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Test Bank for Understanding Pathophysiology (6th Ed)_Sue E. Huether, Kathryn L. McCance NURSINGTB.COM Chapter 01: Cellular Biology Huether & McCance: Understanding Pathophysiology, 6th Edition MUL... TIPLE 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 NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM 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 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 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 NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM 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. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM 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 NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM 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. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM 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 NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM 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 electrophysiology studies reveal 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. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM REF: p. 27 26. 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. ANS: A Anaphase begins when the centromeres split and the sister chromatids are pulled apart. During telophase, 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. REF: p. 26 27. 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 but do not restrain it. Cytokines help overcome intracellular braking mechanisms that restrain cell growth and promote cell growth, but they do not provide nutrients. REF: p. 26 28. 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 is found in the lungs. Simple columnar epithelium is found from the stomach to the anus. Stratified columnar epithelium is found in the lining of the epiglottis, part of the pharynx, the anus, and the male urethra. Pseudostratified ciliate columnar epithelium is found in the lining of the large ducts of some glands (parotid, salivary), male urethra, respiratory passages, and Eustachian tubes of the ears. REF: p. 30, Table 1-6 29. A student is reviewing functions of the cell. The student would be correct in identifying a chief function of the nerve cell as: a. sensory interpretation. b. conductivity. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM c. maintenance of homeostasis. d. communication. ANS: B Conductivity, not sensory interpretation, homeostasis, or communication, is one of the eight chief functions of nerve cells. REF: p. 2 MULTIPLE RESPONSE 1. A nurse recalls that the basic types of tissues are: (select all that apply) a. nerve. b. epithelial. c. mucosal. d. connective. e. skeletal. f. muscle. ANS: A, B, D, F The basic tissue types include nerve, epithelial, connective, and muscle. Mucosal is a type of epithelial cell, while skeletal is a type of connective tissue. REF: p. 27 2. Characteristics of prokaryotes include which of the following? (select all that apply) a. They contain no organelles. b. Their nuclear material is not encased by a nuclear membrane. c. They contain a distinct nucleus. d. They contain histones. e. They contain a cellular membrane. ANS: A, B The prokaryotes lack a cellular membrane that encases nuclear material, thus they have no distinct nucleus; organelles and histones are also missing. REF: p. 1 NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM Chapter 02: Genes and Genetic Diseases Huether & McCance: Understanding Pathophysiology, 6th Edition MULTIPLE CHOICE 1. A nurse recalls the basic components of DNA are: a. pentose sugars and four phosphate bases. b. a phosphate molecule, deoxyribose, and four nitrogenous bases. c. adenine, guanine, and purine. d. codons, oxygen, and cytosine. ANS: B The three basic components of DNA are deoxyribose; a phosphate molecule; and four types of nitrogenous, not phosphate, bases. DNA does not contain condone. REF: p. 38 2. Which of the following mutations have the most significant effect on protein synthesis? a. Base pair substitutions b. Silent mutations c. Intron mutations d. Frameshift mutations ANS: D The frameshift mutation involves the insertion or deletion of one or more base pairs of the DNA molecule. This greatly alters the amino acid sequence, which affects protein synthesis. The base pair substitution is a type of mutation in which one base pair replaces another. Silent mutations do not change amino acids