reviews and word games during social time

• While attending an international nursing conference, many discussions and

break-out sessions focused on the World Health Organization's (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.

• Interests in keeping the older adult 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

• Interventions geared toward keeping the older adult population diagnosed with

diabetes mellitus under tight blood glucose control by providing in-home cooking classes

• Providing transportation for renal dialysis clients to and from their hemodialysis

sessions

• Providing handwashing teaching sessions to a group of young children

Answer: A, B, C, E

Rationale: WHO definition of health is defined as "a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity." Engaging in book reviews facilitates mental and social well-being; chair aerobics helps facilitate physical well-being; and assisting with tight control of diabetes helps with facilitating physical well-being (even though the person has a chronic disease).Handwashing is vital in the prevention of disease and spread of germs.

Question format: Multiple Select

Chapter 1: Concepts of Health and Disease

Cognitive Level: Apply

Client Needs: Safe, Effective Care Environment: Management of Care

Reference: p. 2

• 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?

• The client has a diverse background by being of Asian and Native American/First

Nation descent and practices various alternative therapies to minimize effects of stress.

• The client has a family history of cardiovascular disease related to

hypercholesterolemia and remains noncompliant with the treatment regime.

• The client has a good career with exceptional preventive health care benefits.
• The client lives in an affluent, clean, suburban community with access to many

health care facilities.

Answer: B

(Porth's Essentials of Pathophysiology, 5e Tommie Norris) (Test Bank all Chapters) 1 / 4

Rationale: In Healthy People 2020, the focus is to promote good health to all (such as using alternative therapies to minimize effects of stress); achieving health equity and promoting health for all (which includes having good health care benefits); and promoting good health (which includes living in a clean community with good access to health care). Being noncompliant with treatments to control high cholesterol levels with a family history to CV disease does not meet the "attaining lives free of preventable disease and premature death" goal/objective.

Question format: Multiple Choice

Chapter 1: Concepts of Health and Disease

Cognitive Level: Apply

Client Needs: Health Promotion and Maintenance

Reference: p. 2

• 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 aspect of clients' situations best characterizes pathogenesis rather than etiology?

• A client who has been exposed to the mycobacterium tuberculosis bacterium.
• A client who is has increasing serum ammonia levels due to liver cirrhosis.
• A client who was admitted with the effects of methyl alcohol poisoning.
• A client with multiple skeletal injuries secondary to a motor vehicle accident.

Answer: B

Rationale: 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.

Question format: Multiple Choice

Chapter 1: Concepts of Health and Disease

Cognitive Level: Apply

Client Needs: Physiological Integrity: Physiological Adaptation

Reference: p. 3

• 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?

• "All I have to do is stop smoking and then I won't have any more heart attacks."
• "My artery was clogged by fat so I will need to stop eating fatty foods like french

fries every day."

• "Sounds like this began because of inflammation inside my artery that made it

easy to form fatty streaks which led to my clogged artery."

• " If you do not exercise regularly to get your heart rate up, blood pools in the

veins causing a clot which stops blood flow to the muscle and you have a heart attack."

Answer: C 2 / 4

Rationale: The true etiology/cause of coronary artery disease (CAD) is unknown;

however, the pathogenesis of the disorder relates to the progression of the inflammatory process from a fatty streak to the occlusive vessel lesion seen in people with coronary artery disease. Risk factors for CAD revolve around cigarette smoking, diet high in fat, and lack of exercise.

Question format: Multiple Choice

Chapter 1: Concepts of Health and Disease

Cognitive Level: Apply

Client Needs: Physiological Integrity: Physiological Adaptation

Reference: p. 3

• 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 aspect of the client's current state of health would be best characterized as a symptom rather than a sign?

• The client's oxygen saturation is 83% by pulse oximetry.
• The client notes that he has increased work of breathing when lying supine.
• The RT hears diminished breath sounds to the client's lower lung fields

bilaterally.

• The client's respiratory rate is 31 breaths per minute.

Answer: B

Rationale: Symptoms are subjective reports by the person experiencing the health problem, such as reports of breathing difficulty. Oxygen levels, listening to breath sounds, and respiratory rate are all objective, observable signs of disease.

Question format: Multiple Choice

Chapter 1: Concepts of Health and Disease

Cognitive Level: Analyze

Client Needs: Physiological Integrity: Physiological Adaptation

Reference: p. 5

• Which situation would be classified as a complication of a disease or outcome

from the treatment regimen? Select all that apply.

• Massive pulmonary emboli following diagnosis of new onset atrial fibrillation.
• Burning, intense incision pain following surgery to remove a portion of colon due

to intestinal aganglionosis.

• Development of pulmonary fibrosis following treatment with bleomycin, an

antibiotic chemotherapy agent used in treatment of lymphoma.

• Gradual deterioration in ability to walk unassisted for a client diagnosed with

Parkinson disease.

• Loss of short-term memory in a client diagnosed with Alzheimer disease.

Answer: A, C

Rationale: Development of pulmonary emboli and pulmonary fibrosis following

chemotherapy are both examples of a complication (adverse extensions of a disease or outcome from treatment). It is normal to expect incisional pain following 3 / 4

surgery. As Parkinson disease progresses, the ability to walk independently is expected to decrease. This is a normal progression for people diagnosed with Parkinson disease. Loss of short-term memory in a client diagnosed with Alzheimer disease is an expected finding.

Question format: Multiple Select

Chapter 1: Concepts of Health and Disease

Cognitive Level: Analyze

Client Needs: Physiological Integrity: Physiological Adaptation

Reference: p. 3

• Laboratory testing is ordered for a male client during a clinic visit for routine

follow-up assessment of hypertension. When interpreting lab values, the nurse

knows:

• a normal value represents the test results that fall within the bell curve.
• if the lab result is above the 50% distribution, the result is considered elevated.
• all lab values are adjusted for gender and weight.
• if the result of a very sensitive test is negative, that does not mean the person is

disease free.

Answer: A

Rationale: What is termed a normal value for a laboratory test is established

statistically from results obtained from a selected sample of people. A normal value represents the test results that fall within the bell curve or the 95% distribution.Some lab values (like hemoglobin) are adjusted for gender, other comorbidities, or age. If the result of a very sensitive test is negative, it tells us the person does not have the disease and the disease has been ruled out or excluded.

Question format: Multiple Choice

Chapter 1: Concepts of Health and Disease

Cognitive Level: Analyze

Client Needs: Physiological Integrity: Reduction of Risk Potential

Reference: p. 1

• The laboratory technologists are a 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 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?

• Low validity; high reliability
• High sensitivity, low specificity
• High specificity; low reliability
• High sensitivity; low reliability

Answer: B

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