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MSN 570 Advanced Pathophysiology Final 2024
1. What are the signs of thyroid crisis resulting from Graves' disease?
- A. Constipation with gastric distension.
- B. Bradycardia and bradypnea.
- C. Hyperthermia and tachycardia.
- D. Constipation and lethargy.
Correct answer: C
Rationale: In a thyroid crisis resulting from Graves' disease, the patient typically experiences symptoms such as hyperthermia (elevated body temperature) and tachycardia (rapid heart rate). These symptoms are indicative of the hypermetabolic state seen in thyroid storm. Choices A and D are incorrect as constipation and lethargy are not typical signs of a thyroid crisis; instead, patients with hyperthyroidism often experience diarrhea and agitation. Choice B is incorrect because bradycardia (slow heart rate) and bradypnea (slow breathing rate) are more commonly associated with hypothyroidism rather than a thyroid crisis in Graves' disease.
2. An adult patient has begun treatment with fluconazole. The nurse should recognize the need to likely discontinue the drug if the patient develops which of the following signs or symptoms?
- A. Jaundice
- B. Weight gain
- C. Iron deficiency anemia
- D. Hematuria
Correct answer: A
Rationale: The correct answer is A: Jaundice. Fluconazole, an antifungal medication, can rarely cause hepatotoxicity, which may manifest as jaundice. Monitoring for signs of liver dysfunction, such as jaundice, is crucial during fluconazole therapy. Weight gain, iron deficiency anemia, and hematuria are not commonly associated with fluconazole use and are not indications for discontinuing the drug.
3. When a healthcare professional is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the healthcare professional calls these erythrocytes:
- A. Hyperchromic
- B. Hypochromic
- C. Macrocytic
- D. Microcytic
Correct answer: B
Rationale: Erythrocytes with an abnormally low concentration of hemoglobin are called hypochromic. Hyperchromic refers to erythrocytes with an abnormally high concentration of hemoglobin. Macrocytic indicates larger than normal red blood cells, while microcytic refers to smaller than normal red blood cells. Therefore, in this scenario, the correct term is hypochromic.
4. 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.
5. What is a potential implication of multiple dark bands on the nails?
- A. They are considered a normal variant.
- B. They can be associated with malignant melanoma.
- C. They are indicative of a nail fungus.
- D. They are associated with aging.
Correct answer: B
Rationale: Multiple dark bands on the nails can be a concerning sign of malignant melanoma, a type of skin cancer that can affect the nails. While some nail changes are considered normal variants, dark bands should not be dismissed lightly as they can indicate a serious condition like melanoma. Nail fungus typically presents differently, causing discoloration, thickening, or distortion of the nail without distinct dark bands. Additionally, aging can lead to various nail changes, but dark bands alone are not a common feature of normal aging.
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