Patho final
Which of the following situations would be classified as a complication of a disease or outcome from the treatment regimen? Select all that apply.
A. Development of pulmonary fibrosis following treatment with bleomycin, an antibiotic chemotherapy agent used in treatment of lymphoma D. Massive pulmonary emboli following diagnosis of new-onset atrial fibrillation
A new myocardial infarction patient requiring angioplasty and stent placement 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 patient verifies to the nurse that he has understood the nurse's teachings about coronary artery disease?
B. "Sounds like this began because of inflammation inside my artery that made it easy to form fatty streaks, which lead 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 of the following statements would best characterize a high positive predictive value but a low negative predictive value for this screening test?
A. All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer.
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 of the following types of study is the epidemiologist most likely conducting?
A. 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 of the following statements best conveys an accurate epidemiological characterization of the disease?
A. High morbidity; low mortality; high prevalence, low incidence
An occupational therapist conducts a group therapy program called MindWorks with older adults who have diagnoses of dementia and Alzheimer 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. Tertiary prevention
The neuroscience nursing unit has developed a set of step-by-step directions of what should occur if a nursing assessment reveals that the patient may be exhibiting clinical manifestations of a cerebrovascular accident (CVA). Which of the following statements about clinical practice guidelines are accurate? Select all that apply.
A. The development of evidence-based practice guidelines requires a research review from different studies to develop the most accurate diagnostic method to implement. C. 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. D. A meta-analysis could be utilized to combine evidence from different studies to produce a more accurate diagnostic method.
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 United States, he exhibited no symptoms and returned to his usual activities. During this period of no outward symptoms, the man would be classified as being in
C. the preclinical stage of disease.
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 of the following aspects of clients' situations best characterizes pathogenesis rather than etiology?
B. A client who has increasing serum ammonia levels due to liver cirrhosis
A multidisciplinary health care team operates a program aimed at the prevention, identification, and treatment of diabetes on a large Indian reservation. Which of the following aspects of the program would be most likely to be classified as secondary prevention?
B. Staffing a booth where community residents who are attending a baseball tournament can have their blood glucose levels checked
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 of the following statements most accurately captures a guiding principle of the nurse's task?
B. The guidelines will combine individual expertise with external systematic evidence.
Laboratory testing is ordered for a male patient during a clinic visit for a routine follow-up assessment of hypertension. When interpreting lab values, the nurse knows that
B. a normal value represents the test results that fall within the bell curve.
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
B. cohort study.
As of November 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 people with Hantavirus were exposed while staying in Curry Village in the Signature Tent Cabins. This is an example of
B. the incidence of people who are at risk for developing Hantavirus while staying in Yosemite National Park.
As part of a community class, student nurses are developing a class 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 vehicles. This is an example of which type of 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 of the following aspects of the patient's current state of health would be best characterized as a symptom rather than a sign?
C. The patient notes that he has increased work of breathing when lying supine.
A physician is providing care for a number of patients 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 diseases that cause disease. Which of the following patients most clearly demonstrates the consequences of molecules that cause disease?
D. A 30-year-old homeless man who has Pneumocystis carinii pneumonia (PCP) and is HIV positive.
The laboratory technologists 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 purported to indicate a cardiac etiology. The marketers of the test report that 99.8% of patients who have confirmed cardiac etiologies test positive in the test. However, 1.3% of patients who do not have cardiac etiologies for their shortness of breath also test positive. Which of the following statements best characterizes this blood test?
D. High sensitivity; low specificity
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?
D. The client has a family history of cardiovascular disease related to hypercholesterolemia and remains noncompliant with the treatment regime.
At an international nursing conference, many discussions and breakout sessions focused on the World Health Organization (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.
Interventions geared toward keeping the elderly population diagnosed with diabetes mellitus under tight blood glucose control by providing in-home cooking classes Providing handwashing teaching sessions to a group of young children Interests in keeping the elderly population engaged in such activities as book reviews and word games during social time Increase in the number of chair aerobics classes provided in the skilled care facilities
