ATI RN
MSN 570 Advanced Pathophysiology Final 2024
1. Women who have breast cancer due to a BRCA1 gene mutation are usually:
- A. positive for human epidermal growth factor receptor 1 and 2.
- B. negative for estrogen receptor.
- C. positive for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2.
- D. negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2.
Correct answer: D
Rationale: Women with breast cancer due to a BRCA1 gene mutation commonly have a triple-negative breast cancer subtype, which means they are negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2). This subtype tends to be more aggressive and harder to treat. Choice A is incorrect as they are typically negative for HER2. Choice B is incorrect because they are usually negative for estrogen receptor. Choice C is incorrect as they are usually negative for progesterone receptor and HER2.
2. A patient is taking medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse include in the patient teaching?
- A. Take the medication with food to prevent gastrointestinal upset.
- B. Avoid prolonged sun exposure while taking this medication.
- C. Take the medication at the same time each day to maintain consistent hormone levels.
- D. Discontinue the medication if side effects occur.
Correct answer: C
Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels. This is important for the effectiveness of medroxyprogesterone acetate. Choice A is incorrect because medroxyprogesterone acetate does not need to be taken with food. Choice B is irrelevant as sun exposure is not a concern with this medication. Choice D is incorrect as discontinuing the medication without consulting a healthcare provider can lead to adverse effects.
3. What therapeutic effect is expected from tamsulosin (Flomax) in a male patient with benign prostatic hyperplasia (BPH)?
- A. Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.
- B. Increase in urine flow and relief of urinary obstruction.
- C. Reduction in prostate size and improvement in urinary symptoms.
- D. Improvement in erectile function.
Correct answer: A
Rationale: The correct answer is A: 'Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.' Tamsulosin is an alpha-blocker that specifically targets alpha-1 receptors in the prostate and bladder neck, causing relaxation of smooth muscles. This relaxation results in improved urinary flow and reduced symptoms of BPH. Choice B is incorrect because while tamsulosin does improve urinary flow, it does not directly increase urine flow. Choice C is incorrect because tamsulosin does not reduce prostate size. Choice D is incorrect as tamsulosin does not have a primary effect on erectile function.
4. A healthcare provider is explaining to a patient the difference between primary and secondary immunodeficiency disorders and explains that secondary immunodeficiencies (select ONE that does not apply):
- A. May develop after viral infections
- B. Develop before birth
- C. May develop following immunosuppressive therapies
- D. Are caused by superimposed conditions
Correct answer: B
Rationale: The correct statements about secondary immunodeficiencies are that they may develop after viral infections, following immunosuppressive therapies, and are caused by superimposed conditions. Choice B ('Develop before birth') is incorrect because secondary immunodeficiencies do not develop before birth. They are acquired later in life. Therefore, the correct answers are A, C, and D.
5. 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.
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