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Davis Advantage for Medical-Surgical Nursing Making Connections to Practice 2nd Edition by Janice J. Hoffman, Nancy J. Sullivan
Davis Advantage for Medical-Surgical Nursing Making Connections to Practice 2nd Edition by Janice J. Hoffman, Nancy J. Sullivan
ATI MED SURG PROCTORED EXAM 2024 RETAKE WITH NGN QUESTIONS AND ANSWERS (VERIFIED ANSWERS)GRADED A
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TEST BANK FOR Davis Advantage for Medical-Surgical
Nursing Making Connections to Practice 2nd Edition by
Janice J. Hoffman, Nancy J. Sullivan
Which of the following connective tissue components is located in the ECM but not
in the ground substance?
a. Collagen bundles
b. Fibronectin
c. GAGs
d. Hyaluronan
e. Proteoglycans - ANSWER:*The answer is A.* Collagen is found in the ECM, but not
in the ground substance.
What cells numerous in loose connective tissue are filled with secretory granules and
stain with metachromasia?
a. Macrophages
b. Mast cells
c. Fibrocytes
d. Active fibroblasts
e. Leukocytes - ANSWER:*The answer is B.* Mast cells are found in connective tissue
and are filled with secretory granules with molecules such as histamine and heparin.
Mast cells are stained with metachromasia
What is the first step of collagen production that occurs after the protein undergoes
exocytosis?
a. Cross-linking of collagen fibrils with a short linking collagen
b. Removal of the terminal nonhelical domains by peptidases
c. Hydroxylation of lysine and proline
d. Assembly of subunits to form a larger structure
e. Disulfide bond formation - ANSWER:*The answer is B.* In collagen synthesis, after
the procollagen undergoes exocytosis, the terminal nonhelical domains are cleaved
by procollagen peptidase.
What is an important part of the role played by macrophages during maintenance
and renewal of strong extracellular fibers in connective tissue?
a. Storage for a major energy source needed for ECM maintenance
b. Production of specific collagen subunits
c. A sentinel function against invaders entering the ECM
d. Secretion of matrix metalloproteinases
e. Presentation of antigens important for assembly of collagen bundles -
ANSWER:*The answer is C.* Macrophages are large white blood cell that removes
bacteria, foreign particles, and dead cells. Therefore, they play a sentinel function
against invaders entering the ECM
,Sulfated GAGs are important constituents of what extracellular structures?
a. Hyaluronan
b. Elastic fibers
c. Type I collagen
d. Proteoglycans
e. Multiadhesive glycoproteins - ANSWER:*The answer is D.* Sulfated GAGs are
important constituents of proteoglycans.
Which of the following contains binding sites for integrins and is an important part of
the ECM in both loose connective tissue and dense irregular connective tissue?
a. Aggrecan
b. Fibronectin
c. Perlecan
d. Fibrillin
e. Most types of collagen - ANSWER:*The answer is D.* Fibrillin contains binding
sites for integrins and is an important part of the ECM in both loose connective tisse
and dense irregular connective tissue.
Dense regular connective tissue typically involves which of the following features?
a. Contains mostly synthetically active fibroblasts
b. Contains much ground substance
c. Contains a similar cell population as areolar connective tissue
d. Predominant tissue type in the stroma of most organs
e. Predominantly located in tendons and ligaments - ANSWER:*The answer is E.*
Dense regular connective tissue is predominantly located in tendons and ligaments.
Research scientists at a small biotech firm are investigating new methods of
controlling the growth and metastasis of malignant cells in patients diagnosed with
breast cancer. They have developed a novel peptide-based drug, potentially
deliverable therapeutically, that disrupts the tumor cells' ability to adhere to the
ECM, which in turn triggers apoptosis. Which of the following is a most likely target
of such drugs?
a. Cadherins
b. Adhesins
c. Integrins
d. Glycolipids of the cell membrane
e. Fibrillin - ANSWER:*The answer is C.* Integrins provide a link between the internal
cytoskeleteon of cells and extracellular proteins.
A 36-year-old man is referred by his family physician to the pulmonary clinic. He
complains of shortness of breath following physical activity and decreased capacity
for exercise. He says that strenuous exercise including yard work is impossible
without sitting down and resting every few minutes. After taking several deep
breaths during the physical examination, he begins to wheeze. He is not a smoker
and works in an office not exposed to dust, fumes, or other irritants. He appears
slightly jaundiced. Serum alpha-1-antitrypsin (AAT) concentration analysis is below
, normal and is followed up with AAT phenotype and DNA testing which indicates one
copy of S and one of Z mutations with 40% abnormal AAT production. Urinalysis
shows elevated levels of desmosine and isodesmosine. These excreted compounds
normally contribute to efficient lung function by which of the following mechanisms?
a. Post-translational modification o - ANSWER:*The answer is B.* Desmosine
connects one elastin molecule to another providing structure while being stretched.
A 33-year-old homeless woman has been living in an abandoned building eating
dried meat and bread from the dumpster behind a delicatessen. She smokes
cigarettes "bummed" from others. She presents at a free clinic with bleeding under
the skin, particularly around hair follicles, and bruises on her arms and legs. She is
irritable, clinically depressed, and fatigued with general muscle weakness. Her gums
are bleeding, swollen, purple, and spongy, with several loose teeth. She has an
infected toe, which may be broken. She is afebrile, a glucose finger-stick is normal,
and the urine dipstick shows no sugar, protein, or ketones. You suspect a vitamin
deficiency. What might be the underlying mechanism for this patient's symptoms?
a. Decreased degradation of collagen
b. Stimulation of prolyl hydroxylase
c. Formation of unstable collagen helices
d. Excessive callus formation in healing fractures
e. Organ fibrosis - ANSWER:*The answer is C.* This patient has Scurvy, a deficiency in
Vitamin C. As a result, lysine and proline residues cannot be hydroxylated and she is
unable to form stable collagen helices.
A 7-year-old girl repeatedly sprains her ankles badly. The injuries appear to result
during normal play activity. The joints are extremely extensible, and the tendons and
skin are unusually flexible. These findings can best be explained by an inherited
disorder that affects which of the following protein families?
A. Actin
B. Collagen
C. Elastin
D. Fibrillin
E. Keratin
F. Myosin - ANSWER:*The answer is B.* Collagen is a structural protein that ensures
strength and minimizes flexibility. If the inherited disease affected collagen, the
joints then would be more flexible and, therefore, more prone to injury. Actin,
myosin, and fibrillin are proteins found in muscle. Elastin is a connective tissue
protein; if it were damaged, the skin would lose flexibility. Keratin is a structural
protein of the skin, fingernails, and hair.
What are the three basic components from which all types of connective tissue are
constructed?
A. Arteries, veins, and capillaries
B. Cells, fibrous proteins, and ground substance
C. Collagen, hyaluronic acid, and fibronectin
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