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MSN 570 Advanced Pathophysiology Final 2024
1. In a patient with a subconjunctival hemorrhage due to allergic rhinitis, which statement is accurate?
- A. The hemorrhage will resolve without treatment within 2 weeks.
- B. The patient should be referred for immediate ophthalmologic examination.
- C. Oral antihistamines should be started to prevent further complications.
- D. Topical corticosteroids may be considered to reduce inflammation.
Correct answer: A
Rationale: In a patient with a subconjunctival hemorrhage secondary to allergic rhinitis, the hemorrhage is typically self-limiting and will resolve on its own within 2 weeks without the need for specific treatment. Referring the patient for immediate ophthalmologic examination is not necessary unless there are other concerning symptoms. Starting oral antihistamines may help manage the underlying allergic rhinitis but is not specifically indicated for the hemorrhage. Topical corticosteroids are not routinely prescribed for subconjunctival hemorrhage as they may have limited benefit and could potentially cause complications.
2. Which of the following is a characteristic of the human immunodeficiency virus (HIV), which causes AIDS?
- A. HIV only infects B cells
- B. HIV is a retrovirus
- C. Infection does not require a host cell receptor
- D. After infection, cell death is immediate
Correct answer: B
Rationale: The correct answer is B. HIV is a retrovirus that infects T cells and leads to the gradual destruction of the immune system. Choice A is incorrect because HIV infects T cells primarily, not just B cells. Choice C is incorrect because HIV infection requires host cell receptors for entry. Choice D is incorrect because cell death after HIV infection is not immediate; instead, the virus gradually weakens the immune system over time.
3. Macular degeneration occurs as a result of:
- A. loss of lens accommodation
- B. detachment of the retina
- C. increased intraocular pressure
- D. impaired blood supply leading to cellular waste accumulation and ischemia
Correct answer: D
Rationale: Macular degeneration is a condition that affects the macula, a part of the retina responsible for central vision. It is primarily caused by impaired blood supply to the macula, leading to cellular waste accumulation and ischemia. This results in the death of photoreceptor cells and ultimately vision loss. Choices A, B, and C are incorrect because macular degeneration is not related to the loss of lens accommodation, detachment of the retina, or increased intraocular pressure. The correct answer directly addresses the underlying pathophysiology of macular degeneration.
4. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What critical information should the nurse provide during patient education?
- A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
- B. Tamoxifen may decrease the risk of osteoporosis, so adequate calcium intake is important.
- C. Tamoxifen may cause weight gain, so patients should monitor their diet.
- D. Tamoxifen may increase the risk of breast cancer, so regular mammograms are essential.
Correct answer: A
Rationale: When a patient is prescribed tamoxifen, a critical piece of information that the nurse should provide during patient education is that tamoxifen may increase the risk of venous thromboembolism. Therefore, patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur. Choice B is incorrect because tamoxifen does not decrease the risk of osteoporosis. Choice C is incorrect as weight gain is a possible side effect of tamoxifen, but it is not a critical piece of information compared to the risk of venous thromboembolism. Choice D is incorrect because tamoxifen is actually used to treat breast cancer, not increase its risk.
5. Which of the following is NOT an example of clinical manifestations of leukemia and lymphoma?
- A. Fatigue
- B. Increased risk of bleeding
- C. Increased risk of infections
- D. Increased energy and strength
Correct answer: D
Rationale: The correct answer is D: Increased energy and strength. Leukemia and lymphoma typically present with symptoms such as fatigue, weakness, increased risk of bleeding, and increased risk of infections. Patients with these conditions often experience a lack of energy and strength due to the disease's impact on the body. Therefore, increased energy and strength are not typical manifestations of leukemia and lymphoma.
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