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Answer Key 1
Answer Key
CHAPTER 1—INTRODUCTION TO ANATOMY 11. Mitosis
AND PHYSIOLOGY 12. Phagocytosis
13. Organ
Crossword Puzzle 14. Pinocytosis
Across Down
3. Cell 1. Nucleus
5. Tissue 2. Diffusion
8. System 4. Filtration
9. Membranes 6. Homeostasis
10. Cytoplasm 7. Osmosis
Table Activity
2. See Table 1.6 for additional information.
One Body Part of
Major System Major System Function
Lungs Respiratory Exchange of carbon dioxide for oxygen; regulation of acid-base
balance
Blood vessels Cardiovascular Transportation of nutrition, water, oxygen, and wastes
Brain Nervous Coordination of body’s activities; communication
Stomach Digestive Mechanical and chemical breakdown of food; absorption of
nutrients
Kidneys Urinary Clearing blood of waste products; water and electrolyte balance;
acid-base balance
Bones Skeletal Support; movement; storage of minerals; blood cell formation
Voluntary muscles Muscular Movement; maintenance of posture; heat production
Skin Integumentary Protection; regulation of body temperature; synthesis of
chemicals; sense organ
Thyroid gland Endocrine Production of hormones that affect metabolism
Lymph nodes Lymphatic Protection
Gonads Reproductive Production of sex cells
Figure Labeling: Planes of the Body caudal and cranial portions. See Figure 1.2 for
3. The sagittal plane runs lengthwise from the additional information.
front to the back. A sagittal cut gives a right
and a left portion of the body. A midsagittal cut Multiple Choice
gives two equal halves. The coronal (frontal) 4. Answer 4: Nursing documentation should
plane divides the body into a ventral (front) include medical terminology and specific
section and a dorsal (back) section. The trans- details that describe assessment findings, in-
verse plane cuts the body horizontal to the sag- terventions, or evaluation. (Note to student:
ittal and frontal planes, dividing the body into patient statements can be used in nursing
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2 Answer Key
documentation but should be placed in quota- of vomiting and abdominal pain. A proximal
tion marks.) obstruction is one that is closer to the begin-
5. Answer 2: Water and small solutes from blood ning of the small intestine; therefore, the block-
vessels are filtered through the kidneys. This age is higher up in the system. Vomiting can
leads to the formation of urine. See Tables 1.3 occur whenever there is an intestinal obstruc-
1.4 for additional information. tion; however, in a distal large intestinal ob-
6. Answer 3: Dorsal or posterior is toward the struction, vomiting is less likely. If it develops,
back of the body. The perineal area is inferior it usually occurs later and the emesis could
to the umbilicus. The front of the chest is the have a fecal odor.
anterior surface. The face and top of the head 18. Answer 1: The epidermis or skin is composed
are superior to the rest of the body. of stratified squamous tissue. One of the main
7. Answer 1: The dorsalis pedis pulse is on the functions is to protect the body from infection.
top of the foot and is the most distal pulse in Bones are for strength and structure. Simple
the lower extremity. The popliteal is behind the columnar tissue participates in the secretion of
knee (can be difficult to locate). The posterior mucus. Adipose tissue provides insulation.
tibial pulse is behind the medial malleolus (lat- 19. Answer 3: The mucous membranes are de-
eral ankle). The femoral pulse is in the groin signed to trap microorganisms, and dryness
area. decreases that function. Poor oral hygiene con-
8. Answer 3: Medial is toward the midline. The tributes to respiratory infection, especially for
sternum is in the middle of the chest. patients who are bedridden. Patients who are
9. Answer 4: The plasma membrane contains sur- in a coma are not given solid food. Dignity and
face proteins that identify a cell as coming from preservation of the teeth are desirable for all
one particular individual. Tissue typing is per- patients.
formed for compatibility to reduce the chances 20. Answer 3: The bursae are small cushionlike
of rejection of a transplanted organ. sacs that are found between joints; therefore,
10. Answer 1: A muscle cell cannot operate prop- the nurse would assess the movement and dis-
erly unless the intracellular Ca2+ concentration comfort of the major joints.
is kept low during rest. 21. Answer 3: The flagella propel the sperm to-
11. Answer 2: Hematopoietic disorders affect the ward the ovum for fertilization.
blood cell–producing cells located in the red 22. Answer 4: In biofeedback, patients with asth-
bone marrow; a decreased red blood cell count ma attacks are taught to increase awareness of
is anticipated. Potassium and glucose are elec- physical response (smooth muscle contraction,
trolytes. Blood urea nitrogen reflects kidney which impairs breathing) and increase control
function. over the response.
