Test Bank for Porth's Pathophysiology Concepts of
Altered Health States 11th Edition
by Tommie L. Norris, Chapters 1 - 52
, Porth's Pathophysiology Concepts of Altered Health 11th Edition Norris Test Bank
Table of Content
UNIT 1 CONCEPTS OF HEALTH AND DISEASE
Chapter 1 Concepts of Health and Disease
UNIT 2 CELL FUNCTION AND GROWTH
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
UNIT 3 DISORDERS OF INTEGRATIVE FUNCTION
Chapter 7 Stress and Adaptation
Chapter 8 Disorders of Fluid, Electrolyte, and Acid–Base Balance
UNIT 4 INFECTION, INFLAMMATION, AND IMMUNITY
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
UNIT 5 DISORDERS OF NEURAL FUNCTION
Chapter 13 Organization and Control of Neural Function
Chapter 14 Somatosensory Function, Pain, Headache, and Temperature Regulation
Chapter 15 Disorders of Motor Function
Organization and Control of Motor Function
Chapter 16 Disorders of Brain Function
Chapter 17 Sleep and Sleep–Wake Disorders
Chapter 18 Disorders of Thought, Emotion, and Memory
UNIT 6 DISORDERS OF SPECIAL SENSORY FUNCTION
Chapter 19 Disorders of Visual Function
Chapter 20 Disorders of Hearing and Vestibular Function
UNIT 7 DISORDERS OF THE HEMATOPOIETIC SYSTEM
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
UNIT 8 DISORDERS OF CARDIOVASCULAR FUNCTION
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
UNIT 9 DISORDERS OF RESPIRATORY FUNCTION
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
UNIT 10 DISORDERS OF RENAL FUNCTION
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
UNIT 11 DISORDERS OF GASTROINTESTINAL FUNCTION
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
UNIT 12 DISORDERS OF ENDOCRINE FUNCTION
Chapter 40 Mechanisms of Endocrine Control
Chapter 41 Disorders of Endocrine Control of Growth and Metabolism
UNIT 13 DISORDERS OF GENITOURINARY AND REPRODUCTIVE FUNCTION
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
UNIT 14 DISORDERS OF MUSCULOSKELETAL FUNCTION
Chapter 47 Structure and Function of the Musculoskeletal System
Chapter 48 Disorders of Musculoskeletal Function: Trauma, Infection, Neoplasms
Chapter 49 Disorders of Musculoskeletal Function: Developmental and Metabolic Disorders, Activity
Intolerance, and Fatigue
Chapter 50 Disorders of Musculoskeletal Function: Rheumatic Disorders
UNIT 15 DISORDERS OF INTEGUMENTARY FUNCTION
Chapter 51 Structure and Function of the Skin
Chapter 52 Disorders of Skin Integrity and Function
Porth’s Pathophysiology Concepts of Altered Health 11th Edition Norris Test BankCh
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
commentsmade 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
bookreviews and word games during social time
B) Increase in the number of chair aerobics classes provided in the skilled
, carefacilities
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
hemodialysissessions
E) Providing handwashing teaching sessions to a group of young
childrenANSWER: 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
est 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. Which of theIfolG
loTwin.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
oroutcome 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 btesting bis bordered bfor ba bmale bpatient bduring ba bclinic bvisit bfor ba
broutine bfollow-up bassessment bof bhypertension. bWhen binterpreting blab bvalues,
bthe bnurse bknowsbthat
A) a bnormal bvalue brepresentsUtheStIesNt breTsuBlts bthat bfall b within bthe bbell bcurve.
B) if bthe blab bresult bis babove bthe b50% bdistribution, bthe bresult bis bconsidered belevated.
C) all blab bvalues bare badjusted bfor bgender band bweight.
D) if bthe bresult bof ba bvery bsensitive btest bis bnegative, bthat bdoes bnot bmean bthe
bperson bisbdisease bfree.
ANSWER: b A
Feedback:
What bis btermed ba bnormal bvalue bfor ba blaboratory btest bis bestablished bstatistically
bfrom bresults bobtained bfrom ba bselected bsample bof bpeople. bA bnormal bvalue
brepresents bthe btest bresults bthat bfall bwithin bthe bbell bcurve bor bthe b95% bdistribution.
bSome blab bvalues b(like bhemoglobin) bare badjusted bfor bgender, bother bcomorbidities,
bor bage. bIf bthe bresult bof ba bvery bsensitive btest bis bnegative, bit btells bus bthe bperson
bdoes bnot bhave bthe bdisease, band b the bdiseasebhas bbeen bruled bout bor b excluded.
