Chapter 01: Concepts of Health and Disease
PORTH'S PATHOPHYSIOLOGY: CONCEPTS OF
ALTERED HEALTH STATES 10TH EDITION BY
TOMMIE L NORRIS , RUPA LALCHANDANI TEST
BANK ALL CHAPTERS COVERED
Question 1 1 out of 1 points
The neuroscience nursing unit has developed a set of step-by-step directions of what should occur
if a nursing assessment reveals the client may be exhibiting clinical manifestations of a
cerebrovascular accident (CVA). Which statement about clinical practice guidelines are accurate?
Select all that apply.
Selected C.
Answers: When developing a CVA set of step-by-step directions, the nursing unit should ask for
assistance from experts in the neuroscience field. The potential users of the guidelines should pilot
test it for further feedback.
D.
A meta-analysis could be utilized to combine evidence from different studies to produce a more
accurate diagnostic method.
E.
The development of evidence-based practice guidelines require a research review from different
studies to develop the most accurate diagnostic method to implement.
Response Rationale: Clinical practice guidelines are systematically
Feedback: developed and intended to inform practitioners in making decisions about health care
for CVA clients. They should be developed using research and review by experts in the clinical
content. Potential users should also participate and provide feedback prior to implementation. The
purpose of the guidelines is to review EBP articles and develop new practice guidelines rather that
continuing practicing primarily on "how it has always been done before." Once developed, the
guidelines must be continually reviewed and changed to keep pace with new research findings. A
meta-analysis could be utilized to combine evidence from different studies to produce a more
accurate diagnostic method or the effects of an intervention method.
,Question 2 1 out of 1 points
Question 3
A nurse researcher is interested in the natural history of a disease being studied. What should the
nurse focus on to best understand the condition's natural history?
Question 2 Selected A.
Answer: Focusing on clients who did not receive treatment for the
condition
Response Rationale: The natural history of a disease refers to the
Feedback: progression and projected outcome of the disease without
medical intervention. For this reason, following clients who
have had any level of treatment will be less valuable at
establishing natural history than focusing on only those who
have had no treatment. Client experience with the condition
The nurse is questioning the validity of oxygen saturation readings from the new oximeters on the will not inform how the disease progresses from a
unit. Which action should the nurse take to best determine if the results from the oximeter are valid? pathogenesis perspective.
Selected D. Question 4 1 out of 1 points
Answer: Compare clients' results to measurements taken using arterial blood gas analyses.
A nurse practitioner is working in a crowded neighborhood where the
Response Rationale: Validity refers to the extent to which a
population is primarily immigrants from China. The nurse has designed a
research study to follow children from kindergarten to the age of 25. She
Feedback: measurement tool measures what it is intended to measure. is going to be looking at their diet, successful progression in school, health
The best way to confirm validity is to compare the measurement against those from another test that practices, and development of disease, to name a few items. This type of
measures the same data. Oxygen saturation levels and PaO 2 are both
research is known as:
reported on arterial blood gas (ABG) results. The results from any client who had an ABG done Selected Answer: B. Cohort study
concurrent with an oxygen saturation measurement with the new oximeter could be compared for Response Rationale: In this cohort study, a group of people who were
Feedback: born at approximately the same time or share some
discrepancy. Repeating the test with the same device would provide information about reliability. characteristics of interest is the focus of the research. This
Reviewing the literature may provide the nurse with the company's interpretation of the validity of study does not possess the characteristics of a case–control or
the oximeter brand, but this does not guarantee perfect functioning of the unit in question. If the cross-sectional study. Epidemiologic study is not an existing
methodology.
results are inaccurate, comparing these inaccurate results to one another will not help determine
validity of the measurement.
Question 5 1 out of 1 points
The clinical educator of a hospital medical unit has the mandate of
establishing evidence-based practice guidelines for the nursing care on the
unit. Which statement most accurately captures a guiding principle of the
nurse's task?
Selected A.
Answer: The guidelines will combine individual expertise with
external systematic evidence.
