Norris Porth's Essentials of Pathophysiology------- Chap. 1: Concepts of Health and Disease

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

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.

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.

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.

c) They are a compilation of signs and symptoms characteristic of a specific disease state.

A syndrome is a compilation of signs and symptoms (e.g., chronic fatigue syndrome) that are characteristic of a specific disease state. Complications are possible adverse extensions of a disease or outcomes from treatment. Sequelae are lesions or impairments that follow or are caused by a disease. There is no name for a group of disease states that all have the same cause.

A multidisciplinary healthcare team operates a program aimed at the prevention, identification, and treatment of diabetes on a large Indian reservation. Which aspect of the program would most likely be classified as secondary prevention?

a) Administering oral antihyperglycemic medications to clients who have a diagnosis of diabetes.

b) Teaching school children how a nutritious, traditional diet can lessen their chances of developing adult-onset diabetes.

c) Staffing a booth where community residents who are attending a baseball tournament can have their blood glucose levels checked.

d) Regularly scheduled wound dressing changes for clients who have foot ulcers secondary to peripheral neuropathy and impaired wound healing.

c) Staffing a booth where community residents who are attending a baseball tournament can have their blood glucose levels checked.

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

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?

a) Cohort study

b) Cross-sectional study

c) Risk factor study

d) Case-control study

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

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.

An infant has a difficult time passing through the birth canal and the physician uses forceps to deliver the child. In the process, the facial nerve was damaged, resulting in a facial droop. Which condition does the nurse recognize this to be?

a) Pathogenesis

b) Acquired defect

c) Morphologic change

d) Congenital condition

b) Acquired defect

Acquired defects are those that are caused by events that occur after birth. These include injury, exposure to infectious agents, inadequate nutrition, lack of oxygen, inappropriate immune responses, and neoplasia. Congenital conditions are defects that are present at birth, although they may not be evident until later in life or may never manifest. Morphologic changes are concerned with both the gross anatomic and microscopic changes that are characteristic of a disease. Pathogenesis explains how the disease process evolves.

A nursing student asks the professor why it is important to study the natural history of a disease. Which response to the student is most accurate for the professor to include regarding the importance of knowing the natural history of a disease? Select all that apply.

a) Risk factors to eliminate.

b) Morbidity rates

c) Disease outcome

d) Effects of screening programs

e) Priority for services

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

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?

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

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."

d) "I will limit my alcohol intake while I am pregnant."

c) "I will not drink alcohol or take any medication without approval from my physician during pregnancy."

Congenital conditions are defects that are present at birth, although they may not be evident until later in life or may never manifest. They may be caused by maternal drug use or alcohol intake. There is no data that describes a "safe" amount of alcohol or drug use and it is preferable for the woman to abstain from alcohol use. Medications that may have been deemed safe while not pregnant, such as antihypertensives, may not be safe for the fetus during pregnancy.

A client is taking a synthetic thyroid hormone for the treatment of hypothyroidism. The client develops signs and symptoms of hyperthyroidism. The nurse refers to this adverse extension of disease development as:

a) complications.

b) sequelae.

c) a new diagnosis.

d) syndrome.

a) complications

Complications are possible adverse extensions of a disease or outcomes from treatment. A syndrome is a compilation of signs and symptoms that are characteristic of a specific disease state. Sequelae are lesions or impairments that follow or are caused by a disease.

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

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?

a) Acquired

b) Congenital

c) Mortality

d) Complications

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.

d) They are both carriers of the disease and can pass the gene on to their unborn child if the woman becomes pregnant.

Carrier status refers to a person who harbors an organism but is not infected, as evidenced by antibody response or clinical manifestations. This person still can infect others. Carrier status may be of limited duration or it may be chronic, lasting for months or years.

The nurse evaluates a client for manifestations of a disease. Which assessment data are considered signs? Select all that apply.

a) pain

b) dizziness

c) dilated pupils

d) tachycardia

e) skin rash

f) itching

d) tachycardia

c) dilated pupils

e) skin rash

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 (dyspnea). Although a nurse may observe a client scratching or 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

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.

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.

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?

a) Low validity, high reliability

b) High sensitivity, low specificity

c) High specificity, low reliability

d) High sensitivity, low reliability

b) High sensitivity, low specificity

A large number of clients would receive the correct positive diagnosis (high sensitivity), while a significant number would receive a false-positive diagnosis (low specificity). The information given does not indicate low reliability or low validity.

