Porth'sPathophysiology Concepts of Altered Health 10thEdition Test Bank x3 x3 x3 x3 x3 x3 x3 x3 x3
Chapter 1- Concepts of Health and Disease x3 x3 x3 x3 x3 x3
1. At an international nursing conference, many discussions and breakout sessions focused on
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
the World Health Organization (WHO) views on health. Of the following comments made
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
by nurses during a discussion session, which statements would be considered a good
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
representation of the WHO definition? Select all that apply.
x3 x3 x3 x3 x3 x3 x3 x3 x3
A) Interests in keeping the elderly population engaged in such activities as book x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
reviews and word games during social time x3 x3 x3 x3 x3 x3 x3
B) Increase in the number of chair aerobics classes provided in the skilled care x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
facilities x3
C) Interventions geared toward keeping the elderly population diagnosed with diabetes x3 x3 x3 x3 x3 x3 x3 x3 x3
mellitus under tight blood glucose control by providing in-home cooking classes
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
D) Providing transportation for renal dialysis patients to and from their hemodialysis x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
sessions x3
E) Providing handwashing teaching sessions toa group of young children x3 x3 x3 x3 x3 x3 x3 x3 x3
Ans: A, B, C, E
x3 x 3 x3 x3 x3
Feedback:
The WHO definition of health is defined as “a state of complete physical, mental, and social
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
well-being and not merely the absence of disease and infirmity.” Engaging in book reviews
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
facilitates mental and social well-being; chair aerobics helps facilitate physical well-being;
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
and assisting with tight control of diabetes helps with facilitating physical well-being even
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
though the person has a chronic disease. Handwashing is vital in the prevention of disease and
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
spread of germs.
x3 x3 x3
2. A community health nurse is teaching a group of recent graduates about the large variety
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
of factors that influence an individual's health or lack thereof. The nurse is referring to
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
the Healthy People 2020 report from the U.S. Department of Health and Human Services
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
as a teaching example. Of the following aspects discussed, which would be considered a
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
determinant of health that is outside the focus of this report?
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
A) The client has a diverse background by being of Asian and Native American x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
descent and practices various alternative therapies to minimize effects of stress.
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
B) The client has a family history of cardiovascular disease related to x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
hypercholesterolemia and remainsnoncompliantwiththe treatmentregime.
x3 x3 x3 x3 x3 x3 x3 x3
C) The client has a good career with exceptional preventative health care benefits. x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
D) The client lives in an affluent, clean, suburban community with access to many x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
health care facilities. x3 x3 x3
Ans: B x 3
Feedback:
In Healthy People 2020, the focus is to promote good health to all (such as using alternative
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
therapies to minimize effects of stress); achieving health equity and promoting health for all
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
(which includes having good health care benefits); and promoting good health (which
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
includes living in a clean community with good access to health care). A client's
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
noncompliance with treatments to control high cholesterol levels within the presence of a
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
family history of CV disease does not meet the “attaining lives free of preventable disease
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
and premature death” determinant.
x3 x3 x3 x3
Page 1 x3
,3. A physician is providing care for a number of patients on a medical unit of a large, university
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
hospital. The physician is discussing with a colleague the differentiation between diseases
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
that are caused by abnormal molecules and diseases that cause disease. Which of the
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
following patients most clearly demonstrates the consequences of molecules that cause
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
disease?
x3
A) A 31-year-old woman with sickle cell anemia who is receiving a transfusion of
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
packed red blood cells x3 x3 x3 x3
B) A 91-year-old woman who has experienced an ischemic stroke resulting from
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
familial hypercholesterolemia
x3 x3
C) A 19-year-old man with exacerbation of his cystic fibrosis requiring oxygen
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
therapy and chest physiotherapy
x3 x3 x3 x3
D) A 30-year-old homeless man who hasPneumocystis carinii pneumonia (PCP) and is
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
HIV positive. x3 x3
Ans: D x 3
Feedback:
PCP is an example of the effect of a molecule that directly contributes to disease. Sickle cell
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
anemia, familial hypercholesterolemia, and cystic fibrosis are all examples of the effects of
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
abnormal molecules.
x3 x3
4. A member of the health care team is researching the etiology and pathogenesis of a number
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
of clients who are under his care in a hospital context. Which of the following aspects of
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
clients' situations best characterizes pathogenesis rather than etiology?
x3 x3 x3 x3 x3 x3 x3 x3
A) A client who has been exposed to the Mycobacterium tuberculosis bacterium
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
B) A client who has increasing serum ammonia levels due to liver cirrhosis
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
C) A client who was admitted with the effects of methyl alcohol poisoning
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
D) A client with multiple skeletal injuries secondary to a motor vehicle accident Ans:
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
xB 3
Feedback:
Pathogenesis refers to the progressive and evolutionary course of disease, such as the x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
increasing ammonia levels that accompany liver disease. Bacteria, poisons, and traumatic
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
injuries are examples of etiologic factors.
x3 x3 x3 x3 x3 x3
Page 2 x3
,5. A new myocardial infarction patient requiring angioplasty and stent placement has arrived
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
to his first cardiac rehabilitation appointment. In this first session, a review of the
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
pathogenesis of coronary artery disease is addressed. Which statement by the patient verifies
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
to the nurse that he has understood the nurse's teachings about coronary artery disease?
