Rationale: 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.
Question format: Multiple Choice
Chapter 1: Concepts of Health a...
Porth’s Essentials of Pathophysiology 5th Edition Test Bank
1. While attending an international nursing conference, many discussions and
break-out sessions focused on the World Health Organization's (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 older adult 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 older adult population diagnosed with
diabetes mellitus under tight blood glucose control by providing in-home cooking
classes
D. Providing transportation for renal dialysis clients to and from their hemodialysis
sessions
E. Providing handwashing teaching sessions to a group of young children
Answer: A, B, C, E
Rationale: WHO definition of health is defined as "a state of complete physical,
mental, and social 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.
Question format: Multiple Select
Chapter 1: Concepts of Health and Disease
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: p. 2
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/First
Nation 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 preventive health care benefits.
D. The client lives in an affluent, clean, suburban community with access to many
health care facilities.
Answer: B
,Rationale: 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). Being noncompliant with treatments to control high
cholesterol levels with a family history to CV disease does not meet the "attaining
lives free of preventable disease and premature death" goal/objective.
Question format: Multiple Choice
Chapter 1: Concepts of Health and Disease
Cognitive Level: Apply
Client Needs: Health Promotion and Maintenance
Reference: p. 2
3. 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 aspect 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 is 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.
Answer: B
Rationale: 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.
Question format: Multiple Choice
Chapter 1: Concepts of Health and Disease
Cognitive Level: Apply
Client Needs: Physiological Integrity: Physiological Adaptation
Reference: p. 3
4. A new client who suffered a myocardial infarction requires angioplasty and stent
placement. He 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 client 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. "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 form fatty streaks which led to my clogged artery."
D. " If you do not exercise regularly to get your heart rate up, blood pools in the
veins causing a clot which stops blood flow to the muscle and you have a heart
attack."
Answer: C
,Rationale: 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.
Question format: Multiple Choice
Chapter 1: Concepts of Health and Disease
Cognitive Level: Apply
Client Needs: Physiological Integrity: Physiological Adaptation
Reference: p. 3
5. 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 aspect of the client's current state of
health would be best characterized as a symptom rather than a sign?
A. The client's oxygen saturation is 83% by pulse oximetry.
B. The client notes that he has increased work of breathing when lying supine.
C. The RT hears diminished breath sounds to the client's lower lung fields
bilaterally.
D. The client's respiratory rate is 31 breaths per minute.
Answer: B
Rationale: Symptoms are subjective reports by the person experiencing the health
problem, such as reports of breathing difficulty. Oxygen levels, listening to breath
sounds, and respiratory rate are all objective, observable signs of disease.
Question format: Multiple Choice
Chapter 1: Concepts of Health and Disease
Cognitive Level: Analyze
Client Needs: Physiological Integrity: Physiological Adaptation
Reference: p. 5
6. Which situation 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. Gradual deterioration in ability to walk unassisted for a client diagnosed with
Parkinson disease.
E. Loss of short-term memory in a client diagnosed with Alzheimer disease.
Answer: A, C
Rationale: Development of pulmonary emboli and pulmonary fibrosis following
chemotherapy are both 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 ability to walk independently is
expected to decrease. This is a normal progression for people diagnosed with
Parkinson disease. Loss of short-term memory in a client diagnosed with Alzheimer
disease is an expected finding.
Question format: Multiple Select
Chapter 1: Concepts of Health and Disease
Cognitive Level: Analyze
Client Needs: Physiological Integrity: Physiological Adaptation
Reference: p. 3
7. Laboratory testing is ordered for a male client during a clinic visit for routine
follow-up assessment of hypertension. When interpreting lab values, the nurse
knows:
A. a normal value represents 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.
Answer: A
Rationale: What is termed a normal value for a laboratory test is established
statistically from results obtained from a selected sample of people. A normal value
represents the test results that fall within the bell curve or the 95% distribution.
Some lab values (like hemoglobin) are adjusted for gender, other comorbidities, or
age. If the result of a very sensitive test is negative, it tells us the person does not
have the disease and the disease has been ruled out or excluded.
Question format: Multiple Choice
Chapter 1: Concepts of Health and Disease
Cognitive Level: Analyze
Client Needs: Physiological Integrity: Reduction of Risk Potential
Reference: p. 1
8. The laboratory technologists are a discussing a new blood test that helps
establish a differential diagnosis between shortness of breath with a cardiac
etiology and shortness of breath with a respiratory/pulmonary etiology. A positive
result is purported to indicate a cardiac etiology. The marketers of the test report
that 99.8% of clients who have confirmed cardiac etiologies test positive in the test.
However, 1.3% of clients who do not have cardiac etiologies for their shortness of
breath also test positive. Which statement best characterizes this blood test?
A. Low validity; high reliability
B. High sensitivity, low specificity
C. High specificity; low reliability
D. High sensitivity; low reliability
Answer: B
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