Chapter 1: Introduction to Pathophysiology
Test Bank
MULTIPLE CHOICE
1. C.Q. was recently exposed to group A hemolytic Streptococcus and subsequently developed a
pharyngeal infection. His clinic examination reveals an oral temperature of 102.3° F, skin
rash, dysphagia, and reddened throat mucosa with multiple pustules. He complains of sore
throat, malaise, and joint stiffness. A throat culture is positive for Streptococcus, and
antibiotics have been prescribed. The etiology of C.Q.’s disease is
a. a sore throat.
b. streptococcal infection.
c. genetic susceptibility.
d. pharyngitis.
ANS: B
Etiology refers to the proposed cause or causes of a particular disease process. A sore throat is
the manifestation of the disease process. Genetic susceptibility refers to inherited tendency to
develop a disease. Pharyngitis refers to inflammation of the throat and is also a clinical
manifestation of the disease process.
REF: Pg. 2
2. A 17-year-old college-bound student receives a vaccine against an organism that causes
meningitis. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: A
Primary prevention is prevention of disease by altering susceptibility or reducing exposure for
susceptible individuals by providing vaccination. Secondary prevention is the early detection,
screening, and management of the disease. Tertiary prevention includes rehabilitative and
supportive care and attempts to alleviate disability and restore effective functioning. Disease
treatment involves management of the disease once it has developed.
REF: Pg. 9
3. An obese but otherwise healthy teen is given a prescription for a low-calorie diet and exercise
program. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: B

Secondary prevention is the early detection, screening, and management of the disease such as
prescribing diet and exercise for an individual who has already developed obesity. Primary
prevention is prevention of disease by altering susceptibility or reducing exposure for
susceptible individuals. Tertiary prevention includes rehabilitative and supportive care and
attempts to alleviate disability and restore effective functioning. Disease treatment involves
management of the disease once it has developed.
REF: Pgs. 9-10
4. A patient with high blood pressure who is otherwise healthy is counseled to restrict sodium
intake. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: B
Secondary prevention is the early detection, screening, and management of the disease, such
as by prescribing sodium restriction for high blood pressure. Primary prevention is prevention
of disease by altering susceptibility or reducing exposure for susceptible individuals. Tertiary
prevention includes rehabilitative and supportive care and attempts to alleviate disability and
restore effective functioning. Disease treatment involves management of the disease once it
has developed.
REF: Pgs. 9-10
5. After suffering a heart attack, a middle-aged man is counseled to take a cholesterol-lowering
medication. This is an example of
a. primary prevention.
b. secondary prevention.
c. tertiary prevention.
d. disease treatment.
ANS: C
Tertiary prevention includes rehabilitative and supportive care and attempts to alleviate
disability and restore effective functioning such as prescribing a cholesterol lowering
medication following a heart attack. Primary prevention is prevention of disease by altering
susceptibility or reducing exposure for susceptible individuals. Secondary prevention is the
early detection, screening, and management of the disease. Disease treatment involves
management of the disease once it has developed.
REF: Pgs. 9-10
6. A patient has been exposed to meningococcal meningitis, but is not yet demonstrating signs of
this disease. This stage of illness is called the _____ stage.
a. prodromal
b. latent
c. sequela
d. convalescence
ANS: B

Incubation refers to the interval between exposure of a tissue to an injurious agent and the first
appearance of signs and symptoms. In infectious diseases, this period is often called the
incubation (latent) period. Prodromal refers to the appearance of the first signs and symptoms
indicating the onset of a disease. These are often nonspecific, such as headache, malaise,
anorexia, and nausea, which are associated with a number of different diseases. Sequela refers
to subsequent pathologic condition resulting from a disease. Convalescence is the stage of
recovery after a disease, injury, or surgical operation.
REF: Pg. 3
7. A disease that is native to a particular region is called
a. epidemic.
b. endemic.
c. pandemic.
d. ethnographic.
ANS: B
A disease that is native to a particular region is called endemic. An epidemic is a disease that
spreads to many individuals at the same time. Pandemics are epidemics that affect large
geographic regions, perhaps spreading worldwide.
REF: Pg. 6
8. In general, with aging, organ size and function
a. increase.
b. decrease.
c. remain the same.
d. is unknown.
ANS: B
In general, with aging, organ size and function decrease.
REF: Pg. 5
9. The stage during which the patient functions normally, although the disease processes are well
established, is referred to as
a. latent.
b. subclinical.
c. prodromal.
d. convalescence.
ANS: B
The stage during which the patient functions normally, although the disease processes are well
established, is called the subclinical stage. The interval between exposure of a tissue to an
injurious agent and the first appearance of signs and symptoms may be called a latent period
or, in the case of infectious diseases, an incubation period. The prodromal period, or
prodrome, refers to the appearance of the first signs and symptoms indicating the onset of a
disease. Convalescence is the stage of recovery after a disease, injury, or surgical operation.
REF: Pg. 3

