ATI RN
MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following women is at highest risk for the development of endometrial cancer?
- A. A 50-year-old postmenopausal woman with a history of high-risk human papillomavirus
- B. A 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods
- C. A 40-year-old woman who is overweight and has hypertension
- D. A 55-year-old woman who smokes
Correct answer: B
Rationale: The correct answer is a 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods. Obesity and prolonged exposure to estrogen unopposed by progesterone due to infrequent ovulation are significant risk factors for endometrial cancer. Choices A, C, and D do not directly correlate with the increased risk of endometrial cancer. Postmenopausal status alone (Choice A), overweight with hypertension (Choice C), and smoking (Choice D) are not the primary risk factors for endometrial cancer.
2. A hospital client is at a high risk of developing bacterial endocarditis. Which of the following prophylactic measures is likely to be most effective?
- A. Avoiding exposure to individuals known to carry the streptococcus bacterium
- B. Daily administration of low-dose corticosteroids
- C. Prophylactic antimicrobial therapy before any invasive procedure
- D. Routine vaccinations against meningococcal and pneumococcal infections
Correct answer: C
Rationale: Prophylactic antimicrobial therapy before any invasive procedure is the most effective measure in preventing bacterial endocarditis in at-risk individuals. This measure helps to reduce the risk of bacterial infection during invasive procedures, which can lead to endocarditis. Choice A is incorrect as avoiding exposure to individuals with streptococcus does not address the primary preventive measure needed. Choice B is incorrect as corticosteroids do not prevent bacterial endocarditis, and daily administration is not the recommended prophylactic measure. Choice D is incorrect as routine vaccinations against meningococcal and pneumococcal infections are important for other conditions but not specifically for preventing bacterial endocarditis.
3. A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following assessment findings would most likely occur?
- A. Bronze-colored skin
- B. Decreased iron
- C. Normochromic erythrocytes
- D. Aplastic bone marrow
Correct answer: A
Rationale: The correct answer is A: 'Bronze-colored skin.' Sideroblastic anemia is characterized by excess iron deposition, leading to bronze-colored skin. This occurs due to the abnormal accumulation of iron in tissues. Choices B, C, and D are incorrect because sideroblastic anemia does not typically present with decreased iron levels, normochromic erythrocytes, or aplastic bone marrow.
4. What therapeutic effect is expected from tamsulosin (Flomax) in a male patient with benign prostatic hyperplasia (BPH)?
- A. Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.
- B. Increase in urine flow and relief of urinary obstruction.
- C. Reduction in prostate size and improvement in urinary symptoms.
- D. Improvement in erectile function.
Correct answer: A
Rationale: The correct answer is A: 'Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.' Tamsulosin is an alpha-blocker that specifically targets alpha-1 receptors in the prostate and bladder neck, causing relaxation of smooth muscles. This relaxation results in improved urinary flow and reduced symptoms of BPH. Choice B is incorrect because while tamsulosin does improve urinary flow, it does not directly increase urine flow. Choice C is incorrect because tamsulosin does not reduce prostate size. Choice D is incorrect as tamsulosin does not have a primary effect on erectile function.
5. 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.
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