Porth's Ch.2 The Point Flashcards
Which purpose is primarily taken into account with the study of epidemiology? Select all that apply.
- The occurrence of disease in humans
Particular diseases are affected by factors such as eating habits.
- Disease patterns that occur within a specific population
- How infectious diseases spread
- Risk factors that contribute to singular-faceted diseases
- The occurrence of disease in humans
- Particular diseases are affected by factors such as eating habits.
- Disease patterns that occur within a specific population
- How infectious diseases spread
A nurse researcher is collecting data on the number of people who have been diagnosed with diabetes in a local population at a given time. Which term best categorizes the aspect of epidemiology the nurse is collecting?
- Prevalence
- Mortality
- Morbidity
- Incidence
Prevalence
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 client who was admitted with the effects of methyl alcohol poisoning
- A client who has increasing serum ammonia levels due to liver cirrhosis
- A client with multiple skeletal injuries secondary to a motor vehicle accident
- A client who has been exposed to the mycobacterium tuberculosis bacterium
A client who has increasing serum ammonia levels due to liver cirrhosis
Which attribute is a benefit of health care providers using an evidence-based practice guideline?
- With continued use, it will decrease healing time for clients.
- Once a practice guideline is well developed, it does not require modification.
- It directs research into forming a diagnosis and treatment for a certain condition.
- It uses one research method for delivery of care.
It directs research into forming a diagnosis and treatment for a certain condition.
Rationale: Evidence-based practice guidelines often use methods to combine evidence from different studies to produce a more precise estimate of the accuracy of a diagnostic method or the effects of an intervention method. Practice guidelines require continuous updates as new research is conducted and supported. Practice guidelines are developed on numerous research studies. Not all research is directed toward healing time.
The nurse evaluates a client for manifestations of a disease. Which assessment data is a symptom of a disorder? Select all that apply.
- Dilated pupils
- Itching
- Pain
- Tachycardia
- Dizziness
- Skin rash
- Itching
- Pain
- Dizziness
Rationale: Diseases produce clinical manifestations. Signs are manifestations that can be observed objectively such as changes in vital signs, exudate, rash, and changes in pupil size. Symptoms are subjective manifestations that cannot be measured objectively and include pain, dizziness, itching, and difficulty breathing.
Which actions will a nurse teach as primary prevention of disease? Select all that apply.
- taking antihypertensives for clients post MI
- colonoscopy at age 50 and every 10 years
- annual Pap test for women
- daily foot inspection by clients with DM
- MMR vaccination to school-aged children
- wearing a seat belt when in a motor vehicle
MMR vaccination to school-aged children, wearing a seat belt when in a motor vehicle.
Rationale: Primary prevention is intended to prevent a client from acquiring a disease by removing all risk factors. These measures include vaccines, healthy lifestyles, and safety interventions such as seat belts. Secondary prevention focuses on early detection and treatment and would include diagnostic testing according to protocols. Tertiary prevention is for clients who already have a disease or disorder, and are intended to minimize the impact of the disease by preventing further deterioration and reducing complications. These activities include medications that help regulate a disease, community support, and examinations for complications.
When the nurse questions the blood glucose level obtained via a glucometer, a serum blood level is ordered. This protocol is directed toward ensuring which measure of standardization?
- Reliability
- Predictability
- Validity
- Standardization
Validity
Rationale: Validity refers to the extent to which a measurement tool measures what it is intended to measure, and is assessed by comparing a measurement method with the best possible method of measure that is available. Thus, the validity of a fingerstick method of testing blood glucose is compared with serum testing in the laboratory. Reliability refers to the extent to which an observation, if repeated, gives the same result. Predictive value is the extent to which an observation or test result is able to predict the presence of a given disease or condition. In the field of clinical laboratory measurements, standardization is aimed at increasing the accuracy and reliability of measured values.
The World Health Organization (WHO) defines health as:
the absence of disease and infirmity.
the ability to perform activities of daily living.
a state of complete physical, mental, and social well-being.
what an individual defines as his or her health.
a state of complete physical, mental, and social well-being.
