Applied Pathophysiology A Conceptual Approach to the Mechanisms of Disease 3rd Edition Braun Test Bank

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Applied Pathophysiology A Conceptual Approach to the Mechanisms of Disease 3rd Edition Braun Test Bank Chapter 1Introduction to Pathophysiology 1. The nucleus _________, which is essential for func... tion and survival of the cell. A) is the site of protein synthesis B) contains the genetic code C) transforms cellular energy D) initiates aerobic metabolism 2. Although energy is not made in mitochondria, they are known as the power plants of the cell because they: A) contain RNA for protein synthesis. B) utilize glycolysis for oxidative energy. C) extract energy from organic compounds. D) store calcium bonds for muscle contractions. 3. Although the basic structure of the cell plasma membrane is formed by a lipid bilayer, most of the specific membrane functions are carried out by: A) bound and transmembrane proteins. B) complex, long carbohydrate chains. C) surface antigens and hormone receptors. D) a gating system of selective ion channels. 4. To effectively relay signals, cell-to-cell communication utilizes chemical messenger systems that: A) displace surface receptor proteins. B) accumulate within cell gap junctions. C) bind to contractile microfilaments. D) release secretions into extracellular fluid. 5. Aerobic metabolism, also known as oxidative metabolism, provides energy by: A) removing the phosphate bonds from ATP. B) combining hydrogen and oxygen to form water. C) activating pyruvate stored in the cytoplasm. D) breaking down glucose to form lactic acid. 6. Exocytosis, the reverse of endocytosis, is important in _______ into the extracellular fluid. A) Engulfing and ingesting fluid and proteins for transport B) Killing, degrading, and dissolving harmful microorganisms C) Removing cellular debris and releasing synthesized substances D) Destruction of particles by lysosomal enzymes for secretion 7. The process responsible for generating and conducting membrane potentials is: A) diffusion of current-carrying ions. B) millivoltage of electrical potential. C) polarization of charged particles. D) ion channel neurotransmission. 8. Epithelial tissues are classified according to the shape of the cells and the number of layers. Which of the following is a correctly matched description and type of epithelial tissue? A) Simple epithelium: cells in contact with intercellular matrix; some do not extend to surface B) Stratified epithelium: single layer of cells; all cells rest on basement membrane C) Glandular epithelium: arise from surface epithelia and underlying connective tissue D) Pseudostratified epithelium: multiple layers of cells; deepest layer rests on basement membrane 9. Connective tissue contains fibroblasts that are responsible for: A) providing a fibrous framework for capillaries. B) synthesis of collagen, elastin, and reticular fibers. C) forming tendons and the fascia that covers muscles. D) filling spaces between tissues to keep organs in place. 10. Although all muscle tissue cells have some similarities, smooth muscle (also known as involuntary muscle) differs by: A) having dense bodies attached to actin filaments. B) containing sarcomeres between Z lines and M bands. C) having rapid contractions and abundant cross-striations. D) contracting in response to increased intracellular calcium. 11. Which of the following aspects of the function of the nucleus is performed by ribosomal RNA (rRNA)? A) Copying and carrying DNA instructions for protein synthesis B) Carrying amino acids to the site of protein synthesis C) Providing the site where protein synthesis occurs D) Regulating and controlling protein synthesis 12. Breakdown and removal of foreign substances and worn-out cell parts are performed by which of the following organelles? A) Lysosomes B) Golgi apparatus C) Ribosomes D) Endoplasmic reticulum (ER) 13. Impairment in the function of peroxisomes would result in: A) inadequate sites for protein synthesis. B) an inability to transport cellular products across the cell membrane. C) insufficient energy production within a cell. D) accumulation of free radicals in the cytoplasm. 14. After several months of trying to conceive, a couple is undergoing fertility testing. Semen analysis indicates that the mans sperm have decreased motility, a finding that is thought to underlie the couples inability to become pregnant. Which of the following cellular components may be defective within the mans sperm? A) Ribosomes B) Microtubules C) Mitochondria D) Microfilaments 15. Which of the following statements is true of glycolysis? A) Glycolysis requires oxygen. B) Glycolysis occurs in cells without mitochondria. C) Glycolysis provides the majority of the bodys energy needs. D) Glycolysis produces energy, water, and carbon dioxide. 