Test Bank for Understanding Pathophysiology, 7th Edition
g g g g g g
by Huether and McCance
g g g g
Ch.g1g#1gAtganginternationalgnursinggconference,gmanygdiscussionsgandgbreakoutgsessi
onsgfocusedgongthegWorldgHealthgOrganizationg(WHO)gviewsgonghealth.gOfgthegfollowin
ggcommentsgmadegbygnursesgduringgagdiscussiongsession,gwhichgstatementsgwouldgbeg
consideredgaggoodgrepresentationgofgthegWHOgdefinition?gSelectgallgthatgapply.g
A)gInterestsgingkeepinggthegelderlygpopulationgengagedgingsuchgactivitiesgasgbookgrevie
wsgandgwordggamesgduringgsocialgtimeg
B)gIncreasegingthegnumbergofgchairgaerobicsgclassesgprovidedgingthegskilledgcaregfacilitie
sg
C)gInterventionsggearedgtowardgkeepinggthegelderlygpopulationgdiagnosedgwithgdiabete
sgmellitusgundergtightgbloodgglucosegcontrolgbygprovidinggin-homegcookinggclassesg
D)gProvidinggtransportationgforgrenalgdialysisgpatientsgtogandgfromgtheirghemodialysisgse
ssionsg
E)gProvidingghandwashinggteachinggsessionsgtogaggroupgofgyounggchildreng-
gANSWERgAns:gA,gB,gC,gE
ThegWHOgdefinitiongofghealthgisgdefinedgasg"agstategofgcompletegphysical,gmental,gandgs
ocialgwell-
beinggandgnotgmerelygthegabsencegofgdiseasegandginfirmity."gEngaginggingbookgreviewsg
facilitatesgmentalgandgsocialgwell-being;gchairgaerobicsghelpsgfacilitategphysicalgwell-
being;gandgassistinggwithgtightgcontrolgofgdiabetesghelpsgwithgfacilitatinggphysicalgwell-
beinggevengthoughgthegpersonghasgagchronicgdisease.gHandwashinggisgvitalgingthegprev
entiongofgdiseasegandgspreadgofggerms.
Ch.g1g#2gAgcommunityghealthgnursegisgteachinggaggroupgofgrecentggraduatesgaboutgthegl
argegvarietygofgfactorsgthatginfluencegangindividual'sghealthgorglackgthereof.gThegnursegis
greferringgtogthegHealthygPeopleg2020greportgfromgthegU.S.gDepartmentgof gHealthgandgH
umangServicesgasgagteachinggexample.gOfgthegfollowinggaspectsgdiscussed,gwhichgwou
ldgbegconsideredgagdeterminantgofghealthgthatgisgoutsidegthegfocusgofgthisgreport?g
A)gThegclientghasgagdiversegbackgroundgbygbeinggofgAsiangandgNativegAmericangdesce
ntgandgpracticesgvariousgalternativegtherapiesgtogminimizegeffectsgofgstress.g
B)gThegclientghasgagfamilyghistorygofgcardiovasculargdiseasegrelatedgtoghypercholesterol
emiagandgremainsgnoncompliantgwithgthegtreatmentgregime.gC)gThegclientghasgaggoodgc
areergwithgexceptionalgpreventativeghealthgcaregbenefits.g
D)gThegclientglivesgingangaffluent,gclean,gsuburbangcommunitygwithgaccessgtogmanygheal
thgcaregfacilities.g-gANSWERgAns:gBg
IngHealthygPeopleg2020,gthegfocusgisgtogpromoteggoodghealthgtogallg(suchgasgusinggalter
nativegtherapiesgtogminimizegeffectsgofgstress);gachievingghealthgequitygandgpromotingg
healthgforgallg(whichgincludesghavingggoodghealthgcaregbenefits);gandgpromotingggoodgh
ealthg(whichgincludesglivinggingagcleangcommunitygwithggoodgaccessgtoghealthgcare).gAgc
lient'sgnoncompliancegwithgtreatmentsgtogcontrolghighgcholesterolglevelsgwithingthegpres
encegofgagfamilyghistorygofgCVgdiseasegdoesgnotgmeetgtheg"attainingglivesgfreegofgpreven
tablegdiseasegandgprematuregdeath"gdeterminant.
