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,Applied Pathophysiology for the Advanced Practice Nurse
Lucie Dlugasch, Lachel Story
Answers/Discussion Points for Application to Practice Questions
CHAPTER 1
APPLICATION TO PRACTICE (p. 21)
Scenario 1: A 40-year-old woman has a cervical cytology report with the following
findings: atypical squamous cells of undetermined significance. Choose the tissue level the
findings refer to:
a. Epithelial
b. Connective
c. Muscle
d. Neural
Answer: a
Rationale: The outer part of the cervix, similar to other orifices that open to the outside, is lined
with epithelial tissue. Specifically, the cervix is lined with thin, flat cells termed squamous cells,
which are a type of epithelial tissue. Other types of epithelial cells shape types are cuboidal and
columnar.
Scenario 2: A 55-year-old woman would like to get hyaluronic injection fillers for her
“laugh lines.” Choose the tissue level the injections are administered in:
a. Epithelial
b. Connective
c. Muscle
d. Neural
Answer: b
Rationale: The “laugh lines” are the nasolabial folds that extend from the edge of the nose to the
corner of the mouth, and hyaluronic acid is a component of connective tissue matrix. Generally,
fillers are administered into the connective tissue layer, which is a supporting structure located in
many parts of the body, such as the nasolabial fold, that can deepen, thin, or sag with aging.
Scenario 3: A 40-year-old man is diagnosed with a glioblastoma. Choose the tissue level the
disease is affecting:
a. Epithelial
b. Connective
c. Muscle
d. Neural
Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 1
,Applied Pathophysiology for the Advanced Practice Nurse
Lucie Dlugasch, Lachel Story
Answers/Discussion Points for Application to Practice Questions
Answer: d
Rationale: A glioblastoma is part of neural tissue. Neuroglial (glial) cells are a type of neural
cells that function in a supporting role.
Scenario 4: A 72-year-old woman has a cystoscopy/biopsy report with the following
findings: transitional cell carcinoma of the bladder. Choose the tissue level the disease is
affecting:
a. Epithelial
b. Connective
c. Muscle
d. Neural
Answer: a
Rationale: The lining of the bladder consists of urothelium comprised of transitional epithelial
cells. Transitional epithelial cells line the inside of many organs.
APPLICATION TO PRACTICE (p. 23)
Review and interpret the following endometrial biopsy reports that were completed for two
women with postmenopausal bleeding.
Report 1: Atrophic Endometrium
The findings of this report reveal that the cells in the lining of the endometrium have decreased
in size and number. Because the woman is postmenopausal, a likely cause of the atrophy is loss
of endocrine function (e.g., reduced estrogen) that occurs after menopause. Other causes of
atrophy include disuse, denervation, endocrine hypofunction, inadequate nutrition, and ischemia.
Report 2: Atypical Adenomatous Hyperplasia
The findings of this report reveal that the cells in the endometrial lining have mutated into a
different size, shape, and appearance. Atypical hyperplasia, also known as dysplasia, typically
has cells that are regarded as precancerous. Therefore, this report raises suspicion for a
pathologic condition such as uterine cancer.
Review and interpret the following esophageal biopsy reports that were done for two
people with history of persistent gastroesophageal reflux disease despite therapy.
Report 1: Low-grade dysplasia
Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 2
, Applied Pathophysiology for the Advanced Practice Nurse
Lucie Dlugasch, Lachel Story
Answers/Discussion Points for Application to Practice Questions
Dysplasia refers to cells that have mutated into a different size, shape, and appearance.
Dysplastic changes are often implicated as precancerous cells. Therefore, this report is consistent
with the presence of precancerous cells of the esophagus.
Report 2: Intestinal metaplasia
Metaplasia refers to adult cells being replaced by a cell type that is less mature. This is often
initiated by chronic irritation and inflammation. In this case, the most likely cause of this cellular
change is the persistent gastroesophageal reflux that has caused chronic irritation and
inflammation of the esophagus. The cells can become cancerous if the stimulus is not removed.