or protein synthesis. Intron mutations are part of RNA sequencing. REF: p. 39 3. The base components of DNA are: a. A, G, C, and U. b. P, G, C, and T. c. A, G, C, and T. d. X, XX, XY, and YY. ANS: C The four base components of DNA are cytosine, thymine, adenine, and guanine, and are commonly represented by their first letters (A, C, T, and G) and not components identified as P or U. X, XX, XY, and YY are components of human chromosomes. REF: p. 38 4. A DNA strand has a region with the sequence ATCGGAT. Which of the following would be a complementary strand? a. CGATACGT b. TAGCCTAG c. TUGCCTUG NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM d. UAGCCUAG ANS: B The consistent pairing of adenine with thymine and of guanine with cytosine is known as complementary base pairing; thus, A complements to T and C to G and vice versa throughout the strand. A complements to T; thus, the first letter must be a T. U does not represent a complement in the sequence. REF: p. 39 5. A biologist is explaining how RNA directs the synthesis of protein. Which process is the biologist describing? a. Termination b. Transcription c. Translocation d. Translation ANS: D In translation, RNA directs the synthesis of a polypeptide, interacting with transfer RNA (tRNA), a cloverleaf-shaped strand of about 80 nucleotides. Termination does not involve synthesis of protein. Transcription is the process by which DNA specifies a sequence of messenger RNA (mRNA). Translocation is the interchange of genetic material between nonhomologous chromosomes. REF: p. 41 6. What is the result of homologous chromosomes failing to separate during meiosis? a. Neurofibromatosis b. Nondisjunction c. Polyploidy d. Conjoined twins ANS: B Nondisjunction is an error in which homologous chromosomes or sister chromatids fail to separate normally during meiosis or mitosis. Neurofibromatosis is not due to chromosome failure during meiosis. Polyploidy occurs when a euploid cell has more than the diploid number of chromosomes. Conjoined twins are not due to chromosome failure during meiosis. REF: p. 45 7. A cell that does not contain a multiple of 23 chromosomes is called a _____ cell. a. diploid b. euploid c. polyploid d. haploid ANS: C A polyploid cell is one in which a euploid cell has more than 23 pairs of chromosomes. A diploid cell is when the somatic cell nucleus has 46 chromosomes in 23 pairs. A euploid cell is a cell with multiples of the normal number of chromosomes. A haploid cell has only one member of each chromosome pair, for a total of 23 chromosomes. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM REF: p. 42 8. A 20-year-old pregnant female gives birth to a stillborn child. Autopsy reveals that the fetus has 92 chromosomes. What term may be on the autopsy report to describe this condition? a. Biploidy b. Triploidy c. Tetraploidy d. Aneuploidy ANS: C Tetraploidy is a condition in which euploid cells have 92 chromosomes. Biploidy is a euploid cell with two times more chromosomes, or 46. Triploidy is a zygote that has three copies of each chromosome, rather than the usual two. Aneuploidy is when an aneuploid cell does not contain a multiple of 23 chromosomes. REF: p. 42 9. The condition in which an extra portion of a chromosome is present in each cell is called: a. reciprocal translocation. b. partial trisomy. c. inversion. d. Down syndrome. ANS: B Partial trisomy is a condition in which only an extra portion of a chromosome is present in each cell. A reciprocal translocation occurs when breaks take place in two different chromosomes and the material is exchanged. An inversion occurs when two breaks take place on a chromosome, followed by the reinsertion of the missing fragment at its original site, but in inverted order. Down syndrome is an aneuploidy of the twenty-first chromosome. REF: p. 46 10. After a geneticist talks to a patient about being a chromosomal mosaic, the patient asks the nurse what that means. How should the nurse respond? You may _____ genetic disease(s). a. only be a carrier of the b. have a mild form of the c. have two d. be sterile as a result of the ANS: B A chromosomal mosaic means the body has two or more different cell lines, each of which has a different karyotype; thus, the person has a mild form of the disease. Mosaics are not only carriers; they have the disease; they have two different lines but not two different diseases; and they are not necessarily sterile. REF: p. 46 11. What is the most common cause of Down syndrome? a. Paternal