Ch.g1g#3gAgphysiciangisgprovidinggcaregforgagnumbergofgpatientsgongagmedicalgunitgofgagla
rge,guniversityghospital.gThegphysiciangisgdiscussinggwithgagcolleaguegthegdifferentiation
,gbetweengdiseasesgthatgaregcausedgbygabnormalgmoleculesgandgdiseasesgthatgcausegdi
sease.gWhichgofgthegfollowinggpatientsgmostgclearlygdemonstratesgthegconsequencesgo
fgmoleculesgthatgcausegdisease?g
A)gAg31-year-
oldgwomangwithgsicklegcellganemiagwhogisgreceivinggagtransfusiongofgpackedgredgbloodgc
ellsg
B)gAg91-year-
oldgwomangwhoghasgexperiencedgangischemicgstrokegresultinggfromgfamilialghyperchole
sterolemiag
C)gAg19-year-
oldgmangwithgexacerbationgofghisgcysticgfibrosisgrequiringgoxygengtherapygandgchestgph
ysiotherapyg
D)gAg30-year-
oldghomelessgmangwhoghasgPneumocystisgcariniigpneumoniag(PCP)gandgisgHIVgpositiv
e.g-gANSWERgAns:gD
PCPgisgangexamplegofgthegeffectgofgagmoleculegthatgdirectlygcontributesgtogdisease.gSickl
egcellganemia,gfamilialghypercholesterolemia,gandgcysticgfibrosisgaregallgexamplesgofgthe
geffectsgofgabnormalgmolecules.
Ch.g1g#4gAgmembergofgtheghealthgcaregteamgisgresearchinggthegetiologygandgpathogene
sisgofgagnumbergofgclientsgwhogaregunderghisgcaregingaghospitalgcontext.gWhichgofgthegfoll
owinggaspectsgofgclients'gsituationsgbestgcharacterizesgpathogenesisgrathergthangetiolo
gy?g
A)gAgclientgwhoghasgbeengexposedgtogthegMycobacteriumgtuberculosisgbacteriumg
B)gAgclientgwhoghasgincreasinggserumgammoniaglevelsgduegtoglivergcirrhosisg
C)gAgclientgwhogwasgadmittedgwithgthegeffectsgofgmethylgalcoholgpoisoningg
D)gAgclientgwithgmultiplegskeletalginjuriesgsecondarygtogagmotorgvehiclegaccidentg-
gANSWERgAns:gB
Pathogenesisgrefersgtogthegprogressivegandgevolutionarygcoursegofgdisease,gsuchgasgth
egincreasinggammoniaglevelsgthatgaccompanyglivergdisease.gBacteria,gpoisons,gandgtra
umaticginjuriesgaregexamplesgofgetiologicgfactors.
Ch.g1g#5gAgnewgmyocardialginfarctiongpatientgrequiringgangioplastygandgstentgplacemen
tghasgarrivedgtoghisgfirstgcardiacgrehabilitationgappointment.gIngthisgfirstgsession,gagrevie
wgofgthegpathogenesisgofgcoronarygarterygdiseasegisgaddressed.gWhichgstatementgbygth
egpatientgverifiesgtogthegnursegthatgheghasgunderstoodgthegnurse'sgteachingsgaboutgcoro
narygarterygdisease?
A)g"AllgIghavegtogdogisgstopgsmoking,gandgthengIgwon'tghaveganygmoregheartgattacks."g
B)g"Mygarterygwasgcloggedgbygfat,gsogIgwillgneedgtogstopgeatinggfattygfoodsglikegFrenchgfri
esgeverygday."g
C)g"Soundsglikegthisgbegangbecausegofginflammationginsidegmygarterygthatgmadegitgeasy
gtogformgfattygstreaks,gwhichgleadgtogmygcloggedgartery."g
D)g"IfgIgdognotgexercisegregularlygtoggetgmygheartgrategup,gbloodgpoolsgingthegveinsgcausi
nggagclotgthatgstopsgbloodgflowgtogthegmuscle,gandgIgwillghavegagheartgattack."g-
gANSWERgAns:gC
Thegtruegetiology/causegofgcoronarygarterygdiseaseg(CAD)gisgunknown;ghowever,gthegp
athogenesisgofgthegdisordergrelatesgtogthegprogressiongofgtheginflammatorygprocessgfro
mgagfattygstreakgtogthegocclusivegvesselglesiongseengingpeoplegwithgcoronarygarterygdise
ase.gRiskgfactorsgforgCADgrevolvegaroundgcigarettegsmoking,gdietghighgingfat,gandglackgo
fgexercise.
