,Table of Content
Chapter 01: Cellular Biology ....................................................................................................................................... 4
Chapter 02: Genes and Genetic Diseases .................................................................................................................. 13
Chapter 03: Epigenetics and Disease......................................................................................................................... 23
U SN T O .................................................................................................................................................................... 23
Chapter 04: Altered Cellular and Tissue Biology...................................................................................................... 27
Huether & McCance: Understanding Pathophysiology, 6th Edition ......................................................................... 39
Chapter 06: Innate Immunity: Inflammation and Wound Healing Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................... 48
Chapter 07: Adaptive Immunity ................................................................................................................................ 60
Chapter 08: Infection and Defects in Mechanisms of Defense Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................... 66
SINGTB.COM............................................................................................................................................................... 74
Chapter 09: Stress and Disease .................................................................................................................................. 76
Chapter 10: Biology, Clinical Manifestations, and Treatment of Cancer Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................... 81
Chapter 11: Cancer Epidemiology ............................................................................................................................ 87
Chapter 12: Cancer in Children ................................................................................................................................. 91
Chapter 13: Structure and Function of theNeurologic System Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................... 94
Chapter 14: Pain, Temperature, Sleep, and Sensory Function Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 105
Chapter 15: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function ............................. 116
Chapter 16: Disorders of theCentral and Peripheral Nervous Systems and theNeuromuscular Junction ............... 126
Chapter 17: Alterations of Neurologic Function in Children Huether & McCance: Understanding Pathophysiology,
6th Edition ............................................................................................................................................................... 138
Chapter 18: Mechanisms of Hormonal Regulation ................................................................................................. 147
Chapter 19: Alterations of Hormonal Regulation .................................................................................................... 156
Chapter 20: Structure and Function of the Hematologic System Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 169
Chapter 21: Alterations of Hematologic Function................................................................................................... 176
INGTB.COM ............................................................................................................................................................... 177
Chapter 22: Alterations of Hematologic Function in Children Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 192
Chapter 23: Structure and Function of the Cardiovascular and Lymphatic Systems Huether & McCance:
Understanding Pathophysiology, 6th Edition .......................................................................................................... 200
Chapter 24: Alterations of Cardiovascular Function ............................................................................................... 210
U SN T O .................................................................................................................................................................. 210
SINGTB.COM............................................................................................................................................................. 223
U SN T O .................................................................................................................................................................. 226
U SN T O .................................................................................................................................................................. 228
Chapter 25: Alterations of Cardiovascular Function in Children Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 229
S N T O ...................................................................................................................................................................... 232
Chapter 26: Structure and Function of the Pulmonary System Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 236
Chapter 27: Alterations of Pulmonary Function ...................................................................................................... 245
, Chapter 28: Alterations of Pulmonary Function in Children Huether & McCance: Understanding Pathophysiology,
6th Edition ............................................................................................................................................................... 257
Chapter 29: Structure and Function of the Renal and Urologic Systems Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 265
Chapter 30: Alterations of Renal and Urinary Tract Function Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 273
Chapter 31: Alterations of Renal and Urinary Tract Function in Children Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 280
Chapter 32: Structure and Function of the Reproductive Systems Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 286
Chapter 33: Alterations of the Female Reproductive System Huether & McCance: Understanding Pathophysiology,
6th Edition ............................................................................................................................................................... 295
Chapter 34: Alterations of the Male Reproductive System ..................................................................................... 300
Chapter 35: Structure and Function of the Digestive System Huether & McCance: Understanding Pathophysiology,
6th Edition ............................................................................................................................................................... 305
Chapter 36: Alterations of Digestive Function ........................................................................................................ 312
Chapter 37: Alterations of Digestive Function in Children ..................................................................................... 325
Chapter 38: Structure and Function of the Musculoskeletal System Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 334
U SN T O .................................................................................................................................................................. 337
Chapter 39: Alterations of Musculoskeletal Function ............................................................................................. 342
Chapter 40: Alterations of Musculoskeletal Function in Children Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 352
U SN T O .................................................................................................................................................................. 354
Chapter 41: Structure, Function, and Disorders of the Integument Huether & McCance: Understanding
Pathophysiology, 6th Edition .................................................................................................................................. 357
Chapter 42: Alterations of the Integument in Children ........................................................................................... 366
,Chapter 01: Cellular Biology
Huether & McCance: Understanding Pathophysiology, 6th Edition
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 called a
prokaryote contains free-floating nuclear material but has no organelles.
REF: p. 2
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
b. Communication
c. Secretion
d. Respiration
ANS: D
The cell’s ability to absorb oxygen is referred to as respiration while its communication ability
involves maintenance of a steady dynamic state, metabolic absorption provides nutrition, and
secretion allows for the synthesizing of new substances.
