PHYSIOLOGY
8TH EDITION
• AUTHOR(S)VALERIE C. SCANLON;
TINA SANDERS
TEST BANK
1
Reference: Ch. 1 — Levels of Organization
Question Stem: A nurse observes that a postoperative patient’s
wound is not healing and notes decreased fibroblast activity at
the site. Which level of organization best explains how impaired
fibroblast function affects the patient’s wound closure?
A. Chemical level — because collagen synthesis requires specific
amino acids
B. Cellular level — because fibroblasts are cells that produce
extracellular matrix
C. Tissue level — because wound healing depends only on
tissue blood supply
,D. Organ level — because the skin, as an organ, must
regenerate independently of cells
Correct Answer: B
Rationales:
• Correct (B): Fibroblasts are individual cells (cellular level)
whose activity (collagen and extracellular-matrix
production) is essential for tissue repair; impaired cell
function directly impairs the tissue’s ability to close a
wound.
• A: Collagen synthesis depends on chemical substrates, but
the immediate cause of poor wound healing is cellular
dysfunction.
• C: Blood supply (tissue-level factor) contributes, but it
cannot explain decreased fibroblast activity itself.
• D: Organ-level descriptions are broader; the skin’s
regenerative capacity depends on constituent cells like
fibroblasts.
Teaching Point: Cells (e.g., fibroblasts) perform actions that
determine tissue repair and function.
Citation: Scanlon, V., & Sanders, T. (2021). Essentials of
Anatomy and Physiology (8th Ed.). Ch. 1.
2
,Reference: Ch. 1 — Levels of Organization
Question Stem: A patient’s pulmonary epithelial cells are
damaged by inhalation injury. The nurse recognizes that loss of
functional epithelial cells will most directly disrupt which next-
higher level of organization?
A. Chemical level — because cell damage releases intracellular
ions
B. Tissue level — because epithelial cells together form a tissue
layer
C. Organism level — because the entire person’s health is
immediately altered
D. Organ system level — because the respiratory system
immediately fails
Correct Answer: B
Rationales:
• Correct (B): Epithelial cells aggregate to form epithelial
tissue layers; damage to the cells disrupts that tissue’s
integrity and function.
• A: Chemical changes occur but are secondary; the direct
structural impact is at the tissue level.
• C: Whole-organism effects may follow but are not the
immediate next level affected.
• D: Organ system dysfunction can result, but the most
direct, immediate level above cells is tissue.
, Teaching Point: Damage to cells first alters the tissue level
before higher-level system effects appear.
Citation: Scanlon, V., & Sanders, T. (2021). Essentials of
Anatomy and Physiology (8th Ed.). Ch. 1.
3
Reference: Ch. 1 — Metabolism and Homeostasis
Question Stem: A patient with sepsis has an elevated metabolic
rate and increased lactate production. Which cellular metabolic
shift best explains the raised lactate despite adequate oxygen
delivery in early sepsis?
A. Increased gluconeogenesis due to cortisol release
B. Shift from oxidative phosphorylation to anaerobic glycolysis
in some tissues
C. Increased beta-oxidation of fatty acids producing excess
acetyl-CoA
D. Enhanced protein synthesis using lactate as a substrate
Correct Answer: B
Rationales:
• Correct (B): During severe stress (e.g., sepsis), tissues may
increase anaerobic glycolysis—producing lactate—even
when oxygen delivery is marginal or cellular metabolism is
dysregulated.