The nurse notes that a colleague neglects to wipe away the first drop of blood from the sample during point-of-care blood glucose testing; this in contradiction of the unit policy. What action should the nurse take first?

a) Report the colleague to the nurse in charge so that retraining on using the glucometer can be arranged.

b) Remind the colleague that the purpose of discarding the first drop is to improve the reliability of the results.

c) Retake the blood glucose on the client to ensure a more accurate result for guiding treatment decisions.

d) Remind the colleague that by failing to adhere to unit policy, the colleague will be at risk of disciplinary action.

b) Remind the 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

d) A client with multiple skeletal injuries secondary to a motor vehicle accident

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

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.

The nurse interprets a client's potassium level of 3.8 mEq/L (3.8 mmol/L), which falls within the 95% distribution of test results, as:

a) normal.

b) increased.

c) deviated.

d) decreased.

a) normal.

The normal values refer to 95% distribution of test results for the reference population. The value is not increased or decreased as the normal value for potassium in an adult is 3.5 to 5.0 mEq/L (3.8 mmol/L).

A nurse researcher is collecting data on the number of people who have a current diagnosis of diabetes in a local population. Which term categorizes the aspect of epidemiology the nurse is collecting?

a) prevalence

b) morbidity

c) mortality

d) incidence

a) prevalence

The prevalence rate is a measure of an existing disease in a population at a given point in time. An incidence rate reflects the number of new disease cases arising in an at-risk population, not all clients currently living with the 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.

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.

The nurse documents which assessment data as a symptom?

a) Report of pain

b) Elevated temperature

c) Pinpoint pupil size

d) Enlarged lymph node

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."

c) "Sounds like this began because of inflammation inside my artery that made it easy to form fatty streaks which led to my clogged artery."

d) " 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."

c) "Sounds like this began because of inflammation inside my artery that made it easy to form fatty streaks which led to my clogged artery."

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.

A particular disease has a debilitating effect on the ability of sufferers to perform their activities of daily living and is a significant cause of decreased quality of life. However, few people die as a result of the disease's direct effects. There are hundreds of thousands of Canadians living with the disease but relatively few new cases in recent years. This disease has:

a) low mortality, high morbidity, low prevalence, and high incidence.

b) low mortality, high morbidity, high incidence, and low prevalence.

c) high mortality, low morbidity, high incidence, and low prevalence.

d) high morbidity, low mortality, high prevalence, and low incidence.

d) high morbidity, low mortality, high prevalence, and low incidence

Morbidity is associated with quality of life, while mortality is indicative of causation of death. In this case, morbidity is high and mortality is low. Prevalence refers to the number of cases present in a population, while incidence refers to the number of new cases. In this case, prevalence is high, while incidence is low.

The nurse is conducting a staff educational program on screening tests. The nurse determines that the participants understand the information when they identify the proportion of true positive test results in a given population as being:

a) positive predictive value.

b) negative predictive value.

c) incidence.

d) prevalence.

a) positive predictive value.

The proportion of true positive test results in a given population is positive predictive value, so when the participants identify it as such, the nurse determines that they understand the information.

A nurse documenting a client's health history places hypertension under which category?

a) Acquired

b) Congenital

c) Mortality

d) Complications

a) Acquired

An acquired condition, such as hypertension, is caused by events that occur after birth.

As part of a screening program for prostate cancer, men at a senior citizens center are having their blood levels of prostate-specific antigen (PSA) measured. Which statement would best characterize high positive predictive value but low negative predictive value for this screening test?

a) All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer.

b) All of the men who had low PSA levels were cancer-free; several men who had high levels also remained free of prostate cancer.

c) Men who had low PSA levels also displayed false positive results for prostate cancer; men with high levels were often falsely diagnosed with prostate cancer.

d) The test displayed low sensitivity but high specificity.

a) All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer.

The test's inability to rule out cancer with a low PSA level indicates low negative predictive value. The answer "All of the men who had low PSA levels were cancer-free; several men who had high levels also remained free of prostate cancer" suggests high negative predictive value. The answer "Men who had low PSA levels also displayed false positive results for prostate cancer; men with high levels were often falsely diagnosed with prostate cancer" indicates low positive predictive value. High positive predictive value is associated with high sensitivity.

