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MSN 570 Advanced Pathophysiology Final 2024
1. Macular degeneration occurs as a result of:
- A. loss of lens accommodation
- B. detachment of the retina
- C. increased intraocular pressure
- D. impaired blood supply leading to cellular waste accumulation and ischemia
Correct answer: D
Rationale: Macular degeneration is a condition that affects the macula, a part of the retina responsible for central vision. It is primarily caused by impaired blood supply to the macula, leading to cellular waste accumulation and ischemia. This results in the death of photoreceptor cells and ultimately vision loss. Choices A, B, and C are incorrect because macular degeneration is not related to the loss of lens accommodation, detachment of the retina, or increased intraocular pressure. The correct answer directly addresses the underlying pathophysiology of macular degeneration.
2. Why is the administration of benzene hexachloride (Lindane) for the treatment of scabies applied in small quantities?
- A. Excessive applications will lead to central nervous system toxicity.
- B. Excessive applications will cause irritation, rash, and inflammation.
- C. Excessive applications will cause headaches, dizziness, and diarrhea.
- D. Excessive applications will lead to anorexia and cachexia.
Correct answer: A
Rationale: The rationale for instructing the patient to apply benzene hexachloride (Lindane) in small quantities for scabies treatment is that excessive applications can lead to central nervous system toxicity. Lindane is a neurotoxin, and overuse or incorrect application can result in adverse effects on the central nervous system, such as seizures, dizziness, and even death. Choices B, C, and D are incorrect because they do not reflect the specific toxic effects associated with Lindane, which primarily affects the central nervous system rather than causing skin irritation, gastrointestinal symptoms, or metabolic issues.
3. 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.
4. A male patient receiving androgen therapy is concerned about prostate cancer. What should the nurse explain about the risks associated with this therapy?
- A. Finasteride has been shown to reduce the risk of developing prostate cancer.
- B. Finasteride has no impact on the risk of developing prostate cancer.
- C. Finasteride may increase the risk of developing prostate cancer.
- D. Finasteride has no effect on the risk of prostate cancer.
Correct answer: A
Rationale: The correct answer is A. Finasteride, a type of androgen therapy, has been shown to reduce the risk of developing prostate cancer. It works by shrinking the prostate gland, which can help lower the risk of developing prostate cancer. However, while it may reduce the risk, regular screening is still recommended to monitor for any potential issues. Choice B is incorrect because finasteride does have an impact on reducing the risk of prostate cancer. Choice C is incorrect as finasteride is not known to increase the risk of developing prostate cancer. Choice D is incorrect as finasteride does have an effect on reducing the risk of prostate cancer.
5. During a clinical assessment of a 68-year-old client who has suffered a head injury, a neurologist suspects that the client has sustained damage to her vagus nerve (CN X). Which assessment finding is most likely to lead the physician to this conclusion?
- A. The client has difficulty swallowing.
- B. The client has loss of gag reflex.
- C. The client has an inability to smell.
- D. The client has impaired eye movement.
Correct answer: B
Rationale: The correct answer is B. Damage to the vagus nerve can result in the loss of the gag reflex, which is a key indicator for the neurologist. Difficulty swallowing (Choice A) is more associated with issues related to the glossopharyngeal nerve (CN IX) and hypoglossal nerve (CN XII). An inability to smell (Choice C) is related to the olfactory nerve (CN I), and impaired eye movement (Choice D) is typically associated with damage to the oculomotor nerve (CN III), trochlear nerve (CN IV), or abducens nerve (CN VI), not the vagus nerve.
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