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