REF: p. 2
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 Cytoplasm
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, which is located within
the cell’s nucleus. Mitochondria is associated with cellular respiration, while ribosomes are
involved with protein manufacturing. Cytoplasm is a fluid filling that is a component of the
cell.
REF: p. 2
,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. Peripheral membrane proteins reside at the
surface while cell adhesion molecules are on the outside of the membrane. Glycoprotein
marks cells and does not float.
REF: p. 7
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 bind with receptors on the cell membrane.
REF: p. 9
6. A nurse is reviewing a report from a patient with metastatic cancer. What alternation in the
extracellular matrix would suN
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Ometastatic cancer?
b. Increased collagen
c. Decreased elastin
d. Increased glycoproteins
ANS: A
Only a reduced amount of fibronectin is found in some types of cancerous cells, allowing
them to travel or metastasize.
REF: p. 10
7. Which form of cell communication is used to relate to other cells in direct physical contact?
a. Cell junction
b. Gap junction
c. Desmosome
d. Tight junction
ANS: A
Cell junctions hold cells together and permit molecules to pass from cell to cell.
Gap junctions allow for cellular communication between cells. Neither desmosomes nor tight
junctions are associated with cellular communication.
REF: p. 11
, 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. None of the other options involve signaling that is associated with a local chemical
mediator like insulin.
REF: p. 12
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. Cellular metabolism is not dependent on an attraction between an enzyme and
any of the remaining options.
REF: p. 16
10. An athlete runs a marathon, after which his muscles 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.
REF: p. 16
11. Which phase of catabolism produces the most ATP?
a. Digestion
b. Glycolysis
c. Oxidation
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 does not produce any ATP.
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REF: p. 16
12. A nurse is teaching the staff about the phases of cellular catabolism. Which phases should the
nurse include?
a. Digestion, glycolysis, 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
Only digestion, glycolysis, oxidation, and the citric acid cycle are the phases of cellular
catabolism.
REF: p. 16
13. 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.
REF: p. 16
14. A faculty member asks a student to identify the appropriate term for the movement of a solute
from an area of greater to lesser concentration. 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 through a permeable membrane. 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. In active transport, molecules move up a concentration gradient.
REF: p. 19
15. Which description accurately describes electrolytes?
a. Small lipid-soluble molecules
b. Large protein molecules
c. Micronutrients used to produce ATP
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d. Electrically charged molecules
ANS: D
Electrolytes are electrically charged molecules. They are not lipid soluble, they are not made
up of protein, and they do not play a role in ATP production.
REF: p. 18
16. A nurse is reading a chart and sees the term oncotic pressure. The nurse recalls that oncotic
pressure (colloid osmotic pressure) is determined by:
a. the concentration of sodium.
b. plasma proteins.
c. hydrostatic pressure.
d. the 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.
REF: p. 20
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
liter of solution, or the concentration of molecules per volume of solution. Osmotic pressure is
the amount of hydrostatic pressure required to oppose the osmotic movement of water.
Oncotic pressure is from plasma proteins, not body fluids.
REF: p. 19
18. 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 25–30 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. 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.
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REF: p. 19
19. 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
The transporter protein ATPase is directly related to sodium and potassium transport via
active transport. Electrolyte movements require energy and do not move passively, nor are
they transported by diffusion. Enzymes, not electrolytes, are passed via coupled channels.
REF: p. 21
20. 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 the movement
of molecules in the opposite direction.
REF: p. 19, Figure 1-22
21. During which process are bacteria engulfed for ingestion?
a. Endocytosis
b. Pinocytosis
c. Phagocytosis
d. Exocytosis
ANS: C
Phagocytosis (cell eating) involves the ingestion of large particles, such as bacteria, through
the formation of large vesicles. 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 the formation of small vesicles. Exocytosis occurs when
coated pits invaginate and internalize ligand-receptor complexes in coated vesicles.
REF: p. 22
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
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ANS: C
The M phase includes both nuclear and cytoplasmic divisions. The G1 phase includes the
period between the M phase and the start of DNA synthesis. The S phase includes synthesis of
DNA in the cell nucleus. The G2 phase includes RNA and protein synthesis.
REF: pp. 25-26
23. Which causes the rapid change in the resting membrane 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 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 and channel must be open, not closed. The
action potential is not affected by a change in the potassium gate.
REF: pp. 24-25
24. A cell is isolated, and electroN
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eal that the resting membrane potential is
70 mV. 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
b. 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, not out of, the cell. Sodium movement is not
related to this process.
REF: pp. 24-25
25. A nurse teaching the staff about platelet-derived growth factor includes information that
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, but not platelets, epidermal cells, or fibroblast cells.
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