APPLICATION TO PRACTICE (p. 44)
Case 1: Mary and John want to have a second child. They have a 10-year-old with Down
syndrome, and they have questions about the risk of having a second child with Down
syndrome. Explain the risks for the development of Down syndrome and the recurrence
risk in a second pregnancy.
Most cases of Down syndrome are a result of nondisjunction of the maternal egg (up to 95% of
cases) and to a lesser extent paternal sperm cell nondisjunction. Nondisjunction occurs as a
random event during cell division. Although most Down syndrome cases are not hereditary,
some translocations can be passed on to offspring. Those individuals with a stable translocation
can be unaffected yet they can pass down the stable abnormal translocation to an offspring. In
the offspring, the once-stable translocation can become unstable and result in Down syndrome.
The risk of having a second child with Down syndrome is dependent on why the couple’s first
child had Down syndrome. If the case was random, then the risk is not higher, but if the case is a
result of the parent having a translocation, then the risk is higher. Other factors to consider in
terms of risk of a child being born with Down syndrome are maternal age, possibly paternal age,
and exposure to environmental teratogens.
Case 2: A 5-year-old boy was just diagnosed with red–green color blindness. His parents
are concerned and want clarification regarding how their son got this disorder because
they have a daughter who does not have the disorder. Answer the following questions his
parents have about the new diagnosis.
1. How is red–green color blindness inherited?
2. Why does our daughter not have this disorder?
Red–green color blindness is an X-linked recessive disorder. Fathers do not pass on X
chromosomes to their sons, only to their daughters; fathers pass Y chromosomes to their sons.
Mothers, however, pass X chromosomes to both daughters and sons. In the case of red–green
color blindness, a mother will usually be a carrier (i.e., has defect but is unaffected by the
Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 3
We have all what you need with best price,
Only find what you need and make payment and get your order, Or email us with full name with your
request.
We will give you best best price other than this price.
Our email:
Our websites:
Nursing-pub.com
testbanks-store.com
,Applied Pathophysiology for the Advanced Practice Nurse
Lucie Dlugasch, Lachel Story
Answers/Discussion Points for Application to Practice Questions
CHAPTER 1
APPLICATION TO PRACTICE (p. 21)
Scenario 1: A 40-year-old woman has a cervical cytology report with the following
findings: atypical squamous cells of undetermined significance. Choose the tissue level the
findings refer to:
a. Epithelial
b. Connective
c. Muscle
d. Neural
Answer: a
Rationale: The outer part of the cervix, similar to other orifices that open to the outside, is lined
with epithelial tissue. Specifically, the cervix is lined with thin, flat cells termed squamous cells,
which are a type of epithelial tissue. Other types of epithelial cells shape types are cuboidal and
columnar.
Scenario 2: A 55-year-old woman would like to get hyaluronic injection fillers for her
“laugh lines.” Choose the tissue level the injections are administered in:
a. Epithelial
b. Connective
c. Muscle
d. Neural
Answer: b
Rationale: The “laugh lines” are the nasolabial folds that extend from the edge of the nose to the
corner of the mouth, and hyaluronic acid is a component of connective tissue matrix. Generally,
fillers are administered into the connective tissue layer, which is a supporting structure located in
many parts of the body, such as the nasolabial fold, that can deepen, thin, or sag with aging.
Scenario 3: A 40-year-old man is diagnosed with a glioblastoma. Choose the tissue level the
disease is affecting:
a. Epithelial
b. Connective
c. Muscle
d. Neural
Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 1
,Applied Pathophysiology for the Advanced Practice Nurse
Lucie Dlugasch, Lachel Story
Answers/Discussion Points for Application to Practice Questions
Answer: d
Rationale: A glioblastoma is part of neural tissue. Neuroglial (glial) cells are a type of neural
cells that function in a supporting role.
