Porth's Pathophysiology Concepts of Altered Health 10th Edition Test Bank
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Chapter 1- Concepts of Health and Disease
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1. At an international nursing conference, many discussions and breakout sessions
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focusedon the World Health Organization (WHO) views on health. Of the following
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commentsmade by nurses during a discussion session, which statements would be
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considered a good representation of the WHO definition? Select all that apply.
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A) Interests in keeping the elderly population engaged in such activities as ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S
bookreviews and word games during social time
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B) Increase in the number of chair aerobics classes provided in the skilled ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S
carefacilities ,S ,S
C) Interventions geared toward keeping the elderly population diagnosed with ,S ,S ,S ,S ,S ,S ,S ,S
diabetes mellitus under tight blood glucose control by providing in-home
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cookingclasses ,S ,S
D) Providing transportation for renal dialysis patients to and from their ,S ,S ,S ,S ,S ,S ,S ,S ,S
hemodialysissessions,S ,S
E) Providing handwashing teaching sessions to a group of young ,S ,S ,S ,S ,S ,S ,S ,S
childrenAns: A, B, C, E
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Feedback:
The WHO definition of health is defined as ―a state of complete physical, mental, and
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social well-being and not merely the absence of disease and infirmity.‖ Engaging in
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book reviews facilitates mental and social well-being; chair aerobics helps facilitate
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physical well-being; and assisting with tight control of diabetes helps with facilitating
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physical well-being even though the person has a chronic disease. Handwashing is
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vitalin the prevention of disease and spread of germs.
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2. A community health nurse is teaching a group of recent graduates about the large
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variety of factors that influence an individual's health or lack thereof. The nurse is
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referring to the Healthy People 2020 report from the U.S. Department of Health
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andHuman Services as a teaching example. Of the following aspects discussed,
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which would be considered a determinant of health that is outside the focus of this
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report?
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A) The client has a diverse background by being of Asian and Native American
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descent and practices various alternative therapies to minimize effects of
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stress. ,S
B) The client has a family history of cardiovascular disease related to
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hypercholesterolemia and remains noncompliant with the treatment
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regime. ,S
C) The client has a good career with exceptional preventative health care benefits.
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D) The client lives in an affluent, clean, suburban community with access to
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manyhealth care facilities.
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Ans: B ,S
Feedback:
In Healthy People 2020, the focus is to promote good health to all (such as using
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alternative therapies to minimize effects of stress); achieving health equity and
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promoting health for all (which includes having good health care benefits); and
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promoting good health (which includes living in a clean community with good access
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tohealth care). A client's noncompliance with treatments to control high cholesterol
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levelswithin the presence of a family history of CV disease does not meet the
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―attaining lives free of preventable disease and premature death‖ determinant.
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,3. A physician is providing care for a number of patients on a medical unit of a large,
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university hospital. The physician is discussing with a colleague the differentiation
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between diseases that are caused by abnormal molecules and diseases that cause
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disease.Which of the following patients most clearly demonstrates the consequences of
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molecules that cause disease?
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A) A 31-year-old woman with sickle cell anemia who is receiving a transfusion
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ofpacked red blood cells
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B) A 91-year-old woman who has experienced an ischemic stroke resulting
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fromfamilial hypercholesterolemia
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C) A 19-year-old man with exacerbation of his cystic fibrosis requiring
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oxygentherapy and chest physiotherapy
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D) A 30-year-old homeless man who has Pneumocystis carinii pneumonia (PCP)
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andis HIV positive. ,S ,S ,S ,S
Ans: D ,S
Feedback:
PCP is an example of the effect of a molecule that directly contributes to disease.
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Sicklecell anemia, familial hypercholesterolemia, and cystic fibrosis are all examples
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of the effects of abnormal molecules.
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4. A member of the health care team is researching the etiology and pathogenesis of a
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number of clients who are under his care in a hospital context. Which of the
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followingaspects of clients' situations best characterizes pathogenesis rather than
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etiology?
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A) A client who has been exposed to the Mycobacterium tuberculosis bacterium
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B) A client who has increasing serum ammonia levels due to liver cirrhosis
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C) A client who was admitted with the effects of methyl alcohol poisoning
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D) A client with multiple skeletal injuries secondary to a motor vehicle
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accidentAns: B
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Feedback:
Pathogenesis refers to the progressive and evolutionary course of disease, such as
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theincreasing ammonia levels that accompany liver disease. Bacteria, poisons, and
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traumatic injuries are examples of etiologic factors.
