Pathophysiology Practice Questions Chapter 1: Concepts of Health and Disease

The Framingham cohort study examined characteristics of people who would later develop which disease? - COPD - coronary disease - lung cancer - seizures

coronary disease

The nurse is evaluating the results of a study where the rates of cardiovascular disease were compared in smokers versus nonsmokers. The nurse interprets the results for which type of study? - Cross-sectional - Qualitative - Case control - Cohort

cross-sectional

A client is taking a synthetic thyroid hormone for the treatment of hypothyroidism. The client develops signs and symptoms of hyperthyroidism. The nurse refers to this adverse extension of disease development as: - a new diagnosis. - sequelae. - complications. - syndrome.

complications

A client delivers a child via vaginal birth after having an uneventful prenatal course. After the infant is born, the nurse discovers an extra digit. The client states that she had the same thing when she was born. What does the nurse recognize that this defect is considered? - Acquired defect - Congenital condition - An acute defect - A chronic defect

congenital condition

The nurse is planning care for a client. Which information is most important for the nurse to apply in developing a plan of care?

current clinical practice guidelines combined with the client's health care goals

A school nurse compares the number of cases of measles in one elementary classroom to the number of students in the school. Which term describes this type of comparison? - Prevalence - Risk analysis - Morbidity - Primary prevention

prevalence

The nurse is providing a prenatal class for a group of women at the local women's center. The nurse informs the group about the importance of taking their folic acid supplements for the prevention of neural tube defects. What type of prevention is the nurse providing? - Tertiary prevention - Primary prevention - Secondary prevention - Initial prevention

primary prevention

Which assessment data would a nurse identify as a complication of a disease or disorder? - Pulmonary emboli following deep vein thrombosis (DVT) - Reduced range of motion following a fracture - Hyperlipidemia in cardiovascular disease - Weight gain of 1 to 2 pounds per week during pregnancy

pulmonary emboli following deep vein thrombosis

A client tested positive for the tuberculosis antibody and has been told this does not mean the client will ever develop active tuberculosis. This client is considered to be in which stage of the disease process?

subclinical

Why are some diseases termed syndromes? - They are a group of disease states that has the same etiology. - They are a compilation of signs and symptoms characteristic of a specific disease state. - They have complications. - They leave sequelae (e.g., lesions) and residual effects.

They are a compilation of signs and symptoms characteristic of a specific disease state.

A client develops an infection with a resistant organism while hospitalized for surgery. After treatment, there are no obvious signs of infection, but a culture shows that the organism is present. Which term describes the client's status? - Clinical disease - Chronic disease - Carrier status - Preclinical stage

carrier status

Which of the nurse's assessment questions most directly addresses the client's level of health, based on the World Health Organization's definition of health? - "How would you rate your overall sense of well-being?" - "How often have you been sick over the past 12 months?" - "What are the things that give you the most joy in your life?" - "Would you consider yourself to be more healthy, less healthy, or average?"

"How would you rate your overall sense of well=being?"

The nurse is evaluating a client's understanding of the risk factors for heart disease. The nurse corrects the client based on which inaccurate comment? - "A healthy blood pressure should be below 120/80." - "If I lose as little as 10 pounds, it will help cut my risk." - "My hemoglobin A1c should be between 4% and 5.6%." - "I will switch from smoking to chewing tobacco."

"I will switch from smoking to chewing tobacco."

A nurse is conducting a staff educational program on diagnostic tests. The nurse should include that the normal value of a laboratory test represents the test results that fall within which distribution level? - 5% - 75% - 80% - 100%

95%

The community health nurse is creating a program to improve the health of a select group of clients in the community, based on Healthy People 2030 by the U.S. Department of Health and Human Services. The nurse will base the program on which determinant(s) of health? Select all that apply. - Promote good health for all. - Achieve health equity and eliminate disparities. - Have program availability that will pay for everyone's health care for all illnesses. - Promote healthy behaviors across the lifespan. - Attain lives free of preventable disease, disability, injury, and premature death.

- Promote good health for all. - Achieve health equity and eliminate disparities. - Promote healthy behaviors across the lifespan. - Attain lives free of preventable disease, disability, injury, and premature death.

Which statement accurately describes clinical practice guidelines, or evidence-based practice guidelines? Select all that apply. - They are intended to inform practitioners and clients in making decisions about health care for specific clinical circumstances. - They help health care providers assess current practices and integrate technological advances. - They should review various outcomes; weigh various outcomes, both positive and negative; and make recommendations. - They take the place of both written orders by the doctor and the nursing care plan. - They can take the form of algorithms, which are step-by-step methods for solving a problem; written directives for care; or a combination thereof.

