Essentials of Pathophysiology: Chapter 1 - Health & Disease Q&A, Exams of Nursing

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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? a) Preclinical stage b) Carrier status c) Chronic disease d) Clinical disease - correct answer ✅✅b) Carrier status In carrier status, the client shows no symptoms, tests positive for the disease, and may still transmit the disease but is not infected. Chronic disease is a long-term, continuous process. In the preclinical stage of a disease, a client may show no symptoms but will progress to clinical disease. In clinical disease, the condition is overtly present. There are three fundamental types of prevention used in health care: primary, secondary, and tertiary. Which statement accurately describes secondary prevention? a) Secondary prevention is often accomplished outside the health care system at the community level. b) Secondary prevention goes beyond treating the problem with which the person presents.

Pathophysiology------- Chap. 1: Concepts

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c) Secondary prevention takes place within health care systems and involves the services of a number of different types of health care professionals. d) Secondary prevention detects disease early, and most is done in clinical settings. - correct answer ✅✅d) Secondary prevention detects disease early, and most is done in clinical settings. Secondary prevention detects disease early in its course when it is still asymptomatic and treatment measures can effect a cure or stop the disease from progressing. Most secondary prevention is undertaken in clinical settings. Tertiary prevention goes beyond treating the presenting problem. Tertiary prevention programs are located within health care systems and involve the services of a number of different types of health care professionals. Primary prevention is often accomplished outside the health care system at the community level. Why are some diseases termed syndromes? a) They have complications. b) They leave sequelae (e.g., lesions) and residual effects. c) They are a compilation of signs and symptoms characteristic of a specific disease state. d) They are a group of disease states that has the same etiology. - correct answer ✅✅c) They are a compilation of signs and symptoms characteristic of a specific disease state.

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Secondary prevention focuses on screening and early disease identification, such as checking the blood glucose levels of a large number of individuals to identify potential cases of diabetes. Wound treatment and medication administration would be considered tertiary interventions, and education would be considered primary prevention. An occupational therapist conducts a group therapy program called MindWorks with older adults who have diagnoses of dementia and Alzheimer's 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) Prognosis enhancement b) Tertiary prevention c) Secondary prevention d) Primary prevention - correct answer ✅✅b) Tertiary prevention Interventions aimed at slowing the course of an already-diagnosed disease characterize tertiary prevention. 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 type of study is the epidemiologist most likely conducting?

Pathophysiology------- Chap. 1: Concepts

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a) Cohort study b) Cross-sectional study c) Risk factor study d) Case-control study - correct answer ✅✅d) Case-control study In this study, the mothers with cardiac-affected babies would be the case group, while the mothers of healthy infants would serve as a control. This study does not possess the characteristics of a cohort or cross-sectional study, and risk factor study is not an existing methodology. 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? a) Congenital condition b) Acquired defect c) A chronic defect d) An acute defect - correct answer ✅✅a) Congenital condition Congenital conditions are defects that are present at birth, although they may not be evident until later in life or may never manifest. Congenital conditions may be caused by genetic influences, environmental factors, maternal drug use, irradiation, or gestational problems in utero, or a combination of genetic and environmental factors.

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c) Disease outcome d) Effects of screening programs e) Priority for services - correct answer ✅✅c) Disease outcome e) Priority for services d) 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. 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? a) Condition b) Etiology c) Clinical manifestations d) Signs - correct answer ✅✅b) Etiology The causes of disease are known as etiologic factors. Which assessment data would a nurse identify as a complication of a disease or disorder?

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a) Reduced range of motion following a fracture b) Pulmonary emboli following deep vein thrombosis (DVT) c) Weight gain of 1 to 2 pounds per week during pregnancy d) Hyperlipidemia in cardiovascular disease - correct answer ✅✅b) Pulmonary emboli following deep vein thrombosis (DVT) Pulmonary emboli are a dangerous complication of DVT. Sequelae are lesions or impairments that follow or are caused by a disease. Reduced range of motion following a fracture is a common, often temporary, result of the injury. Weight gain of 1 to 2 pounds per week during pregnancy is considered normal. Hyperlipidemia is a common cause of cardiovascular disease, not the result of the disease. The nurse is discussing care in the prenatal stages with a client that is planning a pregnancy. Which statement by the client demonstrates an understanding of prevention of a congenital condition? a) "My blood pressure medication will not affect the baby since it was prescribed by my doctor last year." b) "As long as I am past the 1st trimester, I can drink wine or take over-the- counter medication." c) "I will not drink alcohol or take any medication without approval from my physician during pregnancy."

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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 - correct answer ✅✅1) Gathering a list of risk factors such as age and family history

2. Performing a stool for occult blood test
3. Performing a colonoscopy to observe for polyps
4. Performing a tissue biopsy for cell morphology The nurse should explain that the first step in screening is identifying those at risk to determine who in a population should be tested. For colon cancer, people over the age of 50 are selected for screening. The members of the population who are deemed at sufficient degree of risk would then be asked to take a screening test, which is a secondary level prevention measure. In the case of colon cancer, this screening test is the stool for occult blood. Next, those who test positive for stool for occult blood would be referred for colonoscopy to see if polyps or other lesions are apparent. Finally, if polyps or other lesions exist, a biopsy would be sent for analysis; this biopsy is the definitive way to diagnose colon cancer. A nurse documenting a client's health history places hypertension under which category?