,Ch.g1g#6gAg77-year-
oldgmangisgaghospitalginpatientgadmittedgforgexacerbationgofghisgchronicgobstructivegpul
monarygdiseaseg(COPD),gandgagrespiratorygtherapistg(RT)gisgassessinggthegclientgforgth
egfirstgtime.gWhichgofgthegfollowinggaspectsgofgthegpatient'sgcurrentgstategofghealthgwould
gbegbestgcharacterizedgasgagsymptomgrathergthangagsign?g
A)gThegpatient'sgoxygengsaturationgisg83%gbygpulsegoxymetry.g
B)gThegpatientgnotesgthatgheghasgincreasedgworkgofgbreathinggwhenglyinggsupine.g
C)gThegRTghearsgdiminishedgbreathgsoundsgtogthegpatient'sglowerglunggfieldsgbilaterally.
g
D)gThegpatient'sgrespiratorygrategisg31gbreaths/minute.g-gANSWERgAns:gB
Symptomsgaregsubjectivegcomplaintsgbygthegpersongexperiencinggtheghealthgproblem,g
suchgasgcomplaintsgofgbreathinggdifficulty.gOxygenglevels,glisteninggtogbreathgsounds,ga
ndgrespiratorygrategaregallgobjective,gobservablegsignsgofgdisease.
Ch.g1g#7gWhichgofgthegfollowinggsituationsgwouldgbegclassifiedgasgagcomplicationgofgagdi
seasegorgoutcomegfromgthegtreatmentgregimen?gSelectgallgthatgapply.g
A)gMassivegpulmonarygemboligfollowinggdiagnosisgofgnew-onsetgatrialgfibrillationg
B)gBurning,gintensegincisiongpaingfollowinggsurgerygtogremovegagportiongofgcolongduegtogi
ntestinalgaganglionosisg
C)gDevelopmentgofgpulmonarygfibrosisgfollowinggtreatmentgwithgbleomycin,gangantibioti
cgchemotherapygagentgusedgingtreatmentgofglymphomag
D)gGradualgdeteriorationgingabilitygtogwalkgunassistedgforgagpatientgdiagnosedgwithgParki
nsongdiseaseg
E)gLossgofgshort-termgmemorygingagpatientgdiagnosedgwithgAlzheimergdiseaseg-
gANSWERgAns:gA,gC
Developmentgofgpulmonarygemboligandgpulmonarygfibrosisgfollowinggchemotherapygare
gbothgexamplesgofgagcomplicationg(adversegextensionsgofgagdiseasegorgoutcomegfromgtr
eatment).gItgisgnormalgtogexpectgincisionalgpaingfollowinggsurgery.gAsgParkinsongdiseas
egprogresses,gtheginabilitygtogwalkgindependentlygisgexpected.gThisgisgagnormalgprogres
siongforgpeoplegdiagnosedgwithgParkinson's.gLossgofgshort-
termgmemorygingagpatientgdiagnosedgwithgAlzheimergdiseasegisgangexpectedgfinding.
Ch.g1g#8gLaboratorygtestinggisgorderedgforgagmalegpatientgduringgagclinicgvisitgforgagroutin
egfollow-
upgassessmentgofghypertension.gWhenginterpretingglabgvalues,gthegnursegknowsgthatg
A)gagnormalgvaluegrepresentsgthegtestgresultsgthatgfallgwithingthegbellgcurve.g
B)gifgtheglabgresultgisgabovegtheg50%gdistribution,gthegresultgisgconsideredgelevated.g
C)gallglabgvaluesgaregadjustedgforggendergandgweight.g
D)gifgthegresultgofgagverygsensitivegtestgisgnegative,gthatgdoesgnotgmeangthegpersongisgdis
easegfree.g-gANSWERgAns:gA
Whatgisgtermedgagnormalgvaluegforgaglaboratorygtestgisgestablishedgstatisticallygfromgres
ultsgobtainedgfromgagselectedgsamplegofgpeople.gAgnormalgvaluegrepresentsgthegtestgres
ultsgthatgfallgwithingthegbellgcurvegorgtheg95%gdistribution.gSomeglabgvaluesg(likeghemogl
obin)garegadjustedgforggender,gothergcomorbidities,gorgage.gIfgthegresultgofgagverygsensiti
vegtestgisgnegative,gitgtellsgusgthegpersongdoesgnotghavegthegdisease,gandgthegdiseasegh
asgbeengruledgoutgorgexcluded.