16. Which of the following membrane transport mechanisms requires the greatest amount of energy? A) Facilitated diffusion B) Passive transport C) Vesicular transport D) Simple diffusion 17. A male patient with a diagnosis of type 1 diabetes mellitus is experiencing hyperglycemia because he lacks sufficient insulin to increase the availability of glucose transporters in his cell membranes. Consequently, his cells lack intracellular glucose and it accumulates in his blood. Which of the following processes would best allow glucose to cross his cell membranes? A) Facilitated diffusion B) Simple diffusion C) Secondary active transport D) Endocytosis 18. Which of the following statements is true of skeletal muscle cells? A) Skeletal muscle cells each have an apical, lateral, and basal surface. B) They are closely apposed and are joined by cell-to-cell adhesion molecules. C) Their basal surface is attached to a basement membrane. D) Skeletal muscle is multinucleated, lacking true cell boundaries. 19. Which of the following body tissues exhibits the highest rate of turnover and renewal? A) The squamous epithelial cells of the skin B) The connective tissue supporting blood vessels C) The skeletal muscle that facilitates movement D) The nervous tissue that constitutes the central nervous system 20. A patient with a pathophysiologic condition that affects the desmosomes is most likely to exhibit: A) impaired contraction of skeletal and smooth muscle. B) weakness of the collagen and elastin fibers in the extracellular space. C) impaired communication between neurons and effector organs. D) separation at the junctions between epithelial cells. Chapter 2 Altered Cells and Tissues 1. Ischemia and other toxic injuries increase the accumulation of intracellular calcium as a result of: A) release of stored calcium from the mitochondria. B) improved intracellular volume regulation. C) decreased influx across the cell membrane. D) attraction of calcium to fatty infiltrates. 2. The patient is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to ___________ of the remaining liver cells. A) metaplasia B) organ atrophy C) compensatory hyperplasia D) physiologic hypertrophy 3. A person eating peanuts starts choking and collapses. His airway obstruction is partially cleared, but he remains hypoxic until he reaches the hospital. The prolonged cell hypoxia caused a cerebral infarction and resulting __________ in the brain. A) caspase activation B) coagulation necrosis C) rapid phagocytosis D) protein p53 deficiency 4. Bacteria and viruses cause cell damage by _______, which is unique from the intracellular damage caused by other injurious agents. A) disrupting the sodium/potassium ATPase pump B) interrupting oxidative metabolism processes C) replicating and producing continued injury D) decreasing protein synthesis and function 5. The patient has a prolonged interruption in arterial blood flow to his left kidney, causing hypoxic cell injury and the release of free radicals. Free radicals damage cells by: A) destroying phospholipids in the cell membrane. B) altering the immune response of the cell. C) disrupting calcium storage in the cell. D) inactivation of enzymes and mitochondria. 6. Injured cells have impaired flow of substances through the cell membrane as a result of: A) increased fat load. B) altered permeability. C) altered glucose utilization. D) increased surface receptors. 7. Reversible adaptive intracellular responses are initiated by: A) stimulus overload. B) genetic mutations. C) chemical messengers. D) mitochondrial DNA. 8. Injured cells become very swollen as a result of: A) increased cell protein synthesis. B) altered cell volume regulation. C) passive entry of potassium into the cell. D) bleb formation in the plasma membrane. 9. A diabetic patient has impaired sensation, circulation, and oxygenation of his feet. He steps on a piece of glass, the wound does not heal, and the area tissue becomes necrotic. The necrotic cell death is characterized by: A) rapid apoptosis. B) cellular rupture. C) shrinkage and collapse. D) chronic inflammation. 10. A 99-year-old woman has experienced the decline of cell function associated with age. A group of theories of cellular aging focus on programmed: A) changes with genetic influences. B) elimination of cell receptor sites. C) insufficient telomerase enzyme. D) DNA mutation or faulty repair. 11. An 89-year-old female patient has experienced significant decreases in her mobility and stamina during a 3-week hospital stay for the treatment of a femoral head fracture. Which of the following phenomena most likely accounts for the patients decrease in muscle function that underlies her reduced mobility? A) Impaired muscle cell metabolism resulting from metaplasia B) Dysplasia as a consequence of inflammation during bone remodeling C) Disuse atrophy of muscle cells during a prolonged period of immobility D) Ischemic atrophy resulting from vascular changes while on bedrest 12. A 20-year-old college student has presented to her campus medical clinic for a scheduled Papanicolaou (Pap) smear. The clinician who will interpret the smear will examine cell samples for evidence of: A) changes in cell shape, size, and organization. B) the presence of unexpected cell types. C) ischemic changes in cell samples. D) abnormally high numbers of cells in a specified field. 