PATHO: CH 1 quiz: Concepts of health and disease

A nurse is investigating the epidemiologic factors influencing breast cancer for women in a population. What information should the nurse include? Select all that apply. (1) The age of women at the time of diagnosis (2) The currently known incidence and prevalence for this population (3) The number of women whose diagnosis was assisted by the use of mammography (4) The geographic location of women diagnosed with breast cancer (5) How cancer cells divide and multiply in breast tissue

(1) The age of women at the time of diagnosis (4) The geographic location of women diagnosed with breast cancer

The neuroscience nursing unit has developed a set of step-by-step directions of what should occur if a nursing assessment reveals the client may be exhibiting clinical manifestations of a cerebrovascular accident (CVA). Which statement about clinical practice guidelines are accurate? Select all that apply. (1) Once developed, practice guidelines only need to be reviewed if a national committee sends out an update on new research. (2) A meta-analysis could be utilized to combine evidence from different studies to produce a more accurate diagnostic method. (3) When developing a CVA set of step-by-step directions, the nursing unit should ask for assistance from experts in the neuroscience field. The potential users of the guidelines should pilot test it for further feedback. (4) Step-by-step guidelines are usually developed and based primarily on "how it has always been done before." (5) The development of evidence-based practice guidelines require a research review from different studies to develop the most accurate diagnostic method to implement.

(2) A meta-analysis could be utilized to combine evidence from different studies to produce a more accurate diagnostic method. (3) When developing a CVA set of step-by-step directions, the nursing unit should ask for assistance from experts in the neuroscience field. The potential users of the guidelines should pilot-test it for further feedback. (5) The development of evidence-based practice guidelines require a research review from different studies to develop the most accurate diagnostic method to implement.

A clinical nurse specialist is interested in developing a research study focused on clients living with the sequelae of ischemic stroke. Which clients should the nurse include? Select all that apply. The nurse should include clients with: (1) aspiration pneumonia. (2) unilateral weakness. (3) falls. (4) Dysphagia (difficulty swallowing). (5) vision changes.

(2) unilateral weakness. (4) Dysphagia (difficulty swallowing). (5) vision changes.

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 is has increasing serum ammonia levels due to liver cirrhosis. (b) A client who has been exposed to the mycobacterium tuberculosis bacterium. (c) A client with multiple skeletal injuries secondary to a motor vehicle accident. (d) A client who was admitted with the effects of methyl alcohol poisoning.

(a) A client who is has increasing serum ammonia levels due to liver cirrhosis.

A nurse practitioner is working in a crowded neighborhood where the population is primarily immigrants from China. The nurse has designed a research study to follow children from kindergarten to the age of 25. She is going to be looking at their diet, successful progression in school, health practices, and development of disease, to name a few items. This type of research is known as: (a) Cohort study (b) Cross-sectional study (c) Epidemiologic study (d) Case-control study

(a) Cohort study

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 family history of cardiovascular disease related to hypercholesterolemia and remains noncompliant with the treatment regime. (b) The client has a diverse background by being of Asian and Native American/First Nation descent and practices various alternative therapies to minimize the effects of stress. (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 healthcare facilities.

(a) The client has a family history of cardiovascular disease related to hypercholesterolemia and remains noncompliant with the treatment regime.

The clinical educator of a hospital medical unit has the mandate of establishing evidence-based practice guidelines for the nursing care on the unit. Which statement most accurately captures a guiding principle of the nurse's task? (a) The guidelines will combine individual expertise with external systematic evidence. (b) Evidence-based practice guidelines will be rooted in research rather than nurses' subjective practice preferences and experiences. (c) Guidelines are synonymous with systematic research reviews. (d) The need for continuity and standardization of guidelines will mean that they will be fixed rather than changeable.

(a) The guidelines will combine individual expertise with external systematic evidence.

