Test Bank
Applied Pathophysiology A Conceptual
Approach 4th Edition Judi Nath
Test Bank For Applied Pathophysiology A Conceptual Approach 4th Edition Judi Nath
Chapter 2, Altered Cells and Tissues
1. Which term indicates a fully differentiated body part with specialized functions?
a. Cell
b. Organ
c. Tissue
d. Organ system
ANS: B
Feedback: Organs are defined as fully differentiated body parts with specialized functions.
Organ systems are groups of organs working together for a specific function. Cells are the
smallest structural and functional units of the human organism. Tissues are groups of similar
cell types that combine to form a specific function.
PTS: 1 REF: Page and Header: 9, Introduction OBJ: 1
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
2. The charge nurse is educating a group of staff nurses about plasma membranes. Which
description of the plasma membrane is accurate?
a. Contains a single layer of lipids with polar heads
b. Contains a single layer of lipids with nonpolar heads
c. Contains a bilayer of lipids with polar heads
d. Contains a bilayer of lipids with nonpolar heads
ANS: C
Feedback: The plasma membrane represents an organized structure composed of lipids,
carbohydrates, and proteins arranged in a bilayer. The lipid bilayers are mainly made up of
phospholipids. The phosphate connected to the lipid structure is known as the “head.” The
heads are polar or hydrophilic (having an affinity to water).
PTS: 1 REF: Page and Header: 10, Plasma (Cell) Membrane
OBJ: 1
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Understand NOT: Multiple Choice
3. Which proteins in the plasma membrane project into either the intracellular or the
extracellular environment?
a. Transmembrane proteins
b. Integral proteins
c. Peripheral proteins
d. Channel proteins
ANS: C
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Test Bank For Applied Pathophysiology A Conceptual Approach 4th Edition Judi Nath
Feedback: Peripheral proteins do not pass through the entire membrane, projecting into
either the intracellular or the extracellular environment. Proteins that pass through the entire
membrane are known as transmembrane proteins, allowing communication and transport
between the extracellular and intracellular environments. Integral proteins are a specific type
of transmembrane protein that, because of the tight binding to lipid tails, becomes part of the
membrane itself. Integral proteins often form channels that allow for the transport of ions
(atoms with an electrical charge) across the plasma membrane.
PTS: 1 REF: Page and Header: 10, Plasma (Cell) Membrane
OBJ: 1
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
4. Which organelle is responsible for synthesis of proteins by bound ribosomes?
a. Rough endoplasmic reticulum
b. Smooth endoplasmic reticulum
c. Golgi apparatus
d. Lysosome
ANS: A
Feedback: The rough endoplasmic reticulum contains ribosomes bound to its membrane that
synthesize protein and produces lysosomal enzymes (acid hydrolyses). Smooth endoplasmic
reticulum is responsible for the synthesis of lipids, lipoproteins, and steroid hormones, and
the regulation of intracellular calcium. The Golgi apparatus prepares substances produced
by the endoplasmic reticulum for secretion out of the cell. Lysosomes digest cellular debris
with hydrolytic enzymes.
PTS: 1 REF: Page and Header: 11, Cytoplasm and Organelles
OBJ: 1
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
5. Which component is part of the cellular cytoskeleton?
a. Mitochondria
b. Gene
c. Cytoplasm
d. Actin
ANS: D
Feedback: The main cytoskeleton components include microtubules (thin protein structures
composed of tubulin) and microfilaments. Thin microfilaments comprise the protein actin.
Intermediate microfilaments comprise filaments with a diameter sized between thin and
thick filaments. Thick microfilaments comprise the protein myosin. The cellular
cytoskeleton does not include mitochondria, cytoplasm, or genes.
PTS: 1 REF: Page and Header: 12, Cytoskeleton OBJ: 1
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
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Test Bank For Applied Pathophysiology A Conceptual Approach 4th Edition Judi Nath
BLM: Cognitive Level: Understand NOT: Multiple Choice
6. Which transport mechanism requires energy?
a. Diffusion
b. Osmosis
c. Facilitated diffusion
d. Primary active transport
ANS: D
Feedback: Primary active transport requires the direct use of energy in the form of
adenosine triphosphate (ATP) when transporting particles across the plasma membrane.
Diffusion is the movement of particles from an area of higher concentration to an area of
lower concentration, which is an example of passive transport. Osmosis is the process by
which water passively moves across the semipermeable plasma membrane. Facilitated
diffusion is the movement of some substances across the plasma membrane aided by the use
of transport proteins.
