Pathophysiology Concepts of Altered Health States 8th Edition Test Bank

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Pathophysiology Concepts of Altered Health States 8th Edition Test Bank

ISBN-13: 978-0781766166

ISBN-10: 0781766168



Pathophysiology Concepts of Altered Health States 8th Edition Test Bank

ISBN-13: 978-0781766166

ISBN-10: 0781766168




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Chapter 55

1. A 60-year-old man has presented to his family physician following an earache that has
become progressively more painful in recent days. Following a history and
examination with an otoscope, the man has been diagnosed with otitis externa. Which
of the physician’s following statements to the man is most accurate?
A) “You’ll need to avoid getting any water in your ear until finish your course of
antibiotic pills.”
B) “I’m going to instill some warm water into your ear to flush out debris and
C) “I’ll prescribe some ear drops for you, and in the mean time it’s important not to
use ear swabs.”
D) “This likely happened because your ears aren’t draining like they should, but
antibiotics that you’ll put in your ears will resolve this.”
2. During descent, an airplane passenger is complaining that his “ears are plugged.”
What aspect of the structure and function of the ear best accounts for the passenger’s
A) The inner ear adjusts its volume in response to atmospheric pressure, increasing
during low pressure and decreasing in high pressure.
B) The eustachian tubes must remain patent to equalize pressure between the
middle ear and inner ear.
C) The tympanic membrane is selectively permeable in order to accommodate
pressure changes and this capacity is often impaired during upper respiratory
D) Air must be able to flow between the middle ear and the nasopharynx in order to
accommodate pressure changes.
3. A 4-year-old boy has had otitis media with effusion (OME) for several weeks and his
condition has recently progressed to acute otitis media (AOM). Which of the
following factors could have contributed to his AOM?
A) Reflux of fluid from the boy’s nose into his middle ear
B) A deficiency in inflammatory response
C) Accumulation of cerumen in the external acoustic meatus
D) Sensorineural deficits in the auditory control apparatus
4. A 29-year-old woman has been diagnosed with otosclerosis after several years of
progressive hearing loss. What pathophysiological process has characterized her
A) New spongy bone has been formed around her stapes and oval window.
B) Her incus, malleus, and stapes have become disconnected from her normal
neural pathways.
C) Her temporal bone is experiencing unusually rapid resorption.
D) Her tympanic cavity is becoming filled with bone due to inappropriate
Page 1
5. Distraught at the persistent ringing in his ears and his inability to alleviate it, a 50year-old
a clinic.

