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MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following is a factor that leads to increased risk for dehydration in the elderly?
- A. More insensible losses
- B. Increase in muscle mass
- C. Decline in kidney function
- D. Decrease in fat
Correct answer: C
Rationale: The correct answer is C: Decline in kidney function. As people age, their kidneys may not work as effectively in conserving water and concentrating urine, leading to a higher risk of dehydration. Choice A is incorrect because more insensible losses do not directly relate to an increased risk of dehydration in the elderly. Choice B, an increase in muscle mass, is not a factor that leads to dehydration. Choice D, a decrease in fat, is also not a direct factor contributing to dehydration in the elderly.
2. A woman is complaining that she feels like the room is spinning even though she is not moving. Which of the following is characteristic of benign positional vertigo?
- A. It usually occurs with a headache.
- B. Pupillary changes are common.
- C. It is usually triggered when the patient bends forward.
- D. Nystagmus continues even when eyes fixate on an object.
Correct answer: C
Rationale: Benign positional vertigo is typically triggered by changes in head position, such as bending forward or turning over in bed. This change in position leads to brief episodes of vertigo, often associated with nystagmus, which is rapid, involuntary eye movements. Pupillary changes and headaches are not typical features of benign positional vertigo, making choices B and A incorrect. Nystagmus in benign positional vertigo usually stops when the eyes fixate on an object, so choice D is also incorrect.
3. What important information should the nurse provide about the risks associated with tamoxifen (Nolvadex) for a patient with a history of breast cancer?
- A. Tamoxifen may increase the risk of venous thromboembolism.
- B. Tamoxifen may decrease the risk of osteoporosis.
- C. Tamoxifen may cause hot flashes and other menopausal symptoms.
- D. Tamoxifen may cause weight gain and fluid retention.
Correct answer: A
Rationale: The correct answer is A: Tamoxifen may increase the risk of venous thromboembolism. Patients on tamoxifen should be educated about the signs and symptoms of blood clots. Choices B, C, and D are incorrect. Tamoxifen does not decrease the risk of osteoporosis; it may cause hot flashes and other menopausal symptoms, and it may cause weight gain and fluid retention.
4. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). The nurse should educate the patient about what potential side effect of this medication?
- A. Increased risk of venous thromboembolism
- B. Increased risk of hot flashes
- C. Increased risk of cataracts
- D. Increased risk of bone fractures
Correct answer: A
Rationale: The correct answer is A: Increased risk of venous thromboembolism. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots such as swelling, redness, warmth, or pain in the affected limb. Choices B, C, and D are incorrect because tamoxifen is not associated with an increased risk of hot flashes, cataracts, or bone fractures.
5. A patient is starting on a new oral contraceptive. What should the nurse emphasize about the timing of the medication?
- A. Take the medication at the same time each day to maintain stable hormone levels.
- B. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
- C. Oral contraceptives can be taken at any time of day as long as the schedule is consistent.
- D. Oral contraceptives are effective immediately upon starting, regardless of timing.
Correct answer: A
Rationale: The correct answer is A. It is crucial for patients taking oral contraceptives to take the medication at the same time each day to maintain stable hormone levels and ensure their effectiveness in preventing pregnancy. Choice B is incorrect because there is no specific requirement to take oral contraceptives in the morning. Choice C is incorrect because consistency in timing is essential, but it should be at the same time each day. Choice D is incorrect because oral contraceptives may take some time to reach peak effectiveness, so it is important to emphasize the need for consistent timing.
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