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a) Acquired b) Congenital c) Mortality d) Complications - correct answer ✅✅a) Acquired An acquired condition, such as hypertension, is caused by events that occur after birth 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? a) Just because they both test positive does not mean the child will get the disease. b) The test must be wrong since neither have signs or symptoms of the disease. c) The couple will eventually have the disease. d) They are both carriers of the disease and can pass the gene on to their unborn child if the woman becomes pregnant. - correct answer ✅✅d) They are both carriers of the disease and can pass the gene on to their unborn child if the woman becomes pregnant.

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having an increased work of breathing, being itchy or feeling short of breath are subjective and, therefore, these data must be collected from the client's perspective as symptoms. 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? a) Biologic agents b) Physical forces c) Chemical agents d) Psychological factors - correct answer ✅✅b) Physical forces The causes of disease are known as etiologic factors. Among the recognized etiologic agents are biologic agents (e.g., bacteria, viruses), physical forces (eg., trauma, burns, radiation), chemical agents (e.g., poisons, alcohol), one's genetic inheritance, and nutritional excess or defects. 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? a) These statistics are recorded so pharmaceutical companies may compile the data to determine future need.

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b) The government requires the statistics in order to calculate the crude mortality rate. c) These statistics are useful in terms of anticipating health care needs, planning public-education programs, directing health research efforts, and allocating health care dollars. d) These statistics are required by the hospital to inform the WHO for the coding of the cause of death. - correct answer ✅✅c) These statistics are useful in terms of anticipating health care needs, planning public-education programs, directing health research efforts, and allocating health care dollars. Mortality statistics are very useful in predicting the needs of clients with similar symptoms, as well as planning future therapeutic interventions. Crude mortality rate does not require these factors. The International Classification of Diseases (ICD) by the WHO is used for coding the cause of death but is not required by the WHO. 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?

Pathophysiology------- Chap. 1: Concepts

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colleague that the purpose of discarding the first drop is to improve the reliability of the results. Reliability of a diagnostic result depends on a combination of the tools being used and the person's skill in taking the measurements. If the colleague does not perform the steps correctly, the reliability of the results are in question. The nurse should remind the colleague as to why the step of wiping away the initial drop is important for reliability. This approach is the most direct and professional of the options provided. Reporting the colleague to the nurse in charge would only be needed if the colleague did not heed the nurse's direction. Retaking the sample without first explaining to the colleague why the nurse was taking the action would be confusing for the colleague and the client. Threatening the nurse regarding disciplinary action is not necessary in this scenario. 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) A client who has been exposed to the mycobacterium tuberculosis bacterium b) A client who has increasing serum ammonia levels due to liver cirrhosis c) A client who was admitted with the effects of methyl alcohol poisoning

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d) A client with multiple skeletal injuries secondary to a motor vehicle accident - correct answer ✅✅b) A client who has increasing serum ammonia levels due to liver cirrhosis Pathogenesis refers to the progressive and evolutionary course of disease, such as the increasing ammonia levels that accompany liver disease. Bacteria, poisons, and traumatic injuries are examples of etiologic factors that set a disease in motion. Which client conditions would be considered a congenital defect? Select all that apply. a) Cleft lip and palate b) Colon cancer c) Club foot d) Hypospadias e) Rheumatoid arthritis - correct answer ✅✅c) Club foot d) Hypospadias a) Cleft lip and palate Congenital defects are present at birth and occur as a result of neonatal factors and may be influenced by genetic influences, environmental factors, maternal drug use, and radiation. Acquired defects are those that develop as a result of events after birth, including exposure to infectious agents, injury, inadequate nutrition, lack of oxygen, inappropriate immune response, and neoplasia.

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diagnosis. Therefore, incidence helps predict the risk of being diagnosed with a certain condition in a population. Morbidity and mortality statistics provide information about the functional effects (morbidity) and death-producing (mortality) characteristics of a disease. 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) A 31-year-old woman with sickle cell anemia who is receiving a transfusion of packed red blood cells b) A 91-year-old woman who has experienced an ischemic stroke resulting from familial hypercholesterolemia c) A 19-year-old man with exacerbation of his cystic fibrosis requiring oxygen therapy and chest physiotherapy. d) A 30-year-old homeless man who has pneumocystis carinii pneumonia (PCP) and is HIV positive. - correct answer ✅✅d) A 30-year-old homeless man who has pneumocystis carinii pneumonia (PCP) and is HIV positive. PCP is an example of the effect of a molecule that directly contributes to disease. Sickle cell anemia, familial hypercholesterolemia, and cystic fibrosis are all examples of the effects of abnormal molecules.

Pathophysiology------- Chap. 1: Concepts

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The nurse documents which assessment data as a symptom? a) Report of pain b) Elevated temperature c) Pinpoint pupil size d) Enlarged lymph node - correct answer ✅✅a) Report of pain A symptom is a subjective complaint that is noted by the person with a disorder, whereas a sign is a manifestation that is noted by an observer. A report of pain is a symptom, which is a subjective complaint. Temperature, pupil size, and lymph node enlargement are signs that can be observed by another person. A new client who suffered a myocardial infarction requires angioplasty and stent placement. He 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 client verifies to the nurse that he has understood the nurse's teachings about coronary artery disease? a) "All I have to do is stop smoking and then I won't have any more heart attacks." b) "My artery was clogged by fat so I will need to stop eating fatty foods like french fries every day."