MULTIPLE RESPONSE
10. Your patient’s red blood cell is slightly elevated today. This might be explained by (Select all
that apply.)
a. gender difference.
b. situational factors.
c. normal variation.
d. cultural variation.
e. illness.
ANS: A, B, C, E
Gender, situations (e.g., altitude), normal variations, and illness may all determine red blood
cell count. Culture affects how manifestations are perceived (normal versus abnormal).
REF: Pgs. 5-6
11. Socioeconomic factors influence disease development due to (Select all that apply.)
a. genetics.
b. environmental toxins.
c. overcrowding.
d. nutrition.
e. hygiene.
ANS: B, C, D, E
Socioeconomic factors influence disease development via exposure to environmental toxins
(occupational) and overcrowding, nutrition (over- or undernutrition), and hygiene (e.g., in
developing countries). Genetics is not influenced by socioeconomic factors.
REF: Pgs. 7-8
COMPLETION
12. When the cause is unknown, a condition is said to be ________.
ANS:
idiopathic
Many diseases are idiopathic in nature.
REF: Pg. 2
13. The nurse is swabbing a patient’s throat to test for streptococcal pharyngitis. The nurse must
understand that tests such as this differ in the probability that they will be positive for a
condition when applied to a person with the condition; this probability is termed ________.
ANS:
sensitivity
The sensitivity of any test refers to the probability that the test will be positive when applied
to a person with the condition and will not provide a false negative result. In contrast,
specificity is the probability that a test will be negative when applied to a person who does not
have a given condition.

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Chapter 2: Homeostasis and Adaptive Responses to Stressors
Test Bank
MULTIPLE CHOICE
1. Indicators that an individual is experiencing high stress include all the following except
a. tachycardia.
b. diaphoresis.
c. increased peripheral resistance.
d. pupil constriction.
ANS: D
Pupils dilate during stress from the effects of catecholamines. Tachycardia, diaphoresis, and
increased peripheral resistance are indicators of stress and also occur due to catecholamine
release.
REF: Pg. 18 | Pg. 21
2. Which is not normally secreted in response to stress?
a. Norepinephrine
b. Cortisol
c. Epinephrine
d. Insulin
ANS: D
Insulin secretion is impaired during stress to promote energy from increased blood glucose.
Norepinephrine is secreted during stress as a mediator of stress and adaptation. Cortisol is
secreted during stress as a mediator of stress and adaptation and stimulates gluconeogenesis in
the liver to supply the body with glucose. Epinephrine is secreted during stress as a mediator of
stress and adaptation and increases glycogenolysis and the release of glucose from the liver.
REF: Pg. 17
3. Selye’s three phases of the stress response include all the following except
a. allostasis.
b. resistance.
c. alarm.
d. exhaustion.
ANS: A
Allostasis is defined as the ability to successfully adapt to challenges. Allostasis may/may not
occur in response to stress. Alarm, resistance, and exhaustion are the three phases of the stress
response as described by Selye in the general adaptation syndrome.

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REF: Pgs. 13-14
4. Many of the responses to stress are attributed to activation of the sympathetic nervous system
and are mediated by
a. norepinephrine.
b. cortisol.
c. glucagon.
d. ACTH.
ANS: A
Norepinephrine is secreted in response to activation of the sympathetic nervous system during
stress by the adrenal medulla. Cortisol is secreted by the adrenal cortex. Glucagon is secreted by
the pancreas. ACTH is secreted by the pituitary gland.
REF: Pg. 17
5. The effects of excessive cortisol production include
a. immune suppression.
b. hypoglycemia.
c. anorexia.
d. inflammatory reactions.
ANS: A
Cortisol suppresses immune function and inflammation and stimulates appetite. Cortisol leads to
hyperglycemia by stimulating gluconeogenesis in the liver.
REF: Pgs. 21-22
6. All the following stress-induced hormones increase blood glucose except
a. aldosterone.
b. cortisol.
c. norepinephrine.
d. epinephrine.
ANS: A
Aldosterone results in water and sodium retention and potassium loss in the urine. It does not
affect blood glucose. Cortisol is a glucocorticoid secreted by the adrenal cortex. Cortisol
stimulates gluconeogenesis in the liver, thus increasing blood glucose. Norepinephrine inhibits
insulin secretion, thus increasing blood sugar. Epinephrine increases glucose release from the
liver and inhibits insulin secretion, thus increasing blood glucose.
REF: Pgs. 17-19

