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MSN 570 Advanced Pathophysiology Final 2024
1. Macular degeneration occurs as a result of:
- A. loss of lens accommodation
- B. detachment of the retina
- C. increased intraocular pressure
- D. impaired blood supply leading to cellular waste accumulation and ischemia
Correct answer: D
Rationale: Macular degeneration is a condition that affects the macula, a part of the retina responsible for central vision. It is primarily caused by impaired blood supply to the macula, leading to cellular waste accumulation and ischemia. This results in the death of photoreceptor cells and ultimately vision loss. Choices A, B, and C are incorrect because macular degeneration is not related to the loss of lens accommodation, detachment of the retina, or increased intraocular pressure. The correct answer directly addresses the underlying pathophysiology of macular degeneration.
2. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What important contraindication should the nurse emphasize during patient education?
- A. Use of nitrates
- B. History of hypertension
- C. History of peptic ulcer disease
- D. Use of antihypertensive medications
Correct answer: A
Rationale: The correct answer is A: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because they are not direct contraindications for sildenafil use. While a history of hypertension or peptic ulcer disease may require caution, they are not absolute contraindications like the concomitant use of nitrates.
3. An adult patient has begun treatment with fluconazole. The nurse should recognize the need to likely discontinue the drug if the patient develops which of the following signs or symptoms?
- A. Jaundice
- B. Weight gain
- C. Iron deficiency anemia
- D. Hematuria
Correct answer: A
Rationale: The correct answer is A: Jaundice. Fluconazole, an antifungal medication, can rarely cause hepatotoxicity, which may manifest as jaundice. Monitoring for signs of liver dysfunction, such as jaundice, is crucial during fluconazole therapy. Weight gain, iron deficiency anemia, and hematuria are not commonly associated with fluconazole use and are not indications for discontinuing the drug.
4. An MRI scan of a 33-year-old female client with new-onset seizures has revealed a lesion on her frontal lobe. Which of the following signs and symptoms would most likely be a direct result of this lesion?
- A. Changes in sensation or movement in the client's limbs
- B. Fluctuations in blood pressure
- C. Changes in speech and reasoning
- D. Increased intracranial pressure
Correct answer: C
Rationale: The correct answer is C: Changes in speech and reasoning. The frontal lobe is responsible for higher cognitive functions, including speech and reasoning. A lesion in this area can lead to difficulties in speech production, language comprehension, and reasoning abilities. Choices A, B, and D are incorrect. Changes in sensation or movement in the client's limbs are more associated with lesions in the motor or sensory cortices of the brain, not the frontal lobe. Fluctuations in blood pressure are often related to autonomic nervous system dysfunction, which is controlled by other brain regions. Increased intracranial pressure is typically seen in conditions like brain tumors or head trauma, not directly related to a frontal lobe lesion.
5. A 30-year-old male is being treated with testosterone enanthate for delayed puberty. What side effect should the nurse inform the patient about?
- A. Increased libido
- B. Decreased muscle mass
- C. Breast tenderness
- D. Increased aggression
Correct answer: D
Rationale: The correct side effect that the nurse should inform the patient about when receiving testosterone enanthate therapy for delayed puberty is increased aggression. Testosterone therapy can lead to mood changes, including increased aggression in some individuals. Therefore, it is essential for healthcare providers to educate patients about this potential side effect. Choices A, B, and C are incorrect because testosterone therapy is more likely to increase libido, promote muscle mass growth, and may cause breast tenderness due to hormonal imbalances.
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