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MSN 570 Advanced Pathophysiology Final 2024
1. A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person:
- A. is normal with no sickle cell disease.
- B. is a sickle cell carrier.
- C. has sickle cell anemia.
- D. has thalassemia.
Correct answer: B
Rationale: The correct answer is that the person is a sickle cell carrier. In HbAS, 'Hb' stands for hemoglobin, 'A' indicates normal hemoglobin, and 'S' indicates the sickle cell trait. Individuals with HbAS are carriers of the sickle cell trait but do not have sickle cell disease. Choice A is incorrect because having the sickle cell trait means carrying the gene for sickle cell disease. Choice C is incorrect as sickle cell anemia is a different condition where individuals have two copies of the abnormal hemoglobin gene, resulting in the disease. Choice D is incorrect because thalassemia is a separate genetic disorder affecting the production of hemoglobin, not related to the sickle cell trait.
2. A patient with erectile dysfunction is prescribed sildenafil (Viagra). What condition would contraindicate the use of this medication?
- A. History of hypertension
- B. Use of nitrates
- C. Recent use of antihypertensive medications
- D. History of peptic ulcer disease
Correct answer: B
Rationale: The correct answer is B: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of hypertension, recent use of antihypertensive medications, or a history of peptic ulcer disease are not direct contraindications for using sildenafil.
3. Which term should the nurse use to document a situation in which cells increase in size and function?
- A. Atrophy
- B. Hypertrophy
- C. Metaplasia
- D. Hyperplasia
Correct answer: B
Rationale: Hypertrophy is the correct term used to describe the situation in which cells increase in size and function. Atrophy (Choice A) is the opposite, indicating a decrease in cell size. Metaplasia (Choice C) refers to the reversible replacement of one mature cell type by another. Hyperplasia (Choice D) involves an increase in the number of cells, not just an increase in size and function as in hypertrophy.
4. During an acute asthma exacerbation, what is the priority nursing intervention for a client with asthma?
- A. Administer corticosteroids to reduce airway inflammation.
- B. Position the client in high-Fowler's position.
- C. Administer short-acting beta-agonists (SABAs) as prescribed.
- D. Obtain a peak flow reading to assess the severity of the exacerbation.
Correct answer: C
Rationale: The priority nursing intervention during an acute asthma exacerbation is to administer short-acting beta-agonists (SABAs) as prescribed. SABAs help in quickly relieving bronchospasm and are considered the first-line treatment for acute exacerbations. Administering corticosteroids, positioning the client, and obtaining a peak flow reading are important interventions but come after administering SABAs in the management of acute asthma exacerbation.
5. 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.
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