Test Bank for Gould's Pathophysiology for the Health Professions, 7th Edition (Chapters 1-28)

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Chapter 01: Introduction to PathophysiologyVanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7th EditionMULTIPLE CHOICE1.Which of the following would be the most likely cause of an iatrogenic disease?a.An inherited disorderb.A combination of specific etiological factorsc.An unwanted effect of a prescribed drugd.Prolonged exposure to toxic chemicals in the environmentANS: C2.The manifestations of a disease are best defined as thea.subjective feelings of discomfort during a chronic illness.b.signs and symptoms of a disease.c.factors that precipitate an acute episode of a chronic illness.d.early indicators of the prodromal stage of infection.ANS: B3.The best definition of the termprognosisis thea.precipitating factors causing an acute episode.b.number of remissions to be expected during the course of a chronic illness.c.predicted outcome or likelihood of recovery from a specific disease.d.exacerbations occurring during chronic illness.ANS: C4.Which of the following is considered a systemic sign of disease?a.Swelling of the kneeb.Feverc.Pain in the neckd.Red rash on the faceANS: B5.Etiology is defined as the study of thea.causes of a disease.b.course of a disease.c.expected complications of a disease.d.manifestations of a disease.ANS: A6.A type of cellular adaptation in which there is a decrease in cell size is referred to asa.hypertrophy.b.metaplasia.c.anaplasia.d.atrophy.ANS: D7.A change in a tissue marked by cells that vary in size and shape and show increasedmitotic figures would be called

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a.metaplasia.b.atrophy.c.dysplasia.d.hypertrophy.ANS: C8.A deficit of oxygen in the cells usually due to respiratory or circulatory problems is calleda.apoptosis.b.ischemia.c.hypertrophy.d.necrosis.ANS: B9.When a group of cells in the body dies, the change is calleda.ischemia.b.gangrene.c.hypoxia.d.necrosis.ANS: D10.Rigorous weightlifting/body building regimens may result in the skeletal musclecells undergoinga.hypertrophy.b.dysplasia.c.atrophy.d.regeneration.ANS: A11.The termcancerrefers toa.dysplasia.b.hyperplasia.c.metaplasia.d.malignant neoplasm.ANS: D12.To which of the following does the termapoptosisrefer?a.Increased rate of mitosis by certain cellsb.Ischemic damage to cellsc.Liquefaction of necrotic tissued.Preprogrammed cell self-destructionANS: D13.Which of the following statements is TRUE?a.Alteration of DNA does not change cell function.b.Damaged cells may be able to repair themselves.c.All types of cells die at the same rate.d.Mild ischemia causes immediate cell death.ANS: B14.Caseation necrosis refers to an area wherea.cell proteins have been denatured.

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b.cells are liquefied by enzymes.c.dead cells form a thick cheesy substance.d.bacterial invasion has occurred.ANS: C15.Routine application of sun block to skin would be an example ofa.an iatrogenic cause of cancer.b.a preventive measure.c.a precipitating factor.d.a predisposing condition.ANS: B16.A circumstance that causes a sudden acute episode of a chronic disease to occur is termeda.latent stage.b.predisposing factor.c.incidence.d.precipitating factor.ANS: D17.The termhomeostasisrefers toa.the causative factors in a particular disease.b.maintenance of a stable internal environment.c.a condition that triggers an acute episode.d.a collection of signs and symptoms.ANS: B18.Which term is used to describe a new and secondary or additional problem that arises afterthe original disease has been established?a.Symptomsb.Occurrencec.Manifestationsd.ComplicationANS: D19.Pathophysiology involves the study ofa.the structure of the human body.b.the functions of various organs in the body.c.functional or structural changes resulting from disease processes.d.various cell structures and related functions.ANS: C20.Which of the following is the best definition of epidemiology?a.The science of tracking the occurrence and distribution of diseasesb.The relative number of deaths resulting from a particular diseasec.Identification of a specific disease through evaluation of signs and symptomsd.The global search for emerging diseasesANS: A

