TEST BANK Porth's Essentials of
Pathophysiology, 5th Edition By Tommie L.
Norris
Total Questions: 200
Question Type: Multiple Choice & Select All That Apply
Answer Key: Correct answer indicated in bold after each question
Rationales: Provided for each correct answer
CHAPTER 1 – CONCEPTS OF HEALTH AND DISEASE
1. While attending an international nursing conference, many discussions and break-out
sessions focused on the World Health Organization's (WHO) views on health. Of the following
comments made by nurses during a discussion session, which statements would be considered
a good representation of the WHO definition? Select all that apply.
- A) Interests in keeping the older adult population engaged in such activities as book reviews
and word games during social time
- B) Increase in the number of chair aerobics classes provided in the skilled care facilities
- C) Interventions geared toward keeping the older adult population diagnosed with diabetes
mellitus under tight blood glucose control by providing in-home cooking classes
- D) Providing transportation for renal dialysis clients to and from their hemodialysis sessions
- E) Providing handwashing teaching sessions to a group of young children
Answer: A, B, C, E
Rationale: The WHO definition of health is "a state of complete physical, mental, and social
well-being and not merely the absence of disease and infirmity." Engaging in book reviews
facilitates mental and social well-being; chair aerobics facilitates physical well-being; and
assisting with tight control of diabetes facilitates physical well-being (even though the person
has a chronic disease). Handwashing is vital in the prevention of disease and spread of germs.
2. A community health nurse is teaching a group of recent graduates about the large variety of
factors that influence an individual's health or lack thereof. The nurse is referring to the Healthy
People 2020 report. Of the following aspects discussed, which would be considered a
determinant of health that is outside the focus of this report?
,- A) The client has a diverse background by being of Asian and Native American/First Nation
descent and practices various alternative therapies to minimize effects of stress.
- B) The client has a family history of cardiovascular disease related to hypercholesterolemia
and remains noncompliant with the treatment regime.
- C) The client has a good career with exceptional preventive health care benefits.
- D) The client lives in an affluent, clean, suburban community with access to many health care
facilities.
Answer: B
Rationale: In Healthy People 2020, the focus is to promote good health to all (such as using
alternative therapies to minimize effects of stress); achieving health equity and promoting health
for all (which includes having good health care benefits); and promoting good health (which
includes living in a clean community with good access to health care). Being noncompliant with
treatments to control high cholesterol levels with a family history of cardiovascular disease does
not meet the "attaining lives free of preventable disease and premature death" goal.
3. A member of the health care team is researching the etiology and pathogenesis of a number
of clients who are under his care in a hospital context. Which aspect of the clients' conditions
best characterizes pathogenesis rather than etiology?
- A) The fact that a client with high cholesterol has a family history of the same problem
- B) The fact that a client with acute renal failure has a history of hypertension that has been
poorly controlled for a decade
- C) The fact that a client with malignant melanoma has a long history of excessive sun
exposure
- D) The fact that a client with tuberculosis is known to have lived in a crowded, poorly ventilated
apartment
Answer: B
Rationale: Etiology refers to the cause of a disease, while pathogenesis refers to the
mechanism by which a disease develops. A family history of high cholesterol (A) is an etiologic
factor. Malignant melanoma from sun exposure (C) describes etiology. Tuberculosis from
crowded living conditions (D) describes etiology. The poorly controlled hypertension leading to
renal failure describes the pathogenic mechanism—how the disease developed.
4. A community health nurse explains to a group of students that health is more than the
absence of disease. One student says, "If a person has no diagnosed illness, then they are
healthy." Which response by the nurse best reflects the pathophysiologic view of health?
- A) Health is a fixed state that is either present or absent
- B) Health reflects the ability to adapt and maintain function across changing conditions
- C) Health is defined only by normal laboratory values
,- D) Health is determined solely by the absence of symptoms
Answer: B
Rationale: Health is best understood as a dynamic balance between internal and external
demands and the body's adaptive capacity. A person may be asymptomatic yet still have risk
factors, impaired reserve, or early pathologic changes. This view aligns with pathophysiology
because disease often develops before obvious symptoms appear.