PTS: 1 REF: Page and Header: 12, Cellular Mechanisms of Transportation
OBJ: 1
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
7. Phagocytosis is an example of which type of cellular function?
a. Ingestion
b. Respiration
c. Communication
d. Reproduction
ANS: A
Feedback: Phagocytosis is the process of ingesting large particles such as cells, bacteria, and
damaged cellular components by cells called phagocytes. This is one of the specific
processes of ingestion that allow the cell to ingest substances necessary for its own use into
the cytoplasm. Phagocytosis is not an example of respiration, communication, or
reproduction.
PTS: 1 REF: Page and Header: 13, Ingestion OBJ: 1
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Understand NOT: Multiple Choice
8. Which form of signal transduction resulting from ligand–receptor binding has the potential
to produce effects in the entire body system?
a. Endocrine
b. Paracrine
c. Autocrine
d. Local mediation
ANS: A
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Test Bank For Applied Pathophysiology A Conceptual Approach 4th Edition Judi Nath
Feedback: Endocrine signaling occurs when signal transduction affects cell behavior within
the entire organism. Paracrine signaling is ligand binding to receptors that results in signal
transduction with a local, rapid effect. Autocrine signaling and local mediation are not forms
of cell-to-cell communication.
PTS: 1 REF: Page and Header: 15, Communication
OBJ: 1
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
9. What is the process that makes cells with the same genetic material develop into specific
cell types?
a. Reproduction
b. Differentiation
c. Proliferation
d. Stimulation
ANS: B
Feedback: Cell division occurs at different times depending on the cell type and on the
signals sent to the cell for division. Differentiation, or changes in physical and functional
properties of cells, directs the cell to develop into specific cell types. As all cells contain
identical genetic material, differentiation explains why one cell contributes to the
development of one tissue while another can develop into a different tissue. This process
occurs by the repression of certain genes in a cell and the expression of others in the same
cell. Proliferation is the increase in cell number. Differentiation and proliferation are
components of cellular reproduction. Stimulation is not a component of cellular
reproduction.
PTS: 1 REF: Page and Header: 15, Reproduction
OBJ: 1
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
10. Which cellular change is caused by a reduction in functional demand?
a. Atrophy
b. Hypertrophy
c. Hyperplasia
d. Dysplasia
ANS: A
Feedback: Atrophy is the decrease in individual cell size, and it can occur for several
reasons, including a decrease in the functional demand on a cell. Hypertrophy is an increase
in cell size, and hyperplasia is an increase in cell number. Both hypertrophy and hyperplasia
can be caused by hormone signaling and an increased workload/functional demand.
Dysplasia refers to the actual change in cell size, shape, uniformity, arrangement, and
structure. Dysplasia is often a cell’s response to a chronic and persistent stressor and is
likely to resolve when the stressor is removed.
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Test Bank For Applied Pathophysiology A Conceptual Approach 4th Edition Judi Nath
PTS: 1 REF: Page and Header: 16, Atrophy OBJ: 2
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Apply NOT: Multiple Choice
11. Which term indicates increased cell size caused by an increase in functional demand?
a. Atrophy
b. Hypertrophy
c. Hyperplasia
d. Dysplasia
ANS: B
Feedback: Hypertrophy is an increase in cell size, and hyperplasia is an increase in cell
number. Both hypertrophy and hyperplasia can be caused by hormone signaling and an
increased workload/functional demand. Dysplasia refers to the actual change in cell size,
shape, uniformity, arrangement, and structure; it is often a cell’s response to a chronic and
persistent stressor. Atrophy is the decrease in individual cell size, and it can be caused by
decreased functional demand on a cell.
PTS: 1 REF: Page and Header: 17, Hypertrophy OBJ: 2
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Apply NOT: Multiple Choice
12. Which term indicates increased cell number caused by increased functional demand?
a. Atrophy
b. Hypertrophy
c. Hyperplasia
d. Dysplasia
ANS: C
Feedback: Hyperplasia is an increase in cell number, and hypertrophy is an increase in cell
size. Both hypertrophy and hyperplasia can be caused by hormone signaling and an
increased workload/functional demand. Dysplasia refers to the actual change in cell size,
shape, uniformity, arrangement, and structure; it is often a cell’s response to a chronic and
persistent stressor. Atrophy is the decrease in individual cell size, and it can be caused by
decreased functional demand on a cell.
