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MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following are manifestations of Cushing syndrome?
- A. Truncal obesity with thin extremities.
- B. Enlargement of face, hands, and feet.
- C. Cachexia.
- D. Thick scalp hair.
Correct answer: A
Rationale: Truncal obesity with thin extremities is a classic manifestation of Cushing syndrome due to the redistribution of fat. Enlargement of face, hands, and feet is seen in conditions like acromegaly, not Cushing syndrome. Cachexia is a state of severe weight loss and muscle wasting, typically seen in conditions like cancer or advanced infections. Thick scalp hair is not typically associated with Cushing syndrome.
2. What best describes sepsis?
- A. An overwhelming allergic reaction
- B. Severe inflammatory response to a pathogen's endotoxins
- C. Unknown causes resulting in hypertension
- D. Poor nursing and health care provider interventions
Correct answer: B
Rationale: The correct answer is B. Sepsis is a severe inflammatory response to a pathogen's endotoxins, leading to widespread infection and organ dysfunction. Choice A is incorrect as sepsis is not primarily an allergic reaction. Choice C is incorrect as sepsis is not characterized by unknown causes resulting in hypertension. Choice D is incorrect as sepsis is a medical condition and not solely caused by poor nursing or healthcare provider interventions.
3. Which of the following is a complication of compartment syndrome?
- A. Hemorrhage
- B. Pain and tissue damage
- C. Increased limb function
- D. Chronic kidney disease
Correct answer: B
Rationale: The correct answer is B: Pain and tissue damage. Compartment syndrome occurs due to increased pressure within the muscle compartments, leading to pain and tissue damage. Hemorrhage (choice A) is not a typical complication of compartment syndrome. Increased limb function (choice C) is not a complication but rather a potential improvement if the condition is managed appropriately. Chronic kidney disease (choice D) is unrelated to compartment syndrome.
4. How should the nurse respond to a 72-year-old patient diagnosed with benign prostatic hypertrophy (BPH) who is skeptical about tamsulosin (Flomax) for symptom relief?
- A. “Flomax can increase the amount of urine your kidneys produce, resulting in better urine flow.”
- B. “Flomax can relax your prostate and your bladder neck, making it easier to pass urine.”
- C. “Flomax makes your urine less alkaline, reducing the irritation that makes your prostate swell.”
- D. “Flomax increases the strength of your bladder muscle and results in a stronger flow of urine.”
Correct answer: B
Rationale: The correct response is choice B because it explains the mechanism of action of Flomax, which helps the patient understand how the medication works. By stating that Flomax relaxes the prostate and bladder neck, making it easier to pass urine, the nurse is addressing the patient's concerns about symptom relief. Choices A, C, and D provide inaccurate information about Flomax's mechanism of action and do not directly address the patient's skepticism or concerns.
5. What is the pathophysiologic process responsible for the decreased glomerular filtration rate in a patient with acute glomerulonephritis?
- A. Decreased renal-induced constriction of the renal arteries
- B. Immune complex deposition, increased capillary permeability, and cellular proliferation
- C. Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure
- D. Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis
Correct answer: B
Rationale: The correct answer is B: Immune complex deposition, increased capillary permeability, and cellular proliferation. Acute glomerulonephritis is characterized by inflammation of the glomeruli in the kidneys. This inflammation leads to the deposition of immune complexes, increased capillary permeability, and cellular proliferation, which collectively contribute to a decreased glomerular filtration rate. Choice A is incorrect as decreased renal-induced constriction of the renal arteries would not directly result in decreased glomerular filtration rate. Choice C is incorrect as necrosis of nephrons due to increased kidney interstitial hydrostatic pressure would affect kidney function differently. Choice D is incorrect as scar tissue formation in the proximal convoluted tubule due to toxin-induced collagen synthesis is not a typical feature of acute glomerulonephritis.
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