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21.Which of the following can cause cell injury or death?1. Hypoxia2. Exposure to excessive cold3. Excessive pressure on a tissue4. Chemical toxinsa.1, 2b.2, 4c.1, 3, 4d.1, 2, 3, 4ANS: D22.All of the following are part of the Seven Steps to Health EXCEPT:a.Follow cancer screening guidelines.b.Use sun block agents whenever exposed.c.Participate in strenuous exercise on a regular daily basis.d.Choose high fiber, lower fat foods.ANS: C23.The termdiseaserefers toa.the period of recovery and return to a normal healthy state.b.a deviation from the normal state of health and function.c.the treatment measures used to promote recovery.d.a basic collection of signs and symptoms.ANS: B24.A collection of signs and symptoms, often affecting more than one organ or system,that usually occur together in response to a certain condition is referred to as a(an)a.acute disease.b.multiorgan disorder.c.syndrome.d.manifestation.ANS: C25.All of the following statements are correct about cell damage EXCEPT:a.The initial stage of cell damage often causes an alteration in metabolic reactions.b.If the factor causing the damage is removed quickly, the cell may be ableto recover and return to its normal state.c.If the noxious factor remains for an extended period of time, the damagebecomes irreversible and the cell dies.d.Initially, cell damage does not change cell metabolism, structure, or function.ANS: D26.Which of the following conditions distinguishes double blind studies used in health research?a.Neither the members of the control group or the experimental group nor theperson administering the treatment knows who is receiving the experimentaltherapy.b.Both groups of research subjects and the person administering the treatment knowwho is receiving the experimental therapy.c.The research subjects do not know, but the person administering thetreatment knows who is receiving placebo or standard therapy.d.Only members of the control group know they are receiving standard therapy.

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ANS: A27.If the data collected from the research process confirm that the new treatment hasincreased effectiveness and is safe, this is calleda.the placebo effect.b.evidence-based research.c.blind research studies.d.approval for immediate distribution.ANS: B28.A short-term illness that develops very quickly with perhaps a high fever or severe painis calleda.acute.b.latent.c.chronic.d.manifestation.ANS: A29.The termprognosisrefers to thea.period of recovery and return to a normal state.b.expected outcome of the disease.c.mortality and morbidity rates for a given population.d.typical collection of signs and symptoms.ANS: B30.When prolonged ischemia occurs to an area of the heart, the resulting damage is referred to asa.atrophy.b.liquefactive necrosis.c.apoptosis.d.infarction.ANS: D31.During the evaluation process for a new therapy’s effectiveness and safety, a doubleblind study may be conducted duringa.the first stage.b.the second stage.c.the third stage.d.any of these stages.ANS: C32.Why are the predisposing factors for a specific disease important to health professionals?a.To predict the prognosisb.To determine treatmentsc.To develop preventive measuresd.To develop morbidity statisticsANS: C33.Cell damage may be caused by exogenous sources such asa.abnormal metabolic processes.b.certain food additives.

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c.genetic defects.d.localized hypoxia.ANS: B34.Which of the following is usually included in a medical history?1. Past illnesses or surgeries2. Current illnesses, acute and chronic3. Prescribed medication or other treatments4. Nonprescription drugs and herbal remedies5. Current allergiesa.1, 3b.2, 4, 5c.1, 3, 4d.1, 2, 3, 4, 5ANS: D35.A situation when there is a higher than expected number of cases of an infectiousdisease within a given area is called a/ana.epidemic.b.exacerbation.c.morbidity.d.pandemic.ANS: A36.The termpathogenesisrefers toa.the development of a disease or sequence of events related to tissuechanges involved in the disease process.b.the determination of the cause(s) involved in the development of amalignant neoplasm.c.the specific signs and symptoms involved in the change from an acute disease toa chronic disease.

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d.the changes in cells of affected tissue that result in necrosis.ANS: A37.A therapy that has been approved for use and may show additional potential to treata different disease is termed “” use.a.over-the-counterb.off-labelc.additionald.conditionalANS: B38.A potential unwanted outcome of a primary condition, such as paralysis followingthe recovery from a stroke, is referred to asa.complication.b.convalescence.c.sequelae.d.postcondition.ANS: C39.An infectious disease that spreads over wide regions of the globe is called a(an)a.pandemic.b.endemic.c.epidemic.d.periodic.ANS: A40.The type of necrosis that occurs when cell proteins are altered or denatured is referred to asa.liquefaction necrosis.b.coagulative necrosis.c.degenerative necrosis.d.caseous necrosis.ANS: B