9. The blaboratory btechnologists bare bdiscussing ba bnew bblood btest bthat bhelps bestablish ba
bdifferential bdiagnosis bbetween bshortness bof bbreath bwith ba bcardiac betiology band
bshortness bof bbreath bwith ba brespiratory/pulmonary betiology. bA bpositive bresult bis
bpurported bto bindicate ba bcardiac betiology. bThe bmarketers bof bthe btest breport bthat
b99.8% bof bpatients bwho bhave bconfirmed bcardiac betiologies btest bpositive bin bthe btest.
bHowever, b1.3% bof bpatients bwho bdo bnot bhave bcardiac betiologies bfor btheir bshortness
bof bbreath balso btest bpositive. bWhichbof bthe bfollowing bstatements bbest bcharacterizes
bthis bblood btest?
A) Low bvalidity; bhigh breliability
B) High bsensitivity; blow bspecificity
C) High bspecificity; blow breliability
D) High bsensitivity; blow breliability
bANSWER: b B
Feedback:
A blarge bnumber bof bpatients bwould breceive bthe bcorrect bpositive bdiagnosis b(high
, bsensitivity), bwhile ba bsignificant bnumber bwould breceive ba bfalse-positive bdiagnosis
b(lowbspecificity). bThe binformation bgiven bdoes bnot bindicate blow breliability bor blow
bvalidity.
10. As bpart bof ba bscreening bprogram bfor bprostate bcancer, bmen bat ba bsenior bcitizens'
bcenter bare bhaving btheir bblood blevels bof bprostate-specific bantigen b(PSA) bmeasured.
bWhich bof bthe bfollowing bstatements bwould bbest bcharacterize ba bhigh bpositive
bpredictive bvalue bbut ba blowbnegative bpredictive bvalue b for bthis bscreening btest?
A) All bof bthe bmen bwho bhad bhigh bPSA blevels bdeveloped bprostate bcancer; bseveral
N SINGTB
bmenbwho b had b low bPSA blevel s balso d
eve loped bprostate b cancer.
B) All bof bthe bmen bwho bhad blow bPSA blevels bwere bcancer-free; bseveral bmen bwho bhad
high blevels balso bremained bfree bof bprostate bcancer.
C) Men bwho bhad blow bPSA blevels balso bdisplayed bfalse-positive bresults bfor
bprostate bcancer; bmen bwith bhigh blevels bwere boften bfalsely bdiagnosed bwith
bprostate bcancer.
D) The btest bdisplayed blow bsensitivity bbut bhigh
bspecificity.bANSWER: b A
Feedback:
The btest's binability bto brule bout bcancer bwith ba blow bPSA blevel bindicates ba blow
bnegative bpredictive bvalue. bAnswer bB bsuggests ba bhigh bnegative bpredictive bvalue,
bwhile banswer bCbindicates ba blow bpositive bpredictive bvalue. bHigh bpositive bpredictive
bvalue bis bassociated bwith bhigh bsensitivity.
11. A bmale binternational bbusiness btraveler bhas breturned bfrom ba btrip bto bIndonesia. bWhile
bthere,bhe bhired ba bprostitute bfor bcompanionship band bengaged bin bunprotected bsex bon
bmore bthan bone boccasion. bUnbeknownst bto bhim, bthis bprostitute bharbored bthe
bhepatitis bC bvirus. bUpon breturn bto bthe bUnited bStates, bhe bexhibited bno bsymptoms
band breturned bto bhis busual bactivities. bDuring bthis bperiod bof bno boutward bsymptoms,
bthe bman bwould bbe bclassified bas bbeing bin
A) the bpreclinical bstage bof bdisease.
B) remission band bunlikely bto bdevelop bhepatitis bC.
C) the bclinical bdisease bstage bof bhepatitis bC.
, D) the bchronic bphase bof bhepatitis
bC.bANSWER: b A
Feedback:
During bthe bpreclinical bstage, bthe bdisease bis bnot bclinically bevident bbut bis
bdestined btobprogress bto bclinical bdisease.
