TEST BANK For Porth's Essentials of Pathophysiology
5th Edition by Tommie L Norris
All Chapters 1 - 52
,Porth's Essentials of Pathophysiology / Edition 5 by Tommie L Norris
Table of Contents
Chapter 1-- Concepts of Health and Disease
Chapter 2 -- Cell and Tissue Characteristics
Chapter 3 -- Cellular Adaptation, Injury, and Death
Chapter 4 -- Genetic Control of Cell Function and Inheritance
Chapter 5 -- Genetic and Congenital Disorders
Chapter 6 -- Neoplasia
Chapter 7 -- Stress and Adaptation
Chapter 8 -- Disorders of Fluid, Electrolyte, and Acid–Base Balance
Chapter 9 -- Inflammation, Tissue Repair, and Wound Healing
Chapter 10 -- Mechanisms of Infectious Disease
Chapter 11-- Innate and Adaptive Immunity
Chapter 12 -- Disorders of the Immune Response, Including HIV/AIDS
Chapter 13 -- Organization and Control of Neural Function
Chapter 14 -- Somatosensory Function, Pain, Headache, and Temperature Regulation
Chapter 15 -- Disorders of Motor Function
Chapter 16 -- Disorders of Brain Function
Chapter 17 -- Sleep and Sleep–Wake Disorders
Chapter 18 -- Disorders of Thought, Emotion, and Memory
Chapter 19 -- Disorders of Visual Function
Chapter 20 -- Disorders of Hearing and Vestibular Function
Chapter 21 -- Blood Cells and the Hematopoietic System
Chapter 22 -- Disorders of Hemostasis
Chapter 23 -- Disorders of Red Blood Cells
,Chapter 24 -- Disorders of White Blood Cells and Lymphoid Tissues
Chapter 25 -- Structure and Function of the Cardiovascular System
Chapter 26 -- Disorders of Blood Flow and Blood Pressure Regulation
Chapter 27 -- Disorders of Cardiac Function, and Heart Failure and Circulatory Shock
Chapter 28 -- Disorders of Cardiac Conduction and Rhythm
Chapter 29 -- Structure and Function of the Respiratory System
Chapter 30 -- Respiratory Tract Infections, Neoplasms, and Childhood Disorders
Chapter 31 -- Disorders of Ventilation and Gas Exchange
Chapter 32 -- Structure and Function of the Kidney
Chapter 33 -- Disorders of Renal Function
Chapter 34 -- Acute Kidney Injury and Chronic Kidney Disease
Chapter 35 -- Disorders of the Bladder and Lower Urinary Tract
Chapter 36 -- Structure and Function of the Gastrointestinal System
Chapter 37 -- Disorders of Gastrointestinal Function
Chapter 38 -- Disorders of Hepatobiliary and Exocrine Pancreas Function
Chapter 39 -- Alterations in Nutritional Status
Chapter 40 -- Mechanisms of Endocrine Control1
Chapter 41-- Disorders of Endocrine Control of Growth and Metabolism
Chapter 42 -- Structure and Function of the Male Genitourinary System
Chapter 43 -- Disorders of the Male Reproductive System
Chapter 44 -- Structure and Function of the Female Reproductive System
Chapter 45 -- Disorders of the Female Reproductive System
Chapter 46 -- Sexually Transmitted Infections
Chapter 47 -- Structure and Function of the Musculoskeletal System
Chapter 48 -- Disorders of Musculoskeletal Function: Trauma, Infection, Neoplasms1
,Chapter 49 -- Disorders of Musculoskeletal Function: Developmental and Metabolic Disorders, Activity
Intolerance, and Fatigue
Chapter 50 -- Disorders of Musculoskeletal Function: Rheumatic Disorders
Chapter 51 -- Structure and Function of the Skin
Chapter 52 -- Disorders of Skin Integrity and Function
,Porth’s Essentials of Pathophysiology 5th Edition Test Bank
Ch 1- Concepts of Health and Disease
1. At an international nursing conference, many discussions and breakout sessions focusedon 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 cookingclasses
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: A, B, C, E
Feedback:
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 vitalin the prevention of disease and spread
of germs.
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 andHuman 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 manyhealth
care facilities.
ANSWER: B
Feedback:
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 tohealth care). A client's noncompliance with
treatments to control high cholesterol levelswithin the presence of a family history of
CV disease does not meet the “attaining lives free of preventable disease and
premature death” determinant.
,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
fromfamilial 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: D
Feedback:
PCP is an example of the effect of a molecule that directly contributes to disease.