, Response Rationale: Evidence-based guidelines are a result of the Question 8
1 out of 1 points
Feedback: combination of empirical, published evidence and the
expertise of accomplished practitioners. They are not the A community health nurse is teaching a group of recent graduates about
same as systematic reviews of the literature and they are fluid the large variety of factors that influence an individual's health or lack
and modifiable in the face of new evidence. thereof. The nurse is referring to the Healthy People 2020 report from
the U.S. Department of Health and Human Services as a teaching
example. Of the following aspects discussed, which would be considered a
Question 6 1 out of 1 points determinant of health that is outside the focus of this report?
Selected B.
A member of the health care team is researching the etiology and Answer: The client has a family history of cardiovascular disease related
pathogenesis of a number of clients who are under his care in a hospital to hypercholesterolemia and remains noncompliant with the
context. Which aspect of clients' situations best characterizes treatment regime.
pathogenesis rather than etiology?
Selected A.
Response Rationale: In Healthy People 2020, the focus is to promote
Answer: A client who is has increasing serum ammonia levels due to Feedback: good health to all (such as using alternative therapies to
liver cirrhosis. minimize effects of stress); achieving health equity and
promoting health for all (which includes having good health
Response Rationale: Pathogenesis refers to the progressive and care benefits); and promoting good health (which includes
Feedback: evolutionary course of disease, such as the increasing living in a clean community with good access to health care).
ammonia levels that accompany liver disease. Bacteria, Being noncompliant with treatments to control high
poisons, and traumatic injuries are examples of etiologic cholesterol levels with a family history to CV disease does
factors. not meet the "attaining lives free of preventable disease and
premature death" goal/objective.
Question 7 1 out of 1 points
Question 9 1 out of 1 points
A clinical nurse specialist is interested in developing a research study
focused on clients living with the sequelae of ischemic stroke. Which A particular disease has a debilitating effect on the ability of sufferers to
clients should the nurse include? Select all that apply. The nurse should perform their activities of daily living, and is a significant cause of
include clients with: decreased quality of life. However, few people die as a result of the
disease's direct effects. There are hundreds of thousands of Americans
Selected Answers: A. unilateral weakness.
living with the disease but relatively few new cases in recent years. Which
C. vision changes. statement best conveys an accurate epidemiologic characterization of the
disease?
E. dysphagia (difficulty swallowing).
Selected C.
Response Rationale: Sequelae are lesions or impairments that follow or Answer: High morbidity; low mortality; high prevalence, low
Feedback: are caused by a disease. In ischemic stroke, the condition incidence.
causes neurologic impairment, which may result in trouble
swallowing, vision changes, or weakness. Falls are not a Response Rationale: Morbidity is associated with quality of life, while
result of the disease process itself. Aspiration pneumonia Feedback: mortality is indicative of causation of death. In this case,
would be a complication of stroke that is associated with morbidity is high and mortality low. Prevalence refers to the
having difficulty swallowing. number of cases present in a population, while incidence
refers to the number of new cases. In this case, prevalence is
high while incidence is low.
, Selected D.
Question 10 1 out of 1 points Answers: The geographic location of women diagnosed with breast
cancer
Laboratory testing is ordered for a male client during a clinic visit for E. The age of women at the time of diagnosis
routine follow-up assessment of hypertension. When interpreting lab
values, the nurse knows: Response Rationale: Epidemiology refers to the study of disease in
Selected B. Feedback: populations. It looks for patterns such as age, race, geographic
Answer: a normal value represents the test results that fall within the location, and dietary habits of people who are affected with a
bell curve. particular disorder. While this data will be compared and
reveal patterns of greater or lesser incidence, the focus is on
Response Rationale: What is termed a normal value for a laboratory test people diagnosed with the condition and should not be
Feedback: is established statistically from results obtained from a influenced by previously calculated statistics. Neither how the
selected sample of people. A normal value represents the test condition was diagnosed, nor the pathogenesis of it once
results that fall within the bell curve or the 95% distribution. present, are part of epidemiology.
