Adults, 3rd Edition Malone Kennedy | 9781719645256 | All
Chapters with Answers and Rationals
Ch. 1 #1 At an international nursing conference, many discussions and breakout sessions focused on the
World Health Organization (WHO) views on health. Of the following comments made by nurses during a
discussion session, which statements would be considered a good representation of the WHO
definition? Select all that apply.
A) Interests in keeping the elderly population engaged in such activities as book reviews and word
games during social time
B) Increase in the number of chair aerobics classes provided in the skilled care facilities
C) Interventions geared toward keeping the elderly population diagnosed with diabetes mellitus under
tight blood glucose control by providing in-home cooking classes
D) Providing transportation for renal dialysis patients to and from their hemodialysis sessions
E) Providing handwashing teaching sessions to a group of young children - ANSWER:Ans: A, B, C, E
The WHO definition of health is defined as "a state of complete physical, mental, and social well-being
and not merely the absence of disease and infirmity." Engaging in book reviews facilitates mental and
social well-being; chair aerobics helps facilitate physical well-being; and assisting with tight control of
diabetes helps with facilitating physical well-being even though the person has a chronic disease.
Handwashing is vital in the prevention of disease and spread of germs.
Ch. 1 #2 A community health nurse is teaching a group of recent graduates about the large variety of
factors that influence an individual's health or lack thereof. The nurse is referring to the Healthy People
2020 report from the U.S. Department of Health and Human Services as a teaching example. Of the
following aspects discussed, which would be considered a determinant of health that is outside the
focus of this report?
A) The client has a diverse background by being of Asian and Native American descent and practices
various alternative therapies to minimize effects of stress.
,B) The client has a family history of cardiovascular disease related to hypercholesterolemia and remains
noncompliant with the treatment regime. C) The client has a good career with exceptional preventative
health care benefits.
D) The client lives in an affluent, clean, suburban community with access to many health care facilities. -
ANSWER:Ans: B
In Healthy People 2020, the focus is to promote good health to all (such as using alternative therapies to
minimize effects of stress); achieving health equity and promoting health for all (which includes having
good health care benefits); and promoting good health (which includes living in a clean community with
good access to health care). A client's noncompliance with treatments to control high cholesterol levels
within the presence of a family history of CV disease does not meet the "attaining lives free of
preventable disease and premature death" determinant.
Ch. 1 #3 A physician is providing care for a number of patients on a medical unit of a large, university
hospital. The physician is discussing with a colleague the differentiation between diseases that are
caused by abnormal molecules and diseases that cause disease. Which of the following patients most
clearly demonstrates the consequences of molecules that cause disease?
A) A 31-year-old woman with sickle cell anemia who is receiving a transfusion of packed red blood cells
B) A 91-year-old woman who has experienced an ischemic stroke resulting from familial
hypercholesterolemia
C) A 19-year-old man with exacerbation of his cystic fibrosis requiring oxygen therapy and chest
physiotherapy
D) A 30-year-old homeless man who has Pneumocystis carinii pneumonia (PCP) and is HIV positive. -
ANSWER:Ans: D
PCP is an example of the effect of a molecule that directly contributes to disease. Sickle cell anemia,
familial hypercholesterolemia, and cystic fibrosis are all examples of the effects of abnormal molecules.
Ch. 1 #4 A member of the health care team is researching the etiology and pathogenesis of a number of
clients who are under his care in a hospital context. Which of the following aspects of clients' situations
best characterizes pathogenesis rather than etiology?
A) A client who has been exposed to the Mycobacterium tuberculosis bacterium
B) A client who has increasing serum ammonia levels due to liver cirrhosis
C) A client who was admitted with the effects of methyl alcohol poisoning
,D) A client with multiple skeletal injuries secondary to a motor vehicle accident - ANSWER:Ans: B
Pathogenesis refers to the progressive and evolutionary course of disease, such as the increasing
ammonia levels that accompany liver disease. Bacteria, poisons, and traumatic injuries are examples of
etiologic factors.
