TEST BANK Goulds Pathophysiology for the Health Professions 6th Edition by Robert J. Hubert BS

GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK MULTIPLE CHOICE 1. Which of the following would be the most likely cause of an iatrogenic disease? a. An inherited disorder b. A combination of specific etiological factors c. An unwanted effect of a prescribed drug d. Prolonged exposure to toxic chemicals in the environment ANS: C REF: 6 2. The manifestations of a disease are best defined as the: a. subjective feelings of discomfort during a chronic illness. b. signs and symptoms of a disease. c. factors that precipitate an acute episode of a chronic illness. d. early indicators of the prodromal stage of infection. ANS: B REF: 6 3. The best definition of the term prognosis is the: a. precipitating factors causing an acute episode. b. number of remissions to be expected during the course of a chronic illness. c. predicted outcome or likelihood of recovery from a specific disease. d. exacerbations occurring during chronic illness. NURSINGTB.COM ANS: C REF: 7 4. Which of the following is considered a systemic sign of disease? a. Swelling of the knee b. Fever c. Pain in the neck d. Red rash on the face ANS: B REF: 6 5. Etiology is defined as the study of the: a. causes of a disease. b. course of a disease. c. expected complications of a disease. d. manifestations of a disease. ANS: A REF: 5 6. A type of cellular adaptation in which there is a decrease in cell size is referred to as: a. hypertrophy. b. metaplasia. c. anaplasia. d. atrophy. ANS: D REF: 8 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK 7. A change in a tissue marked by cells that vary in size and shape and show increased mitotic figures would be called: a. metaplasia. b. atrophy. c. dysplasia. d. hypertrophy. ANS: C REF: 8 8. A deficit of oxygen in the cells usually due to respiratory or circulatory problems is called: a. apoptosis. b. ischemia. c. hypertrophy. d. necrosis. ANS: B REF: 9 9. When a group of cells in the body dies, the change is called: a. ischemia. b. gangrene. c. hypoxia. d. necrosis. ANS: D REF: 10 10. Rigorous weight lifting/body building regimens may result in the skeletal muscle cells undergoing: a. hypertrophy. b. dysplasia. c. atrophy. d. regeneration. ANS: A REF: 8 11. The term cancer refers to: a. dysplasia. b. hyperplasia. c. metaplasia. d. malignant neoplasm. ANS: D REF: 9 NURSINGTB.COM 12. To which of the following does the term apoptosis refer? a. Increased rate of mitosis by certain cells b. Ischemic damage to cells c. Liquefaction of necrotic tissue d. Preprogrammed cell self-destruction ANS: D REF: 9 13. Which of the following statements is TRUE? a. Alteration of DNA does not change cell function. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK b. Damaged cells may be able to repair themselves. c. All types of cells die at the same rate. d. Mild ischemia causes immediate cell death. ANS: B REF: 10 14. Caseation necrosis refers to an area where: a. cell proteins have been denatured. b. cell are liquefied by enzymes. c. dead cells form a thick cheesy substance. d. bacterial invasion has occurred. ANS: C REF: 10 15. Routine application of sun block to skin would be an example of: a. an iatrogenic cause of cancer. b. a preventive measure. c. a precipitating factor. d. a predisposing condition. ANS: B REF: 6 16. A circumstance that causes a sudden acute episode of a chronic disease to occur is termed: a. latent stage. b. predisposing factor. c. incidence. d. precipitating factor. ANS: D REF: 7 17. The term homeostasis refers to: NURSINGTB.COM a. the causative factors in a particular disease. b. maintenance of a stable internal environment. c. a condition that triggers an acute episode. d. a collection of signs and symptoms. ANS: B REF: 2 18. Which term is used to describe a new and secondary or additional problem that arises after the original disease has been established? a. Symptoms b. Occurrence c. Manifestations d. Complication ANS: D REF: 7 19. Pathophysiology involves the study of: a. the structure of the human body. b. the functions of various organs in the body. c. functional or structural changes resulting from disease processes. d. various cell structures and related functions. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK ANS: C REF: 2 20. Which of the following is the best definition of epidemiology? a. The science of tracking the occurrence and distribution of diseases b. The relative number of deaths resulting from a particular disease c. Identification of a specific disease through evaluation of signs and symptoms d. The global search for emerging diseases ANS: A REF: 7 21. Which of the following can cause cell injury or death? 1. Hypoxia 2. Exposure to excessive cold 3. Excessive pressure on a tissue 4. Chemical toxins a. 1, 2 b. 2, 4 c. 1, 3, 4 d. 1, 2, 3, 4 ANS: D REF: 9 22. All of the following are part of the Seven Steps to Health EXCEPT: a. follow cancer screening guidelines. b. use sun block agents whenever exposed. c. participate in strenuous exercise on a regular daily basis. d. choose high fiber, lower fat foods. NURSINGTB.COM ANS: C REF: 2 23. The term disease refers to: a. the period of recovery and return to a normal healthy state. b. a deviation from the normal state of health and function. c. the treatment measures used to promote recovery. d. a basic collection of signs and symptoms. ANS: B REF: 2 24. A collection of signs and symptoms, often affecting more than one organ or system, that usually occur together in response to a certain condition is referred to as a (an): a. acute disease. b. multiorgan disorder. c. syndrome. d. manifestation. ANS: C REF: 7 25. All of the following statements are correct about cell damage EXCEPT: a. The initial stage of cell damage often causes an alteration in metabolic reactions. b. If the factor causing the damage is removed quickly, the cell may be able to recover and return to its normal state. c. If the noxious factor remains for an extended period of time, the damage becomes GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK irreversible and the cell dies. d. Initially, cell damage does not change cell metabolism, structure, or function. ANS: D REF: 9 26. Which of the following conditions distinguishes double blind studies used in health research? a. Neither the members of the control group or the experimental group nor the person administering the treatment knows who is receiving the experimental therapy. b. Both groups of research subjects and the person administering the treatment know who is receiving the experimental therapy. c. The research subjects do not know, but the person administering the treatment knows who is receiving placebo or standard therapy. d. Only members of the control group know they are receiving standard therapy. ANS: A REF: 3 | 4 27. If the data collected from the research process confirm that the new treatment has increased effectiveness and is safe, this is called: a. the placebo effect. b. evidence-based research. c. blind research studies. d. approval for immediate distribution. ANS: B REF: 4 28. A short-term illness that develops very quickly with perhaps a high fever or severe pain is called: a. acute. b. latent. c. chronic. d. manifestation. ANS: A REF: 6 29. The term prognosis refers to the: NURSINGTB.COM a. period of recovery and return to a normal state. b. expected outcome of the disease. c. mortality and morbidity rates for a given population. d. typical collection of signs and symptoms. ANS: B REF: 7 30. When prolonged ischemia occurs to an area of the heart, the resulting damage is referred to as: a. atrophy. b. liquefactive necrosis. c. apoptosis. d. infarction. ANS: D REF: 10 31. During the evaluation process for a new therapy’s effectiveness and safety, a double blind study may be conducted during: a. the first stage. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK b. the second stage. c. the third stage. d. any of these stages. ANS: C REF: 3 32. Why are the predisposing factors for a specific disease important to health professionals? a. To predict the prognosis b. To determine treatments c. To develop preventive measures d. To develop morbidity statistics ANS: C REF: 3 33. Cell damage may be caused by exogenous sources such as: a. abnormal metabolic processes. b. certain food additives. c. genetic defects. d. localized hypoxia. ANS: B REF: 9 | 10 34. Which of the following is usually included in a medical history? 1. Past illnesses or surgeries 2. Current illnesses, acute and chronic 3. Prescribed medication or other treatments 4. Nonprescription drugs and herbal remedies 5. Current allergies a. 1, 3 b. 2, 4, 5 c. 1, 3, 4 d. 1, 2, 3, 4, 5 ANS: D REF: 4 | 5 NURSINGTB.COM 35. A situation when there is a higher than expected number of cases of an infectious disease within a given area is called a/an: a. epidemic. b. exacerbation. c. morbidity. d. pandemic. ANS: A REF: 7 36. The term pathogenesis refers to: a. the development of a disease or sequence of events related to tissue changes involved in the disease process. b. the determination of the cause(s) involved in the development of a malignant neoplasm. c. the specific signs and symptoms involved in the change from an acute disease to a chronic disease. d. the changes in cells of affected tissue that result in necrosis. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK ANS: A REF: 6 NURSINGTB.COM GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK Chapter 02: Fluid, Electrolyte, and Acid-Base Imbalances Test Bank MULTIPLE CHOICE 1. Choose the correct proportion of water to body weight to be expected in a healthy male adult’s body: a. 30% b. 45% c. 60% d. 70% ANS: C REF: 15 2. Choose the correct proportion of blood (to body weight) in an adult male’s body: a. 30% b. 20% c. 10% d. 4% ANS: D REF: 15 3. Insensible fluid loss refers to water lost through: a. perspiration only. b. feces only. c. perspiration and expiration. d. urine and feces. ANS: C REF: 15 NURSINGTB.COM 4. When the osmotic pressure of the blood is elevated above normal, water would shift from the: a. blood into the cells. b. interstitial compartment into the cells. c. interstitial compartment into the blood. d. cells into the interstitial compartment. ANS: C REF: 16 5. Which of the following would result from a deficit of plasma proteins? a. Increased osmotic pressure b. Decreased osmotic pressure c. Increased hydrostatic pressure d. Decreased hydrostatic pressure ANS: B REF: 16 6. Which of the following would cause edema? a. Decreased capillary hydrostatic pressure b. Increased capillary osmotic pressure c. Decreased capillary permeability d. Increased capillary permeability GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK ANS: D REF: 16-19 7. Which of the following would likely be related to an elevated hematocrit reading? a. Fluid excess b. Fluid deficit c. Increased sodium level d. Decreased erythrocytes ANS: B REF: 23-24 8. Which of the following is a typical sign of dehydration? a. Rapid, strong pulse b. Low hematocrit c. Increased urine output d. Rough oral mucosa ANS: D REF: 21 9. Which of the following terms refers to a combination of decreased circulating blood volume combined with excess fluid in a body cavity? a. Dehydration b. Third-spacing c. Hypovolemia d. Water retention ANS: B REF: 21 10. Which of the following is the primNaUrRyScIaNtGioTnBi .nCOthMe extracellular fluid? a. Sodium b. Potassium c. Calcium d. Iron ANS: A REF: 21 11. Which of the following is a common cause of hyponatremia? a. Loss of the thirst mechanism b. Excessive sweating c. Excessive aldosterone secretion d. Prolonged period of rapid, deep respirations ANS: B REF: 22-23 12. Which of the following is a common effect of both hypokalemia and hyperkalemia? a. Skeletal muscle twitch and cramps b. Oliguria c. Elevated serum pH d. Cardiac arrhythmias ANS: D REF: 26 13. Choose the correct effect of increased parathyroid hormone. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK a. Increased movement of calcium ions into the bones b. Increased activation of vitamin D c. Increased absorption of calcium from the digestive tract d. Decreased reabsorption of calcium in the kidneys ANS: C REF: 26 14. Which of the following results from hypocalcemia? 1. Low serum phosphate levels 2. Nausea and constipation 3. Skeletal muscle twitch and spasms 4. Weak cardiac contractions a. 1, 2 b. 1, 4 c. 2, 3 d. 3, 4 ANS: D REF: 27 15. Which of the following causes tetany? a. Increased permeability of nerve membranes due to low serum calcium b. Excess calcium ions in skeletal muscle due to excess parathyroid hormone (PTH) c. Excess calcium ions inside somatic nerves as a result of neoplasms d. Increased stimulation of the nerves in the cerebral cortex ANS: A REF: 27 16. In which of the following processNesUiRsSpINhoGsTpBh.aCtOeMion NOT a major component? a. Bone metabolism b. Metabolic processes involving adenosine triphosphate (ATP) c. Blood clotting d. Acid-base balance ANS: C REF: 28 17. Which of the following would be considered normal serum pH? a. 4.5-8 b. 7.0 c. 7.4 d. 8 ANS: C REF: 28 18. When many excess hydrogen ions accumulate in the blood, what happens to serum pH? The pH: a. decreases. b. increases. c. remains constant. d. varies based on metabolism. ANS: A REF: 28 19. What is the slowest but most effective control for acid-base balance? GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK a. Respiratory system b. Buffer systems in the blood c. Kidneys d. Brain ANS: C REF: 29 20. Which of the following is essential in order to maintain serum pH within normal range? a. Carbonic acid and bicarbonate ion must be present in equal quantities. b. All excess carbonic acid must be excreted by the kidneys. c. The concentration of bicarbonate ion must remain constant. d. The ratio of carbonic acid to bicarbonate ion must be 1:20. ANS: D REF: 30 21. Which is the correct effect on the body of abnormally slow respirations? a. Increased carbonic acid b. Decreased carbonic acid c. Increased bicarbonate ion d. Decreased bicarbonate ion ANS: A REF: 31 22. Which condition is likely to cause metabolic acidosis? a. Slow, shallow respirations b. Prolonged diarrhea c. Mild vomiting d. Excessive fluid in the body ANS: B REF: 32 NURSINGTB.COM 23. What would a serum pH of 7.33 in a patient with kidney disease indicate? a. Metabolic alkalosis b. Metabolic acidosis c. Respiratory alkalosis d. Respiratory acidosis ANS: B REF: 32 24. Which serum value indicates decompensated metabolic acidosis? a. pH is below normal range b. pH is above normal range c. Bicarbonate level decreases d. Bicarbonate level increases ANS: A REF: 32 25. What is the effect on blood serum when excessive lactic acid accumulates in the body? a. Bicarbonate ion levels decrease b. Bicarbonate ion levels increase c. Carbonic acid levels increase d. pH increases GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK ANS: A REF: 32 26. The direct effects of acidosis are manifested primarily in the functioning of the: a. Digestive system b. Urinary system c. Nervous system d. Respiratory system ANS: C REF: 32 27. Compensation mechanisms in the body for dehydration would include: a. increased antidiuretic hormone (ADH). b. decreased aldosterone. c. slow, strong heart contraction. d. peripheral vasodilation. ANS: A REF: 21 28. Which acid-base imbalance results from impaired expiration due to emphysema? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis ANS: C REF: 32 29. In patients with impaired expiration associated with emphysema, effective compensation for the acid-base imbalance would beN : URSINGTB.COM a. increased rate and depth of respiration. b. decreased rate and depth of respiration. c. increased urine pH and decreased serum bicarbonate. d. decreased urine pH and increased serum bicarbonate. ANS: D REF: 32 30. An anxiety attack often causes hyperventilation leading to: a. increased PCO2. b. decreased PCO2. c. respiratory acidosis. d. metabolic acidosis. ANS: B REF: 32 31. One of the factors involved in the increased need for water in infants is: a. proportionally smaller body surface area. b. higher metabolic rate. c. smaller respiratory capacity. d. greater surface area of exposed mucous membranes. ANS: B REF: 20 32. Compensation for respiratory system depression due to anesthesia and sedation would be: a. decreased reabsorption of bicarbonate ions in the kidneys. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK b. increased secretion of hydrogen ions into the filtrate. c. increased respiratory rate and depth. d. increased renin secretion. ANS: B REF: 32 33. A prolonged state of metabolic acidosis often leads to: a. hypokalemia. b. hyperkalemia. c. hyponatremia. d. hypercalcemia. ANS: B REF: 25 34. Strenuous physical exercise on a hot day is likely to result in: a. hypokalemia. b. hypernatremia. c. hyperchloremia. d. hypovolemia. ANS: D REF: 19 | 23 35. Place the following events in the correct sequence of events when ketoacids increase in the blood of a diabetic patient. Not all options are used in the answers. 1. Serum pH decreases 2. Serum bicarbonate decreases 3. PCO2 decreases 4. Respiration decreases 5. Respiration increases 6. Serum pH increases 7. Urine pH decreases a. 1, 3, 7, 4, 2, 6 b. 5, 2, 7, 3, 4, 1 c. 2, 1, 5, 3, 7, 6 d. 3, 1, 2, 5, 7, 6 ANS: C REF: 34-37 NURSINGTB.COM 36. Which of the following is a manifestation of respiratory alkalosis? a. Bradycardia and deep rapid breathing b. Drowsiness and general lethargy c. Increased nervous system irritability d. Decreased urine pH ANS: C REF: 33 37. Prolonged diarrhea results in: a. loss of fluid and bicarbonate ions, leading to metabolic acidosis. b. increased fluid and serum bicarbonate ions, leading to metabolic acidosis. c. loss of chloride ions only, leading to metabolic alkalosis. d. surplus bicarbonate ions, leading to respiratory alkalosis. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK 3 ANS: A REF: 32 38. In the initial stage, vomiting results in: a. metabolic acidosis. b. metabolic alkalosis. c. respiratory alkalosis. d. None of the above ANS: B REF: 32 39. Which two ions are most important for acid-base balance in the body? a. K + , Na+ b. Cl– and HCO – c. Ca++ , Na+ d. Na+ , Cl– ANS: B REF: 28 40. The bicarbonate-carbonic acid buffer system helps maintain serum pH. The balance of the carbonic acid and bicarbonate ion levels are controlled by the: a. liver and pancreas. b. lungs and kidneys. c. lungs and plasma proteins. d. kidneys and bone marrow. ANS: B REF: 30 41. Alkalosis increases irritability andN sU pR oS nI tN anG eT oB u.C sO stMimulation of nerves by: a. blocking normal nerve conduction. b. increasing the permeability of nerve membranes. c. blocking movement of calcium ions. d. decreasing phosphate ion levels. ANS: B REF: 26 | 33 42. Hypocalcemia causes weak cardiac contractions because: a. permeability of nerve membranes increases. b. insufficient calcium ions are available for muscle contraction. c. low phosphate ion levels prevent muscle contraction. d. excessive amounts of calcium are stored in cardiac muscle. ANS: B REF: 27 43. Serum potassium levels are affected by: 1. ADH. 2. aldosterone. 3. serum H + levels. 4. insulin levels. a. 2 only b. 1, 2 c. 1, 3 d. 2, 3, 4 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK e. 1, 2, 3 ANS: D REF: 24 | 25 44. Which of the following is the primary control of serum Na+ levels? a. ADH b. Aldosterone c. Serum H + levels d. serum K + levels ANS: B REF: 21 45. The control center for thirst is located in the: a. kidneys. b. thalamus. c. medulla. d. hypothalamus. ANS: D REF: 15 46. Which statements apply to atrial natriuretic peptide? 1. It is secreted by heart muscle cells. 2. It is a hormone secreted by the kidneys. 3. It helps to control water and sodium balance. 4. It is released in response to low blood pressure. a. 1, 3 b. 1, 4 c. 2, 3 d. 2, 4 ANS: A REF: 15 NURSINGTB.COM 47. What are the three mechanisms that control or compensate for serum pH? a. Hypothalamus, metabolic changes by digestive system, lymphatic system filtration b. Buffer pairs in blood, change in kidney excretion rate, change in respiration rate c. Neural feedback, increase in heart rate, decrease in calcium intake d. Modification of water intake, increased capillary permeability, decrease in blood volume ANS: B REF: 29-31 48. Hypokalemia refers to a condition in which the serum has a very low level of which ion? a. Sodium b. Phosphate c. Calcium d. Potassium ANS: D REF: 24 49. In the blood and extracellular fluids, hypernatremia refers to: a. a deficient sodium level. b. an excess phosphate level. c. an excess sodium level. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK d. an excessively low phosphate level. ANS: C REF: 23 50. Increased milk and/or antacid intake can contribute to development of ―milk-alkali syndrome,‖ which can cause which of the following? a. Hyponatremia b. Hyperkalemia c. Hypercalcemia d. Hypovolemia ANS: C REF: 27 NURSINGTB.COM GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK Chapter 03: Introduction to Basic Pharmacology and Other Common Therapies Test Bank MULTIPLE CHOICE 1. Which of the following are considered to be the toxic effects of a drug? a. Additional, mild, unwanted effects b. Unusual, unexpected mild effects c. Serious, possibly life-threatening effects d. Reduction of the allergic response ANS: C REF: 41 2. What is the unique, simple, and official name assigned to a specific drug for worldwide use? a. Trade name b. Chemical name c. Proprietary name d. Generic name ANS: D REF: 46 3. Which is the route of administration by which the largest proportion of the drug dose is likely lost before reaching the site of action? a. Oral b. Intramuscular c. Sublingual d. Intravenous ANS: A REF: 44 NURSINGTB.COM 4. Ingesting a drug with a large meal may be likely to: a. immediately increase the blood level of the drug. b. prevent gastric irritation. c. ensure that the total dose is absorbed into the blood. d. cause more rapid excretion of the drug. ANS: B REF: 42 5. What is the reaction called when two drugs interact to produce a result much greater than the sum of individual effects? a. Antagonism b. Beneficial c. Synergism d. Potentiation ANS: C REF: 42 6. At which site are most drugs metabolized and prepared for excretion? a. Liver b. Kidneys c. Circulating blood GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK d. Lymphoid tissue ANS: A REF: 45 7. In traditional Asian medicine, acupoints are usually located: a. over pain or other sensory receptors. b. where blood vessels branch. c. over joints. d. on designated meridians. ANS: D REF: 49 8. Traditional drug or surgical therapy is incorporated with nontraditional methods by: a. chiropractors. b. naturopaths. c. homeopaths. d. osteopaths. ANS: D REF: 48 9. Contraindications printed on the label of a drug identify: a. those circumstances under which the drug should probably not be used. b. those typical side effects associated with this drug. c. the dosage limits associated with the use of the drug. d. the maximum shelf life of the medication. ANS: A REF: 41 10. After they are metabolized, most dNrUu Rg Ss IaNrGe Te Bx .c CrOetMed through the: a. lungs. b. pancreas. c. kidneys. d. large intestine. ANS: C REF: 42 11. A drug that binds with selected specific cell receptors may: 1. stimulate activity in those cells. 