12. Answer 3: The spleen plays an important role 23. Answer 1: The function of adipose tissue (fat)
in immune function. Loss of the spleen increas- is insulation, support, and reserve food. The di-
es the patient’s risk for developing infections. etitian would be consulted to design a diet that
13. Answer 3: The gallbladder is located just below would supply the nutrients to recover health
the right ribs. The spleen is on the left side. The and build up reserves.
small intestine and cecum are located in the 24. Answer 2: Nursing documentation is a legal
lower abdominopelvic cavity. record of care that was given to the patient.
14. Answer 2: The urinary bladder is located in This note shows that the patient had a position
the hypogastric region. See Figure 1.4 for addi- change every 2 hours. Position change is one
tional information. intervention used to prevent pressure injuries
15. Answer 1: The stomach is located in the epi- and other complications associated with immo-
gastric region. See Figure 1.4 for additional bility. Based on the type of risks that the patient
information. has, the nurse might also use additional inter-
16. Answer 2: The appendix is located in the right ventions; for example, skin assessment, range-
lower quadrant. See Figure 1.5 for additional of motion, incentive spirometer, toileting, or
information. oral fluids.
17. Answer 4: Once diagnosed, patients are usu-
ally placed on “nothing by mouth” (NPO), but
a patient who develops a small bowel obstruc-
tion at home will often seek health care because
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Answer Key 3
Critical Thinking Activities NEXT-GENERATION NCLEX™ (NGN)
28. Answer: 1 Anterior, 2 Right hypochondriac
Activity 1 region, 3 Deep: Anterior or ventral refers to the
25. Knowledge of how the body works helps the front of the body. Posterior or dorsal refers to the
nurse distinguish normal findings from ab- back of the body. Lateral refers to the side. The
normal findings. Knowledge of location and sagittal plane extends the length of the body
function of organs helps the nurse predict the from front to back. See Figs. 1.1 and 1.2 for ad-
involvement of underlying structures related ditional information. The body is divided into
to patients’ reports of pain and discomfort nine abdominal regions. See Fig. 1.4. The right
and design interventions that will enhance hypochondriac region contains the right lobe of
function or repair dysfunction. Knowledge of the liver and the gallbladder. Epigastric region
physiology at the cellular level helps the nurse includes portions of the liver and most of the
implement interventions that keep the body in stomach. Hypogastric region includes some of
homeostasis. the small intestine, the urinary bladder, and the
appendix. Right lumbar region includes some
Activity 2 of the large and small intestine. Left iliac region
26. A 2-cm ecchymosis on distal tip of first digit of includes portions of the colon and the small
right foot. intestine. The nurse rarely uses deep palpa-
tion. When solid organs such as the gallbladder
Activity 3 are inflamed, swollen, or diseased, there is an
27. Accuracy is an important part of documenta- increased risk for rupture. Gentle palpation,
tion; thus, using the patient’s words in direct lateral or inferior to the site of pain, could be
quotes is acceptable. In addition, assessment performed to determine the size and extent
data should reflect the nurse’s ability to make of the involved area. Superficial touch could
and record professional observations. When be used to elicit sensitivity or pain on the skin
the nurse’s records are reviewed by other surface.
health care professionals or by legal or finan-
cial consultants, use of correct terminology and
accuracy reflect the quality of care.
CHAPTER 2—CARE OF THE SURGICAL PATIENT
Table Activity
1.