5. A 74-year-old man is being assessed by a nurse as part of a weekly, basic health assessment
at the long-term care facility where he resides. His blood pressure at the time is 148/97 mm Hg,
with a consequent pulse pressure of 51 mm Hg. The nurse would recognize that which of the
following is the most significant determinant of the resident's pulse pressure?
- A) Blood volume, resistance, and flow
- B) The cardiac reserve or possible increase in cardiac output over normal resting level
- C) The amount of blood that his heart ejects from the left ventricle during each beat
- D) The relationship between total blood volume and resting heart rate
Answer: C
Rationale: Pulse pressure is a reflection of the amount of blood that the heart ejects from the left
ventricle during each beat combined with the distensibility of the arterial tree. Other factors such
as blood flow characteristics, cardiac reserve, heart rate, and blood volume are less directly
associated with pulse pressure.
6. At 4 AM, the hemodynamic monitor for a critically ill client in the intensive care unit indicates
that the client's mean arterial pressure is at the low end of the normal range; at 6 AM, the
client's MAP has fallen definitively below normal. The client is at risk for:
- A) Pulmonary hypertension
- B) Left ventricular hypertrophy
- C) Organ damage and hypovolemic shock
- D) Orthostatic hypotension
Answer: C
Rationale: The mean arterial pressure (MAP), which represents the average blood pressure in
the systemic circulation, is a good indicator of tissue perfusion. Hospitalization and bed rest
predispose to dehydration and low blood volume. Blood pressure normally follows a diurnal
pattern in which pressures are highest in the morning. The fact that this client's MAP is falling at
a time when it should be at its daily peak is cause for grave concern; blood volume is likely low,
and vital organs, which depend on adequate perfusion, are at risk.
, 7. The nurse practitioner working in an overnight sleep lab is assessing and diagnosing patients
with sleep apnea. During this diagnostic procedure, the nurse notes that a patient's blood
pressure is 162/97. The nurse explains this connection to the patient based on which of the
following pathophysiological principles?
- A) During apneic periods, the patient experiences hypoxemia that stimulates chemoreceptors
to induce vasoconstriction.
- B) When the patient starts to snore, his epiglottis is closed over the trachea.
- C) When the airway is obstructed, specialized cells located in the back of the throat send
signals to the kidney to increase pulse rate.
- D) When airways are obstructed, the body will retain extracellular fluid so that this fluid can be
shifted to intravascular space to increase volume.
Answer: A
Rationale: People with sleep apnea experience periods of hypoxemia during apneic episodes.
This hypoxemia stimulates chemoreceptors that induce systemic vasoconstriction, leading to
elevated blood pressure.
8. Which of the following best describes the concept of "pathogenesis"?
- A) The cause of a disease
- B) The development and sequence of events in a disease process
- C) The predicted outcome of a disease
- D) The manifestations of a disease
Answer: B
Rationale: Pathogenesis refers to the development and sequence of events in a disease
process, describing how the disease evolves from its initial cause to its clinical manifestations.
Etiology is the cause, prognosis is the predicted outcome, and manifestations are the signs and
symptoms.
9. A nurse is teaching a patient about risk factors for disease. Which statement by the patient
indicates understanding of modifiable risk factors?
- A) "My age and gender are things I cannot change, so I shouldn't worry about them."
- B) "I can reduce my risk of heart disease by quitting smoking and eating healthier."
- C) "Since my father had diabetes, I will definitely get it too."
- D) "There is nothing I can do to prevent cancer because it runs in my family."
Answer: B
Rationale: Modifiable risk factors are those that can be changed or controlled, such as smoking,
diet, exercise, and alcohol consumption. Age, gender, and family history are non-modifiable risk
Pathophysiology, 5th Edition By Tommie L.
