Ch.1: Concepts of Health and Disease

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.

- Obtain clinical history - Conduct a physical examination - Perform diganostic testing - Determine the most likely cause of the clients presentation

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?

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

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?

Multifactorial in origin

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?"

An obese client develops osteoarthritis. Which factors will the nurse include when educating the client about the etiology of the disease? Select all that apply.

- Genetic inheritance - Excess nutrition - Physical forces

Which actions will a nurse teach as secondary prevention of disease? Select all that apply.

- Annual pap test for women - Colonscopy at age 50 and every 10 years

Which client conditions would be considered a congenital defect? Select all that apply.

- Cleft lip and palate - Club foot - Hypospadias

Which actions will a nurse teach as tertiary prevention to reduce complications of a disease? Select all that apply.

- Daily foot inspection by clients with diabetes mellitus - Taking beta adrenergic blockers following a heart attack

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.

- Detailed physical examination - Diagnostic tests - A careful history

For a physician to diagnose a client, which process must be followed? Select all that apply.

- Diagnostic testing - Performing a careful physical examination - Getting a complete history

Which client conditions illustrate acquired defects? Select all that apply.

- Rheumatoid arthritis - Colon cancer

A daycare provides daily services to 60 children from 3 months to 5 years of age. Fifteen of the children have experienced an outbreak of diarrhea within the past week. The incidence rate of diarrhea among the children cared for by this daycare is at what percent?

25%

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?

95%

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 who has increasing serum ammonia levels due to liver cirrhosis

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?

A lack of realibility in the readings of the UAP

The nurse is performing an assessment on a client who states she fell and twisted her right ankle during a softball game. The nurse notes that the right ankle is edematous and will probably need to be x-rayed. What term does the nurse use to describe the changes that accompany this finding?

A sign

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

A nurse documenting a client's health history places hypertension under which category?

Acquired

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?

Acquired defect

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?

Carrier 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?

Carrier status

A client is diagnosed with Crohn's disease and is informed that there is no cure; however, the client will have periods when there are no symptoms nor periods of exacerbations. Which type of clinical course does the nurse determine the client will have?

Chronic

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?

Chronic

When considering the clinical course, a disease that is characterized by remissions and exacerbations is considered to be:

Chronic

A nurse is interpreting the test results of a client's screening test for cancer. If the client's result is negative and the test has a 95% specificity, the nurse should conclude that there a 95% chance of which outcome?

Client does not have cancer.

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

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?

Cohort

Researchers have designed a study where the health of a large group of babies will be followed for several years. What type of study is this?

Cohort

A client delivers a child born with an extra digit. The client states that she had the same thing when she was born. What term would the nurse document in the record regarding this defect?

Congenital condition

The Framingham cohort study examined characteristics of people who would later develop which disease?

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

Signs and symptoms describe the structural and functional changes that accompany a disease. Symptoms are what the client describes to the caregiver. Signs are what the caregiver observes. Which is considered a sign?

Elevated white cell count and fever of 101.5°F (38.6°C)

Which science is called on to study the risk factors in multifactorial diseases?

Epidemiology

What do morbidity and mortality statistics refer to?

Functional effects and death-producing characteristics of a disease

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

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?

How the disease process evolves

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?

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

Which attribute is a benefit of health care providers using an evidence-based practice guideline?

It directs research into forming a diagnosis and treatment for a certain condition.

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?

Physical forces

The nurse is conducting a staff educational program on screening tests. The nurse determines that the participants understand the information when they identify the proportion of true positive test results in a given population as being:

Positive predictive value

A nurse researcher is collecting data on the number of people who have been diagnosed with diabetes in a local population at a given time. Which term best categorizes the aspect of epidemiology the nurse is collecting?

Prevalence

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

The nurse is conducting a community program about removing the risk factors that may predispose clients to hypertension. Which type of prevention is the nurse focusing on?

Primary prevention

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?

Primary prevention

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?

Tertiary prevention

The nurse documents which assessment data as a symptom?

Report of pain

There are three fundamental types of prevention used in health care: primary, secondary, and tertiary. Which statement accurately describes secondary prevention?

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

Which statement is an example of a prognosis?

The client's chance of a full recovery is 50%.

Why are some diseases termed syndromes?

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

A couple is seeking genetic counseling because they want to have a child but are concerned about having the genetic disorder, Tay-Sachs. They both test positive for the trait but have no symptoms themselves. What does the nurse recognize is the outcome of this process?

They are both carriers of the disease and can pass the gene on to their unborn child if the woman becomes pregnant.

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?

Validity

A client with hypertension is given an IV medication and has an anaphylactic reaction. This is considered to be:

a complication.

Facility policies on wound dressing selection refer the nurse to a dressing algorithm. The nurse anticipates that the algorithm will include:

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

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:

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