12. As bof bNovember b1, b2012, bthere bwere ba btotal bof b10 bconfirmed bcases bof bHantavirus
binfection bin bpeople bwho bwere brecent bvisitors b(mid-June bto bend bof bAugust, b2012)
bto bYosemite bNational bPark. bThree bvisitors bwith bconfirmed bcases bdied. bHealth
bofficials bbelieve bthat b9 bout bof bthe b10 bpeople bwith bHantavirus bwere bexposed bwhile
bstaying bin bCurrybVillage bin bthe bSignature bTent bCabins. bThis bis ban bexample bof
A) what bthe banticipated bmortality brate bwould bbe bif ba bfamily bof bfive bwere
bplanning btobvacation bin bYosemite bNational bPark.
B) the bprevalence b of bHantaNvirusSoIne bcaTn banticipMate bif bhe bor bshe bis bgoing bto
bvacation bin bYosemite bNational bPark.
C) the blow brate bof bmorbidity bone bcan bexpect bwhile btraveling bto bYosemite
bNationalbPark.
D) the bincidence bof bpeople bwho bare bat brisk bfor bdeveloping bHantavirus bwhile
bstaying binbYosemite bNational bPark.
ANSWER: b D
Feedback:
The bincidence breflects bthe bnumber bof bnew bcases barising bin ba bpopulation bat brisk
bduring babspecified btime.
13. A bparticular bdisease bhas ba bdebilitating beffect bon bthe bability bof bsufferers bto bperform
btheir bactivities bof bdaily bliving band bis ba bsignificant bcause bof bdecreased bquality bof blife.
bHowever, bfew bpeople bdie bas ba bresult bof bthe bdisease's bdirect beffects. bThere bare
bhundreds bof bthousandsbof bAmericans bliving bwith bthe bdisease bbut brelatively bfew bnew
bcases bin brecent b years. bWhichbof bthe bfollowing bstatements bbest bconveys ban baccurate
bepidemiological bcharacterization bofbthe bdisease?
A) Low bmortality; bhigh bmorbidity; blow bprevalence; bhigh bincidence
B) Low bmortality; bhigh bmorbidity; bhigh bincidence; blow bprevalence
Altered Health States 11th Edition
by Tommie L. Norris, Chapters 1 - 52
, Porth's Pathophysiology Concepts of Altered Health 11th Edition Norris Test Bank
Table of Content
UNIT 1 CONCEPTS OF HEALTH AND DISEASE
Chapter 1 Concepts of Health and Disease
UNIT 2 CELL FUNCTION AND GROWTH
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
UNIT 3 DISORDERS OF INTEGRATIVE FUNCTION
Chapter 7 Stress and Adaptation
Chapter 8 Disorders of Fluid, Electrolyte, and Acid–Base Balance
UNIT 4 INFECTION, INFLAMMATION, AND IMMUNITY
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
UNIT 5 DISORDERS OF NEURAL FUNCTION
Chapter 13 Organization and Control of Neural Function
Chapter 14 Somatosensory Function, Pain, Headache, and Temperature Regulation
Chapter 15 Disorders of Motor Function
Organization and Control of Motor Function
Chapter 16 Disorders of Brain Function
Chapter 17 Sleep and Sleep–Wake Disorders
Chapter 18 Disorders of Thought, Emotion, and Memory
UNIT 6 DISORDERS OF SPECIAL SENSORY FUNCTION
Chapter 19 Disorders of Visual Function
Chapter 20 Disorders of Hearing and Vestibular Function
UNIT 7 DISORDERS OF THE HEMATOPOIETIC SYSTEM
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
UNIT 8 DISORDERS OF CARDIOVASCULAR FUNCTION
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
UNIT 9 DISORDERS OF RESPIRATORY FUNCTION
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
UNIT 10 DISORDERS OF RENAL FUNCTION
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
UNIT 11 DISORDERS OF GASTROINTESTINAL FUNCTION
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
UNIT 12 DISORDERS OF ENDOCRINE FUNCTION
Chapter 40 Mechanisms of Endocrine Control
Chapter 41 Disorders of Endocrine Control of Growth and Metabolism
UNIT 13 DISORDERS OF GENITOURINARY AND REPRODUCTIVE FUNCTION
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
UNIT 14 DISORDERS OF MUSCULOSKELETAL FUNCTION
Chapter 47 Structure and Function of the Musculoskeletal System