PTS: 1 REF: Page and Header: 17, Hyperplasia OBJ: 2
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
13. What process may cause columnar cells to turn into squamous cells as a method of
adaptation to a persistent stressor?
a. Metaplasia
b. Dysplasia
c. Apoptosis
d. Hyperplasia
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Test Bank For Applied Pathophysiology A Conceptual Approach 4th Edition Judi Nath
ANS: A
Feedback: Metaplasia refers to the changing of one cell type to another. This is one way that
cells can adapt to a persistent stressor. Dysplasia refers to the actual change in cell size,
shape, uniformity, arrangement, and structure. Hyperplasia is an increase in cell number.
Apoptosis is programmed cell death prompted by a genetic signal and is designed to replace
old cells with new.
PTS: 1 REF: Page and Header: 17, Metaplasia OBJ: 3
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
14. Which term indicates cell death associated with inflammation?
a. Metaplasia
b. Dysplasia
c. Apoptosis
d. Necrosis
ANS: D
Feedback: Cell death by necrosis is a disorderly process associated with inflammation.
Necrosis is death of cells related to cell injury. Metaplasia refers to the changing of one cell
type to another. Dysplasia refers to the actual change in cell size, shape, uniformity,
arrangement, and structure. Apoptosis is programmed cell death prompted by a genetic
signal and is designed to replace old cells with new.
PTS: 1 REF: Page and Header: 19, Necrosis OBJ: 4
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Remember NOT: Multiple Choice
15. Damage to cells resulting from frostbite is classified as which type of injury?
a. Mechanical
b. Thermal
c. Chemical
d. Endogenous
ANS: B
Feedback: Thermal injury is caused by extremes of temperature, as occurs with burns and
frostbite. Mechanical injury can be caused by impact of a body part causing direct injury,
such as falling off a skateboard or a bike. Chemical toxins include both exogenous and
endogenous forms. Endogenous toxins are toxins from within the body system that cause
harm to cells. Exogenous toxins are toxins from the external environment that cause harm to
cells.
PTS: 1 REF: Page and Header: 20, Causes of Cell Injury and Death
OBJ: 4
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Apply NOT: Multiple Choice
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Test Bank For Applied Pathophysiology A Conceptual Approach 4th Edition Judi Nath
16. Which condition is most likely to be associated with atrophic changes in breast tissue?
a. Puberty
b. Pregnancy
c. Menopause
d. Menarche
ANS: C
Feedback: The aging process can result in decreased cell size (atrophy), which translates
into decreased organ size. Atrophy also can occur as a response to the removal of hormonal
signals that stimulate growth, resulting in involution, or shrinkage, of tissues and organs.
Atrophy may result in the manifestation of clinical signs and symptoms stemming from the
decrease in size and function of the organ involved.
PTS: 1 REF: Page and Header: 16, Atrophy OBJ: 5
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Apply NOT: Multiple Choice
17. While educating adolescents about menstruation, the nurse mentions that the sloughing off
of the inner lining of the uterus (the endometrium) at the start of menstruation occurs by
which physiologic process?
a. Apoptosis
b. Necrosis
c. Oxidative stress
d. Dysplasia
ANS: A
Feedback: Apoptosis can be both a physiologic and a pathologic cell response to cellular
signals. Apoptosis is programmed cell death prompted by a genetic signal and is designed to
replace old cells with new ones. Cells are programmed for death for many reasons,
including damaged genetic material or mutation, old age of the cell, and an attempt to
decrease the actual number of cells. Menstruation is the sloughing of the old lining of the
uterus. Cell death by necrosis is a disorderly process associated with inflammation. Necrosis
is the death of cells related to cell injury. Injury causes damage to cellular structures,
including the mitochondria, thereby depleting adenosine triphosphate (ATP). Dysplasia
refers to the actual change in cell size, shape, uniformity, arrangement, and structure.
Dysplasia is often a cell’s response to a chronic and persistent stressor and is likely to
resolve when the stressor is removed. Oxidative stress involves exposure of cells to reactive
oxygen species (ROS), toxic oxygen molecules or radicals that are formed by the reaction
between oxygen (O2) and water (H2O) during mitochondrial respiration. Cell damage can
result from too many ROS or not enough available enzymes, including catalase, to convert
these radicals to less harmful substances.
