Porth's Essentials of Pathophysiology 5th Edition Test Bank
Chapter 1 Concepts of Health and Disease
1. At an international nursing conference, many discussions and breakout sessions focused on 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 cooking classes
D)
k
Providing transportation for renal dialysis patients to and from their hemodialysis
n
sessions
E) Providing handwashing teaching sessions to a group of young children
a
Ans: A, B, C, E
Feedback:
r
The WHO definition of health is defined as “a state of complete physical, mental, and social
F
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 vital in 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 and Human 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 many health
care facilities.
Ans: 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 to health care). A client's noncompliance with
treatments to control high cholesterol levels within the presence of a family history of CV
disease does not meet the “attaining lives free of preventable disease and premature death”
determinant.
k
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
n
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
A 31-year-old woman with sickle cell anemia who is receiving a transfusion of packed
r
red blood cells F
B) A 91-year-old woman who has experienced an ischemic stroke resulting from
familial 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.
Ans: D
Feedback:
PCP is an example of the effect of a molecule that directly contributes to disease. Sickle cell
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 following aspects 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 increasing
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 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) n k
“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 it easy to
a
form fatty streaks, which lead to my clogged artery.”
“If I do not exercise regularly to get my heart rate up, blood pools in the veins causing a
D)
r
clot that stops blood flow to the muscle, and I will have a heart attack.”
Ans: C
F
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 from a 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 the following aspects 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 fields
, bilaterally.
D) The patient's respiratory rate is 31 breaths/minute. Ans: 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 due to
intestinal aganglionosis
C) Development of pulmonary fibrosis following treatment with bleomycin, an
antibiotic chemotherapy agent used in treatment of lymphoma
D)
k
Gradual deterioration in ability to walk unassisted for a patient diagnosed with
n
Parkinson disease
E) Loss of short-term memory in a patient diagnosed with Alzheimer disease Ans:
A, C
a
Feedback:
r
Development of pulmonary emboli and pulmonary fibrosis following chemotherapy are both
F
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 knows that
A) A normal value represent the test results that 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 is disease
free.
Ans: A
Feedback:
Chapter 1 Concepts of Health and Disease
1. At an international nursing conference, many discussions and breakout sessions focused on 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 cooking classes
D)
k
Providing transportation for renal dialysis patients to and from their hemodialysis
n
sessions
E) Providing handwashing teaching sessions to a group of young children
a
Ans: A, B, C, E
Feedback:
r
The WHO definition of health is defined as “a state of complete physical, mental, and social
F
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 vital in 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 and Human 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 many health
care facilities.
Ans: 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 to health care). A client's noncompliance with
treatments to control high cholesterol levels within the presence of a family history of CV
disease does not meet the “attaining lives free of preventable disease and premature death”
determinant.
k
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
n
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
A 31-year-old woman with sickle cell anemia who is receiving a transfusion of packed
r
red blood cells F
B) A 91-year-old woman who has experienced an ischemic stroke resulting from
familial 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.
Ans: D
Feedback:
PCP is an example of the effect of a molecule that directly contributes to disease. Sickle cell
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 following aspects 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 increasing
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 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) n k
“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 it easy to
a
form fatty streaks, which lead to my clogged artery.”
“If I do not exercise regularly to get my heart rate up, blood pools in the veins causing a
D)
r
clot that stops blood flow to the muscle, and I will have a heart attack.”
Ans: C
F
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 from a 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 the following aspects 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 fields
, bilaterally.
D) The patient's respiratory rate is 31 breaths/minute. Ans: 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 due to
intestinal aganglionosis
C) Development of pulmonary fibrosis following treatment with bleomycin, an
antibiotic chemotherapy agent used in treatment of lymphoma
D)
k
Gradual deterioration in ability to walk unassisted for a patient diagnosed with
n
Parkinson disease
E) Loss of short-term memory in a patient diagnosed with Alzheimer disease Ans:
A, C
a
Feedback:
r
Development of pulmonary emboli and pulmonary fibrosis following chemotherapy are both
F
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 knows that
A) A normal value represent the test results that 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 is disease
free.
Ans: A
Feedback:
