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MSN 570 Advanced Pathophysiology Final 2024
1. In chronic obstructive pulmonary disease, the inflammatory response predominantly involves:
- A. eosinophils
- B. neutrophils
- C. monocytes
- D. cells
Correct answer: B
Rationale: In chronic obstructive pulmonary disease, the inflammatory response predominantly involves neutrophils. Neutrophils play a key role in COPD due to their involvement in initiating and sustaining the inflammatory process. Eosinophils are more commonly associated with asthma rather than COPD. Monocytes are less involved in the inflammatory response in COPD compared to neutrophils. The choice 'cells' is too broad and vague to be a specific answer in this context.
2. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What important instruction should the nurse provide about the use of this medication?
- A. Take the medication with food to prevent nausea.
- B. Discontinue the medication if side effects occur.
- C. Take the medication at the same time each day to maintain consistent hormone levels.
- D. Avoid prolonged sun exposure while taking this medication.
Correct answer: C
Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels. This is crucial for the effectiveness of medroxyprogesterone acetate in treating endometriosis. Choice A is incorrect because there is no specific instruction related to food intake. Choice B is incorrect because discontinuing the medication without consulting a healthcare provider can be harmful. Choice D is unrelated to the administration of medroxyprogesterone acetate and is not a specific consideration for this medication.
3. In which patient is alpha-1 antitrypsin deficiency the likely cause of chronic obstructive pulmonary disease?
- A. A 30-year-old who has smoked for 3 years
- B. A 65-year-old man who drove a taxi most of his life
- C. A 70-year-old woman who smoked for 40 years
- D. A 50-year-old with exposure to secondhand smoke
Correct answer: A
Rationale: Alpha-1 antitrypsin deficiency is a genetic cause of chronic obstructive pulmonary disease (COPD). It is more common in younger patients with a history of smoking at a younger age, like the 30-year-old who has smoked for 3 years. Choices B, C, and D are less likely to be associated with alpha-1 antitrypsin deficiency as COPD in these cases is more likely due to smoking and environmental exposures.
4. Following a knee injury, a football player is taking ibuprofen, a nonsteroidal anti-inflammatory drug, for the control of pain. Which drug action is most likely to result in diminished sensation of pain for the player?
- A. Inhibition of cyclooxygenase (COX) enzymes
- B. Activation of opioid receptors
- C. Blocking of NMDA receptors
- D. Stimulation of serotonin receptors
Correct answer: A
Rationale: The correct answer is A: Inhibition of cyclooxygenase (COX) enzymes. Ibuprofen works by inhibiting these enzymes, which are involved in the production of prostaglandins that mediate pain and inflammation. This inhibition leads to decreased prostaglandin production, resulting in a decrease in pain and inflammation. Choices B, C, and D are incorrect because ibuprofen does not act on opioid receptors, NMDA receptors, or serotonin receptors to control pain. It primarily exerts its analgesic and anti-inflammatory effects through COX enzyme inhibition.
5. A patient is prescribed clomiphene citrate (Clomid) for the treatment of infertility. Which of the following statements should be included in the nurse's teaching?
- A. This drug induces ovulation by stimulating gonadotropins.
- B. This drug induces ovulation by inhibiting gonadotropins.
- C. This drug suppresses ovulation by inhibiting gonadotropins.
- D. This drug increases progesterone levels, which maintains pregnancy.
Correct answer: A
Rationale: The correct statement to include in the nurse's teaching is that clomiphene induces ovulation by stimulating the release of gonadotropins, which in turn stimulate the ovaries. Choice B is incorrect because clomiphene does not induce ovulation by inhibiting gonadotropins. Choice C is also incorrect as clomiphene does not suppress ovulation by inhibiting gonadotropins. Choice D is inaccurate as clomiphene does not directly increase progesterone levels to maintain pregnancy.
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