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MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following birthmarks usually fade or regress as the child gets older?
- A. Hemangiomas
- B. Congenital dermal melanocytosis (i.e., Mongolian spots)
- C. Macular stains
- D. Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains
Correct answer: D
Rationale: The correct answer is Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains. These three types of birthmarks are known to fade or regress as the child gets older. Hemangiomas are vascular birthmarks that often shrink and disappear over time. Congenital dermal melanocytosis, commonly known as Mongolian spots, usually fade by adolescence. Macular stains, also called salmon patches, tend to lighten and fade as a child grows. The other choices are incorrect because they do not typically fade or regress with age.
2. A 20-year-old college student has presented to the campus medical clinic seeking to begin oral contraceptive therapy. The nurse has recognized the need for adequate health education related to the patient's request. The nurse should emphasize the fact that successful prevention of pregnancy depends primarily on the patient's
- A. current health status.
- B. vigilant adherence to the drug regimen.
- C. knowledge of sexual health.
- D. risk factors for adverse effects.
Correct answer: B
Rationale: The correct answer is B: 'vigilant adherence to the drug regimen.' When initiating oral contraceptive therapy, the success of preventing pregnancy relies heavily on the patient's commitment to following the prescribed regimen consistently. Compliance with taking the oral contraceptives as directed is crucial for their effectiveness. Choice A, 'current health status,' is not the primary factor for successful prevention of pregnancy with oral contraceptives. Choice C, 'knowledge of sexual health,' while important, is not the primary determinant of contraceptive efficacy. Choice D, 'risk factors for adverse effects,' though relevant for monitoring and managing side effects, is not the primary focus for ensuring contraceptive success.
3. The neurotransmitter GABA mainly functions to trigger inhibitory postsynaptic potentials (IPSPs). Therefore, when explaining this to a group of nursing students, the nurse will state:
- A. It takes at least three chemical substances (amino acids, neuropeptides, and monoamines) to stimulate any activity between the cells.
- B. There is a symbiotic relationship; therefore, the end result will be depolarization of the postsynaptic membrane.
- C. The combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable.
- D. The neurotransmitters will interact with cholinergic receptors to bind to acetylcholine in order to produce hypopolarization within the cell.
Correct answer: C
Rationale: When GABA binds with a receptor site, it causes hyperpolarization of the local nerve membrane, making it less excitable. This hyperpolarization leads to inhibition of nerve cell activity. Choice A is incorrect because GABA is a neurotransmitter itself and does not require three chemical substances to stimulate activity between cells. Choice B is incorrect as GABA triggers inhibitory postsynaptic potentials (IPSPs), leading to hyperpolarization, not depolarization, of the postsynaptic membrane. Choice D is also incorrect as it describes a process involving cholinergic receptors and acetylcholine, which is unrelated to GABA's mechanism of action.
4. A patient is being treated for active tuberculosis with ethambutol (Myambutol). The patient states to the nurse that he cannot identify the red and green on the traffic lights when he is driving. Based on this finding, what medical intervention is most appropriate?
- A. Assess for photosensitivity.
- B. Discontinue ethambutol (Myambutol).
- C. Decrease the ethambutol (Myambutol) dose.
- D. Administer vitamin B.
Correct answer: A
Rationale: The correct answer is to assess for photosensitivity. Ethambutol can cause optic neuritis, leading to visual disturbances, including difficulty differentiating red and green colors. This is a sign of optic nerve damage and requires immediate evaluation. Discontinuing ethambutol may be necessary if optic neuritis is confirmed, but this decision should be made by a healthcare provider. Decreasing the dose of ethambutol may not address the visual changes. Administering vitamin B does not directly address the side effect caused by ethambutol.
5. A patient is being treated for a severe fungal infection with amphotericin B. What is the expected length of treatment for this patient?
- A. 1 to 2 weeks
- B. 3 to 6 weeks
- C. 4 to 12 weeks
- D. 15 to 18 weeks
Correct answer: C
Rationale: The correct answer is C: '4 to 12 weeks.' Amphotericin B treatment duration for severe fungal infections typically ranges from 4 to 12 weeks. This extended period is necessary to ensure complete eradication of the fungal infection and prevent relapse. Choices A, B, and D provide durations that are either too short or too long for treating severe fungal infections effectively, making them incorrect.
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