Porth's Essentials of Pathophysiology 5th Edition Test Bank Chapter 1 Concepts of Health and Disease 1. 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. A) Interests in keeping the elderly population engaged in such activities as book reviews and word games during social time B) Increase in the number of chair aerobics classes provided in the skilled care facilities C) Interventions geared toward keeping the elderly population diagnosed with diabetes mellitus under tight blood glucose control by providing in-home cooking classes D) Providing transportation for renal dialysis patients to and from their hemodialysis sessions E) Providing handwashing teaching sessions to a group of young children Ans: A, B, C, E Feedback: The 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. 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? A) The client has a diverse background by being of Asian and Native American descent and practices various alternative therapies to minimize effects of stress. B) The client has a family history of cardiovascular disease related to hypercholesterolemia and remains noncompliant with the treatment regime. C) The client has a good career with exceptional preventative health care benefits. D) The client lives in an affluent, clean, suburban community with access to many health care facilities. Ans: B Feedback: 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). A client's noncompliance with treatments to control high cholesterol levels within the presence of a family history of CV disease does not meet the “attaining lives free of preventable disease and premature death” determinant. Med C 3. 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? 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. Ans: D Feedback: 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. 4. 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 bNesUtRchSaIraNctGerTizBe.s pCaOthMogenesis 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 D) A client with multiple skeletal injuries secondary to a motor vehicle accident Ans: B Feedback: 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.