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MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?
- A. Eosinophils
- B. Neutrophils
- C. Leukotrienes
- D. Monocytes
Correct answer: B
Rationale: Neutrophils are the first responders to a bacterial infection. They are phagocytes that engulf and destroy bacteria, playing a crucial role in the early stages of the immune response. Eosinophils are primarily involved in combating parasitic infections and allergic reactions, not bacterial infections. Leukotrienes are signaling molecules that contribute to inflammation and immune responses, but they are not cells. Monocytes are another type of white blood cell that differentiates into macrophages and dendritic cells, playing a role in immune response but not as immediate as neutrophils.
2. A patient with a complex medical history is considering the use of oral contraceptives. The nurse should be aware that many antibiotics and antiseizure medications cause what effect when combined with oral contraceptives?
- A. Increased risk of pregnancy
- B. Increased blood pressure
- C. Increased risk of thromboembolism
- D. Increased gastric acid
Correct answer: A
Rationale: The correct answer is A: Increased risk of pregnancy. Certain antibiotics and anticonvulsants can decrease the effectiveness of oral contraceptives by inducing liver enzymes that metabolize the hormones more quickly. This interaction can lead to a decreased contraceptive effect, thereby increasing the risk of pregnancy. Choices B, C, and D are incorrect as they do not directly relate to the effect of antibiotics and antiseizure medications on oral contraceptives.
3. A patient with a history of hypertension presents with a severe headache, confusion, and visual disturbances. His blood pressure is 220/120 mm Hg. Which of the following is the most likely diagnosis?
- A. Migraine
- B. Cluster headache
- C. Hypertensive emergency
- D. Tension headache
Correct answer: C
Rationale: A patient with a history of hypertension presenting with a severe headache, confusion, and visual disturbances, along with a blood pressure of 220/120 mm Hg, likely has a hypertensive emergency. In this situation, the severely elevated blood pressure can lead to end-organ damage, causing symptoms such as headache and confusion. Migraine and tension headaches are not associated with such high blood pressure levels. Cluster headaches typically do not present with visual disturbances and confusion in the setting of severe hypertension.
4. A 34-year-old woman has presented to the clinic for the first time, and the nurse learns that she has been taking Depo Provera for the past 13 years. This aspect of the woman's medical history should prompt what assessment?
- A. Cardiac stress testing
- B. Renal ultrasound
- C. Bone density testing
- D. Evaluation of triglyceride levels
Correct answer: C
Rationale: The correct answer is bone density testing (Choice C). Long-term use of Depo Provera, a hormonal contraceptive, is associated with decreased bone mineral density. Assessing bone density is crucial to monitor for potential osteoporosis. Cardiac stress testing (Choice A) is not indicated based on the medication history provided. Renal ultrasound (Choice B) and evaluation of triglyceride levels (Choice D) are not directly related to the use of Depo Provera.
5. A patient suffers from dysmenorrhea. Which oral medication will be prescribed that has the ability to provide physiological actions on the neuroendocrine control of ovarian function?
- A. Estrogen
- B. Progestins
- C. Naproxen
- D. Ibuprofen
Correct answer: B
Rationale: Progestins are prescribed for dysmenorrhea as they help reduce menstrual pain by inhibiting ovulation and decreasing the production of prostaglandins. Estrogen (Choice A) is not typically used alone in dysmenorrhea treatment as it can worsen symptoms. Naproxen (Choice C) and Ibuprofen (Choice D) are nonsteroidal anti-inflammatory drugs (NSAIDs) commonly used to relieve pain associated with dysmenorrhea, but they do not directly affect the neuroendocrine control of ovarian function like progestins do.
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