2. inhibit activity in those cells. 3. change specificity and attach to other cells. 4. be disabled by macrophages. a. 1, 2 b. 2, 3 c. 3, 4 d. 1, 3, 4 ANS: A REF: 45-46 12. A placebo may be described as a tablet or capsule: a. that does not contain an active drug. b. that contains a small amount of active drug for use in clinical trials. c. that contains a different drug to be used for its psychological effect. d. that contains high amounts of a drug to determine the maximum dose allowed. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK ANS: A REF: 47 13. The form of therapy that involves assessment of physical function and works to restore any problems and prevent any further dysfunction using methods such as appropriate exercises and ultrasound is referred to as: a. registered massage therapy. b. naturopathy. c. physiotherapy. d. reflexology. ANS: C REF: 47 14. A medical history should include all: 1. legally prescribed drugs. 2. vitamin or mineral supplements. 3. any medication not requiring a prescription (over-the-counter items). 4. herbal treatments. a. 1 only b. 1, 3 c. 1, 2, 4 d. 1, 2, 3, 4 ANS: D REF: 47 15. Antagonistic drugs may be used to: a. increase the effectiveness of selected drugs. b. prolong the action of a drug. NURSINGTB.COM c. act as an antidote when necessary. d. speed up the excretion of a drug. ANS: C REF: 42 16. The full course of a prescribed antimicrobial drug should be completed so as to prevent: a. undesirable side effects. b. development of resistant microbes. c. an allergic response. d. proper metabolism and excretion of drug. ANS: B REF: 42 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK Chapter 04: Pain Test Bank MULTIPLE CHOICE 1. The impulses related to acute pain are usually transmitted by: a. nociceptors. b. myelinated A delta fibers. c. unmyelinated C fibers. d. any sensory fiber with a low pain threshold. ANS: B REF: 55 2. In which structure do pain impulses ascend the spinal cord? a. Reticular formation b. Corticospinal tract c. Spinothalamic tract d. Relevant dermatome ANS: C REF: 55 3. According to the gate-control theory, passage of pain impulses may be naturally blocked: a. at the synapse by entry of other sensory impulses. b. by the stress response. c. by administration of morphine directly into the spinal cord. d. by referring the pain to other parts of the body. NURSINGTB.COM ANS: A REF: 55 4. What is the term used to describe the degree of pain that is endured before an individual takes action? a. Pain threshold b. Referred pain c. Phantom pain d. Pain tolerance ANS: D REF: 55 5. What is the definition of endorphins? a. Neurotransmitters at the nociceptors b. Transmitters for sensory impulses c. Opiate-like blocking agents in the central nervous system d. Pain-causing chemical mediators ANS: C REF: 57 6. Pain perceived in the left arm during the course of a heart attack is an example of: a. referred pain. b. phantom pain. c. chronic pain. d. subjective pain response. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK ANS: A REF: 57 7. A headache that is related to changes in cerebral blood flow is classified as a/an headache. a. tension b. sinus c. migraine d. intracranial ANS: C REF: 60 8. What is a common analgesic administered to control a moderate level of pain? a. Meperidine b. Acetaminophen c. Codeine d. Ibuprofen ANS: C REF: 62 9. Which of the following applies to spinal anesthesia? a. It causes analgesia with loss of consciousness. b. The drug is injected into cerebrospinal fluid (CSF) or the epidural space of the spinal cord. c. The drug stimulates release of endorphins in the spinal cord. d. The transmission of pain impulses is blocked in a small area of the body. ANS: B REF: 62 NURSINGTB.COM 10. Which of the following is a characteristic of acute pain but not of chronic pain? a. Depression and debilitation b. A perception of increased generalized pain and discomfort c. Fatigue and lower pain tolerance d. Severe but short term ANS: D REF: 55-57 11. What is the role of nociceptors? They are: a. pain receptors that are stimulated by thermal, chemical, or physical means. b. spinal nerves that conduct impulses from specific areas of the skin. c. responsible for the state of arousal with pain. d. useful in localizing pain to a specific area of the body. ANS: A REF: 54 12. Intractable pain is best defined as: a. pain that is perceived as occurring in an amputated limb. b. severe pain that cannot be controlled by medication. c. pain perceived as coming from a source other than the actual source. d. pain coming from a specific dermatome. ANS: B REF: 62 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK 13. Which of the following statements is TRUE? a. The brain is more aware of pain impulses when the reticular activating system is depressed. b. Acute pain does not cause a reflex response at the spinal cord synapses. c. Young infants typically respond to pain with tachycardia and increased blood pressure. d. Chronic pain is easier to tolerate without negative effects. ANS: C REF: 57 14. Ibuprofen is classified as an NSAID and is particularly useful in treating: a. severe pain. b. pain caused by inflammation. c. intracranial pain. d. pain in young infants. ANS: B REF: 61 15. Which of the following analgesics acts to reduce pain at the peripheral site? a. Acetaminophen b. Morphine c. Codeine d. Intravenous general anesthesia ANS: A REF: 61 16. Cancer-related pain has been broken down into three basic categories: pain caused by the advance of the disease and resultaNnUt dRaSmINaGgTeBt.oCtOhMe body, pain that is the result of a coexisting disease unrelated to the cancer, and: a. phantom pain as a result of amputation. b. pain associated with the treatment of the disease. c. pain caused by emotional stress and metabolic changes. d. pain associated with damage to the peripheral nerves. ANS: B REF: 61 17. Pain that is caused by trauma or disease involving the peripheral nerves is referred to as: a. neuropathic pain. b. central pain. c. neurogenic pain. d. referred pain. ANS: A REF: 61 18. Pain resulting from a profound, sudden loss of blood flow to an organ or tissues in a specific area of the body is referred to as: a. chronic pain. b. central pain. c. cardiovascular pain. d. ischemic pain. ANS: D REF: 61 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK 19. Which of the following is a characteristic of chronic pain? a. It usually initiates a physiological stress response. b. It always involves a strong emotional response such as high anxiety. c. It is more difficult to diagnose and treat than is acute pain. d. It involves tissue damage to a specific organ. ANS: C REF: 59 | 60 20. A headache that results from pressure on the meninges surrounding the brain is referred to as a/an: a. intracranial headache. b. intrameningeal headache. c. migraine headache. d. cerebral headache. ANS: A REF: 60 NURSINGTB.COM GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK Chapter 05: Inflammation and Healing Test Bank MULTIPLE CHOICE 1. Tears are considered to be part of the: 1. first line of defense. 