Assessment Normal Findings Frequency
a. Vital signs Same as or close to preoperative q 15 minutes x 4, q 30 minutes x 4,
q 60 minutes x 4, q 4 hours x 4, until
assessments are within normal range
b. Incision Dressing dry and intact; no drainage Every time vital signs are assessed
c. Respiratory effort Breathing comfortably without Assess concurrently with vital signs
dyspnea
d. Pain Relieved by analgesics and Assess concurrently with vital signs
nonpharmacologic methods
e. Urinary function Voids at least 30 mL/hour Within 6-8 hours of surgery
f. Vascular Extremities are warm, pulse present; q 2 hours
skin color normal for patient
g. Activity Muscle-strengthening exercises, Per health care provider’s orders and
sitting, dangling, and walking; patient’s ability
gradual progression toward baseline
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4 Answer Key
Matching assessments that are most relevant to the skin
2. d preparation relate to skin impairment (e.g.,
3. a infection, irritation, bruises, lesions) and skin
4. f allergies. Skin infections could be a source of
5. e wound infection. Bruises, irritation, and lesions
6. b should be noted as preexisting conditions of
7. g the surgical procedure. Skin allergies impact
8. c the types of solutions, medications, and equip-
9. i ment that contact the skin. Any abnormal as-
10. h sessment findings are recorded and reported to
the surgeon.
Multiple Choice 17. Answer 4: An oral airway can be inserted to
11. Answer 2: Patients are generally encouraged keep the airway open (keeps tongue from
to eat well-balanced diets, but protein foods obstructing airway). Bag-valve-mask is used
are specific for building and repairing body when patients are not breathing. Oral suction-
tissues. ing (also, side-lying position or elevation of the
12. Answer 1: Phenytoin is a antiseizure medica- head) decreases the likelihood of aspirating
tion. Antiseizure and cardiac medications are secretions. Oxygen is administered to maintain
sometimes given with a sip of water. The sur- saturation, but the airway must be open for
geon or anesthesiologist should be contacted oxygen to pass into the lungs.
if there is a query. Warfarin sodium, an antico- 18. Answer 3: The nurse who does the preopera-
agulant, is usually discontinued several days tive care signs the list, thereby taking responsi-
before the surgery. Famotidine is an antiulcer bility for the care on the list. Medication, tasks
medication and may be given prophylactically completed by delegation, and teaching are
in the postsurgical period. Acetaminophen is included in the care prior to surgery.
used postoperatively for mild pain. 19. Answer 2: Standard practice in most facilities
13. Answer 1, 2, 3, 5: Surgeon provides informa- is to monitor vital signs and make general as-
tion regarding the actual surgical procedure, sessments using the “times 4” factor—every 15
as well as the risks, benefits, and possible out- minutes times 4 (for 4 times); every 30 minutes
comes. Nurse is responsible for teaching about times 4; every hour times 4; then every 4 hours,
the other topics. until assessments are within expected ranges.
14. Answer 4: Abnormal potassium levels can 20. Answer 4: Postoperative patients are at risk for
cause cardiac dysrhythmias. All of the val- hypovolemic shock. Signs/symptoms include
ues are slightly above normal and should be hypotension; tachycardia; restlessness; appre-
reported. Normal ranges include: potassium hension; and cold, moist, pale, or cyanotic skin.
3.5-5.0 mEq/L (3.5-5.0 mmol/L); sodium 136- Standard protocol in most facilities includes
145 mEq/L (136-145 mmol/L); glucose 70- (1) administer oxygen; (2) raise legs above the
110 mg/dL (3.9-6.1 mmol/L); and blood urea level of the heart; (3) increase the rate of IV
nitrogen 10-20 mg/dL (3.6 to 7.1 mmol/L). fluid; (4) notify anesthesiologist and surgeon;
15. Answer 3: Urinary catheters are frequently (5) medications as prescribed; and (6) assess
made of latex and swelling is one symptom of response to interventions.
allergic response. Throat discomfort after na- 21. Answer 4: In the induction phase, the patient
sogastric tube insertion is not uncommon. He- is awake and the administration of anesthetic
matoma after a venipuncture could be related agents begins. The stage is completed when
to poor technique or failure to provide pressure the patient loses consciousness, and endotra-
at the site; however, the nurse would follow cheal intubation is established, and placement
up to see if the patient is on any medication verified.
(e.g., warfarin) or had health problems (e.g., 22. Answer 2: Anesthesia is maintained through a
hemophilia) that would interfere with clotting. combination of inhalation and IV medications.
