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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 receiving finasteride (Proscar) for the treatment of benign prostatic hyperplasia. Which of the following is an expected outcome of the medication?
- A. Decrease in the size of the prostate gland.
- B. Improved urinary flow and decreased symptoms of urinary retention.
- C. Increased production of prostate-specific antigen (PSA).
- D. Reduction in the number of nocturnal awakenings.
Correct answer: B
Rationale: The correct answer is B. Finasteride (Proscar) is used in the treatment of benign prostatic hyperplasia to improve urinary flow and decrease symptoms of urinary retention by reducing the size of the prostate gland. Choice A is incorrect because although finasteride may reduce the size of the prostate gland, the expected outcome relevant to the patient's symptoms is improved urinary flow rather than a specific change in gland size. Choice C is incorrect because finasteride actually decreases the production of prostate-specific antigen (PSA) due to its mechanism of action. Choice D is incorrect because although improved urinary flow may lead to a reduction in nocturnal awakenings, the main expected outcome of finasteride treatment is related to urinary symptoms.
3. When starting on oral contraceptives, what should the nurse include in the education regarding the timing of the medication?
- A. Oral contraceptives should be taken at the same time each day to maintain stable hormone levels and prevent pregnancy.
- B. Oral contraceptives can be taken at any time of day, as long as the schedule is consistent.
- C. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
- D. Oral contraceptives are effective immediately upon starting, regardless of timing.
Correct answer: A
Rationale: When educating a patient starting on oral contraceptives, it is essential to stress the importance of taking the medication at the same time each day. This ensures stable hormone levels, improving the effectiveness of the contraceptives in preventing pregnancy. Choice B is incorrect because consistency in timing is crucial for maintaining hormone levels. Choice C is incorrect as there is no specific requirement to take oral contraceptives in the morning to avoid side effects. Choice D is incorrect as oral contraceptives may take some time to become fully effective, and consistent timing is important for their efficacy.
4. A 17-year-old woman has come to the clinic requesting emergency contraception after having unprotected sex 24 hours ago. What medication is the clinician most likely to prescribe?
- A. Levonorgestrel (Plan B)
- B. Mifepristone (RU-486)
- C. Ulipristal acetate (ella)
- D. Estradiol (Estrace)
Correct answer: A
Rationale: The correct answer is A: Levonorgestrel (Plan B). Levonorgestrel is the most commonly prescribed medication for emergency contraception within 72 hours of unprotected intercourse. It is effective when taken within 72 hours after intercourse, with better efficacy the sooner it is taken. Choice B, Mifepristone (RU-486), is not indicated for emergency contraception but is used for medical abortion. Choice C, Ulipristal acetate (ella), is another option for emergency contraception that is effective up to 120 hours after unprotected intercourse. Choice D, Estradiol (Estrace), is not used for emergency contraception.
5. Which of the following is a complication of compartment syndrome?
- A. Hemorrhage
- B. Pain and tissue damage
- C. Increased limb function
- D. Chronic kidney disease
Correct answer: B
Rationale: The correct answer is B: Pain and tissue damage. Compartment syndrome occurs due to increased pressure within the muscle compartments, leading to pain and tissue damage. Hemorrhage (choice A) is not a typical complication of compartment syndrome. Increased limb function (choice C) is not a complication but rather a potential improvement if the condition is managed appropriately. Chronic kidney disease (choice D) is unrelated to compartment syndrome.
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