A male international business traveler has returned from a trip to Indonesia. While there, he hired a prostitute for companionship and engaged in unprotected sex on more than one occasion. Unbeknownst to him, this prostitute harbored the hepatitis C virus. Upon return to the U.S., he exhibited no symptoms and returned to his usual activities. During this period of no outward symptoms, the disease would be classified as being in: (a) the preclinical stage of the disease (b) the chronic phased of Hepatitis C (c) the clinical disease stage of Hepatitis C (d) Remission and unlikely to develop to Hepatitis C

(a) the preclinical stage of disease

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) "Sounds like this began because of inflammation inside my artery that made it easy to form fatty streaks which led to my clogged artery." (c) " 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." (d) "My artery was clogged by fat so I will need to stop eating fatty foods like French fries every day."

(b) "Sounds like this began because of inflammation inside my artery that made it easy to form fatty streaks which led to my clogged artery."

As part of a screening program for prostate cancer, men at a senior citizens center are having their blood levels of prostate-specific antigen (PSA) measured. Which statement would best characterize high positive predictive value but low negative predictive value for this screening test? (a) The test displayed low sensitivity but high specificity. (b) All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer. (c) All of the men who had low PSA levels were cancer-free; several men who had high levels also remained free of prostate cancer. (d) Men who had low PSA levels also displayed false positive results for prostate cancer; men with high levels were often falsely diagnosed with prostate cancer.

(b) All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer.

The nurse is questioning the validity of oxygen saturation readings from the new oximeters on the unit. Which action should the nurse take to best determine if the results from the oximeter are valid? (a) Repeat the test on the same client to determine if the oximeter offers the same results. (b) Compare clients' results to measurements taken using arterial blood gas analyses. (c) Review the literature about this brand of oximeter provided by the company. (d) Compare the findings with all clients' results on the unit to determine if there is a trend in the results.

(b) Compare clients' results to measurements taken using arterial blood gas analyses.

A multidisciplinary healthcare team operates a program aimed at the prevention, identification, and treatment of diabetes on a large Indian reservation. Which aspect of the program would most likely be classified as secondary prevention? (a) Regularly scheduled wound dressing changes for clients who have foot ulcers secondary to peripheral neuropathy and impaired wound healing. (b) Staffing a booth where community residents who are attending a baseball tournament can have their blood glucose levels checked. (c) Administering oral antihyperglycemic medications to clients who have a diagnosis of diabetes. (d) Teaching school children how a nutritious, traditional diet can lessen their chances of developing adult-onset diabetes.

(b) Staffing a booth where community residents who are attending a baseball tournament can have their blood glucose levels checked.

A nurse is considering setting up a screening program for a specific health condition in a population. What characteristic of the condition would need to be true for the nurse to justify screening a population? The condition should: (a) be curable with available treatment. (b) be asymptomatic at an early stage. (c) have a noninvasive diagnostic test available. (d) have a high mortality rate.

(b) be asymptomatic at an early stage.

An epidemiologist is conducting a program of research aimed at identifying factors associated with incidence and prevalence of congenital cardiac defects in infants. The researcher has recruited a large number of mothers whose infants were born with cardiac defects as well as mothers whose infants were born with healthy hearts. The researcher is comparing the nutritional habits of all the mothers while their babies were in utero. Which type of study is the epidemiologist most likely conducting? (a) Risk factor study (b) Cohort study (c) Case-control study (d) Cross-sectional study

(c) Case-control study

A particular disease has a debilitating effect on the ability of sufferers to perform their activities of daily living, and is a significant cause of decreased quality of life. However, few people die as a result of the disease's direct effects. There are hundreds of thousands of Americans living with the disease but relatively few new cases in recent years. Which statement best conveys an accurate epidemiologic characterization of the disease? (a) Low mortality; high morbidity; low prevalence; high incidence. (b) Low mortality; high morbidity; high incidence; low prevalence. (c) High morbidity; low mortality; high prevalence, low incidence. (d) High mortality; low morbidity; high incidence; low prevalence.

(c) High morbidity; low mortality; high prevalence, low incidence.

As part of a community class, student nurses are developing curriculum to teach expectant parents the importance of having their child properly secured in a child safety seat. During the class, the students are going to have a safety officer examine the car seats that the parents have installed in their vehicle. This is an example of which type of prevention? (a) Tertiary prevention (b) Prognosis enhancement (c) Primary prevention (d) Secondary prevention

(c) Primary prevention

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 RT hears diminished breath sounds to the client's lower lung fields bilaterally. (c) The client notes that he has increased work of breathing when lying supine. (d) The client's respiratory rate is 31 breaths per minute.