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
A) “All I have to do is stop smoking, and then I won't have any more heart attacks.” x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
B) “My artery was clogged by fat, so I will need to stop eating fatty foods like x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
French fries every day.” x3 x3 x3 x3
C) “Sounds like this began because of inflammation inside my artery that made it easy x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
to form fatty streaks, which lead to my clogged artery.”
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
D) “If I do not exercise regularly to get my heart rate up, blood pools in the veins causing
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
a clot that stops blood flow to the muscle, and I will have a heart attack.”
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
Ans: C x 3
Feedback:
The true etiology/cause of coronary artery disease (CAD) is unknown; however, the
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
pathogenesis of the disorder relates to the progression of the inflammatory process from a
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
fatty streak to the occlusive vessel lesion seen in people with coronary artery disease. Risk
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
factors for CAD revolve around cigarette smoking, diet high in fat, and lack of exercise.
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
6. A 77-year-old man is a hospital inpatient admitted for exacerbation of his chronic
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
obstructive pulmonary disease (COPD), and a respiratory therapist (RT) is assessing the
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
client for the first time. Which of the following aspects of the patient's current state of health
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
would be best characterized as a symptom rather than a sign?
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
A) The patient's oxygen saturation is 83% by pulse oxymetry. x3 x3 x3 x3 x3 x3 x3 x3
B) The patient notes that he has increased work of breathing when lying supine. x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
C) The RT hears diminished breath sounds to the patient's lower lung fields x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
bilaterally. x3
D) Thepatient's respiratoryrateis31 breaths/minute. x3 x3 x3 x3 x3 x3
Ans: B
x3 x 3
Feedback:
Symptoms are subjective complaints by the person experiencing the health problem, x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
such as complaints of breathing difficulty. Oxygen levels, listening to breath sounds, and
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
respiratory rate are all objective, observable signs of disease.
x3 x3 x3 x3 x3 x3 x3 x3 x3
Page 3 x3
, 7. Which of the following situations would be classified as a complication of a disease or
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
outcome from the treatment regimen? Select all that apply.
x3 x3 x3 x3 x3 x3 x3 x3 x3
A) Massive pulmonary emboli following diagnosis of new-onset atrial fibrillation x3 x3 x3 x3 x3 x3 x3 x3
B) Burning, intense incision pain following surgery to remove a portion of colon due to x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
intestinal aganglionosis x3 x3
C) Development of pulmonary fibrosis following treatment with bleomycin, an x3 x3 x3 x3 x3 x3 x3 x3
antibiotic chemotherapy agent used in treatment of lymphoma
x3 x3 x3 x3 x3 x3 x3 x3
D) Gradual deterioration in ability to walk unassisted for a patient diagnosed with x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
Parkinson disease x3 x3
E) Loss of short-term memory in a patient diagnosed with Alzheimer disease x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
Ans: A, C
x3 x 3 x3
Feedback:
Development of pulmonary emboli and pulmonary fibrosis following chemotherapy are x3 x3 x3 x3 x3 x3 x3 x3 x3
both examples of a complication (adverse extensions of a disease or outcome from
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
treatment). It is normal to expect incisional pain following surgery. As Parkinson disease
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
progresses, the inability to walk independently is expected. This is a normal progression for
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
people diagnosed with Parkinson's. Loss of short-term memory in a patient diagnosed with
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
Alzheimer disease is an expected finding.
x3 x3 x3 x3 x3 x3
8. Laboratory testing is ordered for a male patient during a clinic visit for a routine follow-up
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
assessment of hypertension. When interpreting lab values, the nurse knows that
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
A) a normal value represents the test results that fall within the bell curve.
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
B) if the lab result is above the 50% distribution, the result is considered elevated.
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
C) all lab values are adjusted for gender and weight. x3 x3 x3 x3 x3 x3 x3 x3
D) if the result of a very sensitive test is negative, that does not mean the person is
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
disease free. x3 x3
Ans: A x 3
Feedback:
What is termed a normal value for a laboratory test is established statistically from results
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
obtained from a selected sample of people. A normal value represents the test results that fall
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
within the bell curve or the 95% distribution. Some lab values (like hemoglobin) are adjusted
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
for gender, other comorbidities, or age. If the result of a very sensitive test is negative, it tells
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
us the person does not have the disease, and the disease has been ruled out or excluded.
