ATI RN
MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?
- A. Eosinophils
- B. Neutrophils
- C. Leukotrienes
- D. Monocytes
Correct answer: B
Rationale: Neutrophils are the first responders to a bacterial infection. They are phagocytes that engulf and destroy bacteria, playing a crucial role in the early stages of the immune response. Eosinophils are primarily involved in combating parasitic infections and allergic reactions, not bacterial infections. Leukotrienes are signaling molecules that contribute to inflammation and immune responses, but they are not cells. Monocytes are another type of white blood cell that differentiates into macrophages and dendritic cells, playing a role in immune response but not as immediate as neutrophils.
2. A client with multiple sclerosis (MS) is frustrated by tremors associated with the disease. How should the nurse explain why these tremors occur? Due to the demyelination of neurons that occurs in MS:
- A. there is an imbalance in acetylcholine and dopamine, leading to tremors.
- B. there is a disruption in nerve impulse conduction, causing tremors.
- C. muscles are unable to receive impulses, resulting in tremors.
- D. the reflex arc is disrupted, leading to muscle tremors.
Correct answer: B
Rationale: In multiple sclerosis (MS), demyelination of neurons disrupts nerve impulse conduction. This disruption in nerve impulses can lead to tremors, explaining why the client experiences tremors in MS. Choice A is incorrect because tremors in MS are primarily due to nerve conduction issues, not an imbalance in acetylcholine and dopamine. Choice C is incorrect as it oversimplifies the process; the issue lies in nerve impulses, not the muscle's ability to receive them. Choice D is incorrect as the primary cause of tremors in MS is the disruption in nerve impulse conduction, not the reflex arc being disrupted.
3. A patient has been prescribed raloxifene (Evista) for the prevention of osteoporosis. What effect should the nurse include in the teaching plan regarding the action of this medication?
- A. Decreases calcium excretion by the kidneys.
- B. Increases intestinal absorption of calcium.
- C. Stimulates bone formation by increasing osteoblast activity.
- D. Selectively binds to estrogen receptors, decreasing bone resorption.
Correct answer: D
Rationale: The correct answer is D: Selectively binds to estrogen receptors, decreasing bone resorption. Raloxifene is a selective estrogen receptor modulator (SERM) that works by binding to estrogen receptors, thereby decreasing bone resorption. This action helps in the prevention and treatment of osteoporosis by preserving bone density. Choices A, B, and C are incorrect because raloxifene does not directly affect calcium excretion by the kidneys, intestinal absorption of calcium, or stimulate bone formation by increasing osteoblast activity.
4. A male patient with erectile dysfunction has asked for a prescription for sildenafil (Viagra). Before giving this medication, the nurse should assess for which of the following conditions?
- A. History of peptic ulcer disease
- B. Use of nitrates
- C. Recent history of a stroke
- D. History of hypertension
Correct answer: B
Rationale: The correct answer is B: Use of nitrates. Sildenafil should not be used by patients taking nitrates due to the risk of severe hypotension. Nitrates can potentiate the hypotensive effects of sildenafil, leading to a significant drop in blood pressure. Assessing for the use of nitrates is crucial to avoid this potentially dangerous interaction. Choices A, C, and D are incorrect because they are not specifically contraindications for the use of sildenafil. While a history of hypertension should be considered, it is not as critical as the use of nitrates when prescribing sildenafil.
5. A male patient receiving androgen therapy is concerned about the risk of prostate cancer. What should the nurse explain about this risk?
- A. Finasteride has been shown to lower the risk of developing prostate cancer.
- B. Finasteride does not affect the risk of prostate cancer, so regular screening is unnecessary.
- C. Finasteride may increase the risk of developing prostate cancer, so regular screenings are recommended.
- D. Finasteride has no effect on the risk of prostate cancer, so regular screenings are unnecessary.
Correct answer: A
Rationale: The correct answer is A. Finasteride has been shown to lower the risk of developing prostate cancer. However, regular screenings are still recommended to monitor for any potential issues. Choice B is incorrect because finasteride has been associated with a decreased risk of prostate cancer, making regular screenings important. Choice C is incorrect as finasteride is not known to increase the risk of developing prostate cancer. Choice D is incorrect as finasteride has shown a protective effect against prostate cancer, but regular screenings are still necessary to ensure early detection and monitoring.
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