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Chapter 02: Fluid, Electrolyte, and Acid-Base ImbalancesVanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7thEditionMULTIPLE CHOICE1.Choose the correct proportion of water to body weight to be expected in a healthymale adult’s body:a.30%b.45%c.60%d.70%ANS: C2.Choose the correct proportion of blood (to body weight) in an adult male’s body:a.30%b.20%c.10%d.4%ANS: D3.Which of the following is NOT part of the extracellular fluid compartment (ECF)?a.Bloodb.Cytoplasmc.Cerebrospinal fluidd.Transcellular fluidANS: B4.Insensible fluid loss refers to water lost througha.perspiration only.b.feces only.c.perspiration and expiration.d.urine and feces.ANS: C5.The osmoreceptor cells controlling the thirst mechanism are located in thea.medulla oblongata.b.thalamus.c.epithalamus.d.hypothalamus.ANS: D6.When the osmotic pressure of the blood is elevated above normal, water would shift from thea.blood into the cells.b.interstitial compartment into the cells.c.interstitial compartment into the blood.

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d.cells into the interstitial compartment.ANS: C7.Which of the following would result from a deficit of plasma proteins?a.Increased osmotic pressureb.Decreased osmotic pressurec.Increased hydrostatic pressured.Decreased hydrostatic pressureANS: B8.Which of the following would cause edema?a.Decreased capillary hydrostatic pressureb.Increased capillary osmotic pressurec.Decreased capillary permeabilityd.Increased capillary permeabilityANS: D9.Which of the following would likely be related to an elevated hematocrit reading?a.Fluid excessb.Fluid deficitc.Increased sodium leveld.Decreased erythrocytesANS: B10.Which of the following is a typical sign of dehydration?a.Rapid, strong pulseb.Low hematocritc.Increased urine outputd.Rough oral mucosaANS: D11.Which of the following terms refers to a combination of decreased circulating bloodvolume combined with excess fluid in a body cavity?a.Dehydrationb.Third-spacingc.Hypovolemiad.Water retentionANS: B12.Which of the following is the primary cation in the extracellular fluid?a.Sodiumb.Potassiumc.Calciumd.IronANS: A

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13.Which of the following is a common cause of hyponatremia?a.Loss of the thirst mechanismb.Excessive sweatingc.Excessive aldosterone secretiond.Prolonged period of rapid, deep respirationsANS: B14.Which of the following is a common effect of both hypokalemia and hyperkalemia?a.Skeletal muscle twitch and crampsb.Oliguriac.Elevated serum pHd.Cardiac arrhythmiasANS: D15.Choose the correct effect of increased parathyroid hormone.a.Increased movement of calcium ions into the bonesb.Increased activation of vitamin Dc.Increased absorption of calcium from the digestive tractd.Decreased reabsorption of calcium in the kidneysANS: C16.Which of the following results from hypocalcemia?1. Low serum phosphate levels2. Nausea and constipation3. Skeletal muscle twitch and spasms4. Weak cardiac contractionsa.1, 2b.1, 4c.2, 3d.3, 4ANS: D17.Which of the following causes tetany?a.Increased permeability of nerve membranes due to low serum calciumb.Excess calcium ions in skeletal muscle due to excess parathyroid hormone (PTH)c.Excess calcium ions inside somatic nerves as a result of neoplasmsd.Increased stimulation of the nerves in the cerebral cortexANS: A18.Parestesia is an effect ofa.hyperkalemia.b.hypokalemia.c.hyponatremia.d.hypernatremia.ANS: B19.In which of the following processes is the phosphate ion NOT a major component?

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a.Bone metabolismb.Metabolic processes involving adenosine triphosphate (ATP)c.Blood clottingd.Acid-base balanceANS: C20.Which of the following would be considered normal serum pH?a.4.5-8b.7.0c.7.4d.8ANS: C21.When many excess hydrogen ions accumulate in the blood, what happens to serum pH?The pHa.decreases.b.increases.c.remains constant.d.varies based on metabolism.ANS: A22.What is the slowest but most effective control for acid-base balance?a.Respiratory systemb.Buffer systems in the bloodc.Kidneysd.BrainANS: C23.Which of the following is essential in order to maintain serum pH within normal range?a.Carbonic acid and bicarbonate ion must be present in equal quantities.b.All excess carbonic acid must be excreted by the kidneys.c.The concentration of bicarbonate ion must remain constant.d.The ratio of carbonic acid to bicarbonate ion must be 1:20.ANS: D24.Which is the correct effect on the body of abnormally slow respirations?a.Increased carbonic acidb.Decreased carbonic acidc.Increased bicarbonate iond.Decreased bicarbonate ionANS: A25.Which condition is likely to cause metabolic acidosis?a.Slow, shallow respirationsb.Prolonged diarrheac.Mild vomitingd.Excessive fluid in the body