Chapter 48 Disorders of Musculoskeletal Function: Trauma, Infection, Neoplasms
Chapter 49 Disorders of Musculoskeletal Function: Developmental and Metabolic Disorders, Activity
Intolerance, and Fatigue
Chapter 50 Disorders of Musculoskeletal Function: Rheumatic Disorders
UNIT 15 DISORDERS OF INTEGUMENTARY FUNCTION
Chapter 51 Structure and Function of the Skin
Chapter 52 Disorders of Skin Integrity and Function
Porth’s Pathophysiology Concepts of Altered Health 11th Edition Norris Test BankCh
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
commentsmade 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
bookreviews and word games during social time
B) Increase in the number of chair aerobics classes provided in the skilled
, carefacilities
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
hemodialysissessions
E) Providing handwashing teaching sessions to a group of young
childrenANSWER: 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
est 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. Which of theIfolG
loTwin.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
oroutcome 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 btesting bis bordered bfor ba bmale bpatient bduring ba bclinic bvisit bfor ba
broutine bfollow-up bassessment bof bhypertension. bWhen binterpreting blab bvalues,
bthe bnurse bknowsbthat
A) a bnormal bvalue brepresentsUtheStIesNt breTsuBlts bthat bfall b within bthe bbell bcurve.
B) if bthe blab bresult bis babove bthe b50% bdistribution, bthe bresult bis bconsidered belevated.
C) all blab bvalues bare badjusted bfor bgender band bweight.
D) if bthe bresult bof ba bvery bsensitive btest bis bnegative, bthat bdoes bnot bmean bthe
bperson bisbdisease bfree.
ANSWER: b A
Feedback:
What bis btermed ba bnormal bvalue bfor ba blaboratory btest bis bestablished bstatistically
bfrom bresults bobtained bfrom ba bselected bsample bof bpeople. bA bnormal bvalue
brepresents bthe btest bresults bthat bfall bwithin bthe bbell bcurve bor bthe b95% bdistribution.
bSome blab bvalues b(like bhemoglobin) bare badjusted bfor bgender, bother bcomorbidities,
bor bage. bIf bthe bresult bof ba bvery bsensitive btest bis bnegative, bit btells bus bthe bperson
bdoes bnot bhave bthe bdisease, band b the bdiseasebhas bbeen bruled bout bor b excluded.
9. The blaboratory btechnologists bare bdiscussing ba bnew bblood btest bthat bhelps bestablish ba
bdifferential bdiagnosis bbetween bshortness bof bbreath bwith ba bcardiac betiology band
bshortness bof bbreath bwith ba brespiratory/pulmonary betiology. bA bpositive bresult bis
bpurported bto bindicate ba bcardiac betiology. bThe bmarketers bof bthe btest breport bthat
b99.8% bof bpatients bwho bhave bconfirmed bcardiac betiologies btest bpositive bin bthe btest.
bHowever, b1.3% bof bpatients bwho bdo bnot bhave bcardiac betiologies bfor btheir bshortness
bof bbreath balso btest bpositive. bWhichbof bthe bfollowing bstatements bbest bcharacterizes
bthis bblood btest?
A) Low bvalidity; bhigh breliability
B) High bsensitivity; blow bspecificity
C) High bspecificity; blow breliability
D) High bsensitivity; blow breliability
bANSWER: b B
Feedback:
A blarge bnumber bof bpatients bwould breceive bthe bcorrect bpositive bdiagnosis b(high
, bsensitivity), bwhile ba bsignificant bnumber bwould breceive ba bfalse-positive bdiagnosis
b(lowbspecificity). bThe binformation bgiven bdoes bnot bindicate blow breliability bor blow
bvalidity.
10. As bpart bof ba bscreening bprogram bfor bprostate bcancer, bmen bat ba bsenior bcitizens'
bcenter bare bhaving btheir bblood blevels bof bprostate-specific bantigen b(PSA) bmeasured.
bWhich bof bthe bfollowing bstatements bwould bbest bcharacterize ba bhigh bpositive
bpredictive bvalue bbut ba blowbnegative bpredictive bvalue b for bthis bscreening btest?