13. Which of the following pathophysiologic processes is most likely to result in metastatic calcification? A) Benign prostatic hyperplasia B) Liver cirrhosis C) Impaired glycogen metabolism D) Hyperparathyroidism 14. Despite the low levels of radiation used in contemporary radiologic imaging, a radiology technician is aware of the need to minimize her exposure to ionizing radiation. What is the primary rationale for the technicians precautions? A) Radiation stimulates pathologic cell hypertrophy and hyperplasia. B) Radiation results in the accumulation of endogenous waste products in the cytoplasm. C) Radiation interferes with DNA synthesis and mitosis. D) Radiation decreases the action potential of rapidly dividing cells. 15. The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize? A) White blood cell levels with differential B) Red blood cell levels and morphology C) Urea and creatinine levels D) Liver function panel 16. A 70-year-old male patient has been admitted to a hospital for the treatment of a recent hemorrhagic stroke that has left him with numerous motor and sensory deficits. These deficits are most likely the result of which of the following mechanisms of cell injury? A) Free radical injury B) Hypoxia and ATP depletion C) Interference with DNA synthesis D) Impaired calcium homeostasis 17. Which of the following processes associated with cellular injury is most likely to be reversible? A) Cell damage resulting from accumulation of fat in the cytoplasm B) Cellular changes as a result of ionizing radiation C) Cell damage from accumulation of free radicals D) Apoptosis 18. The extrinsic pathway of apoptosis can be initiated by: A) damage to cellular DNA. B) decreased ATP levels. C) activation of the p53 protein. D) activation of death receptors on the cell surface. 19. A patient with severe peripheral vascular disease has developed signs of dry gangrene on the great toe of one foot. Which of the following pathophysiologic processes most likely contributed to this diagnosis? A) Inappropriate activation of apoptosis B) Bacterial invasion C) Impaired arterial blood supply D) Metaplastic cellular changes 20. Which of the following facts underlies the concept of replicative senescence? A) Genes controlling longevity are present or absent in varying quantities among different individuals. B) Telomeres become progressively shorter in successive generations of a cell. C) The damaging influence of free radicals increases exponentially in later generations of a cell. D) Aging produces mutations in DNA and deficits in DNA repair. Chapter 3 Inflammation and Tissue Repair 1. The characteristic, localized cardinal signs of acute inflammation include: A) fever. B) fatigue. C) redness. D) granuloma. 2. The vascular, hemodynamic stage of acute inflammation is initiated by momentary vasoconstriction followed by vasodilation that causes localized: A) bleeding. B) congestion. C) pale skin. D) coolness. 3. The cellular stage of acute inflammation is marked by the movement of leukocytes into the area. Which of the following cells arrives early in great numbers? A) Basophils B) Lymphocytes C) Neutrophils D) Platelets 4. The phagocytosis process involves three distinct steps. What is the initial step in the process? A) Engulfment B) Intracellular killing C) Antigen margination D) Recognition and adherence 5. Which of the following mediators of inflammation causes increased capillary permeability and pain? A) Serotonin B) Histamine C) Bradykinin D) Nitric oxide 6. Inflammatory exudates are a combination of several types. Which of the following exudates is composed of enmeshed necrotic cells? A) Serous B) Fibrinous C) Suppurative D) Membranous 7. The acute-phase systemic response usually begins within hours of the onset of inflammation and includes: A) fever and lethargy. B) decreased C-reactive protein. C) positive nitrogen balance. D) low erythrocyte sedimentation rate. 8. In contrast to acute inflammation, chronic inflammation is characterized by which of the following phenomena? A) Profuse fibrinous exudation B) A shift to the left of granulocytes C) Metabolic and respiratory alkalosis D) Lymphocytosis and activated macrophages 9. Exogenous pyrogens (interleukin-1) and the presence of bacteria in the blood lead to the release of endogenous pyrogens that: A) stabilize thermal control in the brain. B) produce leukocytosis and anorexia. C) block viral replication in cells. D) inhibit prostaglandin release. 10. An older adult patient has just sheared the skin on her elbow while attempted to boost herself up in bed, an event that has precipitated acute inflammation in the region surrounding the wound. Which of the following events will occur during the vascular stage of the patients inflammation? A) Outpouring of exudate into interstitial spaces B) Chemotaxis C) Accumulation of leukocytes along the epithelium D) Phagocytosis of cellular debris 11. Which of the following individuals most likely has the highest risk of experiencing chronic inflammation? A) A patient who has recently been diagnosed with type 2 diabetes B) A patient who is a carrier of an antibiotic-resistant organism C) A patient who is taking oral antibiotics for an upper respiratory infection D) A patient who is morbidly obese and who has a sedentary