF: Cellular Recept ors TOP: Physiological Integrity 6. A nurse is reviewing a report from a patient with m etastatic cancer. What alternation in the extracellular matrix would support the diagnosis of metastatic cancer? a. Decreased fibronectin b. Increased collagen c. Decreased elastin d. Increased glycoproteins ANS: A Only a reduced amount of fibronectin is found in so me types of cancerous cells, allowing them to travel or metastasize. DIF: Cognitive Level: Remember REF: Extracellular M atrix TOP: Physiological Integrity 7. What type of connection allows for cellular communi cation? a. Belt desmosome b. Gap junction c. Spot desmosome d. Tight junction ANS: B Gap junctions allow for cellular communication betw een cells. Neither desmosomes nor tight junctions are associated with cellular communicatio n. ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Huether and McCance's Understanding Pathophysiology, Canadian Edition, 2nd Edition (Power-Kean, 2023)
2 | P a g e DIF: Cognitive Level: Remember REF: Specialized Cel ls Junction TOP: Physiological Integrity 8. Pancreatic beta cells secrete insulin, which inhibi ts secretion of glucagon from neighbouring alpha cells. This action is an example of which of the following signalling types? a. Paracrine b. Autocrine c. Neurohormonal d. Hormonal ANS: A Paracrine signalling involves the release of local chemical mediators that are quickly taken up, destroyed, or immobilized, as in the case of insuli n and the inhibition of the secretion of glucagon. None of the other options involve signall ing that is associated with a local chemical mediator like insulin. DIF: Cognitive Level: Remember REF: Cellular Commun ication and Signal Transduction TOP: Physiological Integrity 9. In cellular metabolism, each enzyme has a high affi nity 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. Cellular metabolism is not dependent on an attraction between an enzyme and any of the remaining options. DIF: Cognitive Level: Remember REF: Cellular Metabo lism TOP: Physiological Integrity 10. An athlete runs a marathon, after which their muscl es feel fatigued and unable to contract. The athlete asks the nurse why this happened. The nurse ’s response is based on the knowledge that the problem is result of a deficiency of: a. GTP b. AMP c. ATP d. GMP ANS: C When ATP is deficient, impaired muscle contraction results. None of the other options are involved in muscle contraction. DIF: Cognitive Level: Remember REF: Role of Adenosi ne Triphosphate TOP: Physiological Integrity 11. Which phase of catabolism produces the most ATP? a. Digestion b. Glycolysis c. Oxidation ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Huether and McCance's Understanding Pathophysiology, Canadian Edition, 2nd Edition (Power-Kean, 2023)
3 | P a g e d. Citric acid cycle ANS: D While some ATP is produced during the oxidation and glycolysis phases, most of the ATP is generated during the citric acid cycle. Digestion d oes not produce any ATP. DIF: Cognitive Level: Remember REF: Food and Produc tion of Cellular Energy TOP: Physiological Integrity 12. A nurse is teaching the staff about the phases of c ellular catabolism. Which phases should the nurse include? a. Digestion, glycolysis, oxidation, and the citric ac id cycle b. Diffusion, osmosis, and mediated transport c. S phase, G phase, and M phase d. Metabolic absorption, respiration, and excretion ANS: A Only digestion, glycolysis, oxidation, and the citr ic acid cycle are the phases of cellular catabolism. DIF: Cognitive Level: Remember REF: Food and Produc tion of Cellular Energy TOP: Physiological Integrity 13. A runner has depleted all the oxygen available for muscle energy. Which of the following will facilitate the runner’s continued muscle performanc e? a. Electron -transport chain b. Aerobic glycolysis c. Anaerobic glycolysis d. Oxidative phosphorylation ANS: C When no oxygen is available, anaerobic glycolysis o ccurs. The electron-transport chain is part of the citric acid cycle. Aerobic glycolysis involv es the presence of oxygen. Oxidative phosphorylation is the mechanism by which the energ y produced from carbohydrates, fats, and proteins is transferred to ATP. It is not part of muscle performance. DIF: Cognitive Level: Remember REF: Oxidative Phosp horylation TOP: Physiological Integrity 14. A faculty member asks a student to identify the app ropriate term for the movement of a solute from an area of greater to lesser concentration. Wh ich answer indicates the nursing student understood the teaching? a. Osmosis b. Diffusion c. Hydrostatic pressure d. Active transport ANS: B ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Huether and McCance's Understanding Pathophysiology, Canadian Edition, 2nd Edition (Power-Kean, 2023)
4 | P a g e Diffusion is the movement of a solute molecule from an area of greater solute concentration to an area of lesser solute concentration through a pe rmeable membrane. Osmosis is the movement of water across a semipermeable membrane f rom a region of higher water concentration to one of lower concentration. Hydros tatic pressure is the force of fluid against a cell membrane. In active transport, molecules mov e up a concentration gradient. DIF: Cognitive Level: Understand REF: Passive Transport: Diffusion, Filtration, and Osmosis TOP: Physiological Integrity 15. Which description accurately describes electrolytes ? 