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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. A patient is prescribed testosterone gel for hypogonadism. What important instruction should the nurse provide regarding the application of this medication?
- A. Apply the gel to the chest or upper arms.
- B. Apply the gel to the face and neck.
- C. Apply the gel to the genitals for maximum absorption.
- D. Apply the gel to the scalp and back.
Correct answer: A
Rationale: The correct answer is to apply the testosterone gel to the chest or upper arms. This is recommended to minimize the risk of unintentional transfer of the medication to others, especially women and children, through skin contact. Applying the gel to the face, neck, or genitals is not advised as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp or back is not appropriate as these areas are not indicated for absorption of testosterone.
3. When teaching a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?
- A. Oral contraceptives are 100% effective when taken correctly.
- B. Oral contraceptives are effective immediately after starting.
- C. Oral contraceptives are less effective if taken with certain antibiotics.
- D. Oral contraceptives are less effective if taken with food.
Correct answer: C
Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the effectiveness of the contraceptive. It is important for patients to be aware of this interaction to consider additional contraceptive methods during antibiotic therapy. Choices A and B are incorrect as no contraceptive method is 100% effective, and oral contraceptives typically require a period of time to reach full effectiveness. Choice D is incorrect as taking oral contraceptives with food does not significantly impact their effectiveness.
4. Not realizing that its surface was hot, a woman has quickly withdrawn her hand from the surface of a bowl that she was removing from a microwave. Which phenomena has facilitated the rapid movement of her hand in response to the painful stimulus?
- A. Crossed-extensor reflex
- B. Flexor reflex
- C. Withdrawal reflex
- D. Stretch reflex
Correct answer: C
Rationale: The withdrawal reflex is a protective response that allows a person to quickly remove their hand from a painful stimulus.
5. On the advice of his brother, a 53-year-old man has made an appointment to request a prescription for Viagra. The nurse who works at the clinic is reviewing the man's medical history and would recognize what health problem as being prohibitive to this treatment?
- A. Type 2 diabetes, treated with metformin
- B. Hypercholesterolemia, treated with simvastatin
- C. Angina, treated with nitroglycerin
- D. Hypertension, treated with metoprolol
Correct answer: C
Rationale: Nitroglycerin is contraindicated with Viagra due to their combined effects on lowering blood pressure, which can result in a severe drop and potentially life-threatening complications. Using both medications together can lead to hypotension, putting the patient at risk. Therefore, the presence of angina treated with nitroglycerin would make prescribing Viagra unsafe. Choices A, B, and D are not directly contraindicated with Viagra and can be managed concurrently with this treatment.
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