nondisjunction b. Maternal translocations c. Maternal nondisjunction NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM d. Paternal translocations ANS: C The most common cause of Down syndrome is maternal, not paternal, nondisjunction. Translocation is not a cause of this syndrome. REF: p. 46, Table 2-1 12. A patient wants to know the risk factors for Down syndrome. What is the nurse’s best response? a. Fetal exposure to mutagens in the uterus. b. Increased paternal age. c. Family history of Down syndrome. d. Pregnancy in women over age 35. ANS: D The primary risk for Down syndrome is pregnancy in women over 35. Down syndrome is a trisomy and not due to fetal exposure or paternal age. Down syndrome is a chromosomal abnormality and is not related to family history. REF: pp. 46-47 13. A 13-year-old girl has a karyotype that reveals an absent homologous X chromosome with only a single X chromosome present. What medical diagnosis will the nurse observe on the chart? a. Down syndrome b. Cri du chat syndrome c. Turner syndrome d. Fragile X syndrome ANS: C A condition with the presence of a single X chromosome and no homologous X or Y chromosome, so the individual has a total of 45 chromosomes, is known as Turner syndrome. Down syndrome is a change in one arm of a chromosome. Cri du chat syndrome is due to a chromosome deletion. Fragile X syndrome is due to a break or a gap in a chromosome. REF: p. 47 14. What genetic disorder is the result if an individual possesses an XXY chromosome configuration? a. Turner b. Klinefelter c. Down d. Fragile X ANS: B Individuals with at least two X chromosomes and one Y chromosome in each cell (47 XXY karyotype) have a disorder known as Klinefelter syndrome. A condition with the presence of a single X chromosome and no homologous X or Y chromosome, so the individual has a total of 45 chromosomes, is known as Turner syndrome. Down syndrome is a trisomy. Fragile X syndrome is due to a break or a gap in a chromosome, not an extra chromosome. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM REF: p. 47 15. A patient demonstrates severe mental retardation caused by a deletion of part of chromosome 5. What genetic disorder will the nurse see documented in the chart? a. Prader-Willi syndrome b. Down syndrome c. Cri du chat syndrome d. Trisomy X ANS: C Cri du chat syndrome means “cry of the cat” and describes the characteristic cry of the affected child. Another symptom of the disorder is mental retardation. The disease is caused by a deletion of part of the short arm of chromosome 5. Prader-Willi syndrome is characterized by short stature, obesity, and hypogonadism. Down syndrome does cause mental retardation but is due to chromosome 21, not chromosome 5. Trisomy X can result in mental retardation but is due to an extra X chromosome. REF: p. 48 16. An aide asks the nurse why people who have neurofibromatosis will show varying degrees of the disease. Which genetic principle should the nurse explain to the aide? a. Penetrance b. Expressivity c. Dominance d. Recessiveness ANS: B Expressivity is the extent of variation in phenotype associated with a particular genotype. For neurofibromatosis, a variety of manifestations occur among individuals. The penetrance of a trait is the percentage of individuals with a specific genotype who also exhibit the expected phenotype. Dominance refers to observable traits and risk of transmission. Recessiveness refers to silent strains with reduced risk of occurrence. REF: p. 51 17. Cystic fibrosis is caused by what gene abnormality? a. X-linked dominant b. X-linked recessive c. Autosomal dominant d. Autosomal recessive ANS: D Cystic fibrosis is an autosomal recessive disorder. It is not a result of X links or dominant pathology. REF: p. 52 18. A 15-year-old female is diagnosed with Prader-Willi syndrome. This condition is an example of: a. genomic imprinting. b. an autosomal recessive trait. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM c. an autosomal dominant trait. d. a sex-linked trait. ANS: A Prader-Willi, an example of gene imprinting, is not associated with any autosomal sex-linked abnormality. REF: p. 52 19. A patient, age 9, is admitted to a pediatric unit with Duchenne muscular dystrophy. When planning care the nurse recalls the patient inherited this condition through a trait that is: a. X-linked dominant. b. X-influenced. c. X-limited. d. X-linked recessive. ANS: D Duchenne muscular dystrophy is a relatively common X-linked recessive, not dominant, disorder. While it is sex linked, it is not X-limited or X-influenced. REF: p. 55 20. A child is diagnosed with cystic fibrosis. History reveals that the child’s parents are siblings. Cystic fibrosis was most likely the result of: a. X-inactivation. b. genomic imprinting. c. consanguinity. d. obligate carriers. ANS: C - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- d. living in equatorial regions where the sun is most intense. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM ANS: A Protection from the sun, particularly during the childhood years of life, significantly reduces the risk of skin cancer in later years. REF: pp. 1070-1071 21. A 27-year-old male lung transplant patient developed Kaposi sarcoma (KS). The nurse knows that the cause of this patient’s KS is most likely related to the fact that the patient: a. is malnourished. b. was exposed to hepatitis B. c. is immunosuppressed. d. was diagnosed with cystic fibrosis. ANS: C KS is a vascular malignancy associated with immunodeficiency states and occurs among transplant recipients taking immunosuppressive drugs. KS is not directly related to malnourishment, exposure to hepatitis B, or being diagnosed with cystic fibrosis. REF: p. 1073 22. A client is burned through all the dermis with only a few epidermal appendages intact. This burn is classified as: a. first degree. b. superficial partial-thickness. c. deep partial-thickness. d. third degree. ANS: C Deep partial-thickness burns involve the entire dermis, sparing skin appendages such as hair follicles and sweat glands. First-degree burns involve only the epidermis. Superficial partial-thickness burns involve deeper thickness. Third-degree burns involve destruction of the entire epidermis, dermis, and often underlying subcutaneous tissue. REF: p. 1074, Table 41-8 23. Which of the following burns is most painful? a. First degree b. Second degree c. Charring d. Third degree ANS: B Second degree burns leave tactile and pain sensors intact and are the most painful. All of the other options result in less pain. REF: p. 1075 24. A 10-year-old male is playing with matches and gets burned. His burn is waxy white in appearance. This burn is classified as: a. first degree. b. superficial partial-thickness. c. deep partial-thickness. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM d. third degree. ANS: C Deep partial-thickness burns involve the entire dermis, sparing skin appendages such as hair follicles and sweat glands. These wounds look waxy white. First-degree burns are red and have no blisters. Superficial burns involve fluid-filled blisters. Third-degree burns are dry and have a leathery appearance. REF: p. 1075 25. In burn injury patients, the rule of nines and the Lund and Browder chart are used to estimate: a. depth of burn injury. b. possibility of infection. c. degree of systemic involvement. d. total body surface area burned. ANS: D The rule of nines estimates the total body surface area burned, not the depth of burn injury. It does not estimate the degree of systemic involvement. The possibility of infection is 100%. REF: p. 1075 26. Which process would be expected in the first 24 hours following a serious burn? a. Increased capillary permeability b. Diuresis c. Decreased levels of stress hormones d. Fluid overload ANS: A Increased capillary permeability occurs, leading fluid to shift to interstitial spaces. Blood is shunted from the kidneys, so decreased urination occurs. Increased levels of stress hormones are secreted. Hypovolemia, not fluid overload, occurs. REF: p. 1076 27. Hypovolemia in the early stages of burn shock is directly related to: a. decreased cardiac contractility and shunting of blood away from visceral organs. b. increased capillary permeability and evaporative water loss. c. hypometabolism and renal water loss. d. bacterial infection of the wound and resulting bacteremia. ANS: B Hypovolemia occurs due to increased capillary permeability. Decreased cardiac contractility occurs, but this is not the direct cause of hypovolemia. Blood is shunted from the kidneys, so water loss does not occur. Bacterial infection is a risk, but it is not the cause of hypovolemia. REF: p. 1076 28. A 28-year-old male is admitted to the burn unit 2 hours after receiving second- and third-degree burns over 50% of his body surface in an industrial explosion. Abnormal vital signs include low blood pressure and tachycardia. Lab results show a high hematocrit due to: a. sickle cell syndrome. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM b. fluid movement out of the vascular space. c. renal failure. d. increased vascular protein secondary to increased metabolism. ANS: B Fluid and protein movement out of the vascular compartment results in an elevated hematocrit. Sickle cell syndrome does not result in increased hematocrit. Renal failure can occur, but this does not result in an increase in the hematocrit. Protein loss leads to decreased protein, not increased. REF: p. 1076 29. A 36-year-old male is experiencing frontotemporal hair recession. He is diagnosed with male pattern baldness, which is a form of: a. alopecia. b. areata. c. hirsutism. d. paronychia. ANS: A Male-pattern alopecia is an inherited form of irreversible baldness with hair loss in the central scalp and recession of the frontotemporal hairline. Alopecia areata is an autoimmune T-cell-mediated chronic inflammatory disease directed against hair follicles that results in hair loss. Hirsutism is a form of abnormal hair growth in women. Paronychia is an inflammation of the cuticle. REF: p. 1078 30. A 15-year-old female reports abnormal hair growth on her face and body. This condition is referred to as: a. alopecia. b. areata. c. hirsutism. d. paronychia. ANS: C Abnormal hair growth is referred to as hirsutism. Loss of hair is alopecia. Areata is a specific form of alopecia. Paronychia is an infection around the nail. REF: p. 1078 MULTIPLE RESPONSE 1. Dermal appendages include which of the following structures? (select all that apply) a. Apocrine glands b. Nails c. Dermal papilla d. Hair e. Eccrine glands ANS: A, B, D, E NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM The dermal appendages include the nails, hair, sebaceous glands, and the eccrine and apocrine sweat glands. REF: p. 1053 2. A 70-year-old male nursing home resident developed a dermal pressure ulcer. This condition is most often caused by (select all that apply): a. Shearing forces b. Friction c. Moisture d. Unrelieved pressure e. High-carbohydrate diet ANS: A, B, C, D Pressure ulcers are ischemic ulcers resulting from unrelieved pressure, shearing forces, friction, and moisture. A high-carbohydrate diet is not a factor in development of pressure ulcers. REF: p. 1055 3. A 30-year-old female has a history of frequent candidiasis. The area most likely affected includes: (select all that apply) a. plantar surface of the foot. b. eyes. c. ears. d. mucous membranes. e. vagina. ANS: D, E Candidiasis does not affect the soles of the feet, the eyes, or the ears. It does affect the mucous membranes and the vagina. REF: p. 1068 NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM Chapter 42: Alterations of the Integument in Children Huether & McCance: Understanding Pathophysiology, 6th Edition MULTIPLE CHOICE 1. Acne vulgaris involves inflammation of the: a. hair follicles. b. sebaceous follicles. c. eccrine glands. d. apocrine glands. ANS: B Acne is a disorder of the pilosebaceous units, known as sebaceous follicles. Acne is not associated with inflammation of hair follicles, eccrine glands, or apocrine glands. REF: p. 1084 2. A 4-month-old brought to his primary care provider for severe itching and skin lesions is diagnosed with atopic dermatitis. Which of the following would be elevated in this patient? a. Immunoglobulin D (IgD) b. Immunoglobulin M (IgM) c. Immunoglobulin E (IgE) d. Immunoglobulin G (IgG) ANS: C Most individuals affected with atopic dermatitis show an increased serum IgE level. Neither IgD, IgM, nor IgG would be elevated. REF: p. 1085 3. A 4-month-old is diagnosed with atopic dermatitis (AD). Which assessment finding will most likely support this diagnosis? a. Blistering b. Moist reddened skin c. Dry, itchy skin d. White patches ANS: C AD has a constellation of clinical features that include dry, sensitive, itchy, and easily irritated skin because the barrier function of the skin is impaired. Blistering, moist skin is not associated with AD. White patches are characteristic of other disorders, such as measles. REF: p. 1085 4. A 14-year-old presents with severe acne. Which of the following promotes acne development? a. Androgens b. Estrogens c. Gonadotropins d. Glucocorticoids ANS: A NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM Androgens, not estrogens, increase the size and productivity of the sebaceous glands and promote P. acnes. Neither gonadotropins nor glucocorticoids increase the size and productivity of the sebaceous glands and promote P. acnes. REF: p. 1084 5. Bullous