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. Th ey are not lipid soluble, they are not made up of protein, and they do not play a role in ATP p roduction. DIF: Cognitive Level: Remember REF: Electrolytes as Solutes TOP: Physiological Integrity 16. A nurse is reading a chart and sees the term oncoti c pressure. The nurse recalls that oncotic pressure (colloid osmotic pressure) is determined b y: a. diffusion rate. b. plasma proteins. c. hydrostatic pressure. d. the availability of membrane transporter proteins. ANS: B Oncotic pressure is determined by the effect of col loids or plasma proteins. Diffusion involves the movement of solute molecules. Hydrostatic press ure is the force within a vessel moving in opposition to oncotic pressure. Membrane transporte r proteins are involved in active transport within a concentration gradient. DIF: Cognitive Level: Understand REF: Passive Transport: Diffusion, Filtration, and Osmosis TOP: Physiological Integrity 17. A patient has a body fluid of 300 mOsm/kg. This lab result is measuring: a. osmolality. b. 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, while osmolarity measures the number of milliosmoles per litre of solution, or the concentration of molecule s per volume of solution. Osmotic pressure is the amount of hydrostatic pressure required to oppo se the osmotic movement of water. Oncotic pressure is from plasma proteins, not body fluids. DIF: Cognitive Level: Remember ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Huether and McCance's Understanding Pathophysiology, Canadian Edition, 2nd Edition (Power-Kean, 2023)
5 | P a g e REF: Passive Transport: Diffusion, Filtration, and Osmosis TOP: Physiological Integrity 18. A nurse is discussing the movement of fluid across the arterial end of capillary membranes into the interstitial fluid surrounding the capilla ry. What mechanical force is involved with this movement? a. Hydrostatic pressure b. Osmosis c. Diffusion d. Active transport ANS: A Blood reaching the capillary bed has a hydrostatic pressure of 25–30 mm Hg, which is sufficient force to push water across the thin capi llary 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 o r force. Diffusion is the passive movement of a solute from an area of higher solute concentra tion to an area of lower solute concentration. Active transport involves movement u p a concentration gradient. DIF: Cognitive Level: Remember REF: Passive Transport: Diffusion, Filtration, and Osmosis TOP: Physiological Integrity 19. How are potassium and sodium transported across pla sma membranes? a. By passive electrolyte channels b. By coupled channels c. By adenosine triphosphate enzyme (ATPase) d. By diffusion ANS: C The transporter protein ATPase is directly related to sodium and potassium transport via active transport. Electrolyte movements require ene rgy and do not move passively, nor are they transported by diffusion. Enzymes, not electro lytes, are passed via coupled channels. DIF: Cognitive Level: Remember REF: Membrane Transp ort: Cellular Intake and Output TOP: Physiological Integrity 20. The ion transporter that moves Na+ and Ca2+ simultaneously in the same direction is an example of which of the following types of transpor t? a. Biport b. Uniport c. Antiport d. Symport ANS: D When ions are transported in one direction, it is t ermed symport. There is no such term as biport. Uniport refers to the movement of a single molecule. Antiport refers to the movement of molecules in the opposite direction. DIF: Cognitive Level: Remember REF: Membrane Transp ort: Cellular Intake and Output TOP: Physiological Integrity 21. During which process are bacteria engulfed for inge stion? a. Endocytosis ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Huether and McCance's Understanding Pathophysiology, Canadian Edition, 2nd Edition (Power-Kean, 2023)
6 | P a g e b. Pinocytosis c. Phagocytosis d. Exocytosis ANS: C Phagocytosis (cell eating) involves the ingestion o f large particles, such as bacteria, through the formation of large vesicles. Endocytosis involv es the formation of vesicles to facilitate movement into the cell. Pinocytosis is a type of en docytosis in which fluids and solute molecules are ingested through the formation of sma ll vesicles. Exocytosis occurs when coated pits invaginate and internalize ligand-recep tor complexes in coated vesicles. DIF: Cognitive Level: Remember REF: Endocytosis and Exocytosis TOP: Physiological Integrity 22. Some cancer drugs work during the cell cycle phase where nuclear and cytoplasmic divisions occur. What is this cell cycle phase called? a. G1 b. S c. M d. G2 ANS: C The M phase includes both nuclear and cytoplasmic d ivisions. The G 1 phase includes the period between the M phase and the start of DNA syn thesis. The S phase includes synthesis of DNA in the cell nucleus. The G 2 phase includes RNA and protein synthesis. DIF: Cognitive Level: Remember REF: Cellular Reprod uction: The Cell Cycle TOP: Physiological Integrity 23. Which causes the rapid change in the resting membra ne potential that initiates an action potential? 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 cel l to change the membrane potential from positive to negative. d. Potassium gates close, allowing sodium into the cel l to change the membrane potential from positive to negative. ANS: B When the threshold is reached, the cell will contin ue to depolarize with no further stimulation. The sodium gates open, and sodium rushes into the c ell, causing the membrane potential to reduce to zero and then become positive (depolariza tion). Sodium is involved in creating the action potential, not potassium. The sodium gate an d channel must be open, not closed. The action potential is not affected by a change in the potassium gate. DIF: Cognitive Level: Remember REF: Movement of Electrical Impulses: Membrane Pote ntials TOP: Physiological Integrity 24. What event occurs to return a cell to its resting m embrane potential? a. K+ rushes into the cell. ______________________________________________________________________________________________
______________________________________________________________________________________________Test Bank - Huether and McCance's Understanding Pathophysiology, Canadian Edition, 2nd Edition (Power-Kean, 2023)
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