2. second line of defense. 3. third line of defense. 4. specific defenses. 5. nonspecific defenses. a. 1, 4 b. 1, 5 c. 3, 4 d. 2, 5 ANS: B REF: 66 2. A specific defense for the body is: a. phagocytosis. b. sensitized T lymphocytes. c. the inflammatory response. d. intact skin and mucous membranes. ANS: B REF: 66 3. The inflammatory response is a no Nn Us R p S e I c Nif Gic TB re .C sp Oo Mnse to: a. phagocytosis of foreign material. b. local vasodilation. c. any tissue injury. d. formation of purulent exudates. ANS: C REF: 66 4. Chemical mediators released during the inflammatory response include: a. albumin and fibrinogen. b. growth factors and cell enzymes. c. macrophages and neutrophils. d. histamine and prostaglandins. ANS: D REF: 69 5. Which of the following result directly from the release of chemical mediators following a moderate burn injury? 1. Pain 2. Local vasoconstriction 3. Increased capillary permeability 4. Pallor a. 1, 2 b. 1, 3 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK c. 2, 3 d. 2, 4 ANS: B REF: 69 6. Granulation tissue is best described as: a. highly vascular, very fragile, and very susceptible to infection. b. an erosion through the wall of viscera, leading to complications. c. a type of adhesion with no vascularization. d. a form of stenosis, in a duct, that is extremely tough and resists attack by microbes. ANS: A REF: 76 7. Edema associated with inflammation results directly from: a. increased fluid and protein in the interstitial compartment. b. increased phagocytes in the affected area. c. decreased capillary permeability. d. general vasoconstriction. ANS: A REF: 70 8. The warmth and redness related to the inflammatory response results from: a. increased interstitial fluid. b. production of complement. c. a large number of white blood cells (WBCs) entering the area. d. increased blood flow into the area. ANS: D REF: 70 NURSINGTB.COM 9. What is the correct order of the following events in the inflammatory response immediately after tissue injury? 1. Increased permeability of blood vessels 2. Dilation of blood vessels 3. Transient vasoconstriction 4. Migration of leukocytes to the area 5. Hyperemia a. 5, 3, 2, 1, 4 b. 1, 2, 4, 5, 3 c. 2, 3, 5, 4, 1 d. 3, 2, 5, 1, 4 ANS: D REF: 69 10. The process of phagocytosis involves the: a. ingestion of foreign material and cell debris by leukocytes. b. shift of fluid and protein out of capillaries. c. formation of a fibrin mesh around the infected area. d. movement of erythrocytes through the capillary wall. ANS: A REF: 70 11. Systemic effects of severe inflammation include: a. erythema and warmth. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK b. loss of movement at the affected joint. c. fatigue, anorexia, and mild fever. d. abscess formation. ANS: C REF: 71 12. The term leukocytosis means: a. increased white blood cells (WBCs) in the blood. b. decreased WBCs in the blood. c. increased number of immature circulating leukocytes. d. significant change in the proportions of WBCs. ANS: A REF: 72 13. Which of the following statements applies to fever? a. Viral infection is usually present. b. Heat-loss mechanisms have been stimulated. c. It is caused by a signal to the thalamus. d. It results from release of pyrogens into the circulation. ANS: D REF: 71 14. Mechanisms to bring an elevated body temperature down to the normal level include: a. general cutaneous vasodilation. b. generalized shivering. c. increased heart rate. d. increased metabolic rate. ANS: A REF: 71 NURSINGTB.COM 15. Replacement of damaged tissue by similar functional cells is termed: a. fibrosis. b. regeneration. c. resolution. d. repair by scar tissue. ANS: B REF: 73 16. Scar tissue consists primarily of: a. granulation tissue. b. epithelial cells. c. collagen fibers. d. new capillaries and smooth muscle fibers. ANS: C REF: 76 17. Which of the following promotes rapid healing? a. Closely approximated edges of a wound b. Presence of foreign material c. Exposure to radiation d. Vasoconstriction in the involved area ANS: A REF: 76 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK 18. Glucocorticoids are used to treat inflammation because they directly: a. promote the release of prostaglandins at the site. b. decrease capillary permeability. c. mobilize lymphocytes and neutrophils. d. prevent infection. ANS: B REF: 74 19. Patients taking glucocorticoids for long periods of time are likely to develop all of the following EXCEPT: a. decreased bone density. b. wasting of skeletal muscle. c. opportunistic infections. d. increased leukocyte production. ANS: D REF: 75 20. Which of the following drugs relieves fever and some types of pain but is NOT an anti-inflammatory agent? a. Acetaminophen b. Prednisone c. Aspirin d. Ibuprofen ANS: A REF: 74 21. A burn area in which the epidermiNsUaRnSdINpaGrTtBo. fCtOhMe dermis is destroyed is classified as: a. full-thickness. b. deep partial-thickness. c. superficial partial-thickness. d. first-degree. ANS: B REF: 79 22. A woman has burns on the anterior surfaces of her right arm, chest, and right leg. The percentage of body surface area burned is approximately: a. 13.5%. b. 18%. c. 22.5%. d. 31.5%. ANS: C REF: 80 | 82 23. The characteristic appearance of a full-thickness burn is: a. painful with multiple blisters. b. heavy bleeding. c. red with some swelling. d. dry, firm, charred, or hard white surface. ANS: D REF: 79 24. A typical source of infection in burn areas is: GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK a. the skin grafts. b. microbes surviving in the hair follicles in the burn area. c. circulating blood bringing microbes to the burn wound. d. opportunistic virus in digestive tract. ANS: B REF: 83 25. A large burn area predisposes to decreased blood pressure because: a. bleeding occurs under the burn surface. b. the heart is damaged by toxic materials from the burn. c. fluid and protein shift out of the blood. d. vasoconstriction occurs in the burn area. ANS: C REF: 82 26. During an inflammatory response, hyperemia is caused by: a. increased blood flow in the area. b. increased capillary permeability. c. irritation of sensory nerve endings by histamine. d. increased leukocytes in the area. ANS: A REF: 69 27. The advantages of applying a biosynthetic skin substitute to a large area of full-thickness burns include: 1. reduced risk of infection. 2. decreased loss of plasma protein and fluid. 3. developing stronger fibrous scaNr UtiRssSuINe.GTB.COM 4. more rapid healing. 5. regeneration of all glands, nerves, and hair follicles. a. 1, 3 b. 4, 5 c. 1, 2, 4 d. 2, 3, 5 ANS: C REF: 84 28. Purulent exudates usually contain: a. small amounts of plasma protein & histamine in water. b. red blood cells & all types of white blood cells. c. numerous leukocytes, bacteria, and cell debris. d. large amounts of water containing a few cells. ANS: C REF: 71 29. Isoenzymes in the circulating blood: a. are a type of plasma protein normally present in the circulating blood. b. often indicate the precise location of an inflammatory response. c. are normally released from leukocytes during the inflammatory response. d. are pyrogens, causing low-grade fever. ANS: B REF: 72 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK 30. A serous exudate is best described as a: a. thin, watery, colorless exudate. b. thick, sticky, cloudy secretion. c. thick, greenish material containing microbes. d. brownish, clotted material. ANS: A REF: 70 31. Systemic manifestations of an inflammatory response include: a. edema and erythema. b. area of necrosis and loss of function. c. pain and tenderness. d. fever and malaise. ANS: D REF: 71 32. Some local effects of a general inflammatory response would include: a. high, spiking fever and chills. b. redness, warmth, and swelling. c. leukopenia and reduced erythrocyte sedimentation rate (ESR). d. anorexia and headaches. ANS: B REF: 67 33. Prolonged administration of glucocorticoids such as prednisone may cause: 1. atrophy of lymphoid tissue. 