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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 taking raloxifene (Evista) for osteoporosis. What is the primary therapeutic effect of this medication?
- A. It stimulates the formation of new bone.
- B. It decreases bone resorption and increases bone density.
- C. It increases the excretion of calcium through the kidneys.
- D. It increases calcium absorption in the intestines.
Correct answer: B
Rationale: The correct answer is B. Raloxifene, a selective estrogen receptor modulator (SERM), primarily works by decreasing bone resorption and increasing bone density. This mechanism of action helps in the prevention and treatment of osteoporosis by maintaining or improving bone strength. Choice A is incorrect because raloxifene does not directly stimulate the formation of new bone but rather helps in preserving existing bone. Choice C is incorrect because raloxifene does not increase the excretion of calcium through the kidneys; instead, it acts on bone tissue. Choice D is incorrect as raloxifene does not directly increase calcium absorption in the intestines but rather focuses on bone health.
3. A male patient is being treated with testosterone gel for hypogonadism. What important instruction should the nurse provide?
- A. Apply the gel to the face and neck for maximum absorption.
- B. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
- C. Apply the gel to the scalp and back.
- D. Apply the gel to the genitals for improved results.
Correct answer: B
Rationale: The correct instruction for applying testosterone gel is to apply it to the chest or upper arms and allow it to dry completely before dressing. This is important to prevent the transfer of the medication to others. Applying it to the face and neck (Choice A) is incorrect as these areas are not recommended. Similarly, applying it to the scalp and back (Choice C) or the genitals (Choice D) is also incorrect and can lead to inappropriate absorption or undesirable effects.
4. Which condition is characterized by a lack of antidiuretic hormone (ADH)?
- A. Diabetes mellitus
- B. Diabetes insipidus
- C. Cushing's disease
- D. Hyperthyroidism
Correct answer: B
Rationale: The correct answer is B, Diabetes insipidus. Diabetes insipidus is characterized by a lack of antidiuretic hormone (ADH), leading to excessive urination and thirst. Choice A, Diabetes mellitus, is a different condition characterized by high blood sugar levels. Choice C, Cushing's disease, is caused by prolonged exposure to high levels of cortisol. Choice D, Hyperthyroidism, involves an overactive thyroid gland producing excess thyroid hormones.
5. What adverse effect should the nurse monitor for during testosterone therapy in a male patient?
- A. Increased risk of cardiovascular events
- B. Increased risk of liver dysfunction
- C. Increased risk of prostate cancer
- D. Increased risk of bone fractures
Correct answer: A
Rationale: The correct answer is A: Increased risk of cardiovascular events. Testosterone therapy can lead to an increased risk of cardiovascular events, such as heart attacks and strokes. This is why nurses should monitor for signs and symptoms of cardiovascular issues during therapy. Choices B, C, and D are incorrect because testosterone therapy is not typically associated with an increased risk of liver dysfunction, prostate cancer, or bone fractures. It is crucial for nurses to prioritize cardiovascular monitoring in patients receiving testosterone therapy.
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