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7. Allostasis is best defined as
a. steady state.
b. a state of equilibrium, of balance within
the organism.
c. the process by which the body heals
following disease.
d. the overall process of adaptive change
necessary to maintain survival and
well-being.
ANS: D
Allostasis refers to the overall process of adaptive change necessary to maintain survival and
well-being.
REF: Pg. 13
8. The primary adaptive purpose of the substances produced in the alarm stage is
a. energy and repair.
b. invoke resting state.
c. produce exhaustion.
d. set a new baseline steady state.
ANS: A
These resources are used for energy and as building blocks, especially the amino acids, for the
later growth and repair of the organism. The substances do not produce a resting state. The
substances can produce exhaustion if they continue, but that is not the adaptive purpose of these.
Although a new baseline steady state may result from the stress response that is not the adaptive
purpose of the substances produced during the alarm stage.
REF: Pgs. 15-16
9. Persistence of the alarm stage will ultimately result in
a. stress reduction.
b. permanent damage and death.
c. movement into the resistance stage.
d. exhaustion of the sympathetic nervous
system.
ANS: B
If the alarm stage were to persist, the body would soon suffer undue wear and tear and become
subject to permanent damage and even death. Actions taken by the individual during the
resistance stage lead to stress reduction. The resistance stage may or may not occur following the

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alarm stage, based on resource availability. The sympathetic nervous system will continue to
function, resulting in continued release of stress hormones.
REF: Pg. 16
10. The effect of stress on the immune system
a. is unknown.
b. has been demonstrated to be non-existent
in studies.
c. most often involves enhancement of the
immune system.
d. may involve enhancement or impairment
the immune system.
ANS: D
Many studies demonstrate that long-term stress impairs the immune system, but many
researchers identify that short-term stress may enhance the immune system.
REF: Pg. 19
MULTIPLE RESPONSE
11. Aldosterone may increase during stress, leading to (Select all that apply.)
a. decreased urinary output.
b. increased blood potassium.
c. increased sodium retention.
d. increased blood volume.
e. decreased blood pressure.
ANS: A, C, D
Aldosterone increases water and sodium reabsorption and potassium excretion by the renal distal
tubules and collecting ducts, thus leading to decreased urinary output, sodium retention in the
body, and increased extracellular fluid volume. Because it leads to potassium excretion,
aldosterone leads to decreased blood potassium.
REF: Pg. 18
12. Chronic activation of stress hormones can lead to (Select all that apply.)
a. cardiovascular disease.
b. depression.
c. impaired cognitive function.
d. autoimmune disease.

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e. overactive immune function.
ANS: A, B, C, D
Excessive cortisol levels promote hypertension, atherosclerosis, and the development of
cardiovascular disease. Chronic overactive stress hormones may result in atrophy and death of
brain cells. Elevated levels of stress hormones are found in individuals with depressive disorders.
Chronic stress leads to immune function impairment, rather than overactive immune function,
and has been implicated in autoimmune disorders.
REF: Pgs. 21-22
13. Events which occur during the alarm stage of the stress response include secretion of (Select all
that apply.)
a. catecholamines.
b. ACTH.
c. glucocorticoids.
d. immune cytokines.
e. TSH.
ANS: A, B, C, D
During the alarm stage, catecholamines (epinephrine, norepinephrine), ACTH, glucocorticoids,
and immune cytokines are secreted. TSH is not secreted during the stress response.
REF: Pgs. 14-15

