a 70 year old woman has difficulty with driving and she has been frequently getting lost her husband said she has also been acting strange and seems

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MSN 570 Advanced Pathophysiology Final 2024

1. A 70-year-old woman has difficulty with driving, and she has been frequently getting lost. Her husband said she has also been acting strange and seems to want to sleep a lot. He said the other night she kept saying she was seeing animals such as lions in her room. He says her memory is not too bad, but he is very concerned about her health. Physical examination reveals an alert woman with stable vital signs. Bradykinesia and limb rigidity are noted. These findings are consistent with:

A. Alzheimer's disease.
B. Vascular dementia.
C. Dementia with Lewy bodies.
D. Frontotemporal dementia.

Correct answer: C

Rationale: The symptoms described in the scenario, such as visual hallucinations, fluctuations in cognition, and parkinsonism (bradykinesia and limb rigidity), are classic features of dementia with Lewy bodies (DLB). DLB is characterized by the presence of Lewy bodies in the brain, which are abnormal protein deposits. Alzheimer's disease (Choice A) typically presents with memory loss as a predominant symptom, which is not a major concern in this case. Vascular dementia (Choice B) is associated with a history of cerebrovascular disease and is not supported by the symptoms described. Frontotemporal dementia (Choice D) usually presents with changes in behavior and personality, rather than the symptoms described in the scenario.

2. A healthcare professional is documenting the recent vital signs for several clients on an acute medical ward of a hospital. Which hospital client with a noninfectious diagnosis would be most likely to have a fever?

A. A 71-year-old female with limited mobility, chronic obstructive pulmonary disease (COPD), and vascular dementia
B. A 33-year-old female with a postoperative deep vein thrombosis and pulmonary embolism
C. A 51-year-old obese male with hepatic encephalopathy secondary to alcohol abuse
D. A 71-year-old male with congestive heart failure and peripheral edema

Correct answer: B

Rationale: The correct answer is B. Pulmonary emboli can produce fever even without infection. This is known as a noninfectious cause of fever. Choices A, C, and D do not typically present with fever as a prominent symptom. Limited mobility, COPD, vascular dementia, hepatic encephalopathy, alcohol abuse, congestive heart failure, and peripheral edema are not directly associated with causing fever in the absence of infection, unlike pulmonary embolism.

3. Seizures are diagnosed by which of the following?

A. Electroencephalogram (EEG) and ECG
B. Seizure symptoms and complete blood count (CBC)
C. Seizure symptoms and electrocardiogram (ECG)
D. Seizure symptoms and EEG

Correct answer: D

Rationale: Seizures are most accurately diagnosed by EEG, which measures brain activity. Choice A is incorrect as ECG (electrocardiogram) measures heart activity, not brain activity. Choice B is incorrect as CBC (complete blood count) is a blood test and not used to diagnose seizures. Choice C is incorrect as an ECG (electrocardiogram) also measures heart activity, not brain activity, and is not the primary diagnostic tool for seizures.

4. Where are most body fluids located?

A. Intravascular space.
B. Intracellular space.
C. Extracellular space.
D. Transcellular space.

Correct answer: B

Rationale: Most body fluids are located within cells in the intracellular space. While the extracellular space also contains body fluids, the majority is found within the cells. Intravascular space refers to fluids within blood vessels, and transcellular space includes fluids in compartments like cerebrospinal, pleural, and peritoneal cavities.

5. What should the nurse teach the boy about anabolic steroid abuse?

A. The ability of anabolic steroids to build muscle is greatly exaggerated in the media.
B. Anabolic steroids are universally dangerous but are especially harmful to adolescents.
C. The muscle mass resulting from steroid use will atrophy unless doses are continually increased.
D. Anabolic steroids will reduce the boy's ability to perform weight-bearing exercise later in life.

Correct answer: B

Rationale: The correct answer is B because anabolic steroids are indeed universally dangerous, but they pose greater risks to adolescents due to their impact on growth and development. Choice A is incorrect because anabolic steroids do have the potential to build muscle mass, though not to the extent often portrayed in the media. Choice C is incorrect as muscle mass gained from steroid use may persist for a period even after discontinuation. Choice D is incorrect as anabolic steroids can enhance muscle performance initially, though long-term use can have adverse effects on health and not specifically on the ability to perform weight-bearing exercises.