- They are intended to inform practicioners and clients in making decisions about health care for specific clinical circumstances. - They should review various outcomes; weight various outcomes, both positive and negatives; and make recommendations. - They can take the form of algorithims, which are step-by-step methods for solving a problem; written directives for care; or a combination thereof

When attempting to reach a health diagnosis, the health care provider commonly applies four primary steps. Place the steps for reaching a diagnosis in order. Use all the options. - Conduct a physical examination. - Obtain clinical history. - Determine the most likely cause of the client's presentation. - Perform diagnostic testing.

1 Obtain clinical history. 2 Conduct a physical examination. 3 Perform diagnostic testing. 4 Determine the most likely cause of the client's presentation.

A physician is providing care for a number of clients on a medical unit of a large, university hospital. The physician is discussing with a colleague the differentiation between diseases that are caused by abnormal molecules and molecules that cause disease. Which client most clearly demonstrates the consequences of molecules that cause disease? - A 19-year-old man with exacerbation of his cystic fibrosis requiring oxygen therapy and chest physiotherapy. - A 30-year-old homeless man who has pneumocystis carinii pneumonia (PCP) and is HIV positive. - A 91-year-old woman who has experienced an ischemic stroke resulting from familial hypercholesterolemia - A 31-year-old woman with sickle cell anemia who is receiving a transfusion of packed red blood cells

A 30-year-old homeless man who has pneumocystis carinii pneumonia (PCP) and is HIV positive.

A member of the health care team is researching the etiology and pathogenesis of a number of clients who are under her care in a hospital context. Which client situation best characterizes pathogenesis rather than etiology? - A client with multiple skeletal injuries secondary to a motor vehicle accident - A client who has increasing serum ammonia levels due to liver cirrhosis - A client who was admitted with the effects of methyl alcohol poisoning - A client who has been exposed to the mycobacterium tuberculosis bacterium

A client who has increasing serum ammonia levels due to liver cirrhosis

An infant has a difficult time passing through the birth canal and the physician uses forceps to deliver the child. In the process, the facial nerve was damaged, resulting in a facial droop. Which condition does the nurse recognize this to be? - Morphologic change - Pathogenesis - Acquired defect - Congenital condition

Acquired defect

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? - 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. - The test displayed low sensitivity but high specificity. - All of the men who had low PSA levels were cancer free; several men who had high levels also remained free of prostate cancer. - All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer.

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 interested in conducting an epidemiologic research study. Which research question should the nurse choose as appropriate for an epidemiologic study? - Which substances in cigarette smoking contribute to heart disease? - Is there a relationship between smoking rates and incidence of heart disease? - Which is more effective in the treatment of cardiac disease, metoprolol or atenolol? - Does oxygen improve the quality of life for clients living with lung cancer?

Is there a relationship between smoking rates and incidence of heart disease?

Diagnostic tests are used to gain information about the client that is pertinent to the presenting signs and symptoms. Diagnostic tests are judged for their validity, reliability, sensitivity, specificity, and predictive value. In the field of clinical laboratory measurements, standardization is aimed at increasing the trueness and reliability of measured values. Standardization relies on which of the following? Select all that apply. - In vitro laboratory equipment - Reference measurement procedures -Written standards -U.S. Food and Drug Administration -Reference materials

Reference measurement procedures, Written standards, Reference materials

The nurse notes that a colleague neglects to wipe away the first drop of blood from the sample during point-of-care blood glucose testing; this in contradiction of the unit policy. What action should the nurse take first? - Remind the colleague that the purpose of discarding the first drop is to improve the reliability of the results. - Retake the blood glucose on the client to ensure a more accurate result for guiding treatment decisions. - Remind the colleague that by failing to adhere to unit policy, the colleague will be at risk of disciplinary action. - Report the colleague to the nurse in charge so that retraining on using the glucometer can be arranged.

Remind the colleague that the purpose of discarding the first drop is to improve the reliability of the results.

There are three fundamental types of prevention used in health care: primary, secondary, and tertiary. Which statement accurately describes secondary prevention? - Secondary prevention goes beyond treating the problem with which the person presents. - Secondary prevention is often accomplished outside the health care system at the community level. - Secondary prevention detects disease early, and most is done in clinical settings. - Secondary prevention takes place within health care systems and involves the services of a number of different types of health care professionals.

Secondary prevention detects disease early, and most is done in clinical settings.

A client has been 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? - The RT hears diminished breath sounds to the client's lower lung fields bilaterally. - The client's respiratory rate is 31 breaths per minute. - The client notes that he has increased work of breathing when lying supine. - The client's oxygen saturation is 83% by pulse oximetry

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

A client has died and the nurse is responsible for filling out the death certificate. In performing this task, the nurse is required to record the client's age, sex, and cause of death, among other factors. What is the purpose of reporting these statistics?