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ANS: B26.What would a serum pH of 7.33 in a patient with kidney disease indicate?a.Metabolic alkalosisb.Metabolic acidosisc.Respiratory alkalosisd.Respiratory acidosisANS: B27.Which serum value indicates decompensated metabolic acidosis?a.pH is below normal range.b.pH is above normal range.c.Bicarbonate level decreases.d.Bicarbonate level increases.ANS: A28.What is the effect on blood serum when excessive lactic acid accumulates in the body?a.Bicarbonate ion levels decrease.b.Bicarbonate ion levels increase.c.Carbonic acid levels increase.d.pH increases.ANS: A29.The direct effects of acidosis are manifested primarily in the functioning of thea.digestive system.b.urinary system.c.nervous system.d.respiratory system.ANS: C30.Compensation mechanisms in the body for dehydration would includea.increased antidiuretic hormone (ADH).b.decreased aldosterone.c.slow, strong heart contraction.d.peripheral vasodilation.ANS: A31.Which acid-base imbalance results from impaired expiration due to emphysema?a.Metabolic acidosisb.Metabolic alkalosisc.Respiratory acidosisd.Respiratory alkalosisANS: C32.In patients with impaired expiration associated with emphysema, effective compensationfor the acid-base imbalance would be

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a.increased rate and depth of respiration.b.decreased rate and depth of respiration.c.increased urine pH and decreased serum bicarbonate.d.decreased urine pH and increased serum bicarbonate.ANS: D33.An anxiety attack often causes hyperventilation leading toa.increased PCO2.b.decreased PCO2.c.respiratory acidosis.d.metabolic acidosis.ANS: B34.One of the factors involved in the increased need for water in infants isa.proportionally smaller body surface area.b.higher metabolic rate.c.smaller respiratory capacity.d.greater surface area of exposed mucous membranes.ANS: B35.Compensation for respiratory system depression due to anesthesia and sedation would bea.decreased reabsorption of bicarbonate ions in the kidneys.b.increased secretion of hydrogen ions into the filtrate.c.increased respiratory rate and depth.d.increased renin secretion.ANS: B36.A prolonged state of metabolic acidosis often leads toa.hypokalemia.b.hyperkalemia.c.hyponatremia.d.hypercalcemia.ANS: B37.Strenuous physical exercise on a hot day is likely to result ina.hypokalemia.b.hypernatremia.c.hyperchloremia.d.hypovolemia.ANS: D38.Place the following events in the correct sequence of events when ketoacids increase inthe blood of a diabetic patient. Not all options are used in the answers.1. Serum pH decreases2. Serum bicarbonate decreases3. PCO2decreases4. Respiration decreases

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5. Respiration increases6. Serum pH increases7. Urine pH decreasesa.1, 3, 7, 4, 2, 6b.5, 2, 7, 3, 4, 1c.2, 1, 5, 3, 7, 6d.3, 1, 2, 5, 7, 6ANS: C39.Which of the following is a manifestation of respiratory alkalosis?a.Bradycardia and deep rapid breathingb.Drowsiness and general lethargyc.Increased nervous system irritabilityd.Decreased urine pHANS: C40.Prolonged diarrhea results ina.loss of fluid and bicarbonate ions, leading to metabolic acidosis.b.increased fluid and serum bicarbonate ions, leading to metabolic acidosis.c.loss of chloride ions only, leading to metabolic alkalosis.d.surplus bicarbonate ions, leading to respiratory alkalosis.ANS: A41.In the initial stage, vomiting results ina.metabolic acidosis.b.metabolic alkalosis.c.respiratory alkalosis.d.none of these.ANS: B42.Which two ions are most important for acid-base balance in the body?a.K+, Na+b.Cl–and HCO–c.Ca++, Na+d.Na+, Cl–ANS: B43.The bicarbonate-carbonic acid buffer system helps maintain serum pH. The balance ofthe carbonic acid and bicarbonate ion levels are controlled by thea.liver and pancreas.b.lungs and kidneys.c.lungs and plasma proteins.d.kidneys and bone marrow.ANS: B44.Alkalosis increases irritability and spontaneous stimulation of nerves bya.blocking normal nerve conduction.3

