a school nurse is meeting with a high school student who mentions that she is frustrated with her repeated outbreaks of cold sores the student states

ATI RN

Pathophysiology Final Exam

1. A school nurse is meeting with a high school student who mentions that she is frustrated with her repeated outbreaks of cold sores. The student states that she tried an over-the-counter topical cream but that it failed to produce an appreciable improvement. The nurse should recognize that this student used what medication?

A. Ganciclovir
B. Valacyclovir (Valtrex)
C. Famciclovir (Famvir)
D. Docosanol (Abreva)

Correct answer: D

Rationale: The correct answer is D: Docosanol (Abreva). Docosanol is an over-the-counter topical cream commonly used to treat cold sores caused by the herpes simplex virus. It works by inhibiting viral fusion to host cell membranes, reducing the spread of the virus. Ganciclovir (Choice A) is an antiviral medication used for the treatment of cytomegalovirus infections. Valacyclovir (Choice B) and Famciclovir (Choice C) are prescription antiviral medications used to treat herpes simplex virus infections but are not typically available over-the-counter like Docosanol.

2. The college health nurse is providing health education for freshmen. Which of the following pieces of information about immunizations is applicable to individuals of this age group?

A. The oral polio vaccine should be updated.
B. The yearly administration of flu vaccine is recommended.
C. The tetanus toxoid should be within 2 years.
D. The administration of hepatitis A vaccine is mandatory.

Correct answer: B

Rationale: For freshmen in college, the yearly administration of the flu vaccine is recommended. This is important to protect against seasonal influenza outbreaks that can spread rapidly in close living quarters such as dormitories. Choice A is incorrect as oral polio vaccine is not typically given to individuals of this age group. Choice C is incorrect as tetanus toxoid boosters are usually recommended every 10 years, not within 2 years. Choice D is incorrect as the administration of the hepatitis A vaccine is not mandatory for all individuals in this age group.

3. A patient being treated for tuberculosis is determined to be drug resistant. Which of the following medications will the patient be resistant to in the treatment of tuberculosis?

A. Isoniazid (INH) and rifampin
B. Carbamazepine (Tegretol) and phenytoin (Dilantin)
C. Dextroamphetamine (Dexedrine) and doxapram (Dopram)
D. Propranolol (Inderal) and sotalol (Betapace)

Correct answer: A

Rationale: In the treatment of tuberculosis, drug resistance commonly develops against medications like Isoniazid (INH) and rifampin. These two drugs are key components of the standard anti-tuberculosis treatment regimen. Choices B, C, and D are unrelated medications that are not used in the treatment of tuberculosis. Carbamazepine and phenytoin are anticonvulsants, dextroamphetamine is a stimulant, and propranolol and sotalol are used for cardiovascular conditions.

4. In which of the following cases is dehydration more likely to occur?

A. A 50-year-old woman who is a bodybuilder
B. A 50-year-old man who is morbidly obese
C. A 10-year-old child who is thin
D. A 30-year-old with multiple sclerosis

Correct answer: B

Rationale: The correct answer is B. Morbid obesity increases the risk of dehydration due to the larger body surface area and potential for greater insensible losses. Choices A, C, and D are less likely to experience dehydration compared to a morbidly obese individual.

5. A patient is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to ___________ of the remaining liver cells.

A. Metaplasia
B. Organ atrophy
C. Compensatory hyperplasia
D. Physiologic hyperplasia

Correct answer: C

Rationale: Compensatory hyperplasia is the process by which the remaining cells increase in number to adapt to the reduced size of the liver. In this case, after the removal of a lobe of the liver, the remaining cells undergo compensatory hyperplasia to compensate for the lost tissue. Metaplasia refers to the reversible change of one cell type to another, not an increase in cell number. Organ atrophy is the decrease in organ size due to cell shrinkage or loss, which is opposite to an increase in cell number seen in compensatory hyperplasia. Physiologic hyperplasia is the increase in cell number in response to a normal physiological demand, not specifically due to the removal of a portion of the organ.