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,5. A new myocardial infarction patient requiring angioplasty and stent placement has
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arrived to his first cardiac rehabilitation appointment. In this first session, a review of
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the pathogenesis of coronary artery disease is addressed. Which statement by the
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patientverifies to the nurse that he has understood the nurse's teachings about coronary
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artery disease?
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A) ―All I have to do is stop smoking, and then I won't have any more heart attacks.‖
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B) ―My artery was clogged by fat, so I will need to stop eating fatty foods ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S
likeFrench fries every day.‖ ,S ,S ,S ,S ,S
C) ―Sounds like this began because of inflammation inside my artery that made ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S
iteasy to form fatty streaks, which lead to my clogged artery.‖
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D) ―If I do not exercise regularly to get my heart rate up, blood pools in the veins
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causing a clot that stops blood flow to the muscle, and I will have a heart
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attack.‖ ,S
Ans: C ,S
Feedback:
The true etiology/cause of coronary artery disease (CAD) is unknown; however, the
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pathogenesis of the disorder relates to the progression of the inflammatory process
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froma fatty streak to the occlusive vessel lesion seen in people with coronary artery
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disease. Risk factors for CAD revolve around cigarette smoking, diet high in fat, and
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lack of exercise.
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6. A 77-year-old man is a hospital inpatient admitted for exacerbation of his chronic
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obstructive pulmonary disease (COPD), and a respiratory therapist (RT) is assessing
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theclient for the first time. Which of the following aspects of the patient's current state
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of health would be best characterized as a symptom rather than a sign?
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A) The patient's oxygen saturation is 83% by pulse oxymetry. ,S ,S ,S ,S ,S ,S ,S ,S
B) The patient notes that he has increased work of breathing when lying supine.
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C) The RT hears diminished breath sounds to the patient's lower lung
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fieldsbilaterally. ,S ,S
D) The patient's respiratory rate is 31 ,S ,S ,S ,S ,S
breaths/minute.Ans: B
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Feedback:
Symptoms are subjective complaints by the person experiencing the health ,S ,S ,S ,S ,S ,S ,S ,S ,S
problem, such as complaints of breathing difficulty. Oxygen levels, listening to
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breath sounds,and respiratory rate are all objective, observable signs of disease.
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, 7. Which of the following situations would be classified as a complication of a disease
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oroutcome from the treatment regimen? Select all that apply.
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A) Massive pulmonary emboli following diagnosis of new-onset atrial fibrillation ,S ,S ,S ,S ,S ,S ,S ,S
B) Burning, intense incision pain following surgery to remove a portion of colon ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S
dueto intestinal aganglionosis
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C) Development of pulmonary fibrosis following treatment with bleomycin, ,S ,S ,S ,S ,S ,S ,S
anantibiotic chemotherapy agent used in treatment of lymphoma
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D) Gradual deterioration in ability to walk unassisted for a patient diagnosed ,S ,S ,S ,S ,S ,S ,S ,S ,S ,S
withParkinson disease
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E) Loss of short-term memory in a patient diagnosed with Alzheimer
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diseaseAns: A, C
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Feedback:
Development of pulmonary emboli and pulmonary fibrosis following chemotherapy ,S ,S ,S ,S ,S ,S ,S ,S
areboth examples of a complication (adverse extensions of a disease or outcome from
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treatment). It is normal to expect incisional pain following surgery. As Parkinson
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disease progresses, the inability to walk independently is expected. This is a normal
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progression for people diagnosed with Parkinson's. Loss of short-term memory in a
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patient diagnosed with Alzheimer disease is an expected finding.
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8. Laboratory testing is ordered for a male patient during a clinic visit for a routine
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follow-up assessment of hypertension. When interpreting lab values, the nurse
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knowsthat
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A) a normal value represents the test results that fall within the bell curve.
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B) if the lab result is above the 50% distribution, the result is considered elevated.
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C) all lab values are adjusted for gender and weight.
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D) if the result of a very sensitive test is negative, that does not mean the person
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isdisease free. ,S ,S ,S
Ans: A ,S
Feedback:
What is termed a normal value for a laboratory test is established statistically from
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results obtained from a selected sample of people. A normal value represents the test
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results that fall within the bell curve or the 95% distribution. Some lab values (like
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hemoglobin) are adjusted for gender, other comorbidities, or age. If the result of a very
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sensitive test is negative, it tells us the person does not have the disease, and the
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diseasehas been ruled out or excluded.
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