Researchers have designed a study where the health of a large group of recent newborns will be followed for several years. What type of study is this?

a) repetition

b) double-blind placebo

c) case-control

d) cohort

d) cohort

When a certain group of persons are enrolled in study, they are known as a cohort. Cohort members are chosen to have specific similar characteristics. These studies are often longitudinal, following the cohort over time to observe one or more specific health outcomes. A case-control study is done on an individual, case-by-case situation. The double-blind placebo is a drug study. Repetition is a type of study carried out in a laboratory with very tight controls in place.

What do morbidity and mortality statistics refer to?

a) Long-term consequences and recovery rates of a disease

b) Cause of death and impact on the family because of a disease

c) Functional effects and death-producing characteristics of a disease

d) Effects a disease has on a person's life and treatment

c) Functional effects and death-producing characteristics of a disease

Morbidity and mortality statistics provide information about the functional effects (morbidity) and death-producing (mortality) characteristics of a disease. Morbidity statistics do address the effects a disease has on a person's life and the long-term consequences of the disease state, but morbidity and mortality statistics taken together have a broader scope. Neither morbidity nor mortality statistics address recovery rates from a disease or treatment modalities for a disease. Although mortality does address the causes of death in a given population, morbidity does not address the impact the disease state has on the family.

The nurse researcher has gathered the above data. The nurse will apply this data in what type of study?

a) Case-control study

b) Cohort study

c) Longitudinal study

d) Randomized control trial

a) Case-control study

Case-control studies are designed to compare people known to have the outcome of interest (cases) and those known not to have the outcome of interest (controls). In the study outlined, the condition of interest is influenza and the exposure wishing to be measured is vaccination against influenza. This helps the nurse calculate the degree of protection against the condition that may have been created by the vaccine; other influencing factors would need to be controlled. In a cohort study (also called a longitudinal study), people are followed over a period of time to observe a specific health outcome that does not fit the data presented. A randomized control trial of this topic would involve not knowing who received the vaccine prior to gathering the data.

When the nurse is assisting with the diagnostic process for a client with an illness, what is a priority when compiling all of the data to have an accurate diagnosis? Select all that apply.

a) A careful history

b) Detailed physical examination

c) Financial information

d) Diagnostic tests

e) Social data

a) A careful history

b) Detailed physical examination

d) Diagnostic tests

The diagnostic process requires a careful history, physical examination, and diagnostic tests. The history is used to obtain a person's account of his or her symptoms and their progression, and the actors that contribute to a diagnosis. The physical examination is done to observe for signs of altered body structure or function. The diagnostic tests are ordered to validate what is thought to be the problem. They are also performed to determine other possible health problems that were not obtained from the history and physical examination, but may be present given the signs and symptoms identified.

In 2014, an outbreak of Ebola virus disease began in West Africa in which there was a sharp increase in the number of people being diagnosed with this disease. At the same time, a very high proportion of those who were diagnosed died from the disease. The epidemiologic characteristics of this disease include:

a) high prevalence and increased incidence.

b) increased incidence and high mortality.

c) high morbidity and mortality.

d) increased morbidity and high prevalence.

b) increased incidence and high mortality.

Incidence is the rate of new cases of a disease and mortality is the death rate associated with it; Ebola is associated with high incidence and mortality. Morbidity consists of the functional effects of a disease and prevalence is the proportion of the population currently living with a disease.

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?

a) Validity

b) Standardization

c) Reliability

d) Predictability

a) Validity

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.

Reference:

A nurse is conducting a staff educational program on diagnostic tests. The nurse should include that the normal value of a laboratory test represents the test results that fall within which distribution level?

a) 75%

b) 80%

c) 95%

d) 100%

c) 95%

The normal value of a laboratory test represents the test results that fall within the 95% distribution level.

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) A client who has been exposed to the mycobacterium tuberculosis bacterium.

b) A client who is 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.

b) A client who is 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.

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?

a) Low validity, high reliability

b) High sensitivity, low specificity

c) High specificity, low reliability

d) High sensitivity, low reliability

b) High sensitivity, low specificity

A large number of clients would receive the correct positive diagnosis (high sensitivity), while a significant number would receive a false-positive diagnosis (low specificity). The information given does not indicate low reliability or low validity.