Some lab values (like hemoglobin) are adjusted for gender,
other comorbidities, or age. If the result of a very sensitive
test is negative, it tells us the person does not have the disease Question 13 1 out of 1 points
and the disease has been ruled out or excluded.
A male international business traveler has returned from a trip to
Indonesia. While there, he hired a prostitute for companionship and
Question 11 1 out of 1 points engaged in unprotected sex on more than one occasion. Unbeknownst to
him, this prostitute harbored the hepatitis C virus. Upon return to the U.S.,
The laboratory technologists are a discussing a new blood test that helps he exhibited no symptoms and returned to his usual activities. During this
establish a differential diagnosis between shortness of breath with a period of no outward symptoms, the disease would be classified as being
cardiac etiology and shortness of breath with a respiratory/pulmonary in:
etiology. A positive result is purported to indicate a cardiac etiology. The
marketers of the test report that 99.8% of clients who have confirmed Selected Answer: D. the preclinical stage of disease.
cardiac etiologies test positive in the test. However, 1.3% of clients who Response Rationale: During the preclinical stage, the disease is not
do not have cardiac etiologies for their shortness of breath also test Feedback: clinically evident but is destined to progress to clinical
positive. Which statement best characterizes this blood test? disease.
Selected Answer: A. High sensitivity, low specificity
Response Rationale: A large number of clients would receive the correct Question 14 1 out of 1 points
Feedback: positive diagnosis (high sensitivity), while a significant
number would receive a false-positive diagnosis (low
While attending an international nursing conference, many discussions
specificity). The information given does not indicate low
and break-out sessions focused on the World Health Organization's
reliability or low validity.
(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.
Question 12 1 out of 1 points
Selected A.
Answers: Interests in keeping the older adult population engaged in such
A nurse is investigating the epidemiologic factors influencing breast activities as book reviews and word games during social time
cancer for women in a population. What information should the nurse
include? Select all that apply. B.
PORTH'S PATHOPHYSIOLOGY: CONCEPTS OF
ALTERED HEALTH STATES 10TH EDITION BY
TOMMIE L NORRIS , RUPA LALCHANDANI TEST
BANK ALL CHAPTERS COVERED
Question 1 1 out of 1 points
The neuroscience nursing unit has developed a set of step-by-step directions of what should occur
if a nursing assessment reveals the client may be exhibiting clinical manifestations of a
cerebrovascular accident (CVA). Which statement about clinical practice guidelines are accurate?
Select all that apply.
Selected C.
Answers: When developing a CVA set of step-by-step directions, the nursing unit should ask for
assistance from experts in the neuroscience field. The potential users of the guidelines should pilot
test it for further feedback.
D.
A meta-analysis could be utilized to combine evidence from different studies to produce a more
accurate diagnostic method.
E.
The development of evidence-based practice guidelines require a research review from different
studies to develop the most accurate diagnostic method to implement.
Response Rationale: Clinical practice guidelines are systematically
Feedback: developed and intended to inform practitioners in making decisions about health care
for CVA clients. They should be developed using research and review by experts in the clinical
content. Potential users should also participate and provide feedback prior to implementation. The
purpose of the guidelines is to review EBP articles and develop new practice guidelines rather that
continuing practicing primarily on "how it has always been done before." Once developed, the
guidelines must be continually reviewed and changed to keep pace with new research findings. A
meta-analysis could be utilized to combine evidence from different studies to produce a more
accurate diagnostic method or the effects of an intervention method.
,Question 2 1 out of 1 points
Question 3
A nurse researcher is interested in the natural history of a disease being studied. What should the
nurse focus on to best understand the condition's natural history?
Question 2 Selected A.
