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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. What causes atherosclerotic plaques to form initially?
- A. Interruption of blood flow to the brain
- B. Injury to the coronary artery endothelium
- C. Administration of statin medications
- D. Poor dietary modifications
Correct answer: B
Rationale: Atherosclerotic plaques form initially due to injury to the coronary artery endothelium, which triggers a cascade of events leading to plaque buildup. Choice A is incorrect because atherosclerotic plaques do not form due to an interruption of blood flow to the brain. Choice C is incorrect as statin medications are actually used to help lower cholesterol and reduce the risk of plaque formation. Choice D is incorrect as poor dietary modifications can contribute to atherosclerosis but are not the initial cause of plaque formation.
3. Inflammatory exudates are a combination of several types. Which of the following exudates is composed of a large accumulation of leukocytes?
- A. Serous
- B. Purulent
- C. Fibrinous
- D. Hemorrhagic
Correct answer: B
Rationale: The correct answer is B: Purulent. Purulent exudates, or pus, consist primarily of leukocytes and dead cells, indicating a bacterial infection. Serous exudates contain a thin, watery fluid with few leukocytes. Fibrinous exudates are rich in fibrin and are commonly seen in severe inflammation. Hemorrhagic exudates contain red blood cells due to blood vessel damage.
4. When assessing a 7-year-old child's pain after an emergency appendectomy, what is the most appropriate tool for the nurse to use?
- A. Use a visual analog scale (VAS) to assess the pain.
- B. Ask the child to rate their pain on a scale of 0 to 10.
- C. Use the Wong-Baker FACES scale to assess the pain.
- D. Ask the parents to describe the child's pain behavior.
Correct answer: C
Rationale: The correct answer is to use the Wong-Baker FACES scale to assess the child's pain. This scale is specifically designed for children and uses facial expressions of varying intensities to help them communicate their pain levels effectively. Choices A and B may not be as suitable for a young child who may have difficulty understanding or using a numerical scale. Choice D involving parents may not provide an accurate reflection of the child's pain experience, as it is essential to assess the child's self-reporting.
5. In emphysema, what features result in impaired oxygenation?
- A. The bronchioles are inflamed and filled with mucus
- B. The alveoli have lost surfactant and collapse
- C. Enlarged, permanently inflated alveoli
- D. The accumulation of purulent fluid in the bronchioles
Correct answer: C
Rationale: The correct answer is C. In emphysema, impaired oxygenation results from enlarged and permanently inflated alveoli, leading to reduced surface area for gas exchange. Choices A, B, and D are incorrect. In emphysema, bronchioles are not typically filled with mucus, alveoli losing surfactant and collapsing is more characteristic of conditions like atelectasis, and purulent fluid accumulation in the bronchioles is commonly seen in conditions like pneumonia, not emphysema.
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