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Chapter 3: Cell Structure and Function
Test Bank
MULTIPLE CHOICE
1. Glycolysis is the metabolic process of breaking down a glucose molecule to form
a. CO2 and H2O.
b. 2 ATP and 2 pyruvate.
c. 30 ATP.
d. oxygen.
ANS: B
Glycolysis produces a net gain of 2 ATP molecules and breaks down glucose modules to
produce two pyruvate molecules. Oxidative phosphorylation produces CO2 and H2O.
Oxidative phosphorylation produces 30 ATP molecules. Oxygen is not produced by
glycolysis, but it is necessary for oxidative phosphorylation.
REF: Pg. 34
2. The benefit of glycolysis is that this phase supplies
a. ATP to meet energy needs of the body.
b. pyruvate to the citric acid cycle.
c. energy for oxidative phosphorylation
d. lactate during anaerobic conditions.
ANS: B
The benefit of glycolysis is to supply pyruvate to the citric acid cycle of cellular metabolism,
which then produces much ATP. Glycolysis only produces 2 ATP modules, which is
insufficient for energy needs. Glycolysis does not supply energy for oxidative
phosphorylation. Lactate produced during prolonged anaerobic conditions builds up and can
lead to lactic acidosis, which is an undesirable outcome.
REF: Pg. 34
3. Repolarization of a neuron after a depolarizing action potential is due to
a. activation of the Na+-K+ pump.
b. influx of calcium.
c. efflux of potassium.
d. influx of sodium.
ANS: C
Repolarization is due to efflux of potassium from the cell. The Na+-K+ pump maintains
cellular volume via osmotic pressure and helps to maintain resting membrane potential.
Calcium influx prolongs the action potential. Influx of sodium initiates depolarization.
REF: Pg. 45
4. Excitable cells are able to conduct action potentials because they have
a. receptors for neurotransmitters.
b. tight junctions.

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c. ligand-gated channels.
d. voltage-gated channels.
ANS: D
Voltage-gated channels respond to changes in membrane potential and are responsible for
conducting action potentials. Receptors for neurotransmitters allow neurotransmitters to bind
to the cell membrane but are not directly responsible for action potentials in excitable cells.
Tight junctions are intercellular connections that help segregate proteins on the cell membrane
and are not involved in conducting action potentials. Ligand-gated channels respond to
binding of a signaling molecule such as a neurotransmitter, but are not directly responsible for
action potentials in excitable cells.
REF: Pgs. 42-44
5. The resting membrane potential in nerve and skeletal muscle is determined primarily by
a. extracellular sodium ion concentration.
b. the ratio of intracellular to extracellular potassium ions.
c. activation of voltage-gated sodium channels.
d. activity of energy-dependent membrane pumps.
ANS: B
The major determinant of the resting membrane potential is the difference in potassium ion
concentration across the membrane. Extracellular sodium helps to maintain cell volume and
resting membrane potential but it is not the primary determinant. Activation of voltage-gated
sodium channels help to initiate an action potential. Channels are not linked to an energy
source; ions flow passively across the cell membrane.
REF: Pgs. 42-43
6. An increase in extracellular potassium ion from 4.0 to 6.0 mEq/L would
a. hyperpolarize the resting membrane potential.
b. make it more difficult to reach threshold and produce an action potential.
c. hypopolarize the resting membrane potential.
d. alter the threshold potential.
ANS: C
An increase in extracellular potassium hypopolarizes the cell (makes it less negative) because
more K+ ions stay inside the cell owing to the reduced concentration gradient.
Hyperpolarization of the resting membrane potential (makes it more negative) is caused by a
decrease in extracellular potassium. Hyperpolarization due to a decrease in extracellular
potassium makes it more difficult to reach threshold and produce an action potential. The
threshold for action potential does not change with a change in extracellular potassium.
REF: Pg. 43
7. GTP-binding proteins (G proteins) function to
a. activate receptors on the extracellular surface.
b. degrade second-messenger molecules.
c. activate intracellular enzyme systems.
d. synthesize ATP.
ANS: C

