ATI RN
MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following clinical findings in a 51-year-old woman is consistent with Graves disease?
- A. Thin hair, exophthalmos, hyperreflexia, and pretibial edema.
- B. Thin hair, exophthalmos, weight gain, and constipation.
- C. Thick hair, bradycardia, weight loss, and dry skin.
- D. Thick hair, bradycardia, weight gain, and constipation.
Correct answer: A
Rationale: The clinical findings of thin hair, exophthalmos (bulging eyes), hyperreflexia, and pretibial edema are classic manifestations of Graves disease, an autoimmune condition that results in hyperthyroidism. Choice B is incorrect because weight gain and constipation are more indicative of hypothyroidism, not hyperthyroidism seen in Graves disease. Choice C is incorrect as the symptoms described are more characteristic of hypothyroidism, not hyperthyroidism. Choice D is also incorrect as the symptoms listed are not consistent with Graves disease but rather suggest hypothyroidism.
2. After a 27-year-old woman with epilepsy had a generalized seizure, she feels tired and falls asleep. This is:
- A. an ominous sign.
- B. normal and termed the postictal period.
- C. a reflection of an underlying brain tumor.
- D. only worrisome if there are focal neurologic deficits after.
Correct answer: B
Rationale: The correct answer is B: normal and termed the postictal period. The postictal period is a common phase following a seizure where the individual may experience fatigue, confusion, or sleepiness. It is a normal part of the seizure event and does not necessarily indicate a serious issue. Choice A is incorrect because feeling tired and falling asleep after a seizure is not an ominous sign but rather a typical postictal symptom. Choice C is incorrect as there is no indication in the scenario provided that links the symptoms to an underlying brain tumor. Choice D is incorrect because the absence of focal neurologic deficits does not make the postictal period worrisome.
3. In which patient is alpha-1 antitrypsin deficiency the likely cause of chronic obstructive pulmonary disease?
- A. A 30-year-old who has smoked for 3 years
- B. A 65-year-old man who drove a taxi most of his life
- C. A 70-year-old woman who smoked for 40 years
- D. A 50-year-old with exposure to secondhand smoke
Correct answer: A
Rationale: Alpha-1 antitrypsin deficiency is a genetic cause of chronic obstructive pulmonary disease (COPD). It is more common in younger patients with a history of smoking at a younger age, like the 30-year-old who has smoked for 3 years. Choices B, C, and D are less likely to be associated with alpha-1 antitrypsin deficiency as COPD in these cases is more likely due to smoking and environmental exposures.
4. What is a cause of the crystallization within the synovial fluid of the joint affected by gouty arthritis?
- A. Destruction of proteoglycans
- B. Underexcretion of uric acid
- C. Overexcretion of uric acid
- D. Increased absorption of uric acid
Correct answer: B
Rationale: The correct answer is B: Underexcretion of uric acid. In gouty arthritis, the crystallization within the synovial fluid of the affected joint is caused by the underexcretion of uric acid, leading to the accumulation and subsequent crystallization of urate crystals. Choice A, destruction of proteoglycans, is incorrect as it is not directly related to the crystallization process in gouty arthritis. Choice C, overexcretion of uric acid, is incorrect because gout is primarily associated with underexcretion or decreased excretion of uric acid rather than overexcretion. Choice D, increased absorption of uric acid, is also incorrect as the primary issue in gouty arthritis is the body's inability to properly eliminate uric acid.
5. A woman is complaining that she feels like the room is spinning even though she is not moving. Which of the following is characteristic of benign positional vertigo?
- A. It usually occurs with a headache.
- B. Pupillary changes are common.
- C. It is usually triggered when the patient bends forward.
- D. Nystagmus continues even when eyes fixate on an object.
Correct answer: C
Rationale: Benign positional vertigo is typically triggered by changes in head position, such as bending forward or turning over in bed. This change in position leads to brief episodes of vertigo, often associated with nystagmus, which is rapid, involuntary eye movements. Pupillary changes and headaches are not typical features of benign positional vertigo, making choices B and A incorrect. Nystagmus in benign positional vertigo usually stops when the eyes fixate on an object, so choice D is also incorrect.
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