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MSN 570 Advanced Pathophysiology Final 2024
1. When does pain in the lower extremities due to peripheral artery disease usually worsen?
- A. with rest because blood flow decreases.
- B. with elevation of the extremity because blood is diverted away.
- C. when the leg is in a dependent position because blood pools.
- D. when the leg is touched or massaged because cytokines are released.
Correct answer: B
Rationale: Pain in the lower extremities due to peripheral artery disease usually worsens with elevation of the extremity because blood is diverted away from the affected area, leading to decreased perfusion and exacerbation of symptoms. Choices A, C, and D are incorrect because resting, dependent position, and touch/massage do not typically worsen the pain associated with peripheral artery disease.
2. What aspect of this woman's current health status would contraindicate the use of oral contraceptives?
- A. The woman has a diagnosis of type 2 diabetes.
- B. The woman has asthma and uses inhaled corticosteroids and bronchodilators.
- C. The woman has a family history of breast cancer.
- D. The woman takes an antiplatelet medication for coronary artery disease.
Correct answer: A
Rationale: The correct answer is A. Women with type 2 diabetes are at higher risk of developing cardiovascular complications. Oral contraceptives further increase this risk due to their potential effects on blood pressure, lipid metabolism, and clotting factors. Choice B is incorrect as inhaled corticosteroids and bronchodilators do not contraindicate the use of oral contraceptives. Choice C is incorrect as a family history of breast cancer does not directly contraindicate the use of oral contraceptives. Choice D is also incorrect as taking an antiplatelet medication for coronary artery disease does not necessarily contraindicate the use of oral contraceptives.
3. What causes atherosclerotic plaques to form in the body?
- A. Poor dietary habits
- B. Administration of statin medication
- C. Interruption of blood flow to the brain
- D. Injury to the endothelium of the coronary arteries
Correct answer: D
Rationale: Atherosclerotic plaques form in the body due to injury to the endothelium of the coronary arteries. When the endothelium is damaged, it triggers an inflammatory response that leads to the accumulation of fats, cholesterol, and other substances, forming plaques. These plaques can narrow the arteries, reducing blood flow and potentially leading to serious complications like heart attacks or strokes. Poor dietary habits (choice A) can contribute to the development of atherosclerosis by promoting the buildup of plaque-forming substances in the blood, but the direct cause is the injury to the endothelium. Administration of statin medication (choice B) is actually a treatment for high cholesterol and aims to reduce the risk of plaque formation. Interruption of blood flow to the brain (choice C) is more related to conditions like ischemic stroke rather than the primary cause of atherosclerotic plaque formation.
4. When assessing a 7-year-old child's pain after an emergency appendectomy, what is the most appropriate tool for the nurse to use?
- A. Use a visual analog scale (VAS) to assess the pain.
- B. Ask the child to rate their pain on a scale of 0 to 10.
- C. Use the Wong-Baker FACES scale to assess the pain.
- D. Ask the parents to describe the child's pain behavior.
Correct answer: C
Rationale: The correct answer is to use the Wong-Baker FACES scale to assess the child's pain. This scale is specifically designed for children and uses facial expressions of varying intensities to help them communicate their pain levels effectively. Choices A and B may not be as suitable for a young child who may have difficulty understanding or using a numerical scale. Choice D involving parents may not provide an accurate reflection of the child's pain experience, as it is essential to assess the child's self-reporting.
5. Which of the following factors are known to contribute to an individual's ability to adapt to stress? (Select ONE that does not apply.)
- A. Ethnicity
- B. Age
- C. Socioeconomic status
- D. Gender
Correct answer: A
Rationale: The correct factors that contribute to an individual's ability to adapt to stress are age, socioeconomic status, and gender. Age can influence coping mechanisms and resilience. Socioeconomic status can impact access to resources and support systems. Gender differences can also play a role in how individuals experience and manage stress. Ethnicity, while important in other contexts, is not directly mentioned in the provided rationale and is not one of the factors listed as contributing to an individual's ability to adapt to stress.
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