a 70 year old man has a history of chronic obstructive pulmonary disease copd he reports increasing shortness of breath wheezing and cough which of th

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Pathophysiology Practice Questions

1. In a 70-year-old man with a history of chronic obstructive pulmonary disease (COPD) reporting increasing shortness of breath, wheezing, and cough, which finding would indicate a potential exacerbation of his COPD?

A. Increased wheezing
B. Decreased respiratory rate
C. Improved exercise tolerance
D. Decreased sputum production

Correct answer: A

Rationale: The correct answer is A: Increased wheezing. In COPD exacerbations, there is a worsening of symptoms such as increased wheezing due to airway inflammation and narrowing. Choices B, C, and D are incorrect. Decreased respiratory rate would not be expected in COPD exacerbation as it is usually a compensatory mechanism to maintain oxygenation. Improved exercise tolerance is not a typical finding in exacerbations but rather a sign of improvement. Decreased sputum production is also not indicative of exacerbation, as exacerbations are often associated with increased sputum production.

2. Seizures are diagnosed by which of the following?

A. Electroencephalogram (EEG) and ECG
B. Seizure symptoms and complete blood count (CBC)
C. Seizure symptoms and electrocardiogram (ECG)
D. Seizure symptoms and EEG

Correct answer: D

Rationale: Seizures are most accurately diagnosed by EEG, which measures brain activity. Choice A is incorrect as ECG (electrocardiogram) measures heart activity, not brain activity. Choice B is incorrect as CBC (complete blood count) is a blood test and not used to diagnose seizures. Choice C is incorrect as an ECG (electrocardiogram) also measures heart activity, not brain activity, and is not the primary diagnostic tool for seizures.

3. How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?

A. Administer radioactive cobalamin and measure its excretion time
B. Measure antigen-antibody immune complexes
C. Measure serum ferritin and total iron-binding capacity
D. Administer folate and evaluate folate content in a blood serum sample

Correct answer: A

Rationale: The correct answer is A. To prepare a patient for a Schilling test for pernicious anemia, the nurse should administer radioactive cobalamin and measure its excretion time. This test is specifically designed to assess the absorption of vitamin B12. Choices B, C, and D are incorrect because they do not align with the preparation and procedure of a Schilling test. Measuring antigen-antibody immune complexes, serum ferritin, or total iron-binding capacity, as well as administering folate and evaluating folate content, are not part of the Schilling test protocol.

4. What is the action of amphotericin B?

A. It binds to ergosterol and forms holes in the membrane.
B. It binds to an enzyme required for the synthesis of ergosterol.
C. It disrupts the fungal cell walls rather than the cell membrane.
D. It inhibits glucan synthetase required for glucan synthesis.

Correct answer: A

Rationale: Amphotericin B is an antifungal medication that acts by binding to ergosterol, a component of fungal cell membranes, forming pores that disrupt the integrity of the membrane. This action leads to leakage of cellular contents and ultimately cell death. Choice B is incorrect as amphotericin B does not bind to an enzyme required for the synthesis of ergosterol. Choice C is incorrect as the drug primarily affects the cell membrane rather than the cell wall. Choice D is also incorrect as amphotericin B does not inhibit glucan synthetase.

5. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse teach the patient about the use of this medication?

A. Medroxyprogesterone should be taken with food to prevent nausea.
B. Medroxyprogesterone can be taken intermittently when symptoms worsen.
C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels.
D. Medroxyprogesterone should be discontinued if side effects occur.

Correct answer: C

Rationale: The correct answer is C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels and effectiveness. Taking it at different times can lead to hormonal fluctuations and reduced medication efficacy. Choice A is incorrect because medroxyprogesterone does not need to be taken with food to prevent nausea. Choice B is incorrect as medroxyprogesterone is typically taken continuously rather than intermittently. Choice D is incorrect because side effects should be reported to the healthcare provider for further evaluation and management, not automatically leading to discontinuation of the medication.