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b.increasing the permeability of nerve membranes.c.blocking movement of calcium ions.d.decreasing phosphate ion levels.ANS: B45.Hypocalcemia causes weak cardiac contractions becausea.permeability of nerve membranes increases.b.insufficient calcium ions are available for muscle contraction.c.low phosphate ion levels prevent muscle contraction.d.excessive amounts of calcium are stored in cardiac muscle.ANS: B46.Serum potassium levels are affected by1. ADH.2. aldosterone.3. serum H+levels.4. insulin levels.a.2 onlyb.1, 2c.1, 3d.2, 3, 4e.1, 2, 3ANS: D47.Which of the following is the primary control of serum Na+levels?a.ADHb.Aldosteronec.Serum H+levelsd.Serum K+levelsANS: B48.The control center for thirst is located in thea.kidneys.b.thalamus.c.medulla.d.hypothalamus.ANS: D49.Which statements apply to atrial natriuretic peptide?1. It is secreted by heart muscle cells.2. It is a hormone secreted by the kidneys.3. It helps to control water and sodium balance.4. It is released in response to low blood pressure.a.1, 3b.1, 4c.2, 3d.2, 4

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ANS: A50.What are the three mechanisms that control or compensate for serum pH?a.Hypothalamus, metabolic changes by digestive system, lymphatic system filtrationb.Buffer pairs in blood, change in kidney excretion rate, change in respiration ratec.Neural feedback, increase in heart rate, decrease in calcium intaked.Modification of water intake, increased capillary permeability, decrease inblood volumeANS: B51.Hypokalemia refers to a condition in which the serum has a very low level of which ion?a.Sodiumb.Phosphatec.Calciumd.PotassiumANS: D52.In the blood and extracellular fluids, hypernatremia refers toa.a deficient sodium level.b.an excess phosphate level.c.an excess sodium level.d.an excessively low phosphate level.ANS: C53.Increased milk and/or antacid intake can contribute to development of “milk-alkali syndrome,” which can cause which of the following?a.Hyponatremiab.Hyperkalemiac.Hypercalcemiad.HypovolemiaANS: C54.Ingested vitamin D must be activated in thea.liver.b.kidney.c.pancreas.d.lung.ANS: B55.Neuromuscular hyperirritability may be a cause ofa.hypomagnesemia.b.hypermagnesemia.c.hypophosphatemia.d.hyperphosphatemia.ANS: A

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Chapter 03: Introduction to Basic Pharmacology and Other Common TherapiesVanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7thEditionMULTIPLE CHOICE1.Documenting drug-induced responses of physiologic and biochemical systems is part ofa.pharmacokinetics.b.pharmacodynamics.c.pharmacotherapeutics.d.toxicology.ANS: B2.The study of the body’s response to drugs, harmful effects, mechanisms of actions,symptoms, treatment, and identification is the role ofa.pharmacokinetics.b.pharmacodynamics.c.pharmacotherapeutics.d.toxicology.ANS: C3.Which of the following are considered to be the toxic effects of a drug?a.Additional, mild, unwanted effectsb.Unusual, unexpected mild effectsc.Serious, possibly life-threatening effectsd.Reduction of the allergic responseANS: C4.Dry mouth and drowsiness after the administration of an antihistamine is considered to be a(n)a.adverse effect.b.toxic effect.c.side effect.d.hypersensitivity effect.ANS: C5.An unexpected or unusual response to a drug is called a(n)a.iatrogenic reaction.b.teratogenic effect.c.toxic effect.d.idiosyncratic reaction.ANS: D6.A drug dose refers toa.the amount of a drug given at a single time.b.the total amount of a drug given over a period of time.c.the daily amount of a drug given.

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d.the weekly amount of a drug administered.ANS: A7.A study of the toxicity of a drug includes all of the following EXCEPT:a.Physiochemical propertiesb.Geneticsc.Routes of administrationd.Rates of absorptionANS: B8.What is the unique, simple, and official name assigned to a specific drug for worldwide use?a.Trade nameb.Chemical namec.Proprietary named.Generic nameANS: D9.Which is the route of administration by which the largest proportion of the drug dose islikely lost before reaching the site of action?a.Oralb.Intramuscularc.Sublinguald.IntravenousANS: A10.Ingesting a drug with a large meal may be likely toa.immediately increase the blood level of the drug.b.prevent gastric irritation.c.ensure that the total dose is absorbed into the blood.d.cause more rapid excretion of the drug.ANS: B11.What is the reaction called when two drugs interact to produce a result much greater thanthe sum of individual effects?a.Antagonismb.Beneficialc.Synergismd.PotentiationANS: C12.At which site are most drugs metabolized and prepared for excretion?a.Liverb.Kidneysc.Circulating bloodd.Lymphoid tissueANS: A

