Chapter 1: Concept of Health and Disease PrepU Questions

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 documents which assessment data as a symptom?

report of pain

The nurse evaluates a client for manifestations of a disease. Which assessment data is a sign of a disorder? Select all that apply.

Dilated pupils Tachycardia Skin rash

What do morbidity and mortality statistics refer to?

Functional effects and death-producing characteristics of a disease

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

A nurse who has worked with ostomy clients for several years is adept at measuring and cutting the stoma wafer to the correct size for each client's stoma. This is an example of the nurse using:

clinical expertise

Why are some diseases termed syndromes?

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

Which question is an example of an epidemiologic study?

Does smoking cause heart disease?

The nurse evaluates a client for manifestations of a disease. Which assessment data is a symptom of a disorder? Select all that apply.

Pain Dizziness Itching

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

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

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

epidemiology

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

Cleft lip and palate Club foot Hypospadias

Which term is given to the progression and projected outcome of a disease without any medical intervention?

natural history

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?"

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?

validility

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 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%

After teaching a client, the nurse wants to see if the client understands the risk factors for heart disease. Which response by the client would indicate the need for further instruction?

"I will switch from smoking to chewing tobacco."

The nurse is educating a client who will be having a series of diagnostic tests. The clients asks the nurse, "What is the importance of me having all of these tests? I told the physician I know what is wrong with me!" What is the best response by the nurse?

"The physician wants to validate what he believes the client problem is."

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 reliability in the readings of the UAP.

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

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.

Following assessment of a newly admitted client, which assessment results indicate the client has pathophysiology? Select all that apply.

Bruit is heard over the carotid artery. Crepitus often occurs with knee flexion.

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 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 used a prescription medication prescribed by her physician during the first trimester of pregnancy before realizing she was pregnant, which caused a facial deformity in her infant. Which term best descirbes how to categorize this infant's condition?

Congenital condition

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)

The nurse is counseling a group of clients about screening and diagnosing colon cancer. Place in order, from least to most specific for colon cancer, the diagnostic procedures involved. Use all the options.

Gathering a list of risk factors such as age and family history Performing a stool for occult blood test Performing a colonoscopy to observe for polyps Performing a tissue biopsy for cell morphology

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

Getting a complete history Performing a careful physical examination Diagnostic testing

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

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.

A physician is examining a college student who is exhibiting the classic symptoms of schizophrenia. In the course of the evaluation, the physician begins developing a treatment strategy based on what he knows about the disease, available therapies, medications, and consequences of not following the treatment regimen. What aspect of the disease is the physician using?

Natural history

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 diagnostic testing. Determine the most likely cause of the client's presentation.

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.

Physical forces Genetic inheritance Excess nutrition

A school nurse discovers that a student has head lice. Which action describes how epidemiology will best help contain the lice?

Promote effective treatment intervention

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.

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.

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%.

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 health care needs, planning public-education programs, directing health research efforts, and allocating health care dollars.

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

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:

accident prevention.

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

acquired

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 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

The nurse is caring for a client that has been a 2 pack per day smoker for 20 years and developed emphysema 5 years ago. The client has had 3 to 4 admissions per year related to this illness. What form of illness does this client have?

chronic illness

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

clinical

The health care team is attempting to determine the cause of a client's disease. What does the nurse recognize that this will be documented as?

etiology

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.

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:

increased incidence and high mortality.

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

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.