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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 is receiving chloroquine (Aralen) for extraintestinal amebiasis. Which of the following medications should be administered with chloroquine?
- A. Iodoquinol (Yodoxin)
- B. Metronidazole (Flagyl)
- C. Metyrosine (Demser)
- D. Carbamazepine (Tegretol)
Correct answer: B
Rationale: The correct answer is B: Metronidazole (Flagyl). When treating extraintestinal amebiasis, chloroquine is often used in combination with metronidazole to ensure the eradication of the parasite. Metronidazole helps to target the infection more effectively. Choices A, C, and D are incorrect. Iodoquinol (Yodoxin) is another antiprotozoal agent but is not typically used in combination with chloroquine for amebiasis. Metyrosine (Demser) is used in the management of pheochromocytoma, and carbamazepine (Tegretol) is an anticonvulsant and mood-stabilizing drug, neither of which are indicated for extraintestinal amebiasis.
3. A 67-year-old man is receiving androgen therapy for osteoporosis. What laboratory test should the nurse monitor during this therapy?
- A. Liver function tests
- B. Blood glucose levels
- C. Prostate-specific antigen (PSA)
- D. Cholesterol levels
Correct answer: A
Rationale: During androgen therapy, monitoring liver function tests is crucial to detect any signs of liver dysfunction. Androgens can potentially impact liver function, making it essential to monitor enzymes such as ALT and AST. While blood glucose levels and cholesterol levels are important parameters to monitor in certain situations, they are not the primary focus during androgen therapy for osteoporosis. Prostate-specific antigen (PSA) monitoring is more relevant in the context of prostate health and cancer screening, not specifically during androgen therapy for osteoporosis.
4. A patient has been diagnosed with cytomegalovirus (CMV). Which of the following drugs would be ineffective in the treatment of this disease?
- A. Ribavirin (Rebetol)
- B. Ganciclovir (Cytovene) IV
- C. Foscarnet (Foscavir) IV
- D. Valganciclovir hydrochloride (Valcyte)
Correct answer: A
Rationale: The correct answer is A, Ribavirin (Rebetol). Ribavirin is not effective against CMV. Choice B, Ganciclovir (Cytovene) IV, is a common treatment for CMV as it inhibits viral DNA synthesis. Choice C, Foscarnet (Foscavir) IV, is also used for CMV infections by blocking viral DNA polymerase. Choice D, Valganciclovir hydrochloride (Valcyte), is a prodrug of Ganciclovir and is effective against CMV. Therefore, Ribavirin is the drug that would be ineffective in treating CMV.
5. A patient presents with a rash from poison ivy. The nurse knows that this is which type of hypersensitivity?
- A. Type I
- B. Type II
- C. Type III
- D. Type IV
Correct answer: D
Rationale: A rash from poison ivy is an example of a type IV hypersensitivity reaction. Type IV hypersensitivity reactions are delayed cell-mediated immune responses involving T cells. This type of reaction is characterized by a delayed onset, typically occurring 48-72 hours after exposure to the antigen. Choice A, Type I hypersensitivity reactions, are immediate hypersensitivity reactions mediated by IgE antibodies. Choices B and C, Type II and Type III hypersensitivity reactions, involve antibody-mediated cytotoxicity and immune complex deposition, respectively, which are not characteristic of poison ivy-induced rashes.
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