Dermabrasion is a surgical procedure of scrap- Emergence from anesthesia occurs when the
ing away skin. procedure is completed and reversal agents are
16. Answer 2: Complete physical assessment and given.
history are always important; however, the 23. Answer 3: Spinal anesthesia is often used for
lower abdominal, pelvic, and lower extremity
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Answer Key 1
Answer Key
CHAPTER 1—INTRODUCTION TO ANATOMY 11. Mitosis
AND PHYSIOLOGY 12. Phagocytosis
13. Organ
Crossword Puzzle 14. Pinocytosis
Across Down
3. Cell 1. Nucleus
5. Tissue 2. Diffusion
8. System 4. Filtration
9. Membranes 6. Homeostasis
10. Cytoplasm 7. Osmosis
Table Activity
2. See Table 1.6 for additional information.
One Body Part of
Major System Major System Function
Lungs Respiratory Exchange of carbon dioxide for oxygen; regulation of acid-base
balance
Blood vessels Cardiovascular Transportation of nutrition, water, oxygen, and wastes
Brain Nervous Coordination of body’s activities; communication
Stomach Digestive Mechanical and chemical breakdown of food; absorption of
nutrients
Kidneys Urinary Clearing blood of waste products; water and electrolyte balance;
acid-base balance
Bones Skeletal Support; movement; storage of minerals; blood cell formation
Voluntary muscles Muscular Movement; maintenance of posture; heat production
Skin Integumentary Protection; regulation of body temperature; synthesis of
chemicals; sense organ
Thyroid gland Endocrine Production of hormones that affect metabolism
Lymph nodes Lymphatic Protection
Gonads Reproductive Production of sex cells
Figure Labeling: Planes of the Body caudal and cranial portions. See Figure 1.2 for
3. The sagittal plane runs lengthwise from the additional information.
front to the back. A sagittal cut gives a right
and a left portion of the body. A midsagittal cut Multiple Choice
gives two equal halves. The coronal (frontal) 4. Answer 4: Nursing documentation should
plane divides the body into a ventral (front) include medical terminology and specific
section and a dorsal (back) section. The trans- details that describe assessment findings, in-
verse plane cuts the body horizontal to the sag- terventions, or evaluation. (Note to student:
ittal and frontal planes, dividing the body into patient statements can be used in nursing
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2 Answer Key
documentation but should be placed in quota- of vomiting and abdominal pain. A proximal
tion marks.) obstruction is one that is closer to the begin-
5. Answer 2: Water and small solutes from blood ning of the small intestine; therefore, the block-
vessels are filtered through the kidneys. This age is higher up in the system. Vomiting can
leads to the formation of urine. See Tables 1.3 occur whenever there is an intestinal obstruc-
1.4 for additional information. tion; however, in a distal large intestinal ob-
6. Answer 3: Dorsal or posterior is toward the struction, vomiting is less likely. If it develops,
back of the body. The perineal area is inferior it usually occurs later and the emesis could
to the umbilicus. The front of the chest is the have a fecal odor.
anterior surface. The face and top of the head 18. Answer 1: The epidermis or skin is composed
are superior to the rest of the body. of stratified squamous tissue. One of the main
7. Answer 1: The dorsalis pedis pulse is on the functions is to protect the body from infection.
top of the foot and is the most distal pulse in Bones are for strength and structure. Simple
the lower extremity. The popliteal is behind the columnar tissue participates in the secretion of
knee (can be difficult to locate). The posterior mucus. Adipose tissue provides insulation.
tibial pulse is behind the medial malleolus (lat- 19. Answer 3: The mucous membranes are de-
eral ankle). The femoral pulse is in the groin signed to trap microorganisms, and dryness
area. decreases that function. Poor oral hygiene con-
8. Answer 3: Medial is toward the midline. The tributes to respiratory infection, especially for
sternum is in the middle of the chest. patients who are bedridden. Patients who are
9. Answer 4: The plasma membrane contains sur- in a coma are not given solid food. Dignity and
face proteins that identify a cell as coming from preservation of the teeth are desirable for all
one particular individual. Tissue typing is per- patients.
formed for compatibility to reduce the chances 20. Answer 3: The bursae are small cushionlike
of rejection of a transplanted organ. sacs that are found between joints; therefore,
10. Answer 1: A muscle cell cannot operate prop- the nurse would assess the movement and dis-
erly unless the intracellular Ca2+ concentration comfort of the major joints.
is kept low during rest. 21. Answer 3: The flagella propel the sperm to-
11. Answer 2: Hematopoietic disorders affect the ward the ovum for fertilization.
blood cell–producing cells located in the red 22. Answer 4: In biofeedback, patients with asth-
bone marrow; a decreased red blood cell count ma attacks are taught to increase awareness of
is anticipated. Potassium and glucose are elec- physical response (smooth muscle contraction,
trolytes. Blood urea nitrogen reflects kidney which impairs breathing) and increase control
function. over the response.