Ch.g1g#9gTheglaboratorygtechnologistsgaregdiscussinggagnewgbloodgtestgthatghelpsgestab
lishgagdifferentialgdiagnosisgbetweengshortnessgofgbreathgwithgagcardiacgetiologygandgsh
ortnessgofgbreathgwithgagrespiratory/pulmonarygetiology.gAgpositivegresultgisgpurportedgt
, ogindicategagcardiacgetiology.gThegmarketersgofgthegtestgreportgthatg99.8%gofgpatientsgw
hoghavegconfirmedgcardiacgetiologiesgtestgpositivegingthegtest.gHowever,g1.3%gofgpatient
sgwhogdognotghavegcardiacgetiologiesgforgtheirgshortnessgofgbreathgalsogtestgpositive.gW
hichgofgthegfollowinggstatementsgbestgcharacterizesgthisgbloodgtest?
A)gLowgvalidity;ghighgreliabilityg
B)gHighgsensitivity;glowgspecificityg
C)gHighgspecificity;glowgreliabilityg
D)gHighgsensitivity;glowgreliabilityg-gANSWERgAns:gB
Aglargegnumbergofgpatientsgwouldgreceivegthegcorrectgpositivegdiagnosisg(highgsensitivit
y),gwhilegagsignificantgnumbergwouldgreceivegagfalse-
positivegdiagnosisg(lowgspecificity).gTheginformationggivengdoesgnotgindicateglowgreliabil
itygorglowgvalidity.
Ch.g1g#10gAsgpartgofgagscreeninggprogramgforgprostategcancer,gmengatgagseniorgcitizens'
gcentergareghavinggtheirgbloodglevelsgofgprostate-
specificgantigeng(PSA)gmeasured.gWhichgofgthegfollowinggstatementsgwouldgbestgchara
cterizegaghighgpositivegpredictivegvaluegbutgaglowgnegativegpredictivegvaluegforgthisgscre
eninggtest?
A)gAllgofgthegmengwhoghadghighgPSAglevelsgdevelopedgprostategcancer;gseveralgmengw
hoghadglowgPSAglevelsgalsogdevelopedgprostategcancer.g
B)gAllgofgthegmengwhoghadglowgPSAglevelsgweregcancer-
free;gseveralgmengwhoghadghighglevelsgalsogremainedgfreegofgprostategcancer.g
C)gMengwhoghadglowgPSAglevelsgalsogdisplayedgfalse-
positivegresultsgforgprostategcancer;gmengwithghighglevelsgweregoftengfalselygdiagnosedg
withgprostategcancer.g
D)gThegtestgdisplayedglowgsensitivitygbutghighgspecificity.g-gANSWERgAns:gA
Thegtest'sginabilitygtogrulegoutgcancergwithgaglowgPSAglevelgindicatesgaglowgnegativegpre
dictivegvalue.gAnswergBgsuggestsgaghighgnegativegpredictivegvalue,gwhileganswergCgindi
catesgaglowgpositivegpredictivegvalue.gHighgpositivegpredictivegvaluegisgassociatedgwithg
highgsensitivity
Ch.g1g#11gAgmaleginternationalgbusinessgtravelerghasgreturnedgfromgagtripgtogIndonesia.g
Whilegthere,gheghiredgagprostitutegforgcompanionshipgandgengagedgingunprotectedgsexg
ongmoregthangonegoccasion.gUnbeknownstgtoghim,gthisgprostitutegharboredgtheghepatitis
gCgvirus.gUpongreturngtogthegUnitedgStates,ghegexhibitedgnogsymptomsgandgreturnedgtog
hisgusualgactivities.gDuringgthisgperiodgofgnogoutwardgsymptoms,gthegmangwouldgbegclas
sifiedgasgbeinggin
A)gthegpreclinicalgstagegofgdisease.g
B)gremissiongandgunlikelygtogdevelopghepatitisgC.g
C)gthegclinicalgdiseasegstagegofghepatitisgC.g
D)gthegchronicgphasegofghepatitisgC.g-gANSWERgAns:gA
Duringgthegpreclinicalgstage,gthegdiseasegisgnotgclinicallygevidentgbutgisgdestinedgtogprog
ressgtogclinicalgdisease.
