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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. How does influenza immunization produce immunity?
- A. The virus from the vaccine remains in the body until the end of the season
- B. An attenuated virus causes immune system suppression and triggers immunity
- C. The body identifies the virus and develops antibodies against the virus
- D. The vaccine remains in the injection site and produces immune cells
Correct answer: C
Rationale: The correct answer is C. Influenza immunization works by introducing a weakened or inactivated form of the virus into the body, allowing the immune system to recognize it as foreign. This recognition triggers the production of antibodies specific to the virus. Choice A is incorrect as the virus in the vaccine does not remain in the body until the end of the season. Choice B is incorrect as an attenuated virus does not cause immune system suppression but rather stimulates an immune response. Choice D is incorrect because the vaccine does not stay at the injection site but rather prompts a systemic immune response throughout the body.
3. A male patient with erectile dysfunction is prescribed sildenafil (Viagra). What specific instruction should the nurse provide to ensure the safe use of this medication?
- A. Take the medication with food to prevent nausea.
- B. Avoid taking nitrates while on this medication.
- C. Take the medication at bedtime to ensure absorption during sleep.
- D. Take the medication with milk to enhance absorption.
Correct answer: B
Rationale: The correct instruction the nurse should provide is to avoid taking nitrates while on sildenafil (Viagra). Combining sildenafil with nitrates can result in severe hypotension due to additive vasodilatory effects. Choice A is incorrect because sildenafil can be taken with or without food. Choice C is incorrect as there is no specific requirement to take sildenafil at bedtime. Choice D is incorrect as taking sildenafil with milk has not been shown to enhance its absorption.
4. In which disorder does a Staphylococcus aureus organism produce a toxin leading to exfoliation and large blister formation?
- A. Herpes simplex I virus
- B. Herpes simplex II virus
- C. Necrotizing fasciitis
- D. Cellulitis
Correct answer: B
Rationale: The correct answer is 'Herpes simplex I virus.' This disorder is known as Staphylococcal scalded skin syndrome (SSSS), where a Staphylococcus aureus organism produces an exfoliative toxin leading to skin exfoliation and large blister formation. Choices B, C, and D are incorrect. Herpes simplex viruses (I and II) cause different types of skin lesions and do not lead to exfoliation and blister formation. Necrotizing fasciitis is a severe soft tissue infection, while cellulitis is a bacterial skin infection that does not typically involve exfoliation and blister formation like in SSSS.
5. A 1-year-old child will receive her scheduled MMR vaccination shortly. The nurse should teach the child's parents that she may develop what possible adverse effect related to the administration of this vaccine?
- A. Cough and fever
- B. Pallor and listlessness
- C. Serum sickness
- D. Nausea and vomiting
Correct answer: A
Rationale: The correct answer is A: Cough and fever. After receiving the MMR vaccine, some children may experience mild adverse effects such as a low-grade fever and a mild cough. These symptoms are normal reactions to the vaccine and indicate that the child's immune system is responding appropriately. Choices B, C, and D are incorrect because pallor and listlessness, serum sickness, nausea, and vomiting are not common adverse effects associated with the MMR vaccine in children.
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