12. Answer 3: The spleen plays an important role 23. Answer 1: The function of adipose tissue (fat)
in immune function. Loss of the spleen increas- is insulation, support, and reserve food. The di-
es the patient’s risk for developing infections. etitian would be consulted to design a diet that
13. Answer 3: The gallbladder is located just below would supply the nutrients to recover health
the right ribs. The spleen is on the left side. The and build up reserves.
small intestine and cecum are located in the 24. Answer 2: Nursing documentation is a legal
lower abdominopelvic cavity. record of care that was given to the patient.
14. Answer 2: The urinary bladder is located in This note shows that the patient had a position
the hypogastric region. See Figure 1.4 for addi- change every 2 hours. Position change is one
tional information. intervention used to prevent pressure injuries
15. Answer 1: The stomach is located in the epi- and other complications associated with immo-
gastric region. See Figure 1.4 for additional bility. Based on the type of risks that the patient
information. has, the nurse might also use additional inter-
16. Answer 2: The appendix is located in the right ventions; for example, skin assessment, range-
lower quadrant. See Figure 1.5 for additional of motion, incentive spirometer, toileting, or
information. oral fluids.
17. Answer 4: Once diagnosed, patients are usu-
ally placed on “nothing by mouth” (NPO), but
a patient who develops a small bowel obstruc-
tion at home will often seek health care because
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Answer Key 3
Critical Thinking Activities NEXT-GENERATION NCLEX™ (NGN)
28. Answer: 1 Anterior, 2 Right hypochondriac
Activity 1 region, 3 Deep: Anterior or ventral refers to the
25. Knowledge of how the body works helps the front of the body. Posterior or dorsal refers to the
nurse distinguish normal findings from ab- back of the body. Lateral refers to the side. The
normal findings. Knowledge of location and sagittal plane extends the length of the body
function of organs helps the nurse predict the from front to back. See Figs. 1.1 and 1.2 for ad-
involvement of underlying structures related ditional information. The body is divided into
to patients’ reports of pain and discomfort nine abdominal regions. See Fig. 1.4. The right
and design interventions that will enhance hypochondriac region contains the right lobe of
function or repair dysfunction. Knowledge of the liver and the gallbladder. Epigastric region
physiology at the cellular level helps the nurse includes portions of the liver and most of the
implement interventions that keep the body in stomach. Hypogastric region includes some of
homeostasis. the small intestine, the urinary bladder, and the
appendix. Right lumbar region includes some
Activity 2 of the large and small intestine. Left iliac region
26. A 2-cm ecchymosis on distal tip of first digit of includes portions of the colon and the small
right foot. intestine. The nurse rarely uses deep palpa-
tion. When solid organs such as the gallbladder
Activity 3 are inflamed, swollen, or diseased, there is an
27. Accuracy is an important part of documenta- increased risk for rupture. Gentle palpation,
tion; thus, using the patient’s words in direct lateral or inferior to the site of pain, could be
quotes is acceptable. In addition, assessment performed to determine the size and extent
data should reflect the nurse’s ability to make of the involved area. Superficial touch could
and record professional observations. When be used to elicit sensitivity or pain on the skin
the nurse’s records are reviewed by other surface.
health care professionals or by legal or finan-
cial consultants, use of correct terminology and
accuracy reflect the quality of care.
CHAPTER 2—CARE OF THE SURGICAL PATIENT
Table Activity
1.
Assessment Normal Findings Frequency
a. Vital signs Same as or close to preoperative q 15 minutes x 4, q 30 minutes x 4,
q 60 minutes x 4, q 4 hours x 4, until
assessments are within normal range
b. Incision Dressing dry and intact; no drainage Every time vital signs are assessed
c. Respiratory effort Breathing comfortably without Assess concurrently with vital signs
dyspnea
d. Pain Relieved by analgesics and Assess concurrently with vital signs
nonpharmacologic methods
e. Urinary function Voids at least 30 mL/hour Within 6-8 hours of surgery
f. Vascular Extremities are warm, pulse present; q 2 hours
skin color normal for patient
g. Activity Muscle-strengthening exercises, Per health care provider’s orders and
sitting, dangling, and walking; patient’s ability
gradual progression toward baseline
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4 Answer Key
Matching assessments that are most relevant to the skin
2. d preparation relate to skin impairment (e.g.,
3. a infection, irritation, bruises, lesions) and skin
4. f allergies. Skin infections could be a source of
5. e wound infection. Bruises, irritation, and lesions
6. b should be noted as preexisting conditions of
7. g the surgical procedure. Skin allergies impact
8. c the types of solutions, medications, and equip-
9. i ment that contact the skin. Any abnormal as-
10. h sessment findings are recorded and reported to
the surgeon.
