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MSN 570 Advanced Pathophysiology Final 2024
1. In nephritic syndrome compared to nephrotic syndrome, there is:
- A. higher amounts of albuminuria.
- B. negligible hematuria or absence of hematuria.
- C. presence of red blood cell casts in the urine.
- D. hypoalbuminemia
Correct answer: C
Rationale: In nephritic syndrome, the presence of red blood cell casts in the urine is a characteristic finding, reflecting glomerular inflammation and damage. This differentiates it from nephrotic syndrome, where red blood cell casts are typically absent. Choice A is incorrect because nephritic syndrome usually presents with less albuminuria compared to nephrotic syndrome. Choice B is incorrect as hematuria is a common feature of nephritic syndrome. Choice D is incorrect as hypoalbuminemia is more commonly associated with nephrotic syndrome.
2. Which symptoms are typical of asthma?
- A. Chest pain; cough
- B. Diarrhea; wheezing
- C. Wheezing; dyspnea
- D. Tachypnea; constipation
Correct answer: C
Rationale: The correct answer is C: Wheezing and dyspnea are typical symptoms of asthma. Wheezing refers to a high-pitched whistling sound while breathing, and dyspnea is shortness of breath. These symptoms are classic signs of airway obstruction and inflammation seen in asthma. Choice A is incorrect as chest pain is not a typical symptom of asthma, though coughing can occur. Choice B is incorrect as diarrhea is not associated with asthma, while wheezing is a common symptom. Choice D is incorrect as tachypnea (rapid breathing) can occur in asthma, but constipation is not a typical symptom.
3. Which of the following conditions is associated with a positive Homan's sign?
- A. Deep vein thrombosis
- B. Peripheral artery disease
- C. Varicose veins
- D. Lymphedema
Correct answer: A
Rationale: A positive Homan's sign is indicative of deep vein thrombosis. This sign is elicited by dorsiflexing the foot of a patient with the knee slightly flexed, resulting in calf pain. Peripheral artery disease (choice B) is associated with decreased blood flow to the extremities, but it does not produce a positive Homan's sign. Varicose veins (choice C) are enlarged, twisted veins that are typically not related to Homan's sign. Lymphedema (choice D) is swelling caused by a lymphatic system blockage or dysfunction and is not linked to Homan's sign.
4. A college student has a TB test prior to starting the semester. The tuberculin test site is noted with a reddened, raised area. What condition will the student be diagnosed with if the chest radiograph is negative?
- A. Transmission
- B. Primary infection
- C. Latent tuberculosis
- D. Active tuberculosis
Correct answer: C
Rationale: If the chest radiograph is negative despite a positive tuberculin skin test, the student will be diagnosed with latent tuberculosis infection. Latent tuberculosis means the student has the TB bacteria in their body but does not feel sick and cannot spread the disease. Choice A, 'Transmission,' is incorrect as it refers to the spread of TB from person to person. Choice B, 'Primary infection,' is incorrect because primary infection occurs when a person is first infected with the TB bacteria. Choice D, 'Active tuberculosis,' is incorrect as this refers to the active form of the disease where the person feels sick and can spread TB to others.
5. A 40-year-old man has been living with HIV for several years but experienced a significant decrease in his CD4+ levels a few months ago. The patient has just been diagnosed with Mycobacterium avium complex disease. The nurse should anticipate administering which of the following medications?
- A. Clarithromycin
- B. Pyrazinamide
- C. Rifapentine (Priftin)
- D. Azithromycin
Correct answer: A
Rationale: The correct answer is A: Clarithromycin. In the case of Mycobacterium avium complex disease, a common treatment regimen includes a macrolide antibiotic like clarithromycin or azithromycin in combination with other antimicrobials. Clarithromycin is a key component of the treatment due to its effectiveness against Mycobacterium avium complex. Choice B (Pyrazinamide) is not typically part of the standard treatment for this condition. Choice C (Rifapentine) is mainly used in tuberculosis treatment and is not a primary agent for Mycobacterium avium complex disease. Choice D (Azithromycin) is another suitable macrolide antibiotic for treating Mycobacterium avium complex disease but is not the medication typically used first-line.
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