ATI RN
MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following characterizes ductal carcinoma in situ?
- A. It is less common than lobular carcinoma in situ.
- B. Malignant cells have not invaded the stroma.
- C. It is considered a cancer precursor.
- D. Malignant cells have not invaded the stroma; it is considered a cancer precursor and has a higher risk for invasive cancer compared to lobular carcinoma in situ.
Correct answer: D
Rationale: The correct answer is that ductal carcinoma in situ is characterized by malignant cells that have not invaded the stroma, making it a cancer precursor with a higher risk for invasive cancer compared to lobular carcinoma in situ. Choice A is incorrect because ductal carcinoma in situ is more common than lobular carcinoma in situ. Choice B is incorrect as it only partially describes ductal carcinoma in situ without mentioning its potential for progression to invasive cancer. Choice C is incorrect because it does not capture the complete characteristics of ductal carcinoma in situ, which include the risk for invasive cancer.
2. Mrs. Jordan is an elderly client diagnosed with Alzheimer’s disease. She becomes agitated and combative when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation would be to:
- A. tell the client firmly that it is time to get dressed.
- B. obtain assistance to restrain the client for safety.
- C. remain calm and talk quietly to the client.
- D. call the doctor and request an order for sedation.
Correct answer: C
Rationale: When dealing with an elderly client with Alzheimer’s disease who is agitated and combative, the most appropriate nursing intervention is to remain calm and talk quietly to the client. This approach can help soothe the client and prevent escalating the situation. Choice A is incorrect as being firm may further agitate the client. Choice B is inappropriate as restraining should only be used as a last resort for safety reasons and after other de-escalation techniques have been attempted. Choice D is not the best initial intervention and should only be considered after other non-pharmacological interventions have failed.
3. A man with gout has developed large, hard nodules around his toes and elbows. The phase of gout he is in is:
- A. asymptomatic
- B. acute flare
- C. the intercritical period
- D. chronic gout
Correct answer: D
Rationale: The correct answer is 'chronic gout.' Chronic gout is characterized by the presence of tophi, which are large, hard nodules that can develop around joints like toes and elbows. These tophi are a sign of longstanding, untreated gout. Choice A, 'asymptomatic,' is incorrect as the presence of tophi indicates a symptomatic phase. Choice B, 'acute flare,' is incorrect as acute flares are characterized by sudden and severe pain, inflammation, and redness in the joints, not the development of tophi. Choice C, 'the intercritical period,' is also incorrect as this phase occurs between acute attacks and is typically asymptomatic, without the presence of tophi.
4. A patient is hospitalized with active tuberculosis. The patient is receiving antitubercular drug therapy and is not responding to the medications. What do you suspect the patient is suffering from?
- A. Human immunodeficiency virus
- B. Drug-resistant tuberculosis
- C. Methicillin-resistant Staphylococcus aureus
- D. Vancomycin-resistant Staphylococcus aureus
Correct answer: B
Rationale: When a patient with active tuberculosis is not responding to antitubercular drug therapy, drug-resistant tuberculosis should be suspected. Drug-resistant tuberculosis occurs when the bacteria causing tuberculosis become resistant to the medications being used. Choices A, C, and D are incorrect because the scenario described does not align with HIV infection, methicillin-resistant Staphylococcus aureus, or vancomycin-resistant Staphylococcus aureus.
5. The nurse knows which phenomenon listed below is an accurate statement about axonal transport?
- A. Anterograde and retrograde axonal transport allow for the communication of nerve impulses between a neuron and the central nervous system (CNS).
- B. Materials can be transported to the nerve terminal by either fast or slow components.
- C. The unidirectional nature of the axonal transport system protects the CNS against potential pathogens.
- D. Axonal transport facilitates the movement of electrical impulses but precludes the transport of molecular materials.
Correct answer: B
Rationale: The correct answer is B. Axonal transport involves the movement of materials to the nerve terminal by either fast or slow components, which is essential for cell survival. Choice A is incorrect because while anterograde and retrograde axonal transport are involved in the movement of materials, they do not specifically relate to the communication of nerve impulses between a neuron and the CNS. Choice C is incorrect because the unidirectional nature of axonal transport does not primarily function to protect the CNS against pathogens. Choice D is incorrect as axonal transport is responsible for the movement of various materials, not just electrical impulses.
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