Answer: Focusing on clients who did not receive treatment for the
condition
Response Rationale: The natural history of a disease refers to the
Feedback: progression and projected outcome of the disease without
medical intervention. For this reason, following clients who
have had any level of treatment will be less valuable at
establishing natural history than focusing on only those who
have had no treatment. Client experience with the condition
The nurse is questioning the validity of oxygen saturation readings from the new oximeters on the will not inform how the disease progresses from a
unit. Which action should the nurse take to best determine if the results from the oximeter are valid? pathogenesis perspective.
Selected D. Question 4 1 out of 1 points
Answer: Compare clients' results to measurements taken using arterial blood gas analyses.
A nurse practitioner is working in a crowded neighborhood where the
Response Rationale: Validity refers to the extent to which a
population is primarily immigrants from China. The nurse has designed a
research study to follow children from kindergarten to the age of 25. She
Feedback: measurement tool measures what it is intended to measure. is going to be looking at their diet, successful progression in school, health
The best way to confirm validity is to compare the measurement against those from another test that practices, and development of disease, to name a few items. This type of
measures the same data. Oxygen saturation levels and PaO 2 are both
research is known as:
reported on arterial blood gas (ABG) results. The results from any client who had an ABG done Selected Answer: B. Cohort study
concurrent with an oxygen saturation measurement with the new oximeter could be compared for Response Rationale: In this cohort study, a group of people who were
Feedback: born at approximately the same time or share some
discrepancy. Repeating the test with the same device would provide information about reliability. characteristics of interest is the focus of the research. This
Reviewing the literature may provide the nurse with the company's interpretation of the validity of study does not possess the characteristics of a case–control or
the oximeter brand, but this does not guarantee perfect functioning of the unit in question. If the cross-sectional study. Epidemiologic study is not an existing
methodology.
results are inaccurate, comparing these inaccurate results to one another will not help determine
validity of the measurement.
Question 5 1 out of 1 points
The clinical educator of a hospital medical unit has the mandate of
establishing evidence-based practice guidelines for the nursing care on the
unit. Which statement most accurately captures a guiding principle of the
nurse's task?
Selected A.
Answer: The guidelines will combine individual expertise with
external systematic evidence.
, Response Rationale: Evidence-based guidelines are a result of the Question 8
1 out of 1 points
Feedback: combination of empirical, published evidence and the
expertise of accomplished practitioners. They are not the A community health nurse is teaching a group of recent graduates about
same as systematic reviews of the literature and they are fluid the large variety of factors that influence an individual's health or lack
and modifiable in the face of new evidence. thereof. The nurse is referring to the Healthy People 2020 report from
the U.S. Department of Health and Human Services as a teaching
example. Of the following aspects discussed, which would be considered a
Question 6 1 out of 1 points determinant of health that is outside the focus of this report?
Selected B.
A member of the health care team is researching the etiology and Answer: The client has a family history of cardiovascular disease related
pathogenesis of a number of clients who are under his care in a hospital to hypercholesterolemia and remains noncompliant with the
context. Which aspect of clients' situations best characterizes treatment regime.
pathogenesis rather than etiology?
Selected A.
Response Rationale: In Healthy People 2020, the focus is to promote
Answer: A client who is has increasing serum ammonia levels due to Feedback: good health to all (such as using alternative therapies to
liver cirrhosis. minimize effects of stress); achieving health equity and
promoting health for all (which includes having good health
Response Rationale: Pathogenesis refers to the progressive and care benefits); and promoting good health (which includes
Feedback: evolutionary course of disease, such as the increasing living in a clean community with good access to health care).
ammonia levels that accompany liver disease. Bacteria, Being noncompliant with treatments to control high
poisons, and traumatic injuries are examples of etiologic cholesterol levels with a family history to CV disease does
factors. not meet the "attaining lives free of preventable disease and
premature death" goal/objective.