Norris
Total Questions: 200
Question Type: Multiple Choice & Select All That Apply
Answer Key: Correct answer indicated in bold after each question
Rationales: Provided for each correct answer
CHAPTER 1 – CONCEPTS OF HEALTH AND DISEASE
1. While attending an international nursing conference, many discussions and break-out
sessions focused on the World Health Organization's (WHO) views on health. Of the following
comments made by nurses during a discussion session, which statements would be considered
a good representation of the WHO definition? Select all that apply.
- A) Interests in keeping the older adult population engaged in such activities as book reviews
and word games during social time
- B) Increase in the number of chair aerobics classes provided in the skilled care facilities
- C) Interventions geared toward keeping the older adult population diagnosed with diabetes
mellitus under tight blood glucose control by providing in-home cooking classes
- D) Providing transportation for renal dialysis clients to and from their hemodialysis sessions
- E) Providing handwashing teaching sessions to a group of young children
Answer: A, B, C, E
Rationale: The WHO definition of health is "a state of complete physical, mental, and social
well-being and not merely the absence of disease and infirmity." Engaging in book reviews
facilitates mental and social well-being; chair aerobics facilitates physical well-being; and
assisting with tight control of diabetes facilitates physical well-being (even though the person
has a chronic disease). Handwashing is vital in the prevention of disease and spread of germs.
2. A community health nurse is teaching a group of recent graduates about the large variety of
factors that influence an individual's health or lack thereof. The nurse is referring to the Healthy
People 2020 report. Of the following aspects discussed, which would be considered a
determinant of health that is outside the focus of this report?
,- A) The client has a diverse background by being of Asian and Native American/First Nation
descent and practices various alternative therapies to minimize effects of stress.
- B) The client has a family history of cardiovascular disease related to hypercholesterolemia
and remains noncompliant with the treatment regime.
- C) The client has a good career with exceptional preventive health care benefits.
- D) The client lives in an affluent, clean, suburban community with access to many health care
facilities.
Answer: B
Rationale: In Healthy People 2020, the focus is to promote good health to all (such as using
alternative therapies to minimize effects of stress); achieving health equity and promoting health
for all (which includes having good health care benefits); and promoting good health (which
includes living in a clean community with good access to health care). Being noncompliant with
treatments to control high cholesterol levels with a family history of cardiovascular disease does
not meet the "attaining lives free of preventable disease and premature death" goal.
3. A member of the health care team is researching the etiology and pathogenesis of a number
of clients who are under his care in a hospital context. Which aspect of the clients' conditions
best characterizes pathogenesis rather than etiology?
- A) The fact that a client with high cholesterol has a family history of the same problem
- B) The fact that a client with acute renal failure has a history of hypertension that has been
poorly controlled for a decade
- C) The fact that a client with malignant melanoma has a long history of excessive sun
exposure
- D) The fact that a client with tuberculosis is known to have lived in a crowded, poorly ventilated
apartment
Answer: B
Rationale: Etiology refers to the cause of a disease, while pathogenesis refers to the
mechanism by which a disease develops. A family history of high cholesterol (A) is an etiologic
factor. Malignant melanoma from sun exposure (C) describes etiology. Tuberculosis from
crowded living conditions (D) describes etiology. The poorly controlled hypertension leading to
renal failure describes the pathogenic mechanism—how the disease developed.
4. A community health nurse explains to a group of students that health is more than the
absence of disease. One student says, "If a person has no diagnosed illness, then they are
healthy." Which response by the nurse best reflects the pathophysiologic view of health?
- A) Health is a fixed state that is either present or absent
- B) Health reflects the ability to adapt and maintain function across changing conditions
- C) Health is defined only by normal laboratory values
,- D) Health is determined solely by the absence of symptoms
Answer: B
Rationale: Health is best understood as a dynamic balance between internal and external
demands and the body's adaptive capacity. A person may be asymptomatic yet still have risk
factors, impaired reserve, or early pathologic changes. This view aligns with pathophysiology
because disease often develops before obvious symptoms appear.
