ATI RN
Final Exam Pathophysiology
1. A patient has developed a decubitus ulcer on the coccyx. What defense mechanism is most affected by this homeostatic change?
- A. The mucous membrane is affected.
- B. The respiratory tract is affected.
- C. The skin is affected.
- D. The gastrointestinal tract is affected.
Correct answer: C
Rationale: In this scenario, a decubitus ulcer on the coccyx indicates a breakdown of the skin's integrity due to prolonged pressure. The skin is the primary defense mechanism of the body against external pathogens. When the skin is compromised, it can lead to infections and other complications. The mucous membrane (Choice A) plays a role in protecting internal surfaces, not the skin. The respiratory tract (Choice B) is involved in breathing and not directly related to the skin's defense. The gastrointestinal tract (Choice D) is responsible for digestion and absorption of nutrients, not the primary defense mechanism against external threats like the skin.
2. What is the etiology and most likely treatment for myasthenia gravis in a 22-year-old female college student?
- A. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids.
- B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins.
- C. Cerebellar lesions; surgical and immunosuppressive treatment.
- D. Excess acetylcholinesterase production; treatment with thymectomy.
Correct answer: B
Rationale: Myasthenia gravis is characterized by a decline in functioning acetylcholine receptors rather than autoimmune destruction of skeletal muscle cells (Choice A), cerebellar lesions (Choice C), or excess acetylcholinesterase production (Choice D). The most likely treatment for myasthenia gravis involves corticosteroids to reduce inflammation and intravenous immunoglobulins to block the antibodies attacking acetylcholine receptors. Intensive physical therapy and anabolic steroids are not primary treatments for myasthenia gravis.
3. A 10-year-old male is stung by a bee while playing in the yard. He experiences a severe allergic reaction and has to go to the ER. The nurse providing care realizes this reaction is the result of:
- A. Toxoids
- B. IgA
- C. IgE
- D. IgM
Correct answer: C
Rationale: The correct answer is C: IgE. A severe allergic reaction, such as the one experienced by the 10-year-old male after being stung by a bee, is mediated by IgE. IgE is involved in common allergic responses, triggering the release of histamine and other chemicals that lead to allergy symptoms. Choice A, Toxoids, are inactivated toxins used in vaccines. Choice B, IgA, is mainly found in mucosal areas and secretions, playing a role in mucosal immunity. Choice D, IgM, is the first antibody produced in response to an infection.
4. Which immunoglobulin presents the first challenge to the antigen?
- A. IgA
- B. IgG
- C. IgM
- D. IgE
Correct answer: C
Rationale: IgM is the first immunoglobulin to challenge the antigen during an immune response. IgM is the primary antibody produced during the initial or primary immune response. It is efficient in agglutination and complement activation, making it crucial in the early stages of defense. IgA is mainly found in mucosal areas and secretions. IgG is the most abundant antibody in circulation and is involved in secondary immune responses. IgE is primarily associated with allergic reactions and parasitic infections. Therefore, IgM is the correct choice as it acts first during the immune response, while the other immunoglobulins have different roles and functions.
5. A patient is being educated about the use of raloxifene (Evista) for osteoporosis. What is the primary therapeutic action of this medication?
- A. It stimulates the formation of new bone.
- B. It decreases bone resorption and increases bone density.
- C. It increases the excretion of calcium through the kidneys.
- D. It increases calcium absorption in the intestines.
Correct answer: B
Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption, which is the breakdown of bone, and increasing bone density. This action helps in preventing bone loss and maintaining bone strength. Choice A is incorrect because raloxifene does not stimulate the formation of new bone but rather prevents its breakdown. Choice C is incorrect as raloxifene does not increase the excretion of calcium but rather helps in maintaining calcium levels in the bones. Choice D is also incorrect as raloxifene does not directly increase calcium absorption in the intestines.
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