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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 client arrives with symptoms of stroke. What should the nurse assess first?
- A. Level of consciousness
- B. Blood pressure
- C. Pupil reaction
- D. Heart rate
Correct answer: A
Rationale: Assessing the level of consciousness is a critical first step in evaluating a potential stroke. Changes in the level of consciousness can indicate the severity and location of brain damage, helping to guide immediate interventions. Assessing blood pressure, pupil reaction, and heart rate are also important aspects of the assessment in a suspected stroke patient. However, the priority is to quickly determine the client's level of consciousness to assess their neurological status.
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. What is a common cause of a pulmonary embolism?
- A. An autoimmune disorder
- B. A venous blood clot from the lower extremity
- C. An increase in intracranial pressure
- D. Hypotension
Correct answer: B
Rationale: A pulmonary embolism is commonly caused by a blood clot that originates in the venous system of the lower extremity and travels to the lungs, blocking blood flow. This clot is known as a venous thromboembolism. An autoimmune disorder (Choice A) is not typically associated with pulmonary embolism. Intracranial pressure (Choice C) refers to pressure inside the skull and is unrelated to pulmonary embolism. Hypotension (Choice D) is low blood pressure and is not a common cause of pulmonary embolism.
5. A 55-year-old man presents with a history of fatigue, weight loss, and night sweats. He reports recent onset of a productive cough and hemoptysis. Which condition should the nurse suspect?
- A. Lung cancer
- B. Pneumonia
- C. Tuberculosis
- D. Pulmonary embolism
Correct answer: C
Rationale: The correct answer is C: Tuberculosis. The symptoms described - fatigue, weight loss, night sweats, productive cough, and hemoptysis - are classic manifestations of tuberculosis. Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, commonly affecting the lungs but can also involve other organs. **Choice A: Lung cancer** typically presents with symptoms like persistent cough, chest pain, and shortness of breath, but it is less likely in this case due to the presence of hemoptysis. **Choice B: Pneumonia** can present with productive cough, fever, and chest pain, but it is less likely given the chronicity of symptoms and the presence of hemoptysis. **Choice D: Pulmonary embolism** usually presents with sudden onset shortness of breath, chest pain, and can be associated with risk factors like recent surgery or immobility.
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