(c) The client notes that he has increased work of breathing when lying supine.

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) if the result of a very sensitive test is negative, that does not mean the person is disease free. (b) all lab values are adjusted for gender and weight. (c) a normal value represents the test results that fall within the bell curve. (d) if the lab result is above the 50% distribution, the result is considered elevated.

(c) a normal value represents the test results that fall within the bell curve.

The public health nurse is designing a course about risk factors for various chronic illnesses. For risk factors about which chronic illness will the nurse consult the Framingham study? (a) Breast cancer (b) Type 2 diabetes mellitus (c) Chronic obstructive pulmonary disease (COPD) (d) Cardiovascular disease

(d) Cardiovascular disease

A nurse researcher is interested in the natural history of a disease being studied. What should the nurse focus on to best understand the condition's natural history? (a)Following client cases from initial diagnosis and throughout treatment (b) Examining outcomes across a wide variety of treatment approaches (c) Interviewing clients for their first-hand experience with the condition (d) Focusing on clients who did not receive treatment for the condition

(d) Focusing on clients who did not receive treatment for the condition

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) High specificity; low reliability (b) High sensitivity; low reliability (c) Low validity; high reliability (d) High sensitivity, low specificity

(d) High sensitivity, low specificity

An occupational therapist conducts a group therapy program called MindWorks with older adults who have diagnoses of dementia and Alzheimer's disease. The goal of the group is to slow the cognitive decline of clients by engaging them in regular, organized mental activity such as reading maps and solving puzzles. How would the program most likely be characterized? (a) Primary prevention (b) Secondary prevention (c) Prognosis enhancement (d) Tertiary prevention

(d) Tertiary prevention

As of Nov. 1, 2012, there were a total of 10 confirmed cases of hantavirus infection in people who were recent visitors (mid-June to end of August, 2012) to Yosemite National Park. Three visitors with confirmed cases died. Health officials believe that 9 out of the 10 cases of hantavirus were exposed while staying in Curry Village in the Signature Tent Cabins. This is an example of: (a) the prevalence of hantavirus one can anticipate if he or she is going to vacation in Yosemite National Park. (b) the low rate of morbidity one can expect while traveling to Yosemite National Park. (c) what the anticipated mortality rate would be if a family of five were planning to vacation in Yosemite National Park. (d) the incidence of people who are at risk for developing hantavirus while staying in Yosemite National Park.

(d) the incidence of people who are at risk for developing hantavirus while staying in Yosemite National Park.

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. 1. Increase in the number of chair aerobics classes provided in the skilled care facilities 2. Interventions geared toward keeping the older adult population diagnosed with diabetes mellitus under tight blood glucose control by providing in-home cooking classes 3. Providing handwashing teaching sessions to a group of young children. 4. Interests in keeping the older adult population engaged in such activities as book reviews and word games during social time 5. Providing transportation for renal dialysis clients to and from their hemodialysis sessions

1. Increase in the number of chair aerobics classes provided in the skilled care facilities 2. Interventions geared toward keeping the older adult population diagnosed with diabetes mellitus under tight blood glucose control by providing in-home cooking classes 3. Providing handwashing teaching sessions to a group of young children. 4. Interests in keeping the older adult population engaged in such activities as book reviews and word games during social time

Which situation would be classified as a complication of a disease or outcome from the treatment regimen? Select all that apply. 1. Gradual deterioration in ability to walk unassisted for a client diagnosed with Parkinson disease. 2. Development of pulmonary fibrosis following treatment with bleomycin, an antibiotic chemotherapy agent used in treatment of lymphoma. 3. Massive pulmonary emboli following diagnosis of new onset atrial fibrillation. 4. Loss of short-term memory in a client diagnosed with Alzheimer disease. 5. Burning, intense incision pain following surgery to remove a portion of colon due to intestinal aganglionosis.

2. Development of pulmonary fibrosis following treatment with bleomycin, an antibiotic chemotherapy agent used in the treatment of lymphoma. 3. Massive pulmonary emboli following diagnosis of new-onset atrial fibrillation.