2. increased resistance to infection. 3. thrombocytopenia. 4. decreased protein synthesis. a. 1, 2 b. 1, 3 c. 1, 4 d. 2, 4 ANS: C REF: 75 NURSINGTB.COM 34. Application of ice to an injured knee reduces edema by: a. promoting return of lymph fluid. b. causing local vasoconstriction. c. increasing the rate of tissue repair. d. causing systemic vasodilation. ANS: B REF: 75 35. Healing of large areas of skin loss (including dermis and epidermis) would be most successful through: a. rapid mitosis and regeneration of skin layers. b. resolution of damaged cells in the area. c. covering the area with biosynthetic skin substitute. d. graft of fibrous tissue to the area. ANS: C REF: 84 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK 36. Prostaglandins are produced from and cause . a. activated plasma protein; increased capillary permeability b. mast cells; vasodilation and pain c. platelets; attraction of neutrophils, chemotaxis d. mast cell granules; activation of histamines and kinins ANS: B REF: 69 37. The number of neutrophils in the blood is increased significantly: a. during allergic reactions. b. during chronic inflammation. c. to produce antibodies. d. in order to promote phagocytosis. ANS: D REF: 69-70 38. An abscess contains: a. serous exudate. b. purulent exudate. c. fibrinous exudate. d. hemorrhagic exudate. ANS: B REF: 71 39. Nonspecific agents that protect uninfected cells against viruses are called: a. neutrophils. b. macrophages. c. interferons. d. pyrogens. ANS: C REF: 66 40. Causes of inflammation include: NURSINGTB.COM a. direct physical damage such as cuts and sprains. b. allergic reactions. c. infection. d. All the above ANS: D REF: 67 41. In normal capillary exchange, what is net hydrostatic pressure based on? a. The difference between the hydrostatic pressure within the capillary, as compared with the hydrostatic pressure of the interstitial fluid b. The relative osmotic pressures in the blood and the interstitial fluid c. The difference between the hydrostatic pressure and osmotic pressure within the capillary d. The difference between the concentrations of blood cells, plasma proteins, and dissolved substances in the blood and the interstitial fluid ANS: A REF: 66 42. The cardinal signs of inflammation include all of the following EXCEPT: a. redness. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK b. loss of function. c. nausea. d. swelling. ANS: C REF: 67 43. Drugs that have anti-inflammatory, analgesic, and antipyretic activities include: 1. COX-2 inhibitors (NSAIDs). 2. glucocorticoids (e.g., prednisone). 3. ibuprofen (NSAID). 4. acetaminophen. 5. aspirin (ASA). a. 1, 2 b. 2, 4 c. 1, 3, 5 d. 1, 4, 5 ANS: C REF: 74 44. Aspirin (ASA) is discouraged for treatment of viral infection in children because of: a. decreased bone growth after puberty. b. frequent production of blood clots. c. formation of a granuloma filled with virus. d. the risk of developing Reye’s syndrome. ANS: D REF: 74 45. Systemic manifestations of inflamNmUaRtiSoINnGinTcBlu.CdOeMall EXCEPT: a. pyrexia. b. malaise. c. local swelling. d. anorexia. ANS: C REF: 71 46. Which of the following cellular elements found in the inflammatory response are responsible for phagocytosis? a. Macrophages b. Basophils c. B lymphocytes d. T lymphocytes e. Eosinophils ANS: A REF: 66 47. Which chemical mediator is involved in prolonging the inflammatory response? a. Bradykinin b. Histamine c. Leukotrienes d. Chemotactic factors ANS: C REF: 69 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK 48. Potential complications after healing by scar formation include all the following EXCEPT: a. lack of sensory function in the area. b. contractures and adhesions. c. increased hair growth. d. keloid formation. ANS: C REF: 77-78 49. All of the following are correct statements regarding wound healing EXCEPT: a. Resolution occurs where there is minimal tissue damage and the cells can recover. b. Granulation tissue forms a permanent replacement for damaged tissue. c. Regeneration occurs where the cells are capable of mitosis. d. Scar tissue forms where the surrounding cells are incapable of mitosis. ANS: B REF: 73 | 75-76 50. Which of the following statements regarding inflammation is incorrect? a. Inflammation caused by an allergen or a burn will typically produce a serous exudate. b. Infection is one cause of inflammation. c. Inflammation is the body’s nonspecific response to tissue injury. d. Disorders are named using the ending -sarcoma to indicate inflammation. ANS: D REF: 66 | 67 | 70 51. Which of the following helps to localize and ―wall off‖ the foreign material during an inflammatory response? a. Lymphocytes b. Increased fluid c. Fibrinogen d. Antibodies ANS: C REF: 69 NURSINGTB.COM 52. Why is an application of cold recommended as part of the RICE first aid measures immediately following an inflammatory response due to injury? a. It improves circulation in the area removing chemical mediators. b. It causes local vasoconstriction to reduce local edema. c. It draws more phagocytic cells to the area to remove debris. d. It promotes immediate healing. ANS: B REF: 75 53. One goal for current research in tissue engineering is to: a. create a functional replacement tissue when regeneration is not possible. b. adapt cells from the injured organ to produce replacement tissue. c. design a nonliving synthetic replacement tissue. d. use stem cells as a temporary covering for damaged tissue. ANS: A REF: 76 54. Identify the proper sequence in the healing process. a. A blood clot forms; granulation tissue grows into the gap; new blood vessels GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK develop; phagocytosis of foreign material and cell debris occurs; and collagen fibers form a tight, strong scar. b. A blood clot forms; phagocytes remove foreign material and cell debris; granulation tissue grows into the gap; new blood vessels form; and collagen fibers promote formation of a tight, strong scar. c. Collagen fibers form in the damaged area; a blood clot forms; granulation tissue grows into the gap; angiogenesis takes place; and foreign material and cell debris are removed by phagocytes. d. Foreign material and cell debris are removed by phagocytes; a blood clot forms; granulation tissue grows into the gap; new blood vessels form; and collagen fibers grow and cross-link. ANS: B REF: 76 55. All of the following are factors that promote healing EXCEPT: a. good nutrition: protein, vitamins A and C. b. a clean, undisturbed wound. c. effective circulation. d. advanced age. ANS: D REF: 77 56. Identify the correct statement about burns: a. The severity of the burn depends on the temperature, duration, and extent of the burn. b. Young children are less likely to suffer severe burns from immersion in excessively hot water. c. Burns to the palms of the hand N s U a R re SI m NG o T re B d .C a Om Maging than burns on the face. d. With a major burn, excessive bleeding usually causes shock. ANS: A REF: 78 57. Which statement applies to the recommended emergency care for burns? a. Drop and lie completely still on your back. b. Call a neighbor for help if the burn appears to be extensive. c. Apply lotion and cover burn tightly with a sheet or towel. d. Cover the burn area with clean, cool, or tepid water and remove nonsticking clothing. ANS: D REF: 82 58. Inhalation of carbon monoxide is a threat for many burn patients because this gas: a. causes swelling in the trachea. b. quickly reduces the available oxygen in the blood. c. prevents full expansion of the lungs. d. is toxic to the nervous system. ANS: B REF: 82 59. Hypermetabolism is common with major burns because of: a. increased heat loss from the burn wound. b. demand for tissue repair. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK c. recurrent stress response. d. All of the above ANS: D REF: 83 60. How does scar tissue usually cause obstructions to develop in tube-like structures? a. Scar tissue continues to grow and spread, causing a blockage. b. Scar tissue does not stretch, but rather shrinks in time, causing narrowing. c. Scar tissue twists and forms knots as it develops. d. Scar tissue attaches to nearby normal tissue, causing obstruction. ANS: B REF: 78 61. Which of the following is a serious potential complication found only with the anti-inflammatory COX-2 inhibitor drugs? a. Increased risk of infection at the site of inflammation b. Reye’s syndrome developing in children and young adults c. Increased incidence of heart attacks d. Greatly delayed blood clotting ANS: C REF: 74 NURSINGTB.COM GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK Chapter 06: Infection Test Bank MULTIPLE CHOICE 1. Bacteria that form an irregular cluster of spheres are called: a. bacilli. b. diplococci. c. staphylococci. d. streptococci. ANS: C REF: 89 2. A strict anaerobe requires which specific environment? a. A dry environment b. An acidic medium c. Air at a temperature less than 61 F/16 C d. The absence of oxygen ANS: D REF: 89 3. The presence of the bacterial capsule: a. aids in the release of endotoxins. b. protects the microbe from phagocytosis. c. increases the release of toxins and enzymes. d. prevents replication of the bacterium. NURSINGTB.COM ANS: B REF: 90 4. Microbial mutation means that: a. genetic information has changed. b. pathogens become nonpathogens. c. the microbe survives adverse conditions but can no longer replicate. d. the immune response to that microbe is strengthened. ANS: A REF: 101 5. A bacterial endospore can: a. also be classified as an acid-fast bacterium. b. exist in latent form inside a host cell. c. reproduce very rapidly. d. survive high temperatures and a dry environment. ANS: D REF: 96 6. The structure of a virus includes: a. a cell wall and membrane. b. metabolic enzymes for replication. c. a protein coat and either DNA or RNA. d. a slime capsule and cilia. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK ANS: C REF: 92 7. What method do viruses use to replicate? a. Binary fission b. Budding of a daughter cell from the parent viral cell c. Producing reproductive spores d. Using a host cell to produce and assemble components ANS: D REF: 92 8. A retrovirus such as HIV contains: a. RNA and enzymes for its conversion. b. a double strand of DNA. c. many enzymes to limit budding of new virions. d. numerous mitochondria. ANS: A REF: 92 9. How do antiviral drugs act? a. They interfere with cell wall development. b. They decrease cell membrane permeability. c. They destroy new, immature viral particles. d. They reduce the rate of viral replication. ANS: D REF: 107 10. Which statement applies to yeasts? a. They are usually considered toN bU eR pSI aN thG oT gB e. nC iO cM. b. They seldom contain a distinct nucleus. c. They may cause opportunistic infection in the body. d. They are normally not found in large numbers in resident flora. ANS: C REF: 96 11. Fungi reproduce by: 1. budding. 2. extension of hyphae. 3. binary fission. 4. production of spores. a. 1, 2 b. 2, 4 c. 1, 2, 4 d. 2, 3, 4 ANS: C REF: 96 12. Which of the following is NOT classified as a protozoan agent of disease? a. Plasmodium vivax b. Trichomonas vaginalis c. Tinea pedis d. Entamoeba histolytica ANS: C REF: 96-97 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK 13. Which of the following is a characteristic of rickettsia? a. It is a very small gram-negative intracellular microbe. b. It exists in three forms. c. It causes sexually transmitted disease. d. It reproduces by budding. ANS: A REF: 93 14. Entamoeba histolytica is transmitted by which of the following? a. Mosquitoes (bites) b. Inhaling contaminated particles c. Sexual intercourse d. Cysts in feces ANS: D REF: 97 15. Which of the following is a characteristic of resident or normal flora (microflora)? a. It exists in all areas of the body. b. Different species inhabit various areas of the body. c. It is of no benefit to the human host. d. It consists only of bacteria. ANS: B REF: 98 16. Which of the following is normally considered sterile? a. Urine b. Pharynx c. Distal urethra d. Vagina ANS: A REF: 99 NURSINGTB.COM 17. The term nosocomial infection means: a. transmission involves an insect or animal host. b. acquired in a hospital or medical facility. c. transmitted by a fomite. d. spread by direct contact with secretions from an open lesion. ANS: B REF: 99 18. Transmission of microbes by direct contact includes: a. touching a contaminated countertop. b. sexual intercourse. c. drinking contaminated water. d. inhaling dust-borne microbes. ANS: B REF: 99 19. What does the term carrier mean? a. A person with active infection who acts as a reservoir for microbes b. Animals, insects, objects, or surfaces contaminated by pathogens c. An individual who is contagious through infected secretions on the hands GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK d. An asymptomatic person whose body harbors pathogens and can transmit them to others ANS: D REF: 99 20. Opportunistic infection may develop when: a. pathogens enter the body but cannot colonize the site of entry. b. an imbalance occurs in the normal resident flora. c. host resistance increases, and the balance of resident flora is restored. d. contaminated food or water is unknowingly ingested. ANS: B REF: 99 21. Host resistance is promoted by all of the following EXCEPT: a. prescribed immunizations. b. chronic respiratory disease. c. vitamin and mineral supplements. d. appropriate inflammatory or immune response. ANS: B REF: 100-101 22. Which of the following factors would NOT increase the virulence of a specific microbe? a. Secretion of endotoxin b. Presence of a bacterial capsule c. Production of interferons d. Secretion of invasive enzymes ANS: C REF: 101 NURSINGTB.COM 23. That time in the course of an infection when the infected person may experience a headache or fatigue and senses he or she is ―coming down with something‖ is referred to as which of the following? a. Subclinical period b. Eclipse period c. Prodromal period d. Presymptomatic period ANS: C REF: 104 24. The principle of Universal Precautions is based on: a. using disinfectants at all times to eliminate cross-infections. b. not touching any open or bleeding lesions. c. sterilizing all instruments and equipment after each use. d. assuming that all body fluids from all individuals are possible sources of infection. ANS: D REF: 102 25. The ―incubation period‖ refers to the time period between: a. entry of the pathogen into the body and the first signs of infectious disease. b. the onset of the prodromal period and the peak of the acute infection. c. the onset of clinical signs and signs of recovery from infection. d. the acute period and establishment of chronic infection. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK ANS: A REF: 104 26. What does ―bacteremia‖ refer to? a. Numerous pathogens circulating and reproducing in the blood b. Uncontrolled sepsis throughout the body c. Multiple infections, primary and secondary, established in the body d. Microbes present in the blood ANS: D REF: 105 27. Which of the following is a local sign of infection? a. Fever and leukocytosis b. Headache and anorexia c. Pain, erythema, and swelling d. Nausea, weight loss, and fatigue ANS: C REF: 105 28. What are culture and sensitivity tests used for? a. To determine the type of microbe present in an exudate b. To provide a specific medium that supports maximum microbial growth c. To identify the causative microbe and the effective antimicrobial agent for it d. To provide living host cells for microbes requiring such for replication ANS: C REF: 106 29. A broad-spectrum bactericidal agent would be expected to: a. destroy many gram-positive anN dUR grS aImNG -nT eB g.C atO ivMe bacteria. b. destroy all pathogenic microbes in contact with the agent. c. reduce the replication of many bacteria. d. inhibit the growth of most spores and acid-fast bacteria. ANS: A REF: 107 30. How does penicillin act as a bactericidal agent? a. It interferes with cell-wall synthesis. b. It blocks protein synthesis. c. It increases cell membrane permeability. d. It prevents DNA replication. ANS: A REF: 107 31. Secondary infection may occur with administration of antibacterial drugs because the: a. patient is allergic to the drug. b. balance of species in the resident flora is upset. c. mucosa of the stomach is irritated. d. infecting microbes spread to adjacent areas. ANS: B REF: 107-108 32. All of the following are mechanisms of antiviral drug action EXCEPT: a. interference with attachment to host cell. b. block assembly of viral particles. GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK c. interference with mitosis. d. shedding of protein coat. ANS: C REF: 108 33. Secondary bacterial infections occur frequently during influenza epidemics primarily because: a. antiviral drugs lower host resistance. b. the virus causes extensive tissue inflammation and necrosis. c. respiratory droplets transmit infections. d. the viral infection is usually self-limiting. ANS: B REF: 110 34. The primary pathological effect of influenza virus is: a. destruction of the mucosa in the lower respiratory tract. b. replication of the virus in respiratory secretions. c. destruction of leukocytes and macrophages in the lungs. d. inflammation and necrosis of the upper respiratory epithelium. ANS: D REF: 110 35. What does leukocytosis frequently indicate? a. Immunosuppression b. Bone marrow damage c. Presence of bacterial infection d. An allergic or autoimmune reaction ANS: C REF: 105 NURSINGTB.COM 36. When an infection or inflammation is suspected, what does leucopenia often indicate? a. Bacterial infection b. Viral infection c. Allergic reaction d. Septicemia ANS: B REF: 106 37. Which of the following statements applies to Chlamydia? a. The microbe exists as a chain of cells. b. It causes a common STD. c. It possesses many flagella. d. It is excreted in feces. ANS: B REF: 93 38. Which of the following microbes is classified as an obligate intracellular parasite? a. Fungus b. Bacterium c. Virus d. Protozoa ANS: C REF: 93 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK 39. Which of the following are characteristics of influenza virus? 1. It is an obligate intracellular parasite. 2. It contains RNA. 3. It usually causes nausea and vomiting. 4. There are three subtypes: A, B, C. a. 1, 4 b. 1, 3 c. 2, 3, 4 d. 1, 2, 4 ANS: D REF: 93 40. The widespread necrosis of respiratory mucosa caused by an influenza infection often gives rise to: a. severe anemia. b. secondary infections. c. asthma. d. emphysema. ANS: B REF: 110 41. Prions cannot be cultured in a PETRI plate of media because: a. they take so long to grow. b. they require extensive amounts of specialized nutrients. c. they are proteinaceous particles, not living organisms. d. they are viruses that don’t grow on conventional media. ANS: C REF: 98 NURSINGTB.COM 42. Which of the following statements applies to Influenza A H1N1? a. It alters human chromosomes to cause manifestations. b. It usually causes severe respiratory distress and high fever. c. Infection is common in the elderly. d. It contains genetic material from avian, swine, and human viruses. ANS: D REF: 93 43. Which of the following does NOT directly determine the virulence of a microbe? a. Capacity for opportunism b. Production of toxins c. Ability to mutate d. Invasive qualities ANS: A REF: 101 44. Which of the following is a function of interferons? a. They block the invasion of pathogenic bacteria. b. They reduce the inflammatory response to local infection. c. They increase host cell resistance to viral invasion. d. They may facilitate the spread of some cancer cells. ANS: C REF: 100 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK 45. Inflamed tissue is likely to become infected because: a. the immune system is not effective in inflamed tissue. b. the increased fluid and protein in the inflamed area supports microbial growth. c. phagocytes cannot penetrate the inflamed areas. d. capillaries are less permeable in the affected area. ANS: B REF: 105 46. When an infectious disease is occurring globally at a higher rate than usual, it may be designated as a/an: a. sporadic occurrence. b. epidemic. c. pandemic. d. emerging disease. ANS: C REF: 99 47. Which of the following is the primary difference between an antiseptic and a disinfectant? a. Antiseptic is used on living tissue, whereas disinfectant is designed for nonliving surfaces. b. Antiseptic is much stronger than the potency of a disinfectant. c. Antiseptic often causes allergic skin reactions, whereas disinfectant is always hypoallergenic. d. Antiseptic is effective against endospores; disinfectants are not effective against endospores. ANS: A REF: 103-104 NURSINGTB.COM 48. Drugs that are designed to inhibit or slow down growth of microbes but not necessarily kill them are considered: a. ineffective. b. bacteriostatic. c. narrow-spectrum. d. bactericidal. ANS: B REF: 107 GOULDS PATHOPHYSISOtuLvOiaG.coYmF-OThReTMHarEkeHtpElaAceLtToHBuPyRaOndFSEeSllSyI oOurNSStu6 dTy HMaEteDriaITl ION HUBERT TEST BANK Chapter 07: Immunity Test Bank MULTIPLE CHOICE 1. Neutrophils: a. are phagocytic cells. b. produce histamine. c. produce antibodies. d. are elevated during an allergic response. ANS: A REF: 115 2. Which cells are required to process and present antigens from foreign material as the initial step in the immune response? a. T–helper cells b. Macrophages c. Eosinophils d. Monocytes ANS: B REF: 115 3. Humoral immunity is mediated by: a. natural killer cells. b. T lymphocytes (T cells). c. B lymphocytes (B cells). d. neutrophils. ANS: C REF: 115 NURSINGTB.COM 4. A secondary immune response differs from the primary immune response in that: a. it is more rapid than the primary response and results in higher antibody levels. b. it is slower than the primary response and doesn’t change the antibody levels. c. it occurs at t