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
Page 4 x3
Chapter 1- Concepts of Health and Disease x3 x3 x3 x3 x3 x3
1. At an international nursing conference, many discussions and breakout sessions focused on
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
the World Health Organization (WHO) views on health. Of the following comments made
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
by nurses during a discussion session, which statements would be considered a good
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
representation of the WHO definition? Select all that apply.
x3 x3 x3 x3 x3 x3 x3 x3 x3
A) Interests in keeping the elderly population engaged in such activities as book x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
reviews and word games during social time x3 x3 x3 x3 x3 x3 x3
B) Increase in the number of chair aerobics classes provided in the skilled care x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
facilities x3
C) Interventions geared toward keeping the elderly population diagnosed with diabetes x3 x3 x3 x3 x3 x3 x3 x3 x3
mellitus under tight blood glucose control by providing in-home cooking classes
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
D) Providing transportation for renal dialysis patients to and from their hemodialysis x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
sessions x3
E) Providing handwashing teaching sessions toa group of young children x3 x3 x3 x3 x3 x3 x3 x3 x3
Ans: A, B, C, E
x3 x 3 x3 x3 x3
Feedback:
The WHO definition of health is defined as “a state of complete physical, mental, and social
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
well-being and not merely the absence of disease and infirmity.” Engaging in book reviews
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
facilitates mental and social well-being; chair aerobics helps facilitate physical well-being;
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
and assisting with tight control of diabetes helps with facilitating physical well-being even
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
though the person has a chronic disease. Handwashing is vital in the prevention of disease and
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
spread of germs.
x3 x3 x3
2. A community health nurse is teaching a group of recent graduates about the large variety
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
of factors that influence an individual's health or lack thereof. The nurse is referring to
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
the Healthy People 2020 report from the U.S. Department of Health and Human Services
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
as a teaching example. Of the following aspects discussed, which would be considered a
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
determinant of health that is outside the focus of this report?
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
A) The client has a diverse background by being of Asian and Native American x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
descent and practices various alternative therapies to minimize effects of stress.
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
B) The client has a family history of cardiovascular disease related to x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
hypercholesterolemia and remainsnoncompliantwiththe treatmentregime.
x3 x3 x3 x3 x3 x3 x3 x3
C) The client has a good career with exceptional preventative health care benefits. x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
D) The client lives in an affluent, clean, suburban community with access to many x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
health care facilities. x3 x3 x3
Ans: B x 3
Feedback:
In Healthy People 2020, the focus is to promote good health to all (such as using alternative
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
therapies to minimize effects of stress); achieving health equity and promoting health for all
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
(which includes having good health care benefits); and promoting good health (which
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
includes living in a clean community with good access to health care). A client's
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
noncompliance with treatments to control high cholesterol levels within the presence of a
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
family history of CV disease does not meet the “attaining lives free of preventable disease
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
and premature death” determinant.
x3 x3 x3 x3
Page 1 x3
,3. A physician is providing care for a number of patients on a medical unit of a large, university
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
hospital. The physician is discussing with a colleague the differentiation between diseases
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
that are caused by abnormal molecules and diseases that cause disease. Which of the
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
following patients most clearly demonstrates the consequences of molecules that cause
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
disease?
x3
A) A 31-year-old woman with sickle cell anemia who is receiving a transfusion of
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
packed red blood cells x3 x3 x3 x3
B) A 91-year-old woman who has experienced an ischemic stroke resulting from
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
familial hypercholesterolemia
x3 x3
C) A 19-year-old man with exacerbation of his cystic fibrosis requiring oxygen
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
therapy and chest physiotherapy
x3 x3 x3 x3
D) A 30-year-old homeless man who hasPneumocystis carinii pneumonia (PCP) and is
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
HIV positive. x3 x3
Ans: D x 3
Feedback:
PCP is an example of the effect of a molecule that directly contributes to disease. Sickle cell
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
anemia, familial hypercholesterolemia, and cystic fibrosis are all examples of the effects of
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
abnormal molecules.
x3 x3
4. A member of the health care team is researching the etiology and pathogenesis of a number
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
of clients who are under his care in a hospital context. Which of the following aspects of
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
clients' situations best characterizes pathogenesis rather than etiology?
x3 x3 x3 x3 x3 x3 x3 x3
A) A client who has been exposed to the Mycobacterium tuberculosis bacterium
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
B) A client who has increasing serum ammonia levels due to liver cirrhosis
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
C) A client who was admitted with the effects of methyl alcohol poisoning
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
D) A client with multiple skeletal injuries secondary to a motor vehicle accident Ans:
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
xB 3
Feedback:
Pathogenesis refers to the progressive and evolutionary course of disease, such as the x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
increasing ammonia levels that accompany liver disease. Bacteria, poisons, and traumatic
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
injuries are examples of etiologic factors.
x3 x3 x3 x3 x3 x3
Page 2 x3
,5. A new myocardial infarction patient requiring angioplasty and stent placement has arrived
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
to his first cardiac rehabilitation appointment. In this first session, a review of the
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
pathogenesis of coronary artery disease is addressed. Which statement by the patient verifies
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
to the nurse that he has understood the nurse's teachings about coronary artery disease?
