PATHOPHYSIOLOGY OF DISEASE: AN
INTRODUCTION TO CLINICAL MEDICINE
8TH EDITION
AUTHOR(S)GARY D. HAMMER; STEPHEN J.
MCPHEE
TEST BANK
1
Reference
Ch. 1 — Introduction
Question Stem
A 62-year-old man presents with sudden-onset chest pain. As a
clinician using pathophysiologic reasoning, which step best
represents the initial approach to link his symptom to likely
disease mechanism?
A. Rely exclusively on the most common cause of chest pain in
the population.
B. Integrate the patient's history, focused exam, and basic
physiologic principles to generate differential mechanisms.
C. Order a broad battery of tests immediately before history or
,exam to avoid missing rare conditions.
D. Assume psychosomatic origin if preliminary cardiac tests are
normal.
Correct Answer
B
Rationales
Correct: Integrating history, exam, and physiologic principles
narrows likely mechanisms (ischemia, musculoskeletal,
pulmonary) and directs targeted testing. This aligns with clinical
pathophysiologic reasoning emphasized in the introduction.
A: Relying only on population frequency risks missing patient-
specific clues and atypical presentations.
C: Blind broad testing increases harm, costs, and false positives
without pathophysiologic focus.
D: Labeling as psychosomatic prematurely ignores potentially
serious underlying mechanisms.
Teaching Point
Use history + exam + physiology to generate mechanism-based
differentials.
Citation (Simplified APA)
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2
,Reference
Ch. 1 — Introduction
Question Stem
A nurse educator asks: when constructing clinical reasoning for
disease, which statement best reflects the value of
pathophysiology for patient safety decisions?
A. Pathophysiology only deepens academic knowledge but has
little bearing on bedside safety.
B. Understanding mechanisms informs early recognition of
complications and targeted monitoring.
C. Mechanistic knowledge is only useful for rare disorders, not
common clinical problems.
D. Rely on standard order sets rather than pathophysiologic
reasoning for safety.
Correct Answer
B
Rationales
Correct: Mechanistic understanding helps predict complications
(e.g., embolic risk in atrial fibrillation) and guides surveillance,
improving safety.
A: Incorrect — pathophysiology directly informs clinical action.
C: Incorrect — mechanism-based reasoning applies to both
common and rare conditions.
D: Incorrect — order sets help standardize care but should be
informed by pathophysiologic understanding.
, Teaching Point
Mechanistic knowledge improves prediction and prevention of
complications.
Citation (Simplified APA)
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3
Reference
Ch. 2 — Genetic Disease
Question Stem
A 28-year-old woman with a family history of autosomal
dominant cardiomyopathy (father affected) seeks counseling
before pregnancy. Her father is heterozygous for the pathogenic
variant. What is the most appropriate recurrence risk to counsel
her about for each child?
A. 25% for each child.
B. 50% for each child.
C. 75% for each child.
D. 100% for each child.
Correct Answer
B
Rationales
Correct: Autosomal dominant heterozygous parent confers a
INTRODUCTION TO CLINICAL MEDICINE
8TH EDITION
AUTHOR(S)GARY D. HAMMER; STEPHEN J.
MCPHEE
TEST BANK
1
Reference
Ch. 1 — Introduction
Question Stem
A 62-year-old man presents with sudden-onset chest pain. As a
clinician using pathophysiologic reasoning, which step best
represents the initial approach to link his symptom to likely
disease mechanism?
A. Rely exclusively on the most common cause of chest pain in
the population.
B. Integrate the patient's history, focused exam, and basic
physiologic principles to generate differential mechanisms.
C. Order a broad battery of tests immediately before history or
,exam to avoid missing rare conditions.
D. Assume psychosomatic origin if preliminary cardiac tests are
normal.
Correct Answer
B
Rationales
Correct: Integrating history, exam, and physiologic principles
narrows likely mechanisms (ischemia, musculoskeletal,
pulmonary) and directs targeted testing. This aligns with clinical
pathophysiologic reasoning emphasized in the introduction.
A: Relying only on population frequency risks missing patient-
specific clues and atypical presentations.
C: Blind broad testing increases harm, costs, and false positives
without pathophysiologic focus.
D: Labeling as psychosomatic prematurely ignores potentially
serious underlying mechanisms.
Teaching Point
Use history + exam + physiology to generate mechanism-based
differentials.
Citation (Simplified APA)
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2
,Reference
Ch. 1 — Introduction
Question Stem
A nurse educator asks: when constructing clinical reasoning for
disease, which statement best reflects the value of
pathophysiology for patient safety decisions?
A. Pathophysiology only deepens academic knowledge but has
little bearing on bedside safety.
B. Understanding mechanisms informs early recognition of
complications and targeted monitoring.
C. Mechanistic knowledge is only useful for rare disorders, not
common clinical problems.
D. Rely on standard order sets rather than pathophysiologic
reasoning for safety.
Correct Answer
B
Rationales
Correct: Mechanistic understanding helps predict complications
(e.g., embolic risk in atrial fibrillation) and guides surveillance,
improving safety.
A: Incorrect — pathophysiology directly informs clinical action.
C: Incorrect — mechanism-based reasoning applies to both
common and rare conditions.
D: Incorrect — order sets help standardize care but should be
informed by pathophysiologic understanding.
, Teaching Point
Mechanistic knowledge improves prediction and prevention of
complications.
Citation (Simplified APA)
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3
Reference
Ch. 2 — Genetic Disease
Question Stem
A 28-year-old woman with a family history of autosomal
dominant cardiomyopathy (father affected) seeks counseling
before pregnancy. Her father is heterozygous for the pathogenic
variant. What is the most appropriate recurrence risk to counsel
her about for each child?
A. 25% for each child.
B. 50% for each child.
C. 75% for each child.
D. 100% for each child.
Correct Answer
B
Rationales
Correct: Autosomal dominant heterozygous parent confers a