A) All bof bthe bmen bwho bhad bhigh bPSA blevels bdeveloped bprostate bcancer; bseveral
N SINGTB
bmenbwho b had b low bPSA blevel s balso d
eve loped bprostate b cancer.
B) All bof bthe bmen bwho bhad blow bPSA blevels bwere bcancer-free; bseveral bmen bwho bhad
high blevels balso bremained bfree bof bprostate bcancer.
C) Men bwho bhad blow bPSA blevels balso bdisplayed bfalse-positive bresults bfor
bprostate bcancer; bmen bwith bhigh blevels bwere boften bfalsely bdiagnosed bwith
bprostate bcancer.
D) The btest bdisplayed blow bsensitivity bbut bhigh
bspecificity.bANSWER: b A
Feedback:
The btest's binability bto brule bout bcancer bwith ba blow bPSA blevel bindicates ba blow
bnegative bpredictive bvalue. bAnswer bB bsuggests ba bhigh bnegative bpredictive bvalue,
bwhile banswer bCbindicates ba blow bpositive bpredictive bvalue. bHigh bpositive bpredictive
bvalue bis bassociated bwith bhigh bsensitivity.
11. A bmale binternational bbusiness btraveler bhas breturned bfrom ba btrip bto bIndonesia. bWhile
bthere,bhe bhired ba bprostitute bfor bcompanionship band bengaged bin bunprotected bsex bon
bmore bthan bone boccasion. bUnbeknownst bto bhim, bthis bprostitute bharbored bthe
bhepatitis bC bvirus. bUpon breturn bto bthe bUnited bStates, bhe bexhibited bno bsymptoms
band breturned bto bhis busual bactivities. bDuring bthis bperiod bof bno boutward bsymptoms,
bthe bman bwould bbe bclassified bas bbeing bin
A) the bpreclinical bstage bof bdisease.
B) remission band bunlikely bto bdevelop bhepatitis bC.
C) the bclinical bdisease bstage bof bhepatitis bC.
, D) the bchronic bphase bof bhepatitis
bC.bANSWER: b A
Feedback:
During bthe bpreclinical bstage, bthe bdisease bis bnot bclinically bevident bbut bis
bdestined btobprogress bto bclinical bdisease.
12. As bof bNovember b1, b2012, bthere bwere ba btotal bof b10 bconfirmed bcases bof bHantavirus
binfection bin bpeople bwho bwere brecent bvisitors b(mid-June bto bend bof bAugust, b2012)
bto bYosemite bNational bPark. bThree bvisitors bwith bconfirmed bcases bdied. bHealth
bofficials bbelieve bthat b9 bout bof bthe b10 bpeople bwith bHantavirus bwere bexposed bwhile
bstaying bin bCurrybVillage bin bthe bSignature bTent bCabins. bThis bis ban bexample bof
A) what bthe banticipated bmortality brate bwould bbe bif ba bfamily bof bfive bwere
bplanning btobvacation bin bYosemite bNational bPark.
B) the bprevalence b of bHantaNvirusSoIne bcaTn banticipMate bif bhe bor bshe bis bgoing bto
bvacation bin bYosemite bNational bPark.
C) the blow brate bof bmorbidity bone bcan bexpect bwhile btraveling bto bYosemite
bNationalbPark.
D) the bincidence bof bpeople bwho bare bat brisk bfor bdeveloping bHantavirus bwhile
bstaying binbYosemite bNational bPark.
ANSWER: b D
Feedback:
The bincidence breflects bthe bnumber bof bnew bcases barising bin ba bpopulation bat brisk
bduring babspecified btime.
13. A bparticular bdisease bhas ba bdebilitating beffect bon bthe bability bof bsufferers bto bperform
btheir bactivities bof bdaily bliving band bis ba bsignificant bcause bof bdecreased bquality bof blife.
bHowever, bfew bpeople bdie bas ba bresult bof bthe bdisease's bdirect beffects. bThere bare
bhundreds bof bthousandsbof bAmericans bliving bwith bthe bdisease bbut brelatively bfew bnew
bcases bin brecent b years. bWhichbof bthe bfollowing bstatements bbest bconveys ban baccurate
bepidemiological bcharacterization bofbthe bdisease?
A) Low bmortality; bhigh bmorbidity; blow bprevalence; bhigh bincidence
B) Low bmortality; bhigh bmorbidity; bhigh bincidence; blow bprevalence