Ch.g1g#12gAsgofgNovemberg1,g2012,gtheregweregagtotalgofg10gconfirmedgcasesgofgHantav
irusginfectiongingpeoplegwhogweregrecentgvisitorsg(mid-
JunegtogendgofgAugust,g2012)gtogYosemitegNationalgPark.gThreegvisitorsgwithgconfirmedg
casesgdied.gHealthgofficialsgbelievegthatg9goutgofgtheg10gpeoplegwithgHantavirusgweregex
posedgwhilegstayinggingCurrygVillagegingthegSignaturegTentgCabins.gThisgisgangexampleg
of
g g g g g g
by Huether and McCance
g g g g
Ch.g1g#1gAtganginternationalgnursinggconference,gmanygdiscussionsgandgbreakoutgsessi
onsgfocusedgongthegWorldgHealthgOrganizationg(WHO)gviewsgonghealth.gOfgthegfollowin
ggcommentsgmadegbygnursesgduringgagdiscussiongsession,gwhichgstatementsgwouldgbeg
consideredgaggoodgrepresentationgofgthegWHOgdefinition?gSelectgallgthatgapply.g
A)gInterestsgingkeepinggthegelderlygpopulationgengagedgingsuchgactivitiesgasgbookgrevie
wsgandgwordggamesgduringgsocialgtimeg
B)gIncreasegingthegnumbergofgchairgaerobicsgclassesgprovidedgingthegskilledgcaregfacilitie
sg
C)gInterventionsggearedgtowardgkeepinggthegelderlygpopulationgdiagnosedgwithgdiabete
sgmellitusgundergtightgbloodgglucosegcontrolgbygprovidinggin-homegcookinggclassesg
D)gProvidinggtransportationgforgrenalgdialysisgpatientsgtogandgfromgtheirghemodialysisgse
ssionsg
E)gProvidingghandwashinggteachinggsessionsgtogaggroupgofgyounggchildreng-
gANSWERgAns:gA,gB,gC,gE
ThegWHOgdefinitiongofghealthgisgdefinedgasg"agstategofgcompletegphysical,gmental,gandgs
ocialgwell-
beinggandgnotgmerelygthegabsencegofgdiseasegandginfirmity."gEngaginggingbookgreviewsg
facilitatesgmentalgandgsocialgwell-being;gchairgaerobicsghelpsgfacilitategphysicalgwell-
being;gandgassistinggwithgtightgcontrolgofgdiabetesghelpsgwithgfacilitatinggphysicalgwell-
beinggevengthoughgthegpersonghasgagchronicgdisease.gHandwashinggisgvitalgingthegprev
entiongofgdiseasegandgspreadgofggerms.
Ch.g1g#2gAgcommunityghealthgnursegisgteachinggaggroupgofgrecentggraduatesgaboutgthegl
argegvarietygofgfactorsgthatginfluencegangindividual'sghealthgorglackgthereof.gThegnursegis
greferringgtogthegHealthygPeopleg2020greportgfromgthegU.S.gDepartmentgof gHealthgandgH
umangServicesgasgagteachinggexample.gOfgthegfollowinggaspectsgdiscussed,gwhichgwou
ldgbegconsideredgagdeterminantgofghealthgthatgisgoutsidegthegfocusgofgthisgreport?g
A)gThegclientghasgagdiversegbackgroundgbygbeinggofgAsiangandgNativegAmericangdesce
ntgandgpracticesgvariousgalternativegtherapiesgtogminimizegeffectsgofgstress.g
B)gThegclientghasgagfamilyghistorygofgcardiovasculargdiseasegrelatedgtoghypercholesterol
emiagandgremainsgnoncompliantgwithgthegtreatmentgregime.gC)gThegclientghasgaggoodgc
areergwithgexceptionalgpreventativeghealthgcaregbenefits.g
D)gThegclientglivesgingangaffluent,gclean,gsuburbangcommunitygwithgaccessgtogmanygheal
thgcaregfacilities.g-gANSWERgAns:gBg
IngHealthygPeopleg2020,gthegfocusgisgtogpromoteggoodghealthgtogallg(suchgasgusinggalter
nativegtherapiesgtogminimizegeffectsgofgstress);gachievingghealthgequitygandgpromotingg
healthgforgallg(whichgincludesghavingggoodghealthgcaregbenefits);gandgpromotingggoodgh
ealthg(whichgincludesglivinggingagcleangcommunitygwithggoodgaccessgtoghealthgcare).gAgc
lient'sgnoncompliancegwithgtreatmentsgtogcontrolghighgcholesterolglevelsgwithingthegpres
encegofgagfamilyghistorygofgCVgdiseasegdoesgnotgmeetgtheg"attainingglivesgfreegofgpreven
tablegdiseasegandgprematuregdeath"gdeterminant.
