INTRODUCTION TO CLINICAL MEDICINE
8TH EDITION
AUTHOR(S)GARY D. HAMMER; STEPHEN J.
MCPHEE
TEST BANK
1
Reference
Ch. 1 — Introduction
Question Stem
A 68-year-old man presents with progressive shortness of
breath and ankle edema. The clinician documents “disease A is
chronic with episodic decompensations.” Which of the
following best describes the natural history concept the
clinician used to guide prognosis and treatment planning?
A. Point prevalence — the proportion of the population with
disease at one time
B. Natural history — the usual course of disease without
intervention
,C. Incidence rate — frequency of new cases over time
D. Case fatality rate — the proportion that die among diagnosed
patients
Correct Answer
B
Rationales
Correct: Natural history refers to the expected course of a
disease in the absence of interventions and helps predict likely
decompensations and outcomes.
A: Point prevalence describes existing cases at a specific time,
not the course over time.
C: Incidence measures new cases, not the disease’s temporal
clinical pattern.
D: Case fatality focuses on deaths among those diagnosed, not
progression patterns.
Teaching Point
Natural history = expected disease course without intervention.
Citation (Simplified APA)
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2
Reference
Ch. 1 — Introduction
,Question Stem
A nurse interprets a patient’s symptom — transient chest
discomfort on exertion relieved by rest — as an example of
which clinical construct that connects pathophysiology to
patient assessment?
A. Sign — an objective finding by the clinician
B. Syndrome — set of concurrent symptoms with a single cause
always
C. Symptom — subjective experience reported by the patient
D. Lesion — a macroscopic structural abnormality
Correct Answer
C
Rationales
Correct: A symptom is a subjective complaint (chest discomfort
with exertion) that must be correlated with pathophysiology.
A: A sign is objective (e.g., murmur, crackles), not a subjective
complaint.
B: A syndrome is a constellation of signs/symptoms; this single
symptom alone doesn’t define a syndrome.
D: A lesion is a structural pathologic change, not the patient’s
subjective experience.
Teaching Point
Symptoms are subjective and require correlation with objective
signs and tests.
, Citation (Simplified APA)
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3
Reference
Ch. 1 — Introduction
Question Stem
A newly admitted patient’s chart indicates “idiopathic.” Which
management implication best follows this designation?
A. The disease is infectious and requires isolation precautions.
B. The cause is unknown; emphasize symptomatic care and
further diagnostic evaluation.
C. The disease is genetically inherited and requires family
screening.
D. The condition is psychosomatic and needs psychiatric referral
first.
Correct Answer
B
Rationales
Correct: Idiopathic means the cause is unknown; clinicians
prioritize symptom control and continued evaluation while
avoiding assumptions.
A: Idiopathic does not imply infectious etiology.
C: Idiopathic does not automatically mean genetic inheritance.