“This is most often the result of a psychological disturbance, and therapy is often
useful in relieving tinnitus.”
B) “There are many drugs such as blood pressure pills, relaxants, heart medications,
and antihistamines that can cause this.”
C) “A specialist can listen with a sensitive microphone to determine whether you
are actually hearing these sounds.”
D) “There are some treatments, but they address the symptoms rather than curing
the problem.”
6. Which of the following questions is most likely to be clinically useful in the
differential diagnosis of sensorineural versus conductive hearing loss?
A) “What medications do you currently take?”
B) “What effect is this hearing loss having on your quality of life?”
C) “Has your hearing loss developed quickly or more slowly?”
D) “Do you ever hear a persistent ringing in your ears?”
7. As part of a health promotion initiative, a public health nurse is meeting with a group
of older adult residents of an assisted-living facility. Which of the following teaching
points about hearing loss in the elderly should the nurse include in the teaching
A) “It is actually a myth that seniors have worse and worse hearing as they age.”
B) “Most hearing loss in older adults is the result of easily-fixed problems, such as
impacted ear wax.”
C) “Experts don’t quite know what causes seniors to lose their hearing with age, but
drugs like aspirin can contribute to the problem.”
D) “With older adults, the goal is to adjust lifestyle to accommodate diminished
hearing rather than try to treat the hearing loss itself.”
8. A 45-year-old male has had a stroke that left his vestibular system intact and posture
and balance maintained. What areas of the brain would be most likely have been
A) The brain stem
B) The thalamus
C) The temporal and parietal cortex
D) The limbic system of the cerebrum
Page 2
9. Which of the following individuals is most likely to be diagnosed with a central
vestibular disorder?
A) A man who got up quickly from his bed and sustained an injury after he “blacked
B) A woman who has ongoing difficulty balancing herself when walking.
C) A woman who suffered a loss of consciousness after being struck on the head
during a soccer game.
D) A man who states that he feels car sick whenever he rides in the back seat of a
10. A 30-year-old woman has presented to her family doctor complaining of three
distressing episodes over the last several months in which she got extremely dizzy,
had loud ringing in her ears, and felt like her ears were full of fluid. She states that her
hearing diminishes and she feels nauseous during these episodes. What diagnosis is
the physician most likely to first suspect?
A) Acute otitis media (AOM)
B) Acute vestibular neuronitis
C) Benign paroxysmal positional vertigo (BPPV)
D) Ménière disease
11. A 70-year-old woman with a diagnosis of benign paroxysmal positional vertigo
(BPPV) is receiving teaching from her physician about her diagnosis. The client is
eager to avoid future episodes of vertigo and has asked the physician what she can do
to prevent future episodes. How can the physician best respond?
A) “Unfortunately there aren’t any proven treatments for your condition.”
B) “There are some exercises that I’ll teach you to help reorient your inner ear and
prevent vertigo.”
C) “Although they involve some risks, there are some options for ear surgery that
can prevent future vertigo.”
D) “We usually don’t actively treat BPPV unless it starts to affect your hearing.”
12. As part of the diagnostic workup for a client’s longstanding vertigo, a clinician wants
to gauge the eye movements that occur in the client. Which of the following tests is
the clinician most likely to utilize?
A) Romberg test
B) Rotational tests
C) Electronystagmography (ENG)
D) Caloric stimulation
Page 3
13. Otitis media (OM), which can occur in any age group, is the most common diagnosis
made by health care providers who care for children. OM may be of either bacterial
or viral origin, and it resolves spontaneously without treatment in approximately 60
percent of children. Which bacterial pathogen causes the largest proportion of cases
and is least likely to resolve without treatment?
A) Streptococcus pneumoniae
B) Moraxella catarrhalis
C) Haemophilus influenzae
D) Parainfluenza
14. A 15-year-old male is flying on a plane for the first time. As the plane begins its
decent for landing, his ears begin to hurt. The steward sees that he is in pain and tells
him to swallow until the pain goes away. What structure is he instructing the
passenger to use to equalize the pressure and relieve the pain?
A) The auditory canal is being stretched by the distortion of the neck, which allows
air pressure from the inner ear to equalize with the external pressure.
B) Swallowing just distracts the passenger until mechanisms in the inner ear can
change the air pressure.
C) Swallowing pulls air through the eustachian tube, allowing the air pressure to
equalize in the inner ear.
D) Movement of the temporomandibular joint forces air out of the inner ear.
15. A 56-year-old factory worker has been taking the opiate-based oxycodone for
chronic back pain for two years. He recently has been diagnosed with significant
hearing loss linked to chronic oxycodone use. What type of hearing loss is he
A) Conductive
B) Sensorineural
C) Caused by acoustic neuromas
D) Meningioma based
16. Within the first 48 hours of birth, an infant’s hearing is tested. Why are hearing tests
done so soon?
A) It’s easy to test themRemember, just get it out of the way.
B) If there is a hearing problem, it can be addressed right away before the child
begins to acclimate to its life.
C) Tests are done to ensure that all fluids from the birthing process have been
cleared from the auditory canal.
D) Tests are done in order to determine if any damage occurred during the birth.
Page 4
17. Jane M. is a passenger traveling by car. The drive is longRemember, to pass the time she
decides to read a novel. Within about 15 minutes she experiences vertigo and is
nauseous. What causes her motion sickness?
A) Repeated rhythmic stimulation of the vestibular system
B) Overstimulation of the vestibular system
C) Under stimulation of the vestibular system
D) A miscommunication in the thalamus due to environmental mismatching
18. A 43-year-old patient is admitted to the hospital. He is experiencing feelings of
vertigo, is ataxic, and has facial weakness. He is afraid that he is having a stroke.
What is a more likely diagnosis?
B) Brain stem ischemia
C) Cerumin impaction
D) Auditory tumor
Page 5
Answer Key
1. C
2. D
3. A
4. A
5. D
6. A
7. C
8. D
9. B
10. D
11. B
12. C
13. A
14. C
15. B
16. B
17. A
18. B
Page 6



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