Pathophysiology of Disease: An Introduction to
Clinical Medicine
8th Edition
Author(s)Gary D. Hammer; Stephen J. McPhee
TEST BANK
Reference: Ch. 1 — Introduction
Question 1 — Stem:
A 24-year-old nursing student asks why
screening tests are used in apparently healthy
populations. Which best explains the primary
public-health rationale for screening programs?
A. To provide definitive diagnosis for
symptomatic patients
B. To reduce prevalence of disease by removing
affected individuals
,C. To detect disease at an earlier, more
treatable stage to reduce morbidity and
mortality
D. To replace diagnostic testing because it is less
expensive
Correct Answer:
C
Rationales — Correct:
Screening aims to identify disease in
asymptomatic people so early intervention can
reduce morbidity and mortality; it is a public-
health tool rather than a diagnostic substitute.
Rationales — Incorrect:
A. Screening is not intended to be definitive
diagnostic testing for symptomatic patients.
B. Screening may decrease disease burden but
not by “removing” individuals; it reduces
sequelae via early treatment.
,D. Cost may be a consideration, but screening
does not replace confirmatory diagnostic tests.
Teaching Point:
Screening detects early disease in
asymptomatic populations to improve
outcomes.
Citation:
Hammer & McPhee (2021). Pathophysiology of
Disease (8th Ed.). Ch. 1.
Reference: Ch. 1 — Introduction
Question 2 — Stem:
A clinic implements a new screening assay with
very high sensitivity but moderate specificity for
tuberculosis in a low-prevalence population. A
nurse interprets a positive result. Which
statement best describes the likely positive
predictive value (PPV) and appropriate next
step?
, A. High PPV; begin treatment immediately
without confirmatory testing
B. Low PPV; perform confirmatory diagnostic
testing before treatment
C. High PPV; perform no further testing because
false positives are rare
D. Low PPV; assume the result is false and no
follow-up is needed
Correct Answer:
B
Rationales — Correct:
In low-prevalence populations even highly
sensitive tests can have low PPV due to false
positives; confirmatory diagnostic testing is
required before initiating therapy.
Rationales — Incorrect:
A. High PPV is unlikely in low prevalence;
treatment without confirmation risks
unnecessary therapy.
Clinical Medicine
8th Edition
Author(s)Gary D. Hammer; Stephen J. McPhee
TEST BANK
Reference: Ch. 1 — Introduction
Question 1 — Stem:
A 24-year-old nursing student asks why
screening tests are used in apparently healthy
populations. Which best explains the primary
public-health rationale for screening programs?
A. To provide definitive diagnosis for
symptomatic patients
B. To reduce prevalence of disease by removing
affected individuals
,C. To detect disease at an earlier, more
treatable stage to reduce morbidity and
mortality
D. To replace diagnostic testing because it is less
expensive
Correct Answer:
C
Rationales — Correct:
Screening aims to identify disease in
asymptomatic people so early intervention can
reduce morbidity and mortality; it is a public-
health tool rather than a diagnostic substitute.
Rationales — Incorrect:
A. Screening is not intended to be definitive
diagnostic testing for symptomatic patients.
B. Screening may decrease disease burden but
not by “removing” individuals; it reduces
sequelae via early treatment.
,D. Cost may be a consideration, but screening
does not replace confirmatory diagnostic tests.
Teaching Point:
Screening detects early disease in
asymptomatic populations to improve
outcomes.
Citation:
Hammer & McPhee (2021). Pathophysiology of
Disease (8th Ed.). Ch. 1.
Reference: Ch. 1 — Introduction
Question 2 — Stem:
A clinic implements a new screening assay with
very high sensitivity but moderate specificity for
tuberculosis in a low-prevalence population. A
nurse interprets a positive result. Which
statement best describes the likely positive
predictive value (PPV) and appropriate next
step?
, A. High PPV; begin treatment immediately
without confirmatory testing
B. Low PPV; perform confirmatory diagnostic
testing before treatment
C. High PPV; perform no further testing because
false positives are rare
D. Low PPV; assume the result is false and no
follow-up is needed
Correct Answer:
B
Rationales — Correct:
In low-prevalence populations even highly
sensitive tests can have low PPV due to false
positives; confirmatory diagnostic testing is
required before initiating therapy.
Rationales — Incorrect:
A. High PPV is unlikely in low prevalence;
treatment without confirmation risks
unnecessary therapy.
