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 68-year-old patient with multiple chronic illnesses is started
on a new medication that causes an adverse reaction. Which
principle most directly explains why this patient is at higher risk
for adverse drug effects compared with a healthy 30-year-old?
Options
A. Younger patients have higher drug clearance due to
increased hepatic enzyme induction.
B. Physiologic reserve declines with age, reducing the ability to
tolerate physiologic stress.
,C. Older patients have more effective immune responses that
increase hypersensitivity reactions.
D. Drug absorption in the elderly is always increased because of
slower gastric emptying.
Correct Answer
B
Rationales
• Correct (B): Aging reduces physiologic reserve across organ
systems (cardiac, renal, hepatic), limiting compensation
and increasing vulnerability to drug adverse effects.
• A: Hepatic enzyme induction varies and is not a general
protective mechanism in younger patients that explains
the scenario.
• C: Immune function typically declines with age
(immunosenescence), not improves, so increased
hypersensitivity is not generally correct.
• D: Gastric emptying is often slower in older adults, which
may alter absorption but does not uniformly increase
absorption nor fully explain higher adverse-effect risk.
Teaching Point
Physiologic reserve declines with age, increasing vulnerability to
stress and iatrogenic harm.
,Citation (Simplified APA)
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2)
Reference
Ch. 1 — Introduction
Question Stem
A nurse reads a lab report showing a patient’s elevated troponin
after chest pain. Using the framing of pathophysiology in
Hammer & McPhee, which statement best describes the role of
biomarkers in clinical reasoning?
Options
A. Biomarkers replace the need for clinical assessment because
they offer definitive diagnoses.
B. Biomarkers quantify organ injury and must be interpreted
with clinical context to determine cause.
C. Any elevated biomarker indicates irreversible organ failure.
D. Biomarkers are useful only for research, not bedside
decision-making.
Correct Answer
B
Rationales
, • Correct (B): Biomarkers indicate the presence/degree of
tissue injury or dysfunction but require integration with
history, exam, and imaging to determine etiology.
• A: Biomarkers inform but do not replace clinical
assessment; they are part of a diagnostic synthesis.
• C: Elevation signals injury but can reflect reversible or
transient damage; not always irreversible failure.
• D: Biomarkers have broad clinical application at the
bedside for diagnosis, prognosis, and monitoring.
Teaching Point
Biomarkers quantify injury but require clinical correlation for
diagnosis and management.
Citation (Simplified APA)
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3)
Reference
Ch. 1 — Introduction
Question Stem
A hospital identifies an increase in postoperative infections in
one ward. Which epidemiologic concept best helps quantify the
proportion of infections among exposed patients and guide
interventions?
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 patient with multiple chronic illnesses is started
on a new medication that causes an adverse reaction. Which
principle most directly explains why this patient is at higher risk
for adverse drug effects compared with a healthy 30-year-old?
Options
A. Younger patients have higher drug clearance due to
increased hepatic enzyme induction.
B. Physiologic reserve declines with age, reducing the ability to
tolerate physiologic stress.
,C. Older patients have more effective immune responses that
increase hypersensitivity reactions.
D. Drug absorption in the elderly is always increased because of
slower gastric emptying.
Correct Answer
B
Rationales
• Correct (B): Aging reduces physiologic reserve across organ
systems (cardiac, renal, hepatic), limiting compensation
and increasing vulnerability to drug adverse effects.
• A: Hepatic enzyme induction varies and is not a general
protective mechanism in younger patients that explains
the scenario.
• C: Immune function typically declines with age
(immunosenescence), not improves, so increased
hypersensitivity is not generally correct.
• D: Gastric emptying is often slower in older adults, which
may alter absorption but does not uniformly increase
absorption nor fully explain higher adverse-effect risk.
Teaching Point
Physiologic reserve declines with age, increasing vulnerability to
stress and iatrogenic harm.
,Citation (Simplified APA)
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
2)
Reference
Ch. 1 — Introduction
Question Stem
A nurse reads a lab report showing a patient’s elevated troponin
after chest pain. Using the framing of pathophysiology in
Hammer & McPhee, which statement best describes the role of
biomarkers in clinical reasoning?
Options
A. Biomarkers replace the need for clinical assessment because
they offer definitive diagnoses.
B. Biomarkers quantify organ injury and must be interpreted
with clinical context to determine cause.
C. Any elevated biomarker indicates irreversible organ failure.
D. Biomarkers are useful only for research, not bedside
decision-making.
Correct Answer
B
Rationales
, • Correct (B): Biomarkers indicate the presence/degree of
tissue injury or dysfunction but require integration with
history, exam, and imaging to determine etiology.
• A: Biomarkers inform but do not replace clinical
assessment; they are part of a diagnostic synthesis.
• C: Elevation signals injury but can reflect reversible or
transient damage; not always irreversible failure.
• D: Biomarkers have broad clinical application at the
bedside for diagnosis, prognosis, and monitoring.
Teaching Point
Biomarkers quantify injury but require clinical correlation for
diagnosis and management.
Citation (Simplified APA)
Hammer & McPhee (2021). Pathophysiology of Disease (8th
Ed.). Ch. 1.
3)
Reference
Ch. 1 — Introduction
Question Stem
A hospital identifies an increase in postoperative infections in
one ward. Which epidemiologic concept best helps quantify the
proportion of infections among exposed patients and guide
interventions?
