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MSN 570 Advanced Pathophysiology Final 2024
1. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following is consistent with this diagnosis?
- A. Right lower quadrant cramping
- B. Severe bloody diarrhea
- C. Nausea and vomiting
- D. Mostly affects the rectum
Correct answer: A
Rationale: Crohn's disease is a type of inflammatory bowel disease that can affect any part of the digestive tract. Right lower quadrant cramping is consistent with Crohn's disease as it commonly involves the terminal ileum, which is located in the right lower quadrant of the abdomen. Severe bloody diarrhea is more characteristic of ulcerative colitis, another type of inflammatory bowel disease. Nausea and vomiting are not specific symptoms of Crohn's disease. Crohn's disease can affect any part of the digestive tract, not just the rectum, so it is not accurate to say it mostly affects the rectum.
2. Although stress exposure initiates integrated responses by multiple systems, which system first activates the most important changes?
- A. Pulmonary
- B. Gastrointestinal
- C. Neuroendocrine
- D. Cardiovascular
Correct answer: C
Rationale: The correct answer is C, the Neuroendocrine system. When the body is exposed to stress, the neuroendocrine system plays a crucial role in initiating the body's response. This system, particularly through the hypothalamic-pituitary-adrenal axis, triggers a cascade of physiological responses to stress. Choices A, B, and D are incorrect because while other systems like the cardiovascular and gastrointestinal systems also respond to stress, the neuroendocrine system is primarily responsible for the initial and significant changes in the body's stress response.
3. A client arrives with symptoms of stroke. What should the nurse assess first?
- A. Level of consciousness
- B. Blood pressure
- C. Pupil reaction
- D. Heart rate
Correct answer: A
Rationale: Assessing the level of consciousness is a critical first step in evaluating a potential stroke. Changes in the level of consciousness can indicate the severity and location of brain damage, helping to guide immediate interventions. Assessing blood pressure, pupil reaction, and heart rate are also important aspects of the assessment in a suspected stroke patient. However, the priority is to quickly determine the client's level of consciousness to assess their neurological status.
4. Anemia of chronic inflammation is generally classified as:
- A. hypochromic and microcytic.
- B. hypochromic and macrocytic.
- C. normochromic and microcytic.
- D. normochromic and normocytic.
Correct answer: D
Rationale: Anemia of chronic inflammation is characterized by normochromic and normocytic red blood cells. In chronic inflammation, the body typically produces enough red blood cells, but they are often smaller and paler than normal (normocytic and normochromic). Choices A, B, and C are incorrect because hypochromic and microcytic, hypochromic and macrocytic, and normochromic and microcytic anemias are not typically associated with chronic inflammation.
5. 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.
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