PTS: 1 REF: Page and Header: 19, Mechanisms of Cell Death
OBJ: 1 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter: 2 KEY: Integrated Process: Teaching/Learning
BLM: Cognitive Level: Apply NOT: Multiple Choice
18. Which client(s) is at risk for a deficit injury that can result in cellular injury and death?
Select all that apply.
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Test Bank For Applied Pathophysiology A Conceptual Approach 4th Edition Judi Nath
a. A middle-aged client with diabetes who is experiencing ischemia in the lower
extremities
b. The client with a 40 pack-year history of cigarette smoking admitted with deep
vein thrombosis
c. Female, 6 months pregnant, who is experiencing severe nausea and vomiting
d. Athlete who fell off a bike resulting in a fracture of the tibia
e. Exercise coach who has pulled a muscle in the back and experiencing some acute
pain
f. The young client who has begun an intense exercise routine along with a decreased
food intake after being called “fat”
ANS: A, B, C, F
Feedback: Damage to cells can result from deficit injury, in which the cell is deprived of
oxygenation, hydration, and nutrition. This type of injury is commonly seen in conditions of
ischemia (such as a client with diabetes and circulation issues in the lower legs or a client
with deep vein thrombosis due to smoking), severe malnutrition (such as prolonged
nausea/vomiting during pregnancy), and eating disorders such as anorexia nervosa (such as
a client exercising intensely while minimizing food intake). A pulled muscle or bone
fracture from an accident does not necessarily cause a deficit injury.
PTS: 1 REF: Page and Header: 20, Causes of Cell Injury and Death
OBJ: 4
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter: 2 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Analyze NOT: Multiple Select
19. Which statement(s) regarding testing a client for acromegaly is an accurate interpretation of
the results? Select all that apply.
a. Growth hormone levels will need to be collected daily for an entire week.
b. The best time to collect growth hormone levels is during the middle of the night.
c. Growth hormone should be measured as a component of a glucose tolerance test.
d. Following ingestion of 75 g of glucose, it is normal for growth hormone levels to
decrease.
e. An elevated growth hormone level 1 hour after the glucose ingestion indicates that
the negative feedback regulation is normal.
ANS: C, D
Feedback: Measurement of growth hormone is most accurate when measured as a
component of a glucose tolerance test because growth hormone secretion is influenced by
blood glucose levels. Under physiologic conditions, growth hormone levels decrease when
blood glucose levels rise via negative feedback regulation. Growth hormone levels can be
tested after a glucose tolerance test to determine if there is an alteration in negative
feedback, indicating pathologic secretion of growth hormone. Within 2 hours of ingestion of
75 g of glucose, growth hormone is suppressed to less than 1 ng/mL (1 µg/L) under
physiologic conditions. An elevated growth hormone level 1 hour after the glucose ingestion
indicates that glucose did not suppress growth hormone secretion, leading to the diagnosis
of acromegaly.
PTS: 1 REF: Page and Header: 25, Acromegaly OBJ: 6
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
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Test Bank For Applied Pathophysiology A Conceptual Approach 4th Edition Judi Nath
TOP: Chapter: 2 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Select
20. A woman is diagnosed with cervical intraepithelial neoplasia (CIN) with absent glandular
cell involvement and no invasive squamous cell disease. When clarifying treatment options
and educating this client about the new diagnosis, which topic(s) will the nurse include in
the discussion? Select all that apply.
a. Total hysterectomy
b. Cryosurgery
c. CO2 laser ablation
d. Electrocoagulation diathermy ablation
e. No surgical treatment options warranted at this time
ANS: B, C, D
Feedback: Treatment to remove superficial cells (ablative) is an option for women with
cervical intraepithelial neoplasia (CIN) in the absence of glandular cell involvement or
invasive squamous cell disease. Cryosurgery, a form of cold therapy that destroys mildly
dysplastic cells, is a common ablative therapy for cervical dysplasia. Liquid nitrogen is
applied to the dysplastic cells on the exocervix, identified by colposcopy via a probe placed
in the desired area. CO2 laser ablation is accomplished by directing a laser toward the
cervical lesion under colposcopic guidance, destroying the tissue by vaporization. Heat
ablation methods include cold coagulation and electrocoagulation diathermy ablation, with
variations in temperature and time of treatment associated with depth of cervical tissue
destruction. In cases of carcinoma, a hysterectomy may be indicated.
PTS: 1 REF: Page and Header: 29, Cervical Metaplasia and Dysplasia
OBJ: 7
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter: 2 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Select
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