Sicklecell anemia, familial hypercholesterolemia, and cystic fibrosis are all examples of
the effects of abnormal molecules.
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
followingaspects of clients' situations bN
esUt chSaraN
ctGerTizBes paOthMogenesis 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
accidentANSWER: B
Feedback:
Pathogenesis refers to the progressive and evolutionary course of disease, such as
theincreasing ammonia levels that accompany liver disease. Bacteria, poisons, and
traumatic injuries are examples of etiologic factors.
,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
patientverifies 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
iteasy 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: C
Feedback:
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
froma 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.
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. WhicN
h ofRtheIfN
olG
loTwBin.gCaO
spMects 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
fieldsbilaterally.
D) The patient's respiratory rate is 31
breaths/minute.ANSWER: B
Feedback:
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.
,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
dueto intestinal aganglionosis
C) Development of pulmonary fibrosis following treatment with bleomycin,
anantibiotic chemotherapy agent used in treatment of lymphoma
D) Gradual deterioration in ability to walk unassisted for a patient diagnosed
withParkinson disease
E) Loss of short-term memory in a patient diagnosed with Alzheimer
diseaseANSWER: A, C
Feedback:
Development of pulmonary emboli and pulmonary fibrosis following chemotherapy
areboth 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.
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
knowsthat
A) a normal value represenNtsUtheStIesNt reTsuBlts thOat 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
isdisease free.
ANSWER: A
Feedback:
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
diseasehas been ruled out or excluded.
, 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 respiratory/pulmonary etiology. A positive result is
purported to indicate a cardiac etiology. The marketers of the test report that 99.8%
of patients who have confirmed cardiac etiologies test positive in the test. However,
1.3% of patients who do not have cardiac etiologies for their shortness of breath also
test positive. Whichof the following statements best characterizes this blood test?
A) Low validity; high reliability
B) High sensitivity; low specificity
C) High specificity; low reliability
D) High sensitivity; low reliability
ANSWER: B
Feedback:
A large number of patients would receive the correct positive diagnosis (high
sensitivity), while a significant number would receive a false-positive diagnosis (low
specificity). The information given does not indicate low reliability or low validity.
10. As part of a screening program for prostate cancer, men at a senior citizens' center
are having their blood levels of prostate-specific antigen (PSA) measured. Which of
the following statements would best characterize a high positive predictive value but
a lownegative predictive value for this screening test?
A) All of the men who had high PSA levels developed prostate cancer; several
menwho had low PSA levelN s alsoSdIeN
veGloTpBed prostate cancer.
B) All of the men who had low PSA levels were cancer-free; several men who had
high levels also remained free of prostate cancer.
C) Men who had low PSA levels also displayed false-positive results for prostate
cancer; men with high levels were often falsely diagnosed with prostate
cancer.
D) The test displayed low sensitivity but high specificity.
ANSWER: A
Feedback:
The test's inability to rule out cancer with a low PSA level indicates a low negative
predictive value. Answer B suggests a high negative predictive value, while answer C
indicates a low positive predictive value. High positive predictive value is associated
with high sensitivity.
, 11. A male international business traveler has returned from a trip to Indonesia. While
there,he hired a prostitute for companionship and engaged in unprotected sex on
more than one occasion. Unbeknownst to him, this prostitute harbored the hepatitis C
virus. Upon return to the United States, he exhibited no symptoms and returned to his
usual activities. During this period of no outward symptoms, the man would be
classified as being in
A) the preclinical stage of disease.
B) remission and unlikely to develop hepatitis C.
C) the clinical disease stage of hepatitis C.
D) the chronic phase of hepatitis
C.ANSWER: A
Feedback:
During the preclinical stage, the disease is not clinically evident but is destined
toprogress to clinical disease.
12. As of November 1, 2012, there were a total of 10 confirmed cases of Hantavirus
infection in people who were recent visitors (mid-June to end of August, 2012) to
Yosemite National Park. Three visitors with confirmed cases died. Health officials
believe that 9 out of the 10 people with Hantavirus were exposed while staying in
CurryVillage in the Signature Tent Cabins. This is an example of
A) what the anticipated mortality rate would be if a family of five were planning
tovacation in Yosemite National Park.
B) the prevalence of HantaNvirusSoIne caTn anticipMate if he or she is going to vacation
in Yosemite National Park.
C) the low rate of morbidity one can expect while traveling to Yosemite
NationalPark.
D) the incidence of people who are at risk for developing Hantavirus while staying
inYosemite National Park.
ANSWER: D
Feedback:
The incidence reflects the number of new cases arising in a population at risk during
aspecified time.
