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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 client presents to the emergency department with lower right quadrant abdominal pain, fever, nausea, and occasional diarrhea. After palpating the abdomen, the client displays tenderness. What would the nurse anticipate the client to be experiencing?
- A. Pseudomembranous colitis
- B. Peptic ulcer disease
- C. Appendicitis
- D. Esophageal cancer
Correct answer: C
Rationale: The correct answer is C: Appendicitis. The symptoms described - lower right quadrant abdominal pain, fever, nausea, diarrhea, and tenderness upon palpation - are classic signs of appendicitis. Appendicitis is an inflammatory condition of the appendix that often presents with these symptoms and requires immediate medical attention. Choice A, Pseudomembranous colitis, typically presents with watery diarrhea and is associated with antibiotic use. Choice B, Peptic ulcer disease, commonly presents with epigastric pain related to meals and can be accompanied by nausea or vomiting, but it does not typically cause right lower quadrant pain. Choice D, Esophageal cancer, usually presents with symptoms related to swallowing difficulties, weight loss, and sometimes chest pain, but it is not associated with the symptoms described in the scenario.
3. A client has approached the nurse asking for advice on how to deal with his alcohol addiction. The nurse should tell the client that the only effective treatment for alcoholism is:
- A. psychotherapy.
- B. total abstinence.
- C. Alcoholics Anonymous (AA).
- D. aversion therapy.
Correct answer: B
Rationale: The correct answer is B: total abstinence. Total abstinence from alcohol is considered the most effective treatment for alcoholism. This approach eliminates the risk of relapse and helps individuals maintain sobriety. While psychotherapy can be beneficial in addressing underlying issues, total abstinence is crucial in overcoming alcohol addiction. Alcoholics Anonymous (AA) is a supportive group that can complement treatment, but it is not the only effective approach. Aversion therapy aims to create a negative association with alcohol but may not address the underlying causes of addiction, making total abstinence a more comprehensive and recommended approach.
4. What is the most appropriate nursing diagnosis for the client's son based on the information provided?
- A. Risk for other-directed violence
- B. Disturbed sleep pattern
- C. Caregiver role strain
- D. Social isolation
Correct answer: C
Rationale: The correct answer is 'Caregiver role strain.' In the scenario presented, the son expresses that his father's constant confusion, incontinence, and tendency to wander are intolerable. These challenges indicate that the son is experiencing strain in his role as a caregiver. 'Risk for other-directed violence' is not appropriate because there is no indication of violent behavior. 'Disturbed sleep pattern' is not the most relevant nursing diagnosis given the information provided. 'Social isolation' is not the most appropriate choice as the son's concerns are related to the challenges of caregiving, not isolation.
5. What is the common denominator of all forms of heart failure?
- A. Pulmonary edema
- B. Jugular venous distention
- C. Peripheral edema
- D. Reduced cardiac output
Correct answer: D
Rationale: The correct answer is D: Reduced cardiac output. All forms of heart failure share the common denominator of reduced cardiac output, which leads to inadequate tissue perfusion. Pulmonary edema (choice A) is a consequence of heart failure but not the common denominator. Jugular venous distention (choice B) and peripheral edema (choice C) are signs of heart failure but do not represent the common denominator shared by all forms.
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