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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. The healthcare provider is caring for a client with an altered level of consciousness and needs to assess the withdrawal reflex. Which action should the healthcare provider perform?
- A. Apply a painful stimulus to see if the client pulls away.
- B. Check for pupil response to light.
- C. Assess the client's response to verbal commands.
- D. Observe the client's reaction to a cold stimulus.
Correct answer: A
Rationale: The withdrawal reflex is assessed by applying a painful stimulus and observing if the client