Ch.g1g#3gAgphysiciangisgprovidinggcaregforgagnumbergofgpatientsgongagmedicalgunitgofgagla
rge,guniversityghospital.gThegphysiciangisgdiscussinggwithgagcolleaguegthegdifferentiation
,gbetweengdiseasesgthatgaregcausedgbygabnormalgmoleculesgandgdiseasesgthatgcausegdi
sease.gWhichgofgthegfollowinggpatientsgmostgclearlygdemonstratesgthegconsequencesgo
fgmoleculesgthatgcausegdisease?g
A)gAg31-year-
oldgwomangwithgsicklegcellganemiagwhogisgreceivinggagtransfusiongofgpackedgredgbloodgc
ellsg
B)gAg91-year-
oldgwomangwhoghasgexperiencedgangischemicgstrokegresultinggfromgfamilialghyperchole
sterolemiag
C)gAg19-year-
oldgmangwithgexacerbationgofghisgcysticgfibrosisgrequiringgoxygengtherapygandgchestgph
ysiotherapyg
D)gAg30-year-
oldghomelessgmangwhoghasgPneumocystisgcariniigpneumoniag(PCP)gandgisgHIVgpositiv
e.g-gANSWERgAns:gD
PCPgisgangexamplegofgthegeffectgofgagmoleculegthatgdirectlygcontributesgtogdisease.gSickl
egcellganemia,gfamilialghypercholesterolemia,gandgcysticgfibrosisgaregallgexamplesgofgthe
geffectsgofgabnormalgmolecules.
Ch.g1g#4gAgmembergofgtheghealthgcaregteamgisgresearchinggthegetiologygandgpathogene
sisgofgagnumbergofgclientsgwhogaregunderghisgcaregingaghospitalgcontext.gWhichgofgthegfoll
owinggaspectsgofgclients'gsituationsgbestgcharacterizesgpathogenesisgrathergthangetiolo
gy?g
A)gAgclientgwhoghasgbeengexposedgtogthegMycobacteriumgtuberculosisgbacteriumg
B)gAgclientgwhoghasgincreasinggserumgammoniaglevelsgduegtoglivergcirrhosisg
C)gAgclientgwhogwasgadmittedgwithgthegeffectsgofgmethylgalcoholgpoisoningg
D)gAgclientgwithgmultiplegskeletalginjuriesgsecondarygtogagmotorgvehiclegaccidentg-
gANSWERgAns:gB
Pathogenesisgrefersgtogthegprogressivegandgevolutionarygcoursegofgdisease,gsuchgasgth
egincreasinggammoniaglevelsgthatgaccompanyglivergdisease.gBacteria,gpoisons,gandgtra
umaticginjuriesgaregexamplesgofgetiologicgfactors.
Ch.g1g#5gAgnewgmyocardialginfarctiongpatientgrequiringgangioplastygandgstentgplacemen
tghasgarrivedgtoghisgfirstgcardiacgrehabilitationgappointment.gIngthisgfirstgsession,gagrevie
wgofgthegpathogenesisgofgcoronarygarterygdiseasegisgaddressed.gWhichgstatementgbygth
egpatientgverifiesgtogthegnursegthatgheghasgunderstoodgthegnurse'sgteachingsgaboutgcoro
narygarterygdisease?
A)g"AllgIghavegtogdogisgstopgsmoking,gandgthengIgwon'tghaveganygmoregheartgattacks."g
B)g"Mygarterygwasgcloggedgbygfat,gsogIgwillgneedgtogstopgeatinggfattygfoodsglikegFrenchgfri
esgeverygday."g
C)g"Soundsglikegthisgbegangbecausegofginflammationginsidegmygarterygthatgmadegitgeasy
gtogformgfattygstreaks,gwhichgleadgtogmygcloggedgartery."g
D)g"IfgIgdognotgexercisegregularlygtoggetgmygheartgrategup,gbloodgpoolsgingthegveinsgcausi
nggagclotgthatgstopsgbloodgflowgtogthegmuscle,gandgIgwillghavegagheartgattack."g-
gANSWERgAns:gC
Thegtruegetiology/causegofgcoronarygarterygdiseaseg(CAD)gisgunknown;ghowever,gthegp
athogenesisgofgthegdisordergrelatesgtogthegprogressiongofgtheginflammatorygprocessgfro
mgagfattygstreakgtogthegocclusivegvesselglesiongseengingpeoplegwithgcoronarygarterygdise
ase.gRiskgfactorsgforgCADgrevolvegaroundgcigarettegsmoking,gdietghighgingfat,gandglackgo
fgexercise.