These statistics are useful in terms of anticipating healthcare needs, planning public-education programs, directing health research efforts, and allocating healthcare dollars.

A client tests positive for an infectious disease but does not have any symptoms. The physician informs the client that she is capable of infecting others. Which stage of the clinical course is this client experiencing? - Subclinical disease - Acute disorder - Clinical disease - Carrier state

carrier state

When the nurse is assisting with the diagnostic process for a client with an illness, what is a priority when compiling all of the data to have an accurate diagnosis? Select all that apply. - Financial information - A careful history - Social data - Diagnostic tests - Detailed Physical examination

a careful history, diagnostoc tests, and a detailed physical examination

A client with hypertension is given an IV medication and has an anaphylactic reaction. This is considered to be: - a sequelae. - a complication. - a syndrome. - a subacute presentation.

a complication

The nurse observes that blood pressure readings taken by a new unlicensed assistive personnel (UAP) are very different from what other nurses obtain. What does the nurse understand is occurring with these readings? - The blood pressure machine is not sensitive. - The validity of the blood pressure calibration is inconsistent. - The blood pressure readings from the UAP are not specific. - A lack of reliability in the readings of the UAP.

a lack of reliability in the readings of the UAP

The nurse is performing an assessment on a newly admitted client with asthma and hears wheezes in the upper lobes of the lungs. When the nurse documents this finding, the nurse recognize this to be:

a sign

Facility policies on wound dressing selection refer the nurse to a dressing algorithm. The nurse anticipates that the algorithm will include: - standing orders for wound care. - a step-by-step decision-making tree for dressing selection. - a pictorial representation of various dressings. - guidelines for staging pressure injuries.

a step-by-step decision-making tree for dressing selection

The public health nurse is creating a program to reduce childhood mortality rates in a population. To have the greatest impact, the nurse should focus on: -early childhood education. -accident prevention. -healthy eating and activity. -screening for chronic illnesses.

accident prevention

A nurse documenting a client's health history places hypertension under which category? - Acquired - Congenital - Complications - Mortality

acquired

During an assessment, a client tells the nurse that he has suffered from asthma since childhood. He is not experiencing any symptoms at this time but takes an inhaled steroidal medication daily. The nurse should document the asthma as being which type of condition? - Subacute - Acute - Subclinical - Chronic

chronic

When considering the clinical course, a disease that is characterized by remissions and exacerbations is considered to be: - preclinical - subclinical - acute - chronic

chronic

The nurse is caring for clients with chronic illnesses. Which characteristic of chronic illness will the nurse apply when developing plans of care? - Chronic illnesses are adequately managed through lifestyle changes. - Chronic illnesses may have periods of stability and acute exacerbations. - Chronic illnesses result in systemic manifestations rather than local ones. - Chronic illnesses have a stable and predictable course.

chronic illnesses may have periods of stability and acute exacerbations

A client is experiencing signs and symptoms of congestive heart failure. The client's disease is in which phase of its clinical course? - Preclinical - Clinical - Subclinical - Postclinical

clinical

A nurse is evaluating findings from the Nurses' Health Study, a study that has followed a group of nurses since 1976 to study the relationship between oral contraceptive use and breast cancer. The nurse evaluates the findings using criteria for which type of study? - Case control - Cross-sectional - Cohort - Qualitative

cohort

A nurse plans to conduct a research study on a group of clients who had laparoscopic gastric bypass. Which term describes this type of study? - Case control - Cohort - Morbidity - Cross-sectional

cohort

Researchers have designed a study where the health of a large group of recent newborns will be followed for several years. What type of study is this? - double-blind placebo - repetition - case-control - cohort

cohort

The nurse evaluates a client for manifestations of a disease. Which assessment data are considered signs? Select all that apply. itching pain dilated pupils skin rash tachycardia dizziness

dilated pupils tachycardia skin rash

Which science is called on to study the risk factors in multifactorial diseases? - Morphology - Histology - Epidemiology - Scientology

epidemiology

A client diagnosed with chlamydia asks the nurse how this infection has occurred. The explanation by the nurse would involve a description of which aspect of the disease? Histology Morphology Pathogenesis Etiology

etiology

What do morbidity and mortality statistics refer to? - Effects a disease has on a person's life and treatment - Cause of death and impact on the family because of a disease - Functional effects and death-producing characteristics of a disease - Long-term consequences and recovery rates of a disease

