joseph a 12 year old child complains to the school nurse about nausea and dizziness while assessing the child the nurse notices a black eye that looks

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Pathophysiology Practice Questions

1. Joseph, a 12-year-old child, complains to the school nurse about nausea and dizziness. While assessing the child, the nurse notices a black eye that looks like an injury. This is the third time in 1 month that the child has visited the nurse. Each time, the child provides vague explanations for various injuries. Which of the following is the school nurse’s priority intervention?

A. Contact the child’s parents and ask about the child’s injuries.
B. Encourage the child to be honest about the injuries.
C. Question the teacher about the child's injuries.
D. Report suspicion of abuse to the proper authorities.

Correct answer: D

Rationale: The school nurse's priority intervention in this situation is to report suspicion of abuse to the proper authorities. Given the pattern of unexplained injuries and vague explanations provided by the child, it raises significant concerns for possible abuse. Reporting to the appropriate authorities is crucial to ensure the child's safety and well-being. Contacting the child's parents (Choice A) may not be appropriate if abuse is suspected, as it could potentially put the child at further risk. Merely encouraging the child to be honest (Choice B) does not address the immediate safety concerns. Questioning the teacher (Choice C) is not the appropriate initial action when abuse is suspected; reporting to authorities should take precedence.

2. A male patient with benign prostatic hyperplasia (BPH) is being treated with tamsulosin (Flomax). What should the nurse include in the teaching plan for this patient?

A. Avoid lying down after taking the medication.
B. Take the medication with meals.
C. Report any side effects such as dizziness or fainting.
D. Take the medication at bedtime.

Correct answer: C

Rationale: The correct answer is C: 'Report any side effects such as dizziness or fainting.' Patients taking tamsulosin should be advised to report any side effects, such as dizziness or fainting, which can occur due to orthostatic hypotension. Choices A, B, and D are incorrect because avoiding lying down after taking the medication, taking it with meals, or at bedtime are not specific teaching points related to the potential side effects of tamsulosin.

3. How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?

A. Administer radioactive cobalamin and measure its excretion time
B. Measure antigen-antibody immune complexes
C. Measure serum ferritin and total iron-binding capacity
D. Administer folate and evaluate folate content in a blood serum sample

Correct answer: A

Rationale: The correct answer is A. To prepare a patient for a Schilling test for pernicious anemia, the nurse should administer radioactive cobalamin and measure its excretion time. This test is specifically designed to assess the absorption of vitamin B12. Choices B, C, and D are incorrect because they do not align with the preparation and procedure of a Schilling test. Measuring antigen-antibody immune complexes, serum ferritin, or total iron-binding capacity, as well as administering folate and evaluating folate content, are not part of the Schilling test protocol.

4. A 52-year-old male patient is taking finasteride (Proscar) for benign prostatic hyperplasia (BPH). What patient teaching should the nurse provide?

A. Take the medication with food.
B. Avoid taking NSAIDs while on this medication.
C. Avoid driving or operating heavy machinery while taking this medication.
D. Women who are or may become pregnant should not handle crushed or broken tablets.

Correct answer: D

Rationale: The correct answer is D. Finasteride, used for BPH, can be harmful to a developing male fetus. Therefore, women who are or may become pregnant should not handle crushed or broken tablets to avoid potential absorption through the skin. Choice A is incorrect as finasteride can be taken with or without food. Choice B is incorrect because there is no specific interaction between finasteride and NSAIDs mentioned. Choice C is incorrect as finasteride does not typically cause drowsiness or impair mental alertness.

5. Cellular swelling is:

A. Irreversible
B. Evident early in all types of cellular injury
C. Manifested by decreased intracellular sodium
D. None of the above is correct

Correct answer: B

Rationale: Cellular swelling is indeed evident early in all types of cellular injury. This occurs due to the influx of water into the cell, leading to swelling. Choice A is incorrect because cellular swelling is reversible if the injury is not severe. Choice C is incorrect because cellular swelling is not manifested by decreased intracellular sodium; in fact, it is associated with increased intracellular sodium due to water influx. Choice D is incorrect as option B is the correct statement.