,Ch.g1g#6gAg77-year-
oldgmangisgaghospitalginpatientgadmittedgforgexacerbationgofghisgchronicgobstructivegpul
monarygdiseaseg(COPD),gandgagrespiratorygtherapistg(RT)gisgassessinggthegclientgforgth
egfirstgtime.gWhichgofgthegfollowinggaspectsgofgthegpatient'sgcurrentgstategofghealthgwould
gbegbestgcharacterizedgasgagsymptomgrathergthangagsign?g
A)gThegpatient'sgoxygengsaturationgisg83%gbygpulsegoxymetry.g
B)gThegpatientgnotesgthatgheghasgincreasedgworkgofgbreathinggwhenglyinggsupine.g
C)gThegRTghearsgdiminishedgbreathgsoundsgtogthegpatient'sglowerglunggfieldsgbilaterally.
g
D)gThegpatient'sgrespiratorygrategisg31gbreaths/minute.g-gANSWERgAns:gB
Symptomsgaregsubjectivegcomplaintsgbygthegpersongexperiencinggtheghealthgproblem,g
suchgasgcomplaintsgofgbreathinggdifficulty.gOxygenglevels,glisteninggtogbreathgsounds,ga
ndgrespiratorygrategaregallgobjective,gobservablegsignsgofgdisease.
Ch.g1g#7gWhichgofgthegfollowinggsituationsgwouldgbegclassifiedgasgagcomplicationgofgagdi
seasegorgoutcomegfromgthegtreatmentgregimen?gSelectgallgthatgapply.g
A)gMassivegpulmonarygemboligfollowinggdiagnosisgofgnew-onsetgatrialgfibrillationg
B)gBurning,gintensegincisiongpaingfollowinggsurgerygtogremovegagportiongofgcolongduegtogi
ntestinalgaganglionosisg
C)gDevelopmentgofgpulmonarygfibrosisgfollowinggtreatmentgwithgbleomycin,gangantibioti
cgchemotherapygagentgusedgingtreatmentgofglymphomag
D)gGradualgdeteriorationgingabilitygtogwalkgunassistedgforgagpatientgdiagnosedgwithgParki
nsongdiseaseg
E)gLossgofgshort-termgmemorygingagpatientgdiagnosedgwithgAlzheimergdiseaseg-
gANSWERgAns:gA,gC
Developmentgofgpulmonarygemboligandgpulmonarygfibrosisgfollowinggchemotherapygare
gbothgexamplesgofgagcomplicationg(adversegextensionsgofgagdiseasegorgoutcomegfromgtr
eatment).gItgisgnormalgtogexpectgincisionalgpaingfollowinggsurgery.gAsgParkinsongdiseas
egprogresses,gtheginabilitygtogwalkgindependentlygisgexpected.gThisgisgagnormalgprogres
siongforgpeoplegdiagnosedgwithgParkinson's.gLossgofgshort-
termgmemorygingagpatientgdiagnosedgwithgAlzheimergdiseasegisgangexpectedgfinding.
Ch.g1g#8gLaboratorygtestinggisgorderedgforgagmalegpatientgduringgagclinicgvisitgforgagroutin
egfollow-
upgassessmentgofghypertension.gWhenginterpretingglabgvalues,gthegnursegknowsgthatg
A)gagnormalgvaluegrepresentsgthegtestgresultsgthatgfallgwithingthegbellgcurve.g
B)gifgtheglabgresultgisgabovegtheg50%gdistribution,gthegresultgisgconsideredgelevated.g
C)gallglabgvaluesgaregadjustedgforggendergandgweight.g
D)gifgthegresultgofgagverygsensitivegtestgisgnegative,gthatgdoesgnotgmeangthegpersongisgdis
easegfree.g-gANSWERgAns:gA
Whatgisgtermedgagnormalgvaluegforgaglaboratorygtestgisgestablishedgstatisticallygfromgres
ultsgobtainedgfromgagselectedgsamplegofgpeople.gAgnormalgvaluegrepresentsgthegtestgres
ultsgthatgfallgwithingthegbellgcurvegorgtheg95%gdistribution.gSomeglabgvaluesg(likeghemogl
obin)garegadjustedgforggender,gothergcomorbidities,gorgage.gIfgthegresultgofgagverygsensiti
vegtestgisgnegative,gitgtellsgusgthegpersongdoesgnotghavegthegdisease,gandgthegdiseasegh
asgbeengruledgoutgorgexcluded.
