ATI RN
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. How should rifampin most likely be administered to a patient diagnosed with tuberculosis?
- A. Orally, with food
- B. Orally, on an empty stomach
- C. Intramuscularly
- D. Intravenously, as a bolus
Correct answer: A
Rationale: Rifampin is typically administered orally, and it is recommended to be taken with food to enhance its absorption and reduce gastrointestinal side effects. Administering rifampin intramuscularly or intravenously is not the standard route of administration for this medication used in tuberculosis treatment.
3. What therapeutic effect is expected from tamsulosin (Flomax) in a male patient with benign prostatic hyperplasia (BPH)?
- A. Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.
- B. Increase in urine flow and relief of urinary obstruction.
- C. Reduction in prostate size and improvement in urinary symptoms.
- D. Improvement in erectile function.
Correct answer: A
Rationale: The correct answer is A: 'Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.' Tamsulosin is an alpha-blocker that specifically targets alpha-1 receptors in the prostate and bladder neck, causing relaxation of smooth muscles. This relaxation results in improved urinary flow and reduced symptoms of BPH. Choice B is incorrect because while tamsulosin does improve urinary flow, it does not directly increase urine flow. Choice C is incorrect because tamsulosin does not reduce prostate size. Choice D is incorrect as tamsulosin does not have a primary effect on erectile function.
4. A nursing student having trouble moving her head from side to side is likely experiencing a problem with which type of neurons?
- A. General visceral efferent neurons
- B. Preganglionic neurons
- C. Parasympathetic postganglionic neurons
- D. Pharyngeal efferent neurons
Correct answer: D
Rationale: The correct answer is D: Pharyngeal efferent neurons. Pharyngeal efferent neurons are responsible for controlling head movements, including side-to-side motions. General visceral efferent neurons (Choice A) are involved in innervating smooth muscles and glands in the body's internal organs. Preganglionic neurons (Choice B) are part of the autonomic nervous system and connect the central nervous system to the ganglia. Parasympathetic postganglionic neurons (Choice C) are the second neurons in the parasympathetic nervous system pathway, responsible for innervating target organs. In this case, the issue with moving the head from side to side indicates a problem with the pharyngeal efferent neurons.
5. A nurse practitioner is assessing a 7-year-old boy who has been brought to the clinic by his mother, who is concerned about her son's increasingly frequent, severe headaches. Which of the nurse's questions is least likely to yield data that will confirm or rule out migraines as the cause of his problem?
- A. Does your son experience nausea or vomiting when he has a headache?
- B. Does your son have a history of recent head injury?
- C. Does your son become sensitive to light when he has a headache?
- D. Does anyone in your family have a history of migraines?
Correct answer: B
Rationale: Asking about a history of recent head injury is less likely to yield data relevant to confirming or ruling out migraines. Migraines are often associated with symptoms like nausea, vomiting, sensitivity to light, and a family history of migraines. While head injuries can cause headaches, the focus of the assessment in this case should be on symptoms more specific to migraines to guide the diagnosis and management.
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