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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. The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize?
- A. White blood cell levels with differential
- B. Red blood cell levels and morphology
- C. Urea and creatinine levels
- D. Liver function panel
Correct answer: B
Rationale: The correct answer is B: Red blood cell levels and morphology. Lead poisoning primarily affects red blood cells, causing anemia. Therefore, the priority test would be to assess red blood cell levels and morphology. Choice A (White blood cell levels with differential) is incorrect as lead poisoning does not primarily affect white blood cells. Choice C (Urea and creatinine levels) is unrelated to lead poisoning and not a priority in this scenario. Choice D (Liver function panel) is also not the priority as lead poisoning's primary impact is on the red blood cells, not the liver.
3. Staff at the care facility note that a woman has started complaining of back pain in recent weeks and occasionally groans in pain. She has many comorbidities that require several prescription medications. The nurse knows that which factor is likely to complicate the clinician's assessment and treatment of the client's pain?
- A. Her advanced age may influence the expression and perception of pain.
- B. Her polypharmacy may complicate the pain management process.
- C. Her underlying conditions may mask or exacerbate the pain.
- D. Her cognitive function may decline, making pain assessment difficult.
Correct answer: B
Rationale: Polypharmacy, or the use of multiple medications, can complicate pain management due to drug interactions and side effects. While advanced age can influence pain perception, it is not the most likely factor to complicate assessment and treatment in this scenario. Underlying conditions may affect pain perception but do not directly complicate the management process. Cognitive decline can hinder pain assessment, but in this case, the focus is on factors directly impacting the treatment process, making option B the most appropriate choice.
4. A 30-year-old male is being treated with testosterone enanthate for delayed puberty. What side effect should the nurse inform the patient about?
- A. Increased libido
- B. Decreased muscle mass
- C. Breast tenderness
- D. Increased aggression
Correct answer: D
Rationale: The correct side effect that the nurse should inform the patient about when receiving testosterone enanthate therapy for delayed puberty is increased aggression. Testosterone therapy can lead to mood changes, including increased aggression in some individuals. Therefore, it is essential for healthcare providers to educate patients about this potential side effect. Choices A, B, and C are incorrect because testosterone therapy is more likely to increase libido, promote muscle mass growth, and may cause breast tenderness due to hormonal imbalances.
5. What function does aldosterone serve in the body?
- A. Aldosterone causes a release of sodium from the body, decreases fluid volume, and decreases blood pressure
- B. Aldosterone causes a retention of sodium in the body, increases fluid volume, and increases blood pressure
- C. Aldosterone causes a release of sodium from the body, increases fluid volume, and decreases blood pressure
- D. Aldosterone enhances intracellular sodium production and lowers blood pressure
Correct answer: B
Rationale: Aldosterone functions by causing the retention of sodium in the body, which results in an increase in fluid volume and blood pressure. Choice A is incorrect because aldosterone actually promotes sodium retention rather than release. Choice C is incorrect as it states that aldosterone decreases fluid volume, which is not accurate. Choice D is incorrect because aldosterone does not enhance intracellular sodium production; instead, it primarily acts on sodium reabsorption in the kidneys.
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