impetigo is caused by a strain of: a. Staphylococcus aureus. b. Molluscum contagiosum. c. Escherichia coli. d. Candida albicans. ANS: A S. aureus, not molluscum contagiosum, is currently the most common overall cause of impetigo. The most common overall cause of impetigo is not associated with E. coli or Candida albicans. REF: p. 1086 6. A 2-month-old develops diaper dermatitis. A nurse will monitor this patient for which secondary infection? a. Streptococcus b. Proteus c. Candida albicans d. Staphylococcus aureus ANS: C Diaper dermatitis is secondarily infected with Candida albicans, not Streptococcus, Proteus, or Staphylococcus aureus. REF: p. 1086 7. A 10-year-old presents with vesicles consistent with vesicular impetigo. What is the most likely cause of the condition? a. Herpes virus b. Candida albicans c. Streptococcus pyogenes d. Human papillomavirus (HPV) ANS: C Vesicular impetigo is caused by Streptococcus pyogenes. Vesicular impetigo is not caused by herpes, Candida albicans, or HPV. REF: p. 1086, Box 42-1 8. A 3-year-old develops tinea capitis after playing with the family dog. This infection is caused by a: a. fungus. b. bacterium. c. virus. d. parasite. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM ANS: A Tinea capitis is caused by a fungus, not bacteria, a virus, or a parasite. REF: p. 1087 9. A 5-year-old is diagnosed with tinea corporis following development of lesions on the nonhairy parts of the face, trunk, and limbs. What is a common source of this condition? a. Kitten b. Pet bird c. Hamster d. Horse ANS: A Tinea corporis is usually attributed to contact with young dogs and cats, not birds, hamsters, or horses. REF: pp. 1087-1088 10. The nurse would correctly identify the medical term for ringworm as: a. impetigo. b. tinea corporis. c. thrush. d. psoriasis. ANS: B Ringworm is also known as tinea corporis. Ringworm is not impetigo, thrush, or psoriasis. REF: p. 1088 11. A 4-month-old develops oral white spots and shallow ulcers. The pediatrician diagnoses thrush which is caused by: a. Escherichia coli. b. Streptococcal bacteria. c. Candida albicans. d. Staphylococcal bacteria. ANS: C Thrush is caused by Candida albicans. Thrush is not caused by E coli, strep, or staph. REF: p. 1088 12. A 6-year-old presents with slightly umbilicated, dome-shaped lesions on the skin of the trunk, face, and extremities. The child is diagnosed with molluscum contagiosum caused by a highly contagious: a. bacterium. b. virus. c. fungus. d. parasite. ANS: B Molluscum contagiosum is caused by a virus. Molluscum contagiosum is not caused by a bacterium, a fungus, or a parasite. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM REF: p. 1088 13. Molluscum contagiosum affects the skin and: a. nails. b. tongue. c. conjunctiva. d. hair follicles. ANS: C Molluscum contagiosum affects the skin and conjunctiva. Molluscum contagiosum does not affect the nails, the tongue, or the hair. REF: p. 1088 14. The nurse would be correct in identifying the duration of rubella as: a. 12 hours. b. 1-3 days. c. 7days. d. 12-15 days. ANS: B Rubella has a duration of 1-3 days. REF: p. 1088 15. Rubella, rubeola, and roseola are common communicable diseases caused by _____ infection. a. viral b. bacterial c. yeast d. fungal ANS: A Rubella, rubeola, and roseola are all caused by a virus, not bacteria, yeast, or a fungus. REF: pp. 1088-1090 16. A 5-year-old develops chickenpox after exposure at a daycare center. This disease is caused by: a. a pox virus. b. a herpes virus. c. an adenovirus. d. human papillomavirus (HPV). ANS: B Chickenpox is caused by a herpes virus. Chickenpox is not caused by a pox virus, adenovirus, or HPV. REF: p. 1090 17. The nurse would correctly identify the etiologic agent of smallpox as: a. a bacterium. NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test BankN URSINGTB.COM b. a virus. c. insects. d. mites. ANS: B The etiologic agent of smallpox is a virus, not bacteria, insects, or mites. REF: p. 1090 18. The nurse would expect the occurrence of scabies to occur more commonly among children who: a. attend day care. b. live in unsanitary conditions. c. reside in rural areas. d. play outside. ANS: B Scabies does occur in daycare centers, but it occurs more commonly in unsanitary conditions. Scabies is not associated directly with rural areas or outdoor play areas. REF: p. 1091 NURSINGTB.COM Understanding Pathophysiology 6th Edition Huether Test Bank [Show More]

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