Ch.g1g#9gTheglaboratorygtechnologistsgaregdiscussinggagnewgbloodgtestgthatghelpsgestab
lishgagdifferentialgdiagnosisgbetweengshortnessgofgbreathgwithgagcardiacgetiologygandgsh
ortnessgofgbreathgwithgagrespiratory/pulmonarygetiology.gAgpositivegresultgisgpurportedgt
, ogindicategagcardiacgetiology.gThegmarketersgofgthegtestgreportgthatg99.8%gofgpatientsgw
hoghavegconfirmedgcardiacgetiologiesgtestgpositivegingthegtest.gHowever,g1.3%gofgpatient
sgwhogdognotghavegcardiacgetiologiesgforgtheirgshortnessgofgbreathgalsogtestgpositive.gW
hichgofgthegfollowinggstatementsgbestgcharacterizesgthisgbloodgtest?
A)gLowgvalidity;ghighgreliabilityg
B)gHighgsensitivity;glowgspecificityg
C)gHighgspecificity;glowgreliabilityg
D)gHighgsensitivity;glowgreliabilityg-gANSWERgAns:gB
Aglargegnumbergofgpatientsgwouldgreceivegthegcorrectgpositivegdiagnosisg(highgsensitivit
y),gwhilegagsignificantgnumbergwouldgreceivegagfalse-
positivegdiagnosisg(lowgspecificity).gTheginformationggivengdoesgnotgindicateglowgreliabil
itygorglowgvalidity.
Ch.g1g#10gAsgpartgofgagscreeninggprogramgforgprostategcancer,gmengatgagseniorgcitizens'
gcentergareghavinggtheirgbloodglevelsgofgprostate-
specificgantigeng(PSA)gmeasured.gWhichgofgthegfollowinggstatementsgwouldgbestgchara
cterizegaghighgpositivegpredictivegvaluegbutgaglowgnegativegpredictivegvaluegforgthisgscre
eninggtest?
A)gAllgofgthegmengwhoghadghighgPSAglevelsgdevelopedgprostategcancer;gseveralgmengw
hoghadglowgPSAglevelsgalsogdevelopedgprostategcancer.g
B)gAllgofgthegmengwhoghadglowgPSAglevelsgweregcancer-
free;gseveralgmengwhoghadghighglevelsgalsogremainedgfreegofgprostategcancer.g
C)gMengwhoghadglowgPSAglevelsgalsogdisplayedgfalse-
positivegresultsgforgprostategcancer;gmengwithghighglevelsgweregoftengfalselygdiagnosedg
withgprostategcancer.g
D)gThegtestgdisplayedglowgsensitivitygbutghighgspecificity.g-gANSWERgAns:gA
Thegtest'sginabilitygtogrulegoutgcancergwithgaglowgPSAglevelgindicatesgaglowgnegativegpre
dictivegvalue.gAnswergBgsuggestsgaghighgnegativegpredictivegvalue,gwhileganswergCgindi
catesgaglowgpositivegpredictivegvalue.gHighgpositivegpredictivegvaluegisgassociatedgwithg
highgsensitivity
Ch.g1g#11gAgmaleginternationalgbusinessgtravelerghasgreturnedgfromgagtripgtogIndonesia.g
Whilegthere,gheghiredgagprostitutegforgcompanionshipgandgengagedgingunprotectedgsexg
ongmoregthangonegoccasion.gUnbeknownstgtoghim,gthisgprostitutegharboredgtheghepatitis
gCgvirus.gUpongreturngtogthegUnitedgStates,ghegexhibitedgnogsymptomsgandgreturnedgtog
hisgusualgactivities.gDuringgthisgperiodgofgnogoutwardgsymptoms,gthegmangwouldgbegclas
sifiedgasgbeinggin
A)gthegpreclinicalgstagegofgdisease.g
B)gremissiongandgunlikelygtogdevelopghepatitisgC.g
C)gthegclinicalgdiseasegstagegofghepatitisgC.g
D)gthegchronicgphasegofghepatitisgC.g-gANSWERgAns:gA
Duringgthegpreclinicalgstage,gthegdiseasegisgnotgclinicallygevidentgbutgisgdestinedgtogprog
ressgtogclinicalgdisease.
Ch.g1g#12gAsgofgNovemberg1,g2012,gtheregweregagtotalgofg10gconfirmedgcasesgofgHantav
irusginfectiongingpeoplegwhogweregrecentgvisitorsg(mid-
JunegtogendgofgAugust,g2012)gtogYosemitegNationalgPark.gThreegvisitorsgwithgconfirmedg
casesgdied.gHealthgofficialsgbelievegthatg9goutgofgtheg10gpeoplegwithgHantavirusgweregex
posedgwhilegstayinggingCurrygVillagegingthegSignaturegTentgCabins.gThisgisgangexampleg
of