lifestyle 12. Which of the following core body temperatures is within normal range? A) 35.9C (96.6F) B) 38.0C (100.4F) C) 35.5C (95.9F) D) 37.3C (99.1F) 13. A postsurgical patient who is recovering in the postanesthetic recovery unit states that she is freezing cold. Which of the following measures is likely to be initiated in the patients hypothalamus in an effort to reduce heat loss? A) Opening of arteriovenous (AV) shunts B) Reduced exhalation of warmed air C) Contraction of pilomotor muscles D) Decreased urine production 14. An elderly patient is dressed only in a hospital gown and complains of a draft in her room. Consequently, she has requested a warm blanket while she sits in her wheelchair. Which of the following mechanisms of heat loss is most likely the primary cause of her request? A) Evaporation and conduction B) Radiation and convection C) Conduction and convection D) Convection and evaporation 15. Which of the following pathophysiologic processes are capable of inducing the production of pyrogens? Select all that apply. A) Acute inflammation B) Obesity C) Myocardial infarction D) Malignancy E) Renal failure 16. Which of the following patients is most likely to be susceptible to developing a neurogenic fever? A) A patient who has stage II Alzheimer disease B) A patient who has sustained a head injury in a bicycle crash C) A patient who has become delirious after the administration of a benzodiazepine D) A patient who has begun taking a selective serotonin-reuptake inhibitor (SSRI) for the treatment of depression 17. Patients are commonly administered antipyretics when their oral temperature exceeds 37.5C (99.5F). Which of the following statements related to the rationale for this action is most accurate? A) Temperatures in excess of 37.5C (99.5F) can result in seizure activity. B) Lower temperatures inhibit the protein synthesis of bacteria. C) There is little empirical evidence for this treatment modality. D) Most common antipyretics have been shown to have little effect on core temperature. 18. A patient has sought care because of recent malaise and high fever. Upon assessment, the patient states that his current fever began two days earlier, although he states that for the last 2 weeks he is in a cycle of high fever for a couple of days followed by a day or two of normal temperature. Which of the following fever patterns is this patient experiencing? A) Recurrent fever B) Remittent fever C) Sustained fever D) Intermittent fever 19. A febrile, 3-week-old infant has been brought to the emergency department by his parents and is currently undergoing a diagnostic workup to determine the cause of his fever. Which of the following statements best conveys the rationale for this careful examination? A) The immature hypothalamus is unable to perform normal thermoregulation. B) Infants are susceptible to serious infections because of their decreased immune function. C) Commonly used antipyretics often have no effect on the core temperature of infants. D) Fever in neonates is often evidence of a congenital disorder rather than an infection. 20. An 84-year-old patients blood cultures have come back positive, despite the fact that his oral temperature has remained within normal range. Which of the following phenomena underlies the alterations in fever response that occur in the elderly? A) Disturbance in the functioning of the thermoregulatory center B) Increased heat loss by evaporation C) The presence of comorbidities that are associated with lowered core temperature D) Persistent closure of arteriovenous shunts Chapter 10 Altered Sensory Function and Pain Perception 1. The somatosensory system consists of three types of sensory neurons. The special somatic type of afferent sensory neurons has receptors that sense: A) muscle position. B) visceral fullness. C) temperature. D) painful touch. 2. Proprioceptive somatosensory information from the limbs and trunk is transmitted by the: A) reflexive networks. B) dorsal root ganglion neurons. C) anterolateral pathway. D) trigeminal sensory neurons. 3. Full localization, discrimination of intensity, and interpretation of somatosensory stimuli requires processing by the: A) somatosensory cortex. B) autonomic nervous system. C) Ruffini end-organ receptors. D) Pacinian corpuscle receptors. 4. What pain theory proposes that pain receptors share pathways with other sensory modalities and that different activity patterns of the same neurons can be used to signal painful or nonpainful stimuli? A) Pattern B) Specificity C) Gate control D) Neuromatrix 5. Nociceptors are sensory receptors that are activated by: A) cortisol. B) noxious stimuli. C) pressure and touch. D) sudden movements. 6. When a person is stung on the index finger by a bee, the thalamus interprets the pain as: A) somewhere on the hand. B) a spot on the index finger. C) attributable to a bee stung. D) similar to a previous bee sting. 