Question 7 1 out of 1 points
Question 9 1 out of 1 points
A clinical nurse specialist is interested in developing a research study
focused on clients living with the sequelae of ischemic stroke. Which A particular disease has a debilitating effect on the ability of sufferers to
clients should the nurse include? Select all that apply. The nurse should perform their activities of daily living, and is a significant cause of
include clients with: decreased quality of life. However, few people die as a result of the
disease's direct effects. There are hundreds of thousands of Americans
Selected Answers: A. unilateral weakness.
living with the disease but relatively few new cases in recent years. Which
C. vision changes. statement best conveys an accurate epidemiologic characterization of the
disease?
E. dysphagia (difficulty swallowing).
Selected C.
Response Rationale: Sequelae are lesions or impairments that follow or Answer: High morbidity; low mortality; high prevalence, low
Feedback: are caused by a disease. In ischemic stroke, the condition incidence.
causes neurologic impairment, which may result in trouble
swallowing, vision changes, or weakness. Falls are not a Response Rationale: Morbidity is associated with quality of life, while
result of the disease process itself. Aspiration pneumonia Feedback: mortality is indicative of causation of death. In this case,
would be a complication of stroke that is associated with morbidity is high and mortality low. Prevalence refers to the
having difficulty swallowing. number of cases present in a population, while incidence
refers to the number of new cases. In this case, prevalence is
high while incidence is low.
, Selected D.
Question 10 1 out of 1 points Answers: The geographic location of women diagnosed with breast
cancer
Laboratory testing is ordered for a male client during a clinic visit for E. The age of women at the time of diagnosis
routine follow-up assessment of hypertension. When interpreting lab
values, the nurse knows: Response Rationale: Epidemiology refers to the study of disease in
Selected B. Feedback: populations. It looks for patterns such as age, race, geographic
Answer: a normal value represents the test results that fall within the location, and dietary habits of people who are affected with a
bell curve. particular disorder. While this data will be compared and
reveal patterns of greater or lesser incidence, the focus is on
Response Rationale: What is termed a normal value for a laboratory test people diagnosed with the condition and should not be
Feedback: is established statistically from results obtained from a influenced by previously calculated statistics. Neither how the
selected sample of people. A normal value represents the test condition was diagnosed, nor the pathogenesis of it once
results that fall within the bell curve or the 95% distribution. present, are part of epidemiology.
Some lab values (like hemoglobin) are adjusted for gender,
other comorbidities, or age. If the result of a very sensitive
test is negative, it tells us the person does not have the disease Question 13 1 out of 1 points
and the disease has been ruled out or excluded.
A male international business traveler has returned from a trip to
Indonesia. While there, he hired a prostitute for companionship and
Question 11 1 out of 1 points engaged in unprotected sex on more than one occasion. Unbeknownst to
him, this prostitute harbored the hepatitis C virus. Upon return to the U.S.,
The laboratory technologists are a discussing a new blood test that helps he exhibited no symptoms and returned to his usual activities. During this
establish a differential diagnosis between shortness of breath with a period of no outward symptoms, the disease would be classified as being
cardiac etiology and shortness of breath with a respiratory/pulmonary in:
etiology. A positive result is purported to indicate a cardiac etiology. The
marketers of the test report that 99.8% of clients who have confirmed Selected Answer: D. the preclinical stage of disease.
cardiac etiologies test positive in the test. However, 1.3% of clients who Response Rationale: During the preclinical stage, the disease is not
do not have cardiac etiologies for their shortness of breath also test Feedback: clinically evident but is destined to progress to clinical
positive. Which statement best characterizes this blood test? disease.
Selected Answer: A. High sensitivity, low specificity
Response Rationale: A large number of clients would receive the correct Question 14 1 out of 1 points
Feedback: positive diagnosis (high sensitivity), while a significant
number would receive a false-positive diagnosis (low
While attending an international nursing conference, many discussions
specificity). The information given does not indicate low
and break-out sessions focused on the World Health Organization's
reliability or low validity.
(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.
Question 12 1 out of 1 points
Selected A.
Answers: Interests in keeping the older adult population engaged in such
A nurse is investigating the epidemiologic factors influencing breast activities as book reviews and word games during social time
cancer for women in a population. What information should the nurse
include? Select all that apply. B.
