Patho ch1

A nursing student asks the professor why it is important to study the natural history of a disease. Which response to the student is most accurate for the professor to include regarding the importance of knowing the natural history of a disease? Select all that apply.

Disease outcome Priority for services Effects of screening programs + Knowledge of the natural history of a disease can be used to determine disease outcomes, establish priorities for health care services, determine effects of screening and early detection programs on disease outcomes, and compare the results of new treatments with the expected outcome minus treatment.

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.

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

Clinical

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 +Persons enrolled in a cohort study (also called a longitudinal study) are followed over a period of time to observe one or more specific health outcomes. A case-control study is done on an individual, case-by-case situation. The double-blind placebo is a drug study. Repetition is a type of study carried out in a laboratory with very tight controls in place.

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?

Congenital condition

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%

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?" + The WHO defines health as a "state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity." For this reason, an assessment question that directly addresses overall well-being is reflective of this definition. The other listed questions are clinically relevant, but none directly reflects the WHO definition of health.

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." + Tobacco use is a strong factor in heart disease no matter what form is used. Overweight clients who implement weight reduction experience benefits even if they are still above their ideal weight. For the average individual, a blood pressure between 90/60 and 120/80 is considered healthy. A healthy hemoglobin A1c is between 4% and 5.6%. Clients at increased risk are those with higher levels.

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.

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

Two years ago, the nurse assisted with a difficult vaginal birth and the infant sustained facial paralysis related to the use of forceps. What form of defect does the nurse recognize this injury is related to?

Acquired defect

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

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.

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

Coronary disease

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 A careful history Diagnostic tests

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 Skin rash Tachycardia

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

Epidemiology +Epidemiology is the study of patterns of disease, such as the spread of a disease in an epidemic. It has also emerged as a science to study the risk factors in multifactorial diseases, such as heart disease and cancer. Scientology is a religion. Morphology refers to the fundamental structure or form of cells or tissues. Histology deals with the study of the cells and extracellular matrix of body tissues.

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

What do morbidity and mortality statistics refer to?

Functional effects and death-producing characteristics of a disease +Morbidity and mortality statistics provide information about the functional effects (morbidity) and death-producing (mortality) characteristics of a disease. Morbidity statistics do address the effects a disease has on a person's life and the long-term consequences of the disease state, but morbidity and mortality statistics taken together have a broader scope. Neither morbidity nor mortality statistics address recovery rates from a disease or treatment modalities for a disease. Although mortality does address the causes of death in a given population, morbidity does not address the impact the disease state has on the family.

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

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

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.

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 + The natural history of a disease refers to the progression and outcome of the disease without medical intervention. Knowledge of the natural history can be used to determine disease outcome, establish services, and compare the results of treatments to the expected outcome without treatment. The causation, etiology, and morbidity are all parts that are necessary in understanding the natural history of the disease.

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

Natural history +The natural history of a disease refers to the way the disease will run its course and the expected outcome of the disease process if medical intervention is not undertaken. Prognosis is the term used to designate the probable outcome and prospect of recovery from a disease. Morbidity describes the effects an illness has on a person's life. It is concerned with the incidence of disease as well as its persistence and long-term consequences. Conditions suspected of contributing to the development of a disease are called risk factors.

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 +Prevalence is a measure of existing disease in a population at a given point in time. Primary prevention is intervention to avoid disease. Morbidity is the functional effect of a disease, such as missed school days. Risk analysis would evaluate which members of the population were at risk for a disease.

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.

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

Which statement is an example of a prognosis?

The client's chance of a full recovery is 50%. + A prognosis refers to the probable outcome and prospect of recovery from disease as demonstrated by "The client's chance of a full recovery is 50%." Stating the ocurrence of a disease in a given population is the incidence. Statements that relate information about causes of death refer to mortality.

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

a complication. +Complications are possible adverse extensions of a disease or outcome from treatment. An example is an anaphylactic reaction to a medication.

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. +Algorithms are step-by-step methods for solving problems. An example would be a decision tree for selection of wound care dressings based on type of wound.