ATI RN
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 patient who is undergoing treatment for cytomegalovirus received his first dose of IV ganciclovir 3 days ago. When reviewing this patient's most recent blood work, what abnormality should the nurse most likely attribute to the use of this drug?
- A. Hemoglobin 17 g/dL (high normal)
- B. INR 3.8 (high)
- C. Platelet count 118,000/mm3 (low)
- D. Leukocytes 11,900/mm3 (high)
Correct answer: C
Rationale: The correct answer is C: Platelet count 118,000/mm3 (low). Ganciclovir, used to treat cytomegalovirus, is known to cause bone marrow suppression, leading to decreased platelet count (thrombocytopenia). This condition can increase the risk of bleeding. Choices A, B, and D are not typically associated with ganciclovir therapy. High hemoglobin levels (choice A) are not commonly seen with ganciclovir treatment. INR elevation (choice B) is associated with coagulation abnormalities, which are not a typical side effect of ganciclovir. Elevated leukocyte count (choice D) is not a common consequence of ganciclovir use.
3. What is the treatment for patients with hemophilia A?
- A. Chemotherapy
- B. Factor VIII replacement
- C. Heparin administration
- D. Bone marrow transplant
Correct answer: B
Rationale: The correct treatment for patients with hemophilia A is Factor VIII replacement. Hemophilia A is a genetic disorder where there is a deficiency in clotting factor VIII. Therefore, replacing this factor is crucial in managing and preventing bleeding episodes. Choice A, chemotherapy, is not the correct treatment for hemophilia A. Choice C, heparin administration, is not recommended as it can further increase the risk of bleeding in patients with hemophilia. Choice D, bone marrow transplant, is not a standard treatment for hemophilia A.
4. What critical point should the nurse include in patient education regarding tamoxifen (Nolvadex) for a patient with breast cancer?
- A. Tamoxifen may increase the risk of venous thromboembolism.
- B. Tamoxifen may cause hot flashes and other menopausal symptoms.
- C. Tamoxifen may cause weight gain and fluid retention.
- D. Tamoxifen may decrease the risk of osteoporosis.
Correct answer: A
Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism. Patients should be educated about the signs and symptoms of blood clots, such as swelling, redness, and pain in the legs. Choices B, C, and D are incorrect because tamoxifen is not associated with causing hot flashes, weight gain, fluid retention, or decreasing the risk of osteoporosis.
5. A patient has acute respiratory failure (ARF). Which of the following would the nurse expect to find?
- A. Alkalosis and hyperventilation
- B. Hypoxemia and hypercapnia
- C. Alkalosis and high potassium
- D. Elevated sodium and acidosis
Correct answer: B
Rationale: In acute respiratory failure, hypoxemia (low blood oxygen) and hypercapnia (high blood carbon dioxide) are commonly observed. Choice A is incorrect because alkalosis (high pH) and hyperventilation are not typically seen in acute respiratory failure. Choice C is incorrect as it mentions alkalosis and high potassium, which are not characteristic of acute respiratory failure. Choice D is also incorrect because elevated sodium and acidosis are not typically associated with acute respiratory failure.
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