Page 1
, Chapter‘1-‘Concepts‘of‘Health‘and‘Disease
1. At‘an‘international‘nursing‘conference,‘many‘discussions‘and‘breakout‘sessions‘focused‘o
n‘the‘World‘Health‘Organization‘(WHO)‘views‘on‘health.‘Of‘the‘following‘comments‘m
ade‘by‘nurses‘during‘a‘discussion‘session,‘which‘statements‘would‘be‘considered‘a‘good‘r
epresentation‘of‘the‘WHO‘definition?‘Select‘all‘that‘apply.
A) Interests‘in‘keeping‘the‘elderly‘population‘engaged‘in‘such‘activities‘as‘book‘r
eviews‘and‘word‘games‘during‘social‘time
B) Increase‘in‘the‘number‘of‘chair‘aerobics‘classes‘provided‘in‘the‘skilled‘care‘f
acilities
C) Interventions‘geared‘toward‘keeping‘the‘elderly‘population‘diagnosed‘with‘diabete
s‘mellitus‘under‘tight‘blood‘glucose‘control‘by‘providing‘in-home‘cooking‘classes
D) Providing‘transportation‘for‘renal‘dialysis‘patients‘to‘and‘from‘their‘hemodialysis‘s
essions
E) Providing‘handwashing‘teaching‘sessions‘to‘a‘group‘of‘young‘children‘
Ans:‘ A,‘B,‘C,‘E
Feedback:
The‘WHO‘definition‘of‘health‘is‘defined‘as‘―a‘state‘of‘complete‘physical,‘mental,‘and‘soc
ial‘well-
being‘and‘not‘merely‘the‘absence‘of‘disease‘and‘infirmity.‖‗Engaging‘in‘book‘reviews‘fac
ilitates‘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‘preventio
n‘of‘disease‘and‘spread‘of‘germs.
2. A‘community‘health‘nurse‘is‘teaching‘a‘group‘of‘recent‘graduates‘about‘the‘large‘vari
ety‘of‘factors‘that‘influence‘an‘individual's‘health‘or‘lack‘thereof.‘The‘nurse‘is‘referrin
g‘to‘the‘Healthy’People’2020’report‘from‘the‘U.S.‘Department‘of‘Health‘and‘Human‘S
ervices‘as‘a‘teaching‘example.‘Of‘the‘following‘aspects‘discussed,‘which‘would‘be‘co
nsidered‘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‘des
cent‘and‘practices‘various‘alternative‘therapies‘to‘minimize‘effects‘of‘stress.
B) The‘client‘has‘a‘family‘history‘of‘cardiovascular‘disease‘related‘to‘hyperchol
esterolemia‘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‘h
ealth‘care‘facilities.
Ans:‘ B
Feedback:
In‘Healthy’People’2020,‘the‘focus‘is‘to‘promote‘good‘health‘to‘all‘(such‘as‘using‘alternati
ve‘therapies‘to‘minimize‘effects‘of‘stress);‘achieving‘health‘equity‘and‘promoting‘health‘f
or‘all‘(which‘includes‘having‘good‘health‘care‘benefits);‘and‘promoting‘good‘health‘(whi
ch‘includes‘living‘in‘a‘clean‘community‘with‘good‘access‘to‘health‘care).‘A‘client's‘nonco
mpliance‘with‘treatments‘to‘control‘high‘cholesterol‘levels‘within‘the‘presence‘of‘a‘famil
y‘history‘of‘CV‘disease‘does‘not‘meet‘the‘―attaining‘lives‘free‘of‘preventable‘disease‘and‘
premature‘death‖‗determinant.
Page 2
,3. A‘physician‘is‘providing‘care‘for‘a‘number‘of‘patients‘on‘a‘medical‘unit‘of‘a‘large,‘univers
ity‘hospital.‘The‘physician‘is‘discussing‘with‘a‘colleague‘the‘differentiation‘between‘disea
ses‘that‘are‘caused‘by‘abnormal‘molecules‘and‘diseases‘that‘cause‘disease.‘Which‘of‘the‘fo
llowing‘patients‘most‘clearly‘demonstrates‘the‘consequences‘of‘molecules‘that‘cause‘dise
ase?
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‘hyp
ercholesterolemia
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‘posit
ive.
Ans:‘ D
Feedback:
PCP‘is‘an‘example‘of‘the‘effect‘of‘a‘molecule‘that‘directly‘contributes‘to‘disease.‘Sickle‘ce
ll‘anemia,‘familial‘hypercholesterolemia,‘and‘cystic‘fibrosis‘are‘all‘examples‘of‘the‘effect
s‘of‘abnormal‘molecules.
4. A‘member‘of‘the‘health‘care‘team‘is‘researching‘the‘etiology‘and‘pathogenesis‘of‘a‘num
ber‘of‘clients‘who‘are‘under‘his‘care‘in‘a‘hospital‘context.‘Which‘of‘the‘following‘aspect
s‘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‘
Ans:‘ B
Feedback:
Pathogenesis‘refers‘to‘the‘progressive‘and‘evolutionary‘course‘of‘disease,‘such‘as‘the‘incr
easing‘ammonia‘levels‘that‘accompany‘liver‘disease.‘Bacteria,‘poisons,‘and‘traumatic‘inj
uries‘are‘examples‘of‘etiologic‘factors.
Page 3
, 5. A‘new‘myocardial‘infarction‘patient‘requiring‘angioplasty‘and‘stent‘placement‘has‘arrive
d‘to‘his‘first‘cardiac‘rehabilitation‘appointment.‘In‘this‘first‘session,‘a‘review‘of‘the‘patho
genesis‘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‘F
rench‘fries‘every‘day.‖
C) ―Sounds‘like‘this‘began‘because‘of‘inflammation‘inside‘my‘artery‘that‘made‘it‘e
asy‘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‘caus
ing‘a‘clot‘that‘stops‘blood‘flow‘to‘the‘muscle,‘and‘I‘will‘have‘a‘heart‘attack.‖
Ans:‘ C
Feedback:
The‘true‘etiology/cause‘of‘coronary‘artery‘disease‘(CAD)‘is‘unknown;‘however,‘the‘path
ogenesis‘of‘the‘disorder‘relates‘to‘the‘progression‘of‘the‘inflammatory‘process‘from‘a‘fatt
y‘streak‘to‘the‘occlusive‘vessel‘lesion‘seen‘in‘people‘with‘coronary‘artery‘disease.‘Risk‘fa
ctors‘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‘pulmo
nary‘disease‘(COPD),‘and‘a‘respiratory‘therapist‘(RT)‘is‘assessing‘the‘client‘for‘the‘first‘ti
me.‘Which‘of‘the‘following‘aspects‘of‘the‘patient's‘current‘state‘of‘health‘would‘be‘best‘c
haracterized‘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‘b
ilaterally.
D) The‘patient's‘respiratory‘rate‘is‘31‘breaths/minute.‘
Ans:‘ B
Feedback:
Symptoms‘are‘subjective‘complaints‘by‘the‘person‘experiencing‘the‘health‘problem,‘s
uch‘as‘complaints‘of‘breathing‘difficulty.‘Oxygen‘levels,‘listening‘to‘breath‘sounds,‘an
d‘respiratory‘rate‘are‘all‘objective,‘observable‘signs‘of‘disease.
Page 4