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MSN 570 Advanced Pathophysiology Final 2024
1. What is the primary cause of primary hypercholesteremia?
- A. High-density lipoprotein (HDL) defects
- B. Monogenic mutations, sedentary lifestyle, and high cholesterol diet
- C. Polygenic mutations and environmental factors
- D. Low-density lipoprotein (LDL) receptor mutation with defects in breakdown
Correct answer: D
Rationale: The correct answer is 'Low-density lipoprotein (LDL) receptor mutation with defects in breakdown.' Primary hypercholesteremia is mainly caused by mutations in the LDL receptor, leading to impaired clearance of LDL cholesterol from the blood. This results in high levels of LDL cholesterol in the bloodstream. Choices A, B, and C are incorrect because they do not directly relate to the primary cause of primary hypercholesteremia.
2. A patient was sneezing frequently after a few days of allergic rhinitis, and she noticed her eye became red. She denies any trauma, eye pain, or visual disturbance. Physical examination reveals a subconjunctival hemorrhage. Which statement is accurate pertaining to this case?
- A. The hemorrhage will resolve without treatment within 2 weeks.
- B. The patient should be referred for immediate ophthalmologic examination.
- C. Corticosteroid eye drops will be prescribed to reduce the bleeding.
- D. Antibiotic eye drops will be prescribed to prevent infection.
Correct answer: A
Rationale: The correct answer is A: 'The hemorrhage will resolve without treatment within 2 weeks.' Subconjunctival hemorrhage typically resolves on its own without treatment. It is a self-limiting condition that does not require specific intervention. Choice B is incorrect as immediate ophthalmologic examination is not necessary for subconjunctival hemorrhage unless there are other concerning symptoms or risk factors present. Choice C is incorrect because corticosteroid eye drops are not typically used for subconjunctival hemorrhage. Choice D is also incorrect as antibiotic eye drops are not indicated since subconjunctival hemorrhage is not due to an infection.
3. An oncology nurse is providing care for an adult patient who is currently immunocompromised. The nurse is aware of the physiology involved in hematopoiesis and immune function, including the salient role of cytokines. What is the primary role of cytokines in maintaining homeostasis?
- A. Cytokines perform phagocytosis in response to bacterial and protozoal infections.
- B. Cytokines perform a regulatory role in the development of diverse blood cells.
- C. Cytokines play a significant role in the formation of all blood cells.
- D. Cytokines are produced in response to the presence of antibodies.
Correct answer: B
Rationale: The primary role of cytokines in maintaining homeostasis is to perform a regulatory function in the development of diverse blood cells. Cytokines act as signaling molecules that regulate the immune response and hematopoiesis. Choice A is incorrect because cytokines do not perform phagocytosis; they regulate immune responses. Choice C is incorrect because while cytokines are involved in the formation of some blood cells, they are not considered the basic 'building blocks' of all blood cells. Choice D is incorrect because cytokines are not formed in response to antibodies, but rather play a role in the immune response to various stimuli.
4. A toddler is displaying signs/symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The client's family asks how he got this. The nurse will respond:
- A. This could result from playing in soil and then ingesting bacteria that is now attacking his motor neurons.
- B. No one really knows how this disease is formed. We just know that in time, he may grow out of it.
- C. This is a degenerative disorder that tends to be inherited as an autosomal recessive trait.
- D. This is a segmental demyelination disorder that affects all nerve roots and eventually all muscle groups as well.
Correct answer: C
Rationale: The correct answer is C. Spinal muscular atrophy (SMA) is an inherited disorder, often autosomal recessive, that affects lower motor neurons. Choice A is incorrect because SMA is not caused by ingesting bacteria from playing in soil. Choice B is incorrect as SMA is not something that a person grows out of. Choice D is incorrect because SMA is not a demyelination disorder that affects nerve roots and muscle groups.
5. Muscular dystrophy is a result of an abnormality of the muscle protein:
- A. glycoprotein
- B. dystrophin
- C. troponin
- D. actinomyosin
Correct answer: B
Rationale: Muscular dystrophy is primarily caused by mutations in the gene that provides instructions for making the protein dystrophin. Dystrophin plays a crucial role in maintaining the structure of muscle fibers. Glycoprotein is a general term for proteins with sugar molecules attached, not specifically related to muscular dystrophy. Troponin is a protein involved in muscle contraction regulation, and actinomyosin is not a specific muscle protein but a complex formed during muscle contraction. Therefore, the correct answer is dystrophin.
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