a 30 year old man has a history of heart transplant and is receiving long term steroids to prevent rejection the patient is due for routine vaccines a
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MSN 570 Advanced Pathophysiology Final 2024

1. A 30-year-old man has a history of heart transplant and is receiving long-term steroids to prevent rejection. The patient is due for routine vaccines. Attenuated vaccines are contraindicated in this patient because the antigen is:

Correct answer: live and can cause infection.

Rationale: The correct answer is A: live and can cause infection. Patients who are immunocompromised, like those receiving long-term steroids after an organ transplant, should not receive live vaccines because the live attenuated organisms in these vaccines can cause infections in individuals with weakened immune systems. Choice B is incorrect because attenuated vaccines are live but weakened, not mutated. Choice C is incorrect because while inactive, attenuated vaccines are not infectious. Choice D is incorrect because attenuated vaccines are not pathogenic; they are attenuated (weakened) forms of the pathogen.

2. What is the main water-holding force in the blood capillaries?

Correct answer: C

Rationale: The correct answer is C: Protein in the blood plasma. Plasma proteins, especially albumin, create oncotic pressure, which is the main force responsible for holding water within the blood capillaries. Capillary blood pressure (Choice A) is involved in pushing blood through the capillaries, while sodium and chloride in the blood plasma (Choices B and D) are electrolytes and do not play a significant role in the water-holding force within capillaries.

3. Which psychosexual stage focuses on castration anxiety?

Correct answer: D

Rationale: Castration anxiety is a concept from Freudian psychoanalytic theory that occurs during the Phallic stage. This stage occurs between 3 to 6 years of age and is when children experience conflicts related to the Oedipus complex (boys) and Electra complex (girls). During this stage, children may fear castration (in boys) or penis envy (in girls), which are crucial components of castration anxiety. Therefore, the correct answer is Phallic. The other options (A: Genital, B: Oral, C: Anal) are incorrect as they do not specifically involve castration anxiety but rather represent different stages in Freud's psychosexual development theory.

4. Which type of medication helps to reduce blood pressure by relaxing the blood vessels?

Correct answer: A

Rationale: The correct answer is A, Calcium channel blocker. Calcium channel blockers work by relaxing the blood vessels, making it easier for the heart to pump blood and reducing blood pressure. Choice B, ACE inhibitor, reduces blood pressure by blocking the production of angiotensin II, a substance that narrows blood vessels. Choice C, Beta-blocker, reduces heart rate and the heart's workload, not directly relaxing blood vessels. Choice D, Diuretic, reduces blood pressure by increasing urine output, reducing the volume of fluid in the blood vessels, rather than directly relaxing them.

5. A client with COPD is developing a plan of care. Which of the following interventions should the nurse include in the plan?

Correct answer: Instruct the client to use pursed-lip breathing

Rationale: In COPD, pursed-lip breathing helps improve breathing efficiency by maintaining positive pressure in the airways, preventing airway collapse, and promoting oxygenation. This technique assists in controlling respiratory rate, reducing dyspnea, and enhancing oxygen saturation levels. Restricting fluid intake is not typically a part of COPD management. Providing a low-protein diet is not a standard intervention for COPD. Early-morning hours are generally not recommended for exercise due to cooler temperatures and higher pollution levels, which can exacerbate COPD symptoms.

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