5th Edition by Tommie L Norris
All Chapters 1 - 52
,Porth's Essentials of Pathophysiology / Edition 5 by Tommie L Norris
Table of Contents
Chapter 1-- Concepts of Health and Disease
Chapter 2 -- Cell and Tissue Characteristics
Chapter 3 -- Cellular Adaptation, Injury, and Death
Chapter 4 -- Genetic Control of Cell Function and Inheritance
Chapter 5 -- Genetic and Congenital Disorders
Chapter 6 -- Neoplasia
Chapter 7 -- Stress and Adaptation
Chapter 8 -- Disorders of Fluid, Electrolyte, and Acid–Base Balance
Chapter 9 -- Inflammation, Tissue Repair, and Wound Healing
Chapter 10 -- Mechanisms of Infectious Disease
Chapter 11-- Innate and Adaptive Immunity
Chapter 12 -- Disorders of the Immune Response, Including HIV/AIDS
Chapter 13 -- Organization and Control of Neural Function
Chapter 14 -- Somatosensory Function, Pain, Headache, and Temperature Regulation
Chapter 15 -- Disorders of Motor Function
Chapter 16 -- Disorders of Brain Function
Chapter 17 -- Sleep and Sleep–Wake Disorders
Chapter 18 -- Disorders of Thought, Emotion, and Memory
Chapter 19 -- Disorders of Visual Function
Chapter 20 -- Disorders of Hearing and Vestibular Function
Chapter 21 -- Blood Cells and the Hematopoietic System
Chapter 22 -- Disorders of Hemostasis
Chapter 23 -- Disorders of Red Blood Cells
,Chapter 24 -- Disorders of White Blood Cells and Lymphoid Tissues
Chapter 25 -- Structure and Function of the Cardiovascular System
Chapter 26 -- Disorders of Blood Flow and Blood Pressure Regulation
Chapter 27 -- Disorders of Cardiac Function, and Heart Failure and Circulatory Shock
Chapter 28 -- Disorders of Cardiac Conduction and Rhythm
Chapter 29 -- Structure and Function of the Respiratory System
Chapter 30 -- Respiratory Tract Infections, Neoplasms, and Childhood Disorders
Chapter 31 -- Disorders of Ventilation and Gas Exchange
Chapter 32 -- Structure and Function of the Kidney
Chapter 33 -- Disorders of Renal Function
Chapter 34 -- Acute Kidney Injury and Chronic Kidney Disease
Chapter 35 -- Disorders of the Bladder and Lower Urinary Tract
Chapter 36 -- Structure and Function of the Gastrointestinal System
Chapter 37 -- Disorders of Gastrointestinal Function
Chapter 38 -- Disorders of Hepatobiliary and Exocrine Pancreas Function
Chapter 39 -- Alterations in Nutritional Status
Chapter 40 -- Mechanisms of Endocrine Control1
Chapter 41-- Disorders of Endocrine Control of Growth and Metabolism
Chapter 42 -- Structure and Function of the Male Genitourinary System
Chapter 43 -- Disorders of the Male Reproductive System
Chapter 44 -- Structure and Function of the Female Reproductive System
Chapter 45 -- Disorders of the Female Reproductive System
Chapter 46 -- Sexually Transmitted Infections
Chapter 47 -- Structure and Function of the Musculoskeletal System
Chapter 48 -- Disorders of Musculoskeletal Function: Trauma, Infection, Neoplasms1
,Chapter 49 -- Disorders of Musculoskeletal Function: Developmental and Metabolic Disorders, Activity
Intolerance, and Fatigue
Chapter 50 -- Disorders of Musculoskeletal Function: Rheumatic Disorders
Chapter 51 -- Structure and Function of the Skin
Chapter 52 -- Disorders of Skin Integrity and Function
,Porth’s Essentials of Pathophysiology 5th Edition Test Bank
Ch 1- Concepts of Health and Disease
1. At an international nursing conference, many discussions and breakout sessions focusedon 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 cookingclasses
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: A, B, C, E
Feedback:
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 vitalin the prevention of disease and spread
of germs.
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 andHuman 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 manyhealth
care facilities.
ANSWER: B
Feedback:
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 tohealth care). A client's noncompliance with
treatments to control high cholesterol levelswithin the presence of a family history of
CV disease does not meet the “attaining lives free of preventable disease and
premature death” determinant.
,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
fromfamilial 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: D
Feedback:
PCP is an example of the effect of a molecule that directly contributes to disease.