functional effects and death-producing characteristics of a disease

The parents of a child with spina bifida ask what caused the condition. Which factor would the nurse identify as the most likely etiologic factor in the child's history? - Insufficient maternal folic acid intake - Birth trauma during delivery - Neonatal infection - Domestic violence

insufficient maternal folic acid intake

A nurse researcher is collecting data on the number of people who have a current diagnosis of diabetes in a local population. Which term categorizes the aspect of epidemiology the nurse is collecting? - prevalence - mortality - incidence - morbidity

prevalence

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 Canadians living with the disease but relatively few new cases in recent years. This disease has: - low mortality, high morbidity, high incidence, and low prevalence. - high morbidity, low mortality, high prevalence, and low incidence. - high mortality, low morbidity, high incidence, and low prevalence. - low mortality, high morbidity, low prevalence, and high incidence.

high morbidity, low mortality, high prevalence, and low incidence.

Nurses are 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 known 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? High sensitivity, low specificity High specificity, low reliability Low validity, high reliability High sensitivity, low reliability

high sensitivity, low specificity

Pathogenesis is the term used to describe the sequence of cellular and tissue events that occur from the time of first contact with an etiologic agent until the disease becomes evident. What is another way of defining pathogenesis? - What sets the disease process in motion - How the disease process evolves - Multiple factors that predispose a person to a particular disease - The causes of disease

how the disease process evolves

In 2014, an outbreak of Ebola virus disease began in West Africa in which there was a sharp increase in the number of people being diagnosed with this disease. At the same time, a very high proportion of those who were diagnosed died from the disease. The epidemiologic characteristics of this disease include: - high prevalence and increased incidence. - increased incidence and high mortality. - increased morbidity and high prevalence. - high morbidity and mortality.

increased incidence and high mortality

Despite using the same screening tools as previous years (which have been confirmed as highly valid, reliable, sensitive, and specific), the public health nurse notes an increase in the number of people in the population testing positive for type 2 diabetes this year. What action should the nurse take? - Examine the commonalities of those people who did not test positive for diabetes. - Send all people who test positive to a laboratory for assessment using a different diagnostic test. - Ask all people who tested positive to return to the screening clinic to be retested. - Investigate the population for factors that would cause an increase in the prevalence of diabetes.

investigate the population for factors that would cause an increase in the prevalence of diabetes

A disease agent can affect more than one organ of the body, and more than one disease agent can affect the same organ of the body. Which term best describes this aspect of disease etiology? - Singular cause - Complicated and hard to diagnose - Multifactorial in origin - Simple and less complex to diagnose

multifactorial in origin

A nurse is conducting a staff development program on the Healthy People 2030 determinants of health. The nurse notes that the participants need additional education based on which statement? - Health promotion is an important part of nursing practice. - Nursing practice should include interventions that focus on disease prevention. - Nursing practice should focus solely on the management of chronic disease. - Nurses should work toward the elimination of health disparities.

nursing practice should focus solely on the management of chronic disease

A public health nurse is working in a rural community that has experienced a sudden increase in people diagnosed with hepatitis C virus. What will the nurse focus on in an epidemiological investigation of this situation?

patterns and characteristics influencing incidence rates

The nurse is caring for a client in the burn unit who has sustained partial and full thickness burns over 16 percent of the body. What type of etiologic factor does the nurse recognize these burns are? - Psychological factors - Physical forces - Chemical agents - Biologic agents

physical forces

A client has been diagnosed with a heart attack and has been placed on beta-blockers to reduce the workload on the heart, as well as a statin drug and a low-fat diet to lower cholesterol. Which level of prevention of disease would these therapies be classified?

tertiary

A client has been admitted to the intensive care unit with a myocardial infarction. After the client recovers from the acute course of the event and ready for discharge, the nurse provides information about the beta adrenergic blocker, atenolol, that the client will take to prevent complications after the MI. What type of prevention is the nurse providing? - Secondary prevention - Tertiary prevention - Initial prevention - Primary prevention

tertiary prevention

Which information should a public nurse collect when assessing components of the social determinants of health in a population? Select all that apply. - unemployment rate - prevalence of chronic illness - education levels - overall mortality rates - Crime rates

unemployment rate, education levels, crime rates

When the nurse questions the blood glucose level obtained via a glucometer, a serum blood level is ordered. This protocol is directed toward ensuring which measure of standardization? - Reliability - Validity - Standardization - Predictability

validity

A newly introduced diagnostic test has been found to produce unacceptably low levels of reliability. The nurse should recognize that the test: - yields inconsistent results when repeated. - does not actually measure what it purports to measure. - does not reflect the status of the population as a whole. - is impractical to implement in daily practice.

yields inconsistent results when repeated