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G-proteins activate specific target enzymes within the cell and these enzymes then produce
second messenger molecules that trigger specific intracellular function. Membrane-bound
G-protein channels are a component of the cell membrane; they do not activate other receptors
on the extracellular surface. G-proteins do not degrade second messengers, but instead
produce these. G-proteins do not synthesize ATP.
REF: Pg. 49
8. Phospholipids spontaneously form lipid bilayers, because they are
a. polar.
b. charged.
c. insoluble.
d. amphipathic.
ANS: D
Phospholipids have a hydrophilic (water-loving) polar end and a hydrophobic (water-fearing)
polar end. This amphipathic nature causes the lipids to form bilayers. It is the water-loving
and water-fearing nature of the end rather than simply being polar, charged, or insoluble that
forms the bilayers.
REF: Pg. 27
9. Cell-to-cell communication through secretion of chemical signals into the bloodstream to
target cells throughout the body is called _____ signaling.
a. synaptic
b. paracrine
c. endocrine
d. autocrine
ANS: C
Endocrine signaling is accomplished by specialized endocrine cells that secrete hormones that
travel via the bloodstream to target cells throughout the body. Synaptic signaling occurs at
specialized junctions between the nerve cell and its target cell; the neuron secretes a chemical
neurotransmitter into a small space between the nerve and target cell. In paracrine signaling
chemicals are secreted into a localized area, and only those cells in the immediate area are
affected. Autocrine signaling occurs when cells respond to signaling molecules that they
secrete and provides feedback to that cell rather than other cells.
REF: Pg. 47
10. Ribosomes are very important organelles within the cell that have the function of
a. detoxifying substances.
b. synthesizing proteins.
c. converting energy to forms that can be used.
d. coding for protein synthesis.
ANS: B
Ribosomes primary function is the synthesis of proteins. Lysosomes and peroxisomes
detoxify substances. Mitochondria convert energy to forms that can be used to drive cell
reactions. The nucleus contains genomic DNA that codes for protein synthesis.

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REF: Pg. 31
11. The cardiac drug digitalis enhances myocardial contraction, because it
a. increases intracellular calcium level in cardiac cells.
b. inhibits sodium from entering cardiac cells.
c. enhances the sodium-potassium pump.
d. increases the sodium gradient across the cell membrane.
ANS: A
Digitalis inhibits the sodium-potassium pump and allows the accumulation of intracellular
sodium, decreasing the sodium gradient across the cell membrane. This leads to less efficient
calcium removal by the sodium-dependent calcium pump. Increased calcium inside the
cardiac cell leads to more forceful cardiac muscle contraction to treat congestive heart failure
due to cardiac muscle weakness.
REF: Pg. 41
12. The organelle that contains enzymes necessary for oxidative phosphorylation to produce ATP
is the
a. mitochondria.
b. ribosome.
c. lysosome.
d. nucleus.
ANS: A
The inner membrane of the mitochondria contains many enzymes that promote oxidative
phosphorylation which produces ATP. Ribosomes synthesize proteins. Lysosomes and
peroxisomes detoxify substances. The nucleus contains genomic DNA that codes for protein
synthesis.
REF: Pg. 32
13. Ion channels open and close in response to all the following except
a. mechanical pressure.
b. ligand binding.
c. voltage changes.
d. temperature changes.
ANS: D
No temperature change channels are present on the cell membrane. Mechanically gated
channels respond to mechanical deformation. Ligand-gated channels respond to the binding of
a signaling molecule (neurotransmitter or hormone). Voltage-gated channels respond to a
change in membrane potential.
REF: Pg. 42
14. Gap junctions are connecting channels that allow passage of small molecules from one cell to
the next and are especially important for
a. distance signaling.
b. tissues requiring synchronized function.
c. communication within a cell.

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d. passage of large molecules.
ANS: B
Gap junctions are especially important in tissues in which synchronized functions are required
such as in cardiac muscle contraction. Gap junctions are channels between adjacent cells, not
distant cells. Gap junctions function to promote communication not within a cell, but between
adjacent cells. Gap junctions allow passage of small molecules, but not large molecules.
REF: Pg. 45
COMPLETION
15. During conditions of prolonged insufficient oxygen availability (e.g., respiratory or
cardiovascular disease) anaerobic glycolysis accumulated pyruvate can lead to _____ acidosis.
ANS:
lactic
Pyruvate is converted to lactate and released into the blood stream, resulting in lactic acidosis.
REF: Pg. 34
16. The phase of cellular metabolism in which energy is released during breakdown of nutrient
sources is ________.
ANS:
catabolism
Catabolism involves energy release via breakdown of nutrient sources such as glucose to
provide ATP to the cell. In contrast, anabolism refers to energy-using processes that result in
complex molecules such as fats.
REF: Pg. 34
17. Some individuals inherit a gene that results in dangerously high blood cholesterol due to
impaired ________ of low-density lipoproteins (LDLs).
ANS:
endocytosis
The defective gene inhibits the synthesis of LDL protein receptors on the cell membrane. This
impairs endocytosis of LDL. High levels of LDL in the blood predispose to atherosclerosis.
REF: Pg. 38

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Test Bank For Pathophysiology, 6th Edition

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