Which clients are exhibiting sequelae of disease? Select all that apply.
A client who has a prescribed serologic test and has discovered she is positive for human immunodeficiency virus.
A toddler who develops bronchiolitis after being treated for respiratory syncytial virus (RSV)
A client with diabetes who has developed a loss of vision.
A client who has a mastectomy to treat stage T3 breast cancer.
An older adult client who experienced liver failure after overdosing on acetaminophen in a suicide attempt.
- A toddler who develops bronchiolitis after being treated for respiratory syncytial virus (RSV)
- A client with diabetes who has developed a loss of vision.
Rationale: Sequelae are lesions or impairments that follow or are caused by a disease. Children who develop RSV, for example, frequently have bronchiolitis in the months and years following. Cancer, liver failure, and HIV are not normally the direct pathophysiologic consequences of other diseases. Retinopathy is a common sequela of diabetes.
The nurse documents which assessment data as a symptom?
- Elevated temperature
- Enlarged lymph node
- Report of pain
- Pinpoint pupil size
Report of pain
Rationale: 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 client tested positive for a streptococcal bacteria but is not exhibiting signs or symptoms of infection. This client is said to be in carrier status. Which statement is true?
- The client cannot infect others.
- The client can spread the bacteria to others.
- The client will likely test negative within 1 week.
- The client needs to be isolated until a negative test is produced.
The client can spread the bacteria to others.
Rationale: Carrier status refers to an individual who harbors and organism but is not infected or demonstrating clinical manifestations. A carrier will not test negative within 1 week, and can spread the organism to others.
When considering the clinical course, a disease that is characterized by remissions and exacerbations is considered to be:
- chronic.
- subclinical.
- preclinical.
- acute.
Chronic
Rationale: The clinical course describes the evolution of a disease. A disease can have an acute or chronic course. Chronic disease implies a continuous, long-term process. A chronic disease can run a continuous course or can present with exacerbations (aggravation of symptoms and severity of the disease) and remissions (a period during which there is a decrease in severity and symptoms). An acute disorder is one that is relatively severe, but self-limiting. The terms preclinical and subclinical are used when discussing the severity of the disease.
Which action is an example of a nurse delivering care at the tertiary care level?
- Informing a new mother about childhood immunizations
- Participating in an education program about bicycle safety
- Teaching a client how to care for a temporary wound drain
- Educating a diabetic client about good foot care
Educating a diabetic client about good foot care
Rationale: Tertiary prevention is directed at clinical interventions that prevent further deterioration or reduce the complications of a disease once it has been diagnosed. Educating a diabetic client about good foot care will not eliminate or prevent the disease process but will help prevent further deterioration. Teaching wound care is an example of secondary level of care. Immunizations and education directed toward preventing an illness or injury are examples of the primary level of care.
A client diagnosed with chlamydia asks the nurse how this infection has occurred. The explanation by the nurse would involve a description of which aspect of the disease?
- Pathogenesis
- Etiology
- Histology
- Morphology
Pathogenesis
Rationale: Pathogenesis is the sequence of cellular and tissue events that take place from the time of initial contact with an etiologic agent until the ultimate expression of a disease. The causes of disease are known as etiologic factors. Morphology refers to the fundamental structure or form of cells or tissues. Histology deals with the study of the cells and extracellular matrix of body tissues.
A client has tested positive for the tuberculosis antibody but is not exhibiting signs of the disease. This client is considered to be in which stage of the disease process?
- Subacute
- Preclinical
- Acute
- Subclinical
Subclinical
Rationale: Subclinical disease is not clinically apparent and is not destined to become clinically apparent. It is diagnosed with antibody or culture tests. Most cases of tuberculosis are not clinically apparent, and evidence of their presence is established by skin tests. Clinical disease is manifested by signs and symptoms. A persistent chronic infectious disease persists for years, sometimes for life. A disease can be acute (relatively severe, but self-limiting), chronic (continuous or episodic, but taking place over a long period), or subacute (not as severe as acute or as prolonged as chronic).