Scenario 4: A 72-year-old woman has a cystoscopy/biopsy report with the following
findings: transitional cell carcinoma of the bladder. Choose the tissue level the disease is
affecting:
a. Epithelial
b. Connective
c. Muscle
d. Neural
Answer: a
Rationale: The lining of the bladder consists of urothelium comprised of transitional epithelial
cells. Transitional epithelial cells line the inside of many organs.
APPLICATION TO PRACTICE (p. 23)
Review and interpret the following endometrial biopsy reports that were completed for two
women with postmenopausal bleeding.
Report 1: Atrophic Endometrium
The findings of this report reveal that the cells in the lining of the endometrium have decreased
in size and number. Because the woman is postmenopausal, a likely cause of the atrophy is loss
of endocrine function (e.g., reduced estrogen) that occurs after menopause. Other causes of
atrophy include disuse, denervation, endocrine hypofunction, inadequate nutrition, and ischemia.
Report 2: Atypical Adenomatous Hyperplasia
The findings of this report reveal that the cells in the endometrial lining have mutated into a
different size, shape, and appearance. Atypical hyperplasia, also known as dysplasia, typically
has cells that are regarded as precancerous. Therefore, this report raises suspicion for a
pathologic condition such as uterine cancer.
Review and interpret the following esophageal biopsy reports that were done for two
people with history of persistent gastroesophageal reflux disease despite therapy.
Report 1: Low-grade dysplasia
Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 2
, Applied Pathophysiology for the Advanced Practice Nurse
Lucie Dlugasch, Lachel Story
Answers/Discussion Points for Application to Practice Questions
Dysplasia refers to cells that have mutated into a different size, shape, and appearance.
Dysplastic changes are often implicated as precancerous cells. Therefore, this report is consistent
with the presence of precancerous cells of the esophagus.
Report 2: Intestinal metaplasia
Metaplasia refers to adult cells being replaced by a cell type that is less mature. This is often
initiated by chronic irritation and inflammation. In this case, the most likely cause of this cellular
change is the persistent gastroesophageal reflux that has caused chronic irritation and
inflammation of the esophagus. The cells can become cancerous if the stimulus is not removed.
APPLICATION TO PRACTICE (p. 44)
Case 1: Mary and John want to have a second child. They have a 10-year-old with Down
syndrome, and they have questions about the risk of having a second child with Down
syndrome. Explain the risks for the development of Down syndrome and the recurrence
risk in a second pregnancy.
Most cases of Down syndrome are a result of nondisjunction of the maternal egg (up to 95% of
cases) and to a lesser extent paternal sperm cell nondisjunction. Nondisjunction occurs as a
random event during cell division. Although most Down syndrome cases are not hereditary,
some translocations can be passed on to offspring. Those individuals with a stable translocation
can be unaffected yet they can pass down the stable abnormal translocation to an offspring. In
the offspring, the once-stable translocation can become unstable and result in Down syndrome.
The risk of having a second child with Down syndrome is dependent on why the couple’s first
child had Down syndrome. If the case was random, then the risk is not higher, but if the case is a
result of the parent having a translocation, then the risk is higher. Other factors to consider in
terms of risk of a child being born with Down syndrome are maternal age, possibly paternal age,
and exposure to environmental teratogens.
Case 2: A 5-year-old boy was just diagnosed with red–green color blindness. His parents
are concerned and want clarification regarding how their son got this disorder because
they have a daughter who does not have the disorder. Answer the following questions his
parents have about the new diagnosis.
1. How is red–green color blindness inherited?
2. Why does our daughter not have this disorder?
Red–green color blindness is an X-linked recessive disorder. Fathers do not pass on X
chromosomes to their sons, only to their daughters; fathers pass Y chromosomes to their sons.
Mothers, however, pass X chromosomes to both daughters and sons. In the case of red–green
color blindness, a mother will usually be a carrier (i.e., has defect but is unaffected by the
Copyright © 2024 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 3