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13.In traditional Asian medicine, acupoints are usually locateda.over pain or other sensory receptors.b.where blood vessels branch.c.over joints.d.on designated meridians.ANS: D14.Traditional drug or surgical therapy is incorporated with nontraditional methods bya.chiropractors.b.naturopaths.c.homeopaths.d.osteopaths.ANS: D15.Contraindications printed on the label of a drug identifya.those circumstances under which the drug should probably not be used.b.those typical side effects associated with this drug.c.the dosage limits associated with the use of the drug.d.the maximum shelf life of the medication.ANS: A16.After they are metabolized, most drugs are excreted through thea.lungs.b.pancreas.c.kidneys.d.large intestine.ANS: C17.A drug that binds with selected specific cell receptors may1. stimulate activity in those cells.2. inhibit activity in those cells.3. change specificity and attach to other cells.4. be disabled by macrophages.a.1, 2b.2, 3c.3, 4d.1, 3, 4ANS: A18.A placebo may be described as a tablet or capsulea.that does not contain an active drug.b.that contains a small amount of active drug for use in clinical trials.c.that contains a different drug to be used for its psychological effect.d.that contains high amounts of a drug to determine the maximum dose allowed.ANS: A

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19.The form of therapy that involves assessment of physical function and works to restore anyproblems and prevent any further dysfunction using methods such as appropriate exercisesand ultrasound is referred to asa.registered massage therapy.b.naturopathy.c.physiotherapy.d.reflexology.ANS: C20.A medical history should include all1. legally prescribed drugs.2. vitamin or mineral supplements.3. any medication not requiring a prescription (over-the-counter items).4. herbal treatments.a.1 onlyb.1, 3c.1, 2, 4d.1, 2, 3, 4ANS: D21.Antagonistic drugs may be used toa.increase the effectiveness of selected drugs.b.prolong the action of a drug.c.act as an antidote when necessary.d.speed up the excretion of a drug.ANS: C22.The full course of a prescribed antimicrobial drug should be completed so as to preventa.undesirable side effects.b.development of resistant microbes.c.an allergic response.d.proper metabolism and excretion of drug.ANS: B23.Transcutaneous electrical nerve stimulation (TENS) is a technology often used ina.chemotherapy.b.physiotherapy.c.occupational therapy.d.massage therapy.ANS: B24.Which of the following therapies is considered an alternative therapy?a.Acupunctureb.Chiropractic therapyc.Osteopathyd.Speech therapy

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ANS: A

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Chapter 04: PainVanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7thEditionMULTIPLE CHOICE1.The impulses related to acute pain are usually transmitted bya.nociceptors.b.myelinated A delta fibers.c.unmyelinated C fibers.d.any sensory fiber with a low pain threshold.ANS: B2.In which structure do pain impulses ascend the spinal cord?a.Reticular formationb.Corticospinal tractc.Spinothalamic tractd.Relevant dermatomeANS: C3.According to the gate-control theory, passage of pain impulses may be naturally blockeda.at the synapse by entry of other sensory impulses.b.by the stress response.c.by administration of morphine directly into the spinal cord.d.by referring the pain to other parts of the body.ANS: A4.What is the term used to describe the degree of pain that is endured before an individualtakes action?a.Pain thresholdb.Referred painc.Phantom paind.Pain toleranceANS: D5.What is the definition of endorphins?a.Neurotransmitters at the nociceptorsb.Transmitters for sensory impulsesc.Opiate-like blocking agents in the central nervous systemd.Pain-causing chemical mediatorsANS: C6.Pain perceived in the left arm during the course of a heart attack is an example ofa.referred pain.b.phantom pain.c.chronic pain.