Ch. 1 #5 A new myocardial infarction patient requiring angioplasty and stent placement has arrived to
his first cardiac rehabilitation appointment. In this first session, a review of the pathogenesis of coronary
artery disease is addressed. Which statement by the patient verifies to the nurse that he has understood
the nurse's teachings about coronary artery disease?
A) "All I have to do is stop smoking, and then I won't have any more heart attacks."
B) "My artery was clogged by fat, so I will need to stop eating fatty foods like French fries every day."
C) "Sounds like this began because of inflammation inside my artery that made it easy to form fatty
streaks, which lead to my clogged artery."
D) "If I do not exercise regularly to get my heart rate up, blood pools in the veins causing a clot that
stops blood flow to the muscle, and I will have a heart attack." - ANSWER:Ans: C
The true etiology/cause of coronary artery disease (CAD) is unknown; however, the pathogenesis of the
disorder relates to the progression of the inflammatory process from a fatty streak to the occlusive
vessel lesion seen in people with coronary artery disease. Risk factors for CAD revolve around cigarette
smoking, diet high in fat, and lack of exercise.
Ch. 1 #6 A 77-year-old man is a hospital inpatient admitted for exacerbation of his chronic obstructive
pulmonary disease (COPD), and a respiratory therapist (RT) is assessing the client for the first time.
Which of the following aspects of the patient's current state of health would be best characterized as a
symptom rather than a sign?
A) The patient's oxygen saturation is 83% by pulse oxymetry.
B) The patient notes that he has increased work of breathing when lying supine.
C) The RT hears diminished breath sounds to the patient's lower lung fields bilaterally.
D) The patient's respiratory rate is 31 breaths/minute. - ANSWER:Ans: B
Symptoms are subjective complaints by the person experiencing the health problem, such as complaints
of breathing difficulty. Oxygen levels, listening to breath sounds, and respiratory rate are all objective,
observable signs of disease.
, Ch. 1 #7 Which of the following situations would be classified as a complication of a disease or outcome
from the treatment regimen? Select all that apply.
A) Massive pulmonary emboli following diagnosis of new-onset atrial fibrillation
B) Burning, intense incision pain following surgery to remove a portion of colon due to intestinal
aganglionosis
C) Development of pulmonary fibrosis following treatment with bleomycin, an antibiotic chemotherapy
agent used in treatment of lymphoma
D) Gradual deterioration in ability to walk unassisted for a patient diagnosed with Parkinson disease
E) Loss of short-term memory in a patient diagnosed with Alzheimer disease - ANSWER:Ans: A, C
Development of pulmonary emboli and pulmonary fibrosis following chemotherapy are both examples
of a complication (adverse extensions of a disease or outcome from treatment). It is normal to expect
incisional pain following surgery. As Parkinson disease progresses, the inability to walk independently is
expected. This is a normal progression for people diagnosed with Parkinson's. Loss of short-term
memory in a patient diagnosed with Alzheimer disease is an expected finding.
Ch. 1 #8 Laboratory testing is ordered for a male patient during a clinic visit for a routine follow-up
assessment of hypertension. When interpreting lab values, the nurse knows that
A) a normal value represents the test results that fall within the bell curve.
B) if the lab result is above the 50% distribution, the result is considered elevated.
C) all lab values are adjusted for gender and weight.
D) if the result of a very sensitive test is negative, that does not mean the person is disease free. -
ANSWER:Ans: A
What is termed a normal value for a laboratory test is established statistically from results obtained
from a selected sample of people. A normal value represents the test results that fall within the bell
curve or the 95% distribution. 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, and the disease has been ruled out or excluded.
Ch. 1 #9 The laboratory technologists are discussing a new blood test that helps establish a differential
diagnosis between shortness of breath with a cardiac etiology and shortness of breath with a