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
A) “All I have to do is stop smoking, and then I won't have any more heart attacks.” x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
B) “My artery was clogged by fat, so I will need to stop eating fatty foods like x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
French fries every day.” x3 x3 x3 x3
C) “Sounds like this began because of inflammation inside my artery that made it easy x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
to form fatty streaks, which lead to my clogged artery.”
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
D) “If I do not exercise regularly to get my heart rate up, blood pools in the veins causing
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
a clot that stops blood flow to the muscle, and I will have a heart attack.”
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
Ans: C x 3
Feedback:
The true etiology/cause of coronary artery disease (CAD) is unknown; however, the
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
pathogenesis of the disorder relates to the progression of the inflammatory process from a
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
fatty streak to the occlusive vessel lesion seen in people with coronary artery disease. Risk
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
factors for CAD revolve around cigarette smoking, diet high in fat, and lack of exercise.
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
6. A 77-year-old man is a hospital inpatient admitted for exacerbation of his chronic
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
obstructive pulmonary disease (COPD), and a respiratory therapist (RT) is assessing the
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
client for the first time. Which of the following aspects of the patient's current state of health
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
would be best characterized as a symptom rather than a sign?
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
A) The patient's oxygen saturation is 83% by pulse oxymetry. x3 x3 x3 x3 x3 x3 x3 x3
B) The patient notes that he has increased work of breathing when lying supine. x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
C) The RT hears diminished breath sounds to the patient's lower lung fields x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
bilaterally. x3
D) Thepatient's respiratoryrateis31 breaths/minute. x3 x3 x3 x3 x3 x3
Ans: B
x3 x 3
Feedback:
Symptoms are subjective complaints by the person experiencing the health problem, x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
such as complaints of breathing difficulty. Oxygen levels, listening to breath sounds, and
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
respiratory rate are all objective, observable signs of disease.
x3 x3 x3 x3 x3 x3 x3 x3 x3
Page 3 x3
, 7. Which of the following situations would be classified as a complication of a disease or
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
outcome from the treatment regimen? Select all that apply.
x3 x3 x3 x3 x3 x3 x3 x3 x3
A) Massive pulmonary emboli following diagnosis of new-onset atrial fibrillation x3 x3 x3 x3 x3 x3 x3 x3
B) Burning, intense incision pain following surgery to remove a portion of colon due to x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
intestinal aganglionosis x3 x3
C) Development of pulmonary fibrosis following treatment with bleomycin, an x3 x3 x3 x3 x3 x3 x3 x3
antibiotic chemotherapy agent used in treatment of lymphoma
x3 x3 x3 x3 x3 x3 x3 x3
D) Gradual deterioration in ability to walk unassisted for a patient diagnosed with x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
Parkinson disease x3 x3
E) Loss of short-term memory in a patient diagnosed with Alzheimer disease x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
Ans: A, C
x3 x 3 x3
Feedback:
Development of pulmonary emboli and pulmonary fibrosis following chemotherapy are x3 x3 x3 x3 x3 x3 x3 x3 x3
both examples of a complication (adverse extensions of a disease or outcome from
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
treatment). It is normal to expect incisional pain following surgery. As Parkinson disease
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
progresses, the inability to walk independently is expected. This is a normal progression for
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
people diagnosed with Parkinson's. Loss of short-term memory in a patient diagnosed with
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
Alzheimer disease is an expected finding.
x3 x3 x3 x3 x3 x3
8. Laboratory testing is ordered for a male patient during a clinic visit for a routine follow-up
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
assessment of hypertension. When interpreting lab values, the nurse knows that
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
A) a normal value represents the test results that fall within the bell curve.
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
B) if the lab result is above the 50% distribution, the result is considered elevated.
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
C) all lab values are adjusted for gender and weight. x3 x3 x3 x3 x3 x3 x3 x3
D) if the result of a very sensitive test is negative, that does not mean the person is
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
disease free. x3 x3
Ans: A x 3
Feedback:
What is termed a normal value for a laboratory test is established statistically from results
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
obtained from a selected sample of people. A normal value represents the test results that fall
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
within the bell curve or the 95% distribution. Some lab values (like hemoglobin) are adjusted
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
for gender, other comorbidities, or age. If the result of a very sensitive test is negative, it tells
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
us the person does not have the disease, and the disease has been ruled out or excluded.
x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3 x3
Page 4 x3
