ATI RN
MSN 570 Advanced Pathophysiology Final 2024
1. Why does multiple sclerosis manifest as asymmetrical and in different parts of the body?
- A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
- B. Acetylcholine receptors are destroyed by immunoglobulin G.
- C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
- D. Cortical motor cells degenerate.
Correct answer: C
Rationale: Multiple sclerosis is characterized by the immune system mistakenly attacking the myelin sheath in the central nervous system. This results in the formation of lesions that can occur in different parts of the central nervous system, leading to varied symptoms depending on the location of the damage. Choice A is the correct answer because it accurately describes the pathophysiology of multiple sclerosis. Choices B, C, and D are incorrect because they describe mechanisms or locations that are not associated with the pathogenesis of multiple sclerosis.
2. The nurse is planning care for a client with damage to the vestibular area of the vestibulocochlear nerve. What should the nurse include in the plan of care? Select all that apply.
- A. Assistance with ambulation
- B. Regular hearing tests
- C. Monitoring for nausea
- D. Vision assessments
Correct answer: A
Rationale: Damage to the vestibular area affects balance and may cause nausea. Therefore, the nurse should include assistance with ambulation in the care plan to help the client maintain stability while walking. Regular hearing tests (choice B) are not directly related to damage in the vestibular area of the vestibulocochlear nerve. While nausea (choice C) may occur due to vestibular damage, monitoring for it alone is not as essential as providing assistance with ambulation. Vision assessments (choice D) are important for assessing visual function but are not the priority when dealing with vestibular issues.
3. A child with a serious fungal infection is receiving amphotericin B parenterally. Which of the following minerals will the patient most likely be required to receive?
- A. Chloride
- B. Magnesium
- C. Glucose
- D. Sodium
Correct answer: B
Rationale: When a patient is receiving amphotericin B, which is known to cause renal toxicity, they are most likely to require magnesium supplementation. Amphotericin B can lead to renal loss of magnesium, potassium, and calcium. Magnesium is an essential mineral that plays a vital role in various physiological functions, and its levels need to be monitored and supplemented when necessary. Chloride, glucose, and sodium are not typically supplemented in the context of amphotericin B therapy for a serious fungal infection.
4. Innate resistance or immunity:
- A. Involves 'memory'
- B. Is a development of an individual's later years
- C. Is a relatively slow and specific process
- D. Depends on physical, mechanical, and biochemical barriers
Correct answer: D
Rationale: Innate resistance or immunity relies on the body's natural defenses like physical, mechanical, and biochemical barriers. These barriers act as the first line of defense against pathogens and do not involve memory (choice A). Innate immunity is present from birth and does not develop over an individual's later years (choice B). Additionally, innate immunity is a rapid and nonspecific process, not a slow and specific one (choice C). Therefore, the correct answer is D.
5. Which of the following are normal arterial blood gas values?
- A. PH 7.25, PaCO2 52 mm Hg, PaO2 75 mm Hg, HCO3 18 mEq/L
- B. PH 7.50, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 28 mEq/L
- C. PH 7.40, PaCO2 40 mm Hg, PaO2 90 mm Hg, HCO3 24 mEq/L
- D. PH 7.15, PaCO2 30 mm Hg, PaO2 50 mm Hg, HCO3 24 mEq/L
Correct answer: C
Rationale: The correct answer is C: PH 7.40, PaCO2 40 mm Hg, PaO2 90 mm Hg, HCO3 24 mEq/L. These values represent a balanced state for arterial blood gas. Choice A has lower than normal PH and HCO3 levels and higher PaCO2 and lower PaO2 levels. Choice B has higher than normal PH and HCO3 levels, lower PaCO2, and a normal PaO2 level. Choice D has a significantly lower PH and PaO2 level, normal HCO3 level, and low PaCO2 level, indicating an acidic state with impaired oxygenation.
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