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d.subjective pain response.ANS: A7.A headache that is related to changes in cerebral blood flow is classified as a/anheadache.a.tensionb.sinusc.migrained.intracranialANS: C8.What is a common analgesic administered to control a moderate level of pain?a.Meperidineb.Acetaminophenc.Codeined.IbuprofenANS: C9.Which of the following applies to spinal anesthesia?a.It causes analgesia with loss of consciousness.b.The drug is injected into cerebrospinal fluid (CSF) or the epidural space ofthe spinal cord.c.The drug stimulates release of endorphins in the spinal cord.d.The transmission of pain impulses is blocked in a small area of the body.ANS: B10.Which of the following is a characteristic of acute pain but not of chronic pain?a.Depression and debilitationb.A perception of increased generalized pain and discomfortc.Fatigue and lower pain toleranced.Severe but short termANS: D11.What is the role of nociceptors? They area.pain receptors that are stimulated by thermal, chemical, or physical means.b.spinal nerves that conduct impulses from specific areas of the skin.c.responsible for the state of arousal with pain.d.useful in localizing pain to a specific area of the body.ANS: A12.Intractable pain is best defined asa.pain that is perceived as occurring in an amputated limb.b.severe pain that cannot be controlled by medication.c.pain perceived as coming from a source other than the actual source.d.pain coming from a specific dermatome.ANS: B

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13.Which of the following statements is TRUE?a.The brain is more aware of pain impulses when the reticular activating systemis depressed.b.Acute pain does not cause a reflex response at the spinal cord synapses.c.Young infants typically respond to pain with tachycardia and increasedblood pressure.d.Chronic pain is easier to tolerate without negative effects.ANS: C14.Ibuprofen is classified as an NSAID and is particularly useful in treatinga.severe pain.b.pain caused by inflammation.c.intracranial pain.d.pain in young infants.ANS: B15.Which of the following analgesics acts to reduce pain at the peripheral site?a.Acetaminophenb.Morphinec.Codeined.Intravenous general anesthesiaANS: A16.Cancer-related pain has been broken down into three basic categories: pain caused by theadvance of the disease and resultant damage to the body, pain that is the result of acoexisting disease unrelated to the cancer, anda.phantom pain as a result of amputation.b.pain associated with the treatment of the disease.c.pain caused by emotional stress and metabolic changes.d.pain associated with damage to the peripheral nerves.ANS: B17.Pain that is caused by trauma or disease involving the peripheral nerves is referred to asa.neuropathic pain.b.central pain.c.neurogenic pain.d.referred pain.ANS: A18.Pain resulting from a profound, sudden loss of blood flow to an organ or tissues in aspecific area of the body is referred to asa.chronic pain.b.central pain.c.cardiovascular pain.d.ischemic pain.ANS: D

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19.Which of the following is a characteristic of chronic pain?a.It usually initiates a physiological stress response.b.It always involves a strong emotional response such as high anxiety.c.It is more difficult to diagnose and treat than is acute pain.d.It involves tissue damage to a specific organ.ANS: C20.A headache that results from pressure on the meninges surrounding the brain is referred toas a/ana.intracranial headache.b.intrameningeal headache.c.migraine headache.d.cerebral headache.ANS: A21.Opioids released within the central nervous system are secreted bya.astrocytes.b.motoneurons.c.oligodendrocytes.d.interneurons.ANS: D22.The release of neuropeptides due to a reduction in serotonin is often the cause ofa.migraine.b.tension headache.c.phantom pain.d.visceral pain.ANS: A23.Trigger point injections may be used to help relieve pain ina.acute pain.b.phantom pain.c.fibromyalgia.d.arthritis.ANS: C24.A non-medication therapy that can be used in pain management and can be self-administered isa.trigger point injection.b.TENS.c.bioelectric therapy.d.trigger point injection and TENS.ANS: B25.A therapy that induces the production of endorphins to help relieve pain and should onlybe used as a part of a total pain management program is

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a.TENS.b.trigger point injections.c.bioelectric therapy.d.surgical implants.ANS: C

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Chapter 05: Inflammation and HealingVanMeter and Hubert: Gould’s Pathophysiology for the Health Professions, 7thEditionMULTIPLE CHOICE1.Tears are considered to be part of thea.first line of defense.b.second line of defense.c.third line of defense.d.specific defense.ANS: A2.A specific defense for the body isa.phagocytosis.b.sensitized T lymphocytes.c.the inflammatory response.d.intact skin and mucous membranes.ANS: B3.The inflammatory response is a nonspecific response toa.phagocytosis of foreign material.b.local vasodilation.c.any tissue injury.d.formation of purulent exudates.ANS: C4.Chemical mediators released during the inflammatory response includea.albumin and fibrinogen.b.growth factors and cell enzymes.c.macrophages and neutrophils.d.histamine and prostaglandins.ANS: D5.The unnecessary spread or prolongation of inflammation is mediated bya.prostaglandins.b.histamines.c.resolvins.d.serotonin.ANS: C6.Granulation tissue is best described asa.highly vascular, very fragile, and very susceptible to infection.b.an erosion through the wall of viscera, leading to complications.c.a type of adhesion with no vascularization.d.a form of stenosis, in a duct, that is extremely tough and resists attack by microbes.