Multiple Choice 17. Answer 4: An oral airway can be inserted to
11. Answer 2: Patients are generally encouraged keep the airway open (keeps tongue from
to eat well-balanced diets, but protein foods obstructing airway). Bag-valve-mask is used
are specific for building and repairing body when patients are not breathing. Oral suction-
tissues. ing (also, side-lying position or elevation of the
12. Answer 1: Phenytoin is a antiseizure medica- head) decreases the likelihood of aspirating
tion. Antiseizure and cardiac medications are secretions. Oxygen is administered to maintain
sometimes given with a sip of water. The sur- saturation, but the airway must be open for
geon or anesthesiologist should be contacted oxygen to pass into the lungs.
if there is a query. Warfarin sodium, an antico- 18. Answer 3: The nurse who does the preopera-
agulant, is usually discontinued several days tive care signs the list, thereby taking responsi-
before the surgery. Famotidine is an antiulcer bility for the care on the list. Medication, tasks
medication and may be given prophylactically completed by delegation, and teaching are
in the postsurgical period. Acetaminophen is included in the care prior to surgery.
used postoperatively for mild pain. 19. Answer 2: Standard practice in most facilities
13. Answer 1, 2, 3, 5: Surgeon provides informa- is to monitor vital signs and make general as-
tion regarding the actual surgical procedure, sessments using the “times 4” factor—every 15
as well as the risks, benefits, and possible out- minutes times 4 (for 4 times); every 30 minutes
comes. Nurse is responsible for teaching about times 4; every hour times 4; then every 4 hours,
the other topics. until assessments are within expected ranges.
14. Answer 4: Abnormal potassium levels can 20. Answer 4: Postoperative patients are at risk for
cause cardiac dysrhythmias. All of the val- hypovolemic shock. Signs/symptoms include
ues are slightly above normal and should be hypotension; tachycardia; restlessness; appre-
reported. Normal ranges include: potassium hension; and cold, moist, pale, or cyanotic skin.
3.5-5.0 mEq/L (3.5-5.0 mmol/L); sodium 136- Standard protocol in most facilities includes
145 mEq/L (136-145 mmol/L); glucose 70- (1) administer oxygen; (2) raise legs above the
110 mg/dL (3.9-6.1 mmol/L); and blood urea level of the heart; (3) increase the rate of IV
nitrogen 10-20 mg/dL (3.6 to 7.1 mmol/L). fluid; (4) notify anesthesiologist and surgeon;
15. Answer 3: Urinary catheters are frequently (5) medications as prescribed; and (6) assess
made of latex and swelling is one symptom of response to interventions.
allergic response. Throat discomfort after na- 21. Answer 4: In the induction phase, the patient
sogastric tube insertion is not uncommon. He- is awake and the administration of anesthetic
matoma after a venipuncture could be related agents begins. The stage is completed when
to poor technique or failure to provide pressure the patient loses consciousness, and endotra-
at the site; however, the nurse would follow cheal intubation is established, and placement
up to see if the patient is on any medication verified.
(e.g., warfarin) or had health problems (e.g., 22. Answer 2: Anesthesia is maintained through a
hemophilia) that would interfere with clotting. combination of inhalation and IV medications.
Dermabrasion is a surgical procedure of scrap- Emergence from anesthesia occurs when the
ing away skin. procedure is completed and reversal agents are
16. Answer 2: Complete physical assessment and given.
history are always important; however, the 23. Answer 3: Spinal anesthesia is often used for
lower abdominal, pelvic, and lower extremity
Copyright © 2023, 2019, 2015, 2011, 2006, 2003, 1999, 1995, 1991 by Elsevier Inc. All rights reserved.
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