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MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following chronic inflammatory skin diseases is characterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation?
- A. Psoriasis
- B. Melanoma
- C. Atopic dermatitis
- D. Urticaria
Correct answer: A
Rationale: Psoriasis is the correct answer because it is a chronic inflammatory skin condition characterized by features such as angiogenesis (formation of new blood vessels), immune cell activation (especially T cells), and excessive keratinocyte proliferation. This results in the typical symptoms seen in psoriasis, such as red, scaly patches on the skin. Melanoma is a type of skin cancer arising from melanocytes, not characterized by the features mentioned. Atopic dermatitis is a different skin condition involving eczematous changes, not specifically associated with the described characteristics of psoriasis. Urticaria is a skin condition characterized by hives and does not involve the same pathophysiological processes as psoriasis.
2. A patient's antiretroviral therapy has not been as efficacious as her care team had predicted, and maraviroc (Selzentry) has consequently been added to her drug regimen. The nurse should recognize this drug as belonging to what category of antiretroviral?
- A. Fusion protein inhibitors
- B. Protease inhibitors
- C. CCR5 antagonists
- D. Integrase strand transfer inhibitors
Correct answer: C
Rationale: Women with a history of breast cancer should avoid hormone replacement therapy due to the increased risk of cancer recurrence.
3. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?
- A. Has your child received all recommended vaccinations?
- B. Has your child been feeding poorly or showing signs of constipation?
- C. Has your child been exposed to any sick individuals?
- D. Has your child been displaying signs of respiratory distress?
Correct answer: B
Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.
4. Which immunoglobulin is the first to appear in response to a new antigen?
- A. IgA
- B. IgG
- C. IgE
- D. IgM
Correct answer: D
Rationale: The correct answer is IgM. IgM is the first immunoglobulin to appear in response to a new antigen. It is produced initially during the primary immune response. IgA is mainly found in mucosal areas and secretions. IgG is produced in a secondary immune response and is the most abundant immunoglobulin in the bloodstream. IgE is involved in allergic reactions and parasitic infections, not the initial response to a new antigen.
5. During the cellular stage of acute inflammation, which type of cells arrive first and in great numbers?
- A. Basophils
- B. Lymphocytes
- C. Neutrophils
- D. Platelets
Correct answer: C
Rationale: During the cellular stage of acute inflammation, neutrophils are the first responders. Neutrophils arrive at the site of injury in large numbers to combat pathogens and remove debris. Basophils and lymphocytes are also involved in the inflammatory response, but they are not the first to arrive. Platelets play a role in hemostasis and blood clotting, rather than being the primary cells involved in the initial inflammatory response.
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