7. Pain assessment is likely to be most challenging when providing care for which of the following older adult patients? A) A 90-year-old patient who takes multiple medications for cardiac and respiratory conditions B) A 77-year-old man who has sustained burns on the lower part of his body C) An 82-year-old woman who has been diagnosed with diabetes and an anxiety disorder D) An 87-year-old man with vascular dementia and numerous other health problems 8. In contrast to acute pain, persistent chronic pain: A) serves as a warning system. B) raises the pain threshold. C) imposes physiologic stresses. D) causes secondary reflexive spasms. 9. The sites of referred pain are determined by: A) intensity-coding receptors. B) location of the noxious stimuli. C) visceral embryonic development. D) stimulation that activates C fibers. 10. Complex regional pain syndrome is characterized by: A) repetitious dermatome pain attacks. B) trigeminal neuralgia with facial tics. C) severe limb pain after amputation. D) disproportionate pain with mobility. 11. An otherwise-healthy patient has been referred to a pain clinic because she claims to experience exquisite pain from the friction of her clothes on her torso. This patient is likely to be diagnosed with which of the following health problems? A) Visceral pain B) Hypoalgesia C) Allodynia D) Primary hyperalgesia 12. A woman has cut her finger while dicing onions in the kitchen, causing her to drop her knife in pain. Which of the following components of this pain signal was transmitted by a third-order neuron? A) The neurons between the womans finger and the womans spinal cord B) The neurons between the thalamus and the cortex C) The neurons between the CNS and the thalamus D) The neurons of the efferent pathway that causes muscle contraction 13. A patient with a diagnosis of lung cancer has developed bone metastases resulting in severe and protracted pain. Which of the following assessment components should the nurse prioritize when assessing the patients pain? A) The appearance of grimacing, guarding, or wincing B) The presence of changes in vital signs that correspond to pain C) The patients subjective report of the character and severity of pain D) The results of a detailed neurologic assessment 14. A hospital patient has been reluctant to accept morphine sulfate despite visible signs of pain. Upon questioning, the patient reveals that he is afraid of becoming addicted to the drug. How can a member of the care team best respond to the patients concern? A) You might become addicted, but there are excellent resources available in the hospital to deal with that development. B) You should likely prioritize the control of your pain over any fears of addiction that you have. C) If you start needing higher doses to control your pain, then well address those concerns. D) Theres only a minute chance that you will become addicted to these painkillers. 15. Which of the following patients may be experiencing the effects of neuropathic pain? A) A girl whose playground accident resulted in an arm fracture B) A man with pain secondary to his poorly controlled diabetes C) An elderly woman with a stage III pressure ulcer D) A man whose pain is caused by gastric cancer 16. Which of the following statements is true of migraine headaches? A) Non-pharmacologic treatments and lifestyle modifications can control migraines in most patients. B) Surgical treatments for migraines are indicated if pharmacologic treatments are unsuccessful. C) Migraines may have a hormonal etiology in some patients. D) Opioid analgesics achieve adequate pain control in most patients. 17. Which of the following pain disorders is a manifestation of a disruption of cranial nerve function? A) Trigeminal neuralgia B) Complex regional pain syndrome C) Phantom limb pain D) Temporomandibular joint (TMJ) syndrome 18. Which of the following characteristics differentiates a migraine with aura from a migraine without aura? A) Gastrointestinal involvement in the hours leading up to the headache B) A decrease in mood and affect prior to the headache C) Lack of response to non-pharmacologic treatments D) Visual symptoms that precede the headache 19. A 44-year-old woman has sought care for the treatment of headaches that have been increasing in severity and frequency, and has been subsequently diagnosed with migraines. Which of the following teaching points should her care provider emphasize? A) Weight loss and exercise are very important components of your treatment. B) Stopping all of your current medications, even temporarily, should provide some relief. C) It would be helpful for you to take control of your diet, sleep schedule, and stress levels. D) Your headaches are likely a result of nerve disorder and, unfortunately, cannot be treated successfully. 20. Which of the following principles should underlie the pain control strategy in the care of a child with a diagnosis of cancer? A) Opioids should be avoided in order to prevent liver and kidney insult. B) Dosing and timing should aim for a steady serum level of the drug that is chosen. C) Doses of analgesia should be given only when the patients pain becomes severe. D) Drugs from numerous classifications should be used to maximize pain control. Answer Key 1. A 2. B ........................continue with answers................................ [Show More]

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