5. A 74-year-old man is being assessed by a nurse as part of a weekly, basic health assessment
at the long-term care facility where he resides. His blood pressure at the time is 148/97 mm Hg,
with a consequent pulse pressure of 51 mm Hg. The nurse would recognize that which of the
following is the most significant determinant of the resident's pulse pressure?
- A) Blood volume, resistance, and flow
- B) The cardiac reserve or possible increase in cardiac output over normal resting level
- C) The amount of blood that his heart ejects from the left ventricle during each beat
- D) The relationship between total blood volume and resting heart rate
Answer: C
Rationale: Pulse pressure is a reflection of the amount of blood that the heart ejects from the left
ventricle during each beat combined with the distensibility of the arterial tree. Other factors such
as blood flow characteristics, cardiac reserve, heart rate, and blood volume are less directly
associated with pulse pressure.
6. At 4 AM, the hemodynamic monitor for a critically ill client in the intensive care unit indicates
that the client's mean arterial pressure is at the low end of the normal range; at 6 AM, the
client's MAP has fallen definitively below normal. The client is at risk for:
- A) Pulmonary hypertension
- B) Left ventricular hypertrophy
- C) Organ damage and hypovolemic shock
- D) Orthostatic hypotension
Answer: C
Rationale: The mean arterial pressure (MAP), which represents the average blood pressure in
the systemic circulation, is a good indicator of tissue perfusion. Hospitalization and bed rest
predispose to dehydration and low blood volume. Blood pressure normally follows a diurnal
pattern in which pressures are highest in the morning. The fact that this client's MAP is falling at
a time when it should be at its daily peak is cause for grave concern; blood volume is likely low,
and vital organs, which depend on adequate perfusion, are at risk.
, 7. The nurse practitioner working in an overnight sleep lab is assessing and diagnosing patients
with sleep apnea. During this diagnostic procedure, the nurse notes that a patient's blood
pressure is 162/97. The nurse explains this connection to the patient based on which of the
following pathophysiological principles?
- A) During apneic periods, the patient experiences hypoxemia that stimulates chemoreceptors
to induce vasoconstriction.
- B) When the patient starts to snore, his epiglottis is closed over the trachea.
- C) When the airway is obstructed, specialized cells located in the back of the throat send
signals to the kidney to increase pulse rate.
- D) When airways are obstructed, the body will retain extracellular fluid so that this fluid can be
shifted to intravascular space to increase volume.
Answer: A
Rationale: People with sleep apnea experience periods of hypoxemia during apneic episodes.
This hypoxemia stimulates chemoreceptors that induce systemic vasoconstriction, leading to
elevated blood pressure.
8. Which of the following best describes the concept of "pathogenesis"?
- A) The cause of a disease
- B) The development and sequence of events in a disease process
- C) The predicted outcome of a disease
- D) The manifestations of a disease
Answer: B
Rationale: Pathogenesis refers to the development and sequence of events in a disease
process, describing how the disease evolves from its initial cause to its clinical manifestations.
Etiology is the cause, prognosis is the predicted outcome, and manifestations are the signs and
symptoms.
9. A nurse is teaching a patient about risk factors for disease. Which statement by the patient
indicates understanding of modifiable risk factors?
- A) "My age and gender are things I cannot change, so I shouldn't worry about them."
- B) "I can reduce my risk of heart disease by quitting smoking and eating healthier."
- C) "Since my father had diabetes, I will definitely get it too."
- D) "There is nothing I can do to prevent cancer because it runs in my family."
Answer: B
Rationale: Modifiable risk factors are those that can be changed or controlled, such as smoking,
diet, exercise, and alcohol consumption. Age, gender, and family history are non-modifiable risk
