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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. A person is given an attenuated antigen as a vaccine. When the person asks what was given in the vaccine, how should the nurse respond? The antigen is:
- A. Alive, but less infectious
- B. Mutated, but highly infectious
- C. Normal, but not infectious
- D. Inactive, but infectious
Correct answer: A
Rationale: An attenuated antigen used in a vaccine is alive but less infectious, aiming to stimulate an immune response. Choice B is incorrect because an attenuated antigen is not highly infectious. Choice C is incorrect as the antigen is intentionally altered to be less infectious. Choice D is incorrect as an attenuated antigen is not infectious.
3. When assessing for potential signs and symptoms of cryptococcosis in a patient with HIV being treated with Amphotericin B, the nurse should prioritize what assessment?
- A. Neurological assessment
- B. Functional assessment
- C. Nutritional assessment
- D. Cardiac assessment
Correct answer: A
Rationale: In a patient with cryptococcosis and HIV, neurological assessment should be prioritized because cryptococcosis commonly affects the central nervous system, leading to symptoms such as headache, confusion, and altered mental status. This assessment is crucial in monitoring for any neurological complications and guiding appropriate interventions. Functional assessment focuses on the patient's ability to perform activities of daily living and is not directly associated with cryptococcosis. Nutritional assessment is important for overall health but is not the priority when assessing for cryptococcosis. Cardiac assessment is not a priority in cryptococcosis as the primary manifestations are related to the central nervous system.
4. When does pain in the lower extremities due to peripheral artery disease usually worsen?
- A. with rest because blood flow decreases.
- B. with elevation of the extremity because blood is diverted away.
- C. when the leg is in a dependent position because blood pools.
- D. when the leg is touched or massaged because cytokines are released.
Correct answer: B
Rationale: Pain in the lower extremities due to peripheral artery disease usually worsens with elevation of the extremity because blood is diverted away from the affected area, leading to decreased perfusion and exacerbation of symptoms. Choices A, C, and D are incorrect because resting, dependent position, and touch/massage do not typically worsen the pain associated with peripheral artery disease.
5. In chronic obstructive pulmonary disease, the inflammatory response predominantly involves:
- A. eosinophils
- B. neutrophils
- C. monocytes
- D. cells
Correct answer: B
Rationale: In chronic obstructive pulmonary disease, the inflammatory response predominantly involves neutrophils. Neutrophils play a key role in COPD due to their involvement in initiating and sustaining the inflammatory process. Eosinophils are more commonly associated with asthma rather than COPD. Monocytes are less involved in the inflammatory response in COPD compared to neutrophils. The choice 'cells' is too broad and vague to be a specific answer in this context.
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