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ANS: A7.Edema associated with inflammation results directly froma.increased fluid and protein in the interstitial compartment.b.increased phagocytes in the affected area.c.decreased capillary permeability.d.general vasoconstriction.ANS: A8.The warmth and redness related to the inflammatory response results froma.increased interstitial fluid.b.production of complement.c.a large number of white blood cells (WBCs) entering the area.d.increased blood flow into the area.ANS: D9.What is the correct order of the following events in the inflammatory responseimmediately after tissue injury?1. Increased permeability of blood vessels2. Dilation of blood vessels3. Transient vasoconstriction4. Migration of leukocytes to the area5. Hyperemiaa.5, 3, 2, 1, 4b.1, 2, 4, 5, 3c.2, 3, 5, 4, 1d.3, 2, 5, 1, 4ANS: D10.The process of phagocytosis involves thea.ingestion of foreign material and cell debris by leukocytes.b.shift of fluid and protein out of capillaries.c.formation of a fibrin mesh around the infected area.d.movement of erythrocytes through the capillary wall.ANS: A11.Systemic effects of severe inflammation includea.erythema and warmth.b.loss of movement at the affected joint.c.fatigue, anorexia, and mild fever.d.abscess formation.ANS: C12.The termleukocytosismeansa.increased white blood cells (WBCs) in the blood.b.decreased WBCs in the blood.c.increased number of immature circulating leukocytes.

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d.significant change in the proportions of WBCs.ANS: A13.Which of the following statements applies to fever?a.Viral infection is usually present.b.Heat-loss mechanisms have been stimulated.c.It is caused by a signal to the thalamus.d.It results from release of pyrogens into the circulation.ANS: D14.Mechanisms to bring an elevated body temperature down to the normal level includea.general cutaneous vasodilation.b.generalized shivering.c.increased heart rate.d.increased metabolic rate.ANS: A15.Replacement of damaged tissue by similar functional cells is termeda.fibrosis.b.regeneration.c.resolution.d.repair by scar tissue.ANS: B16.Scar tissue consists primarily ofa.granulation tissue.b.epithelial cells.c.collagen fibers.d.new capillaries and smooth muscle fibers.ANS: C17.Which of the following promotes rapid healing?a.Closely approximated edges of a woundb.Presence of foreign materialc.Exposure to radiationd.Vasoconstriction in the involved areaANS: A18.Glucocorticoids are used to treat inflammation because they directlya.promote the release of prostaglandins at the site.b.decrease capillary permeability.c.mobilize lymphocytes and neutrophils.d.prevent infection.ANS: B

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19.Patients taking glucocorticoids for long periods of time are likely to develop all ofthe following EXCEPTa.decreased bone density.b.wasting of skeletal muscle.c.opportunistic infections.d.increased leukocyte production.ANS: D20.Which of the following drugs relieves fever and some types of pain but is NOTan anti-inflammatory agent?a.Acetaminophenb.Prednisonec.Aspirind.IbuprofenANS: A21.A burn area in which the epidermis and part of the dermis is destroyed is classified asa.full-thickness.b.deep partial-thickness.c.superficial partial-thickness.d.first-degree.ANS: B22.A woman has burns on the anterior surfaces of her right arm, chest, and right leg.The percentage of body surface area burned is approximatelya.13.5%.b.18%.c.22.5%.d.31.5%.ANS: C23.The characteristic appearance of a full-thickness burn isa.painful with multiple blisters.b.heavy bleeding.c.red with some swelling.d.dry, firm, charred, or hard white surface.ANS: D24.A typical source of infection in burn areas isa.the skin grafts.b.microbes surviving in the hair follicles in the burn area.c.circulating blood bringing microbes to the burn wound.d.opportunistic virus in digestive tract.ANS: B25.A large burn area predisposes to decreased blood pressure becausea.bleeding occurs under the burn surface.

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