Sicklecell anemia, familial hypercholesterolemia, and cystic fibrosis are all examples of
the effects of abnormal molecules.
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
followingaspects of clients' situations bN
esUt chSaraN
ctGerTizBes paOthMogenesis 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
accidentANSWER: B
Feedback:
Pathogenesis refers to the progressive and evolutionary course of disease, such as
theincreasing ammonia levels that accompany liver disease. Bacteria, poisons, and
traumatic injuries are examples of etiologic factors.
,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
patientverifies 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
iteasy 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: C
Feedback:
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
froma 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.
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. WhicN
h ofRtheIfN
olG
loTwBin.gCaO
spMects 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
fieldsbilaterally.
D) The patient's respiratory rate is 31
breaths/minute.ANSWER: B
Feedback:
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.
,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
dueto intestinal aganglionosis
C) Development of pulmonary fibrosis following treatment with bleomycin,
anantibiotic chemotherapy agent used in treatment of lymphoma
D) Gradual deterioration in ability to walk unassisted for a patient diagnosed
withParkinson disease
E) Loss of short-term memory in a patient diagnosed with Alzheimer
diseaseANSWER: A, C
Feedback:
Development of pulmonary emboli and pulmonary fibrosis following chemotherapy
areboth 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.
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
knowsthat
A) a normal value represenNtsUtheStIesNt reTsuBlts thOat 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
isdisease free.
ANSWER: A
Feedback:
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
diseasehas been ruled out or excluded.
, 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 respiratory/pulmonary etiology. A positive result is
purported to indicate a cardiac etiology. The marketers of the test report that 99.8%
of patients who have confirmed cardiac etiologies test positive in the test. However,
1.3% of patients who do not have cardiac etiologies for their shortness of breath also
test positive. Whichof the following statements best characterizes this blood test?
A) Low validity; high reliability
B) High sensitivity; low specificity
C) High specificity; low reliability
D) High sensitivity; low reliability
ANSWER: B
Feedback:
A large number of patients would receive the correct positive diagnosis (high
sensitivity), while a significant number would receive a false-positive diagnosis (low
specificity). The information given does not indicate low reliability or low validity.
10. As part of a screening program for prostate cancer, men at a senior citizens' center
are having their blood levels of prostate-specific antigen (PSA) measured. Which of
the following statements would best characterize a high positive predictive value but
a lownegative predictive value for this screening test?
A) All of the men who had high PSA levels developed prostate cancer; several
menwho had low PSA levelN s alsoSdIeN
veGloTpBed prostate cancer.
B) All of the men who had low PSA levels were cancer-free; several men who had
high levels also remained free of prostate cancer.
C) Men who had low PSA levels also displayed false-positive results for prostate
cancer; men with high levels were often falsely diagnosed with prostate
cancer.
D) The test displayed low sensitivity but high specificity.
ANSWER: A
Feedback:
The test's inability to rule out cancer with a low PSA level indicates a low negative
predictive value. Answer B suggests a high negative predictive value, while answer C
indicates a low positive predictive value. High positive predictive value is associated
with high sensitivity.
, 11. A male international business traveler has returned from a trip to Indonesia. While
there,he hired a prostitute for companionship and engaged in unprotected sex on
more than one occasion. Unbeknownst to him, this prostitute harbored the hepatitis C
virus. Upon return to the United States, he exhibited no symptoms and returned to his
usual activities. During this period of no outward symptoms, the man would be
classified as being in
A) the preclinical stage of disease.
B) remission and unlikely to develop hepatitis C.
C) the clinical disease stage of hepatitis C.
D) the chronic phase of hepatitis
C.ANSWER: A
Feedback:
During the preclinical stage, the disease is not clinically evident but is destined
toprogress to clinical disease.
12. As of November 1, 2012, there were a total of 10 confirmed cases of Hantavirus
infection in people who were recent visitors (mid-June to end of August, 2012) to
Yosemite National Park. Three visitors with confirmed cases died. Health officials
believe that 9 out of the 10 people with Hantavirus were exposed while staying in
CurryVillage in the Signature Tent Cabins. This is an example of
A) what the anticipated mortality rate would be if a family of five were planning
tovacation in Yosemite National Park.
B) the prevalence of HantaNvirusSoIne caTn anticipMate if he or she is going to vacation
in Yosemite National Park.
C) the low rate of morbidity one can expect while traveling to Yosemite
NationalPark.
D) the incidence of people who are at risk for developing Hantavirus while staying
inYosemite National Park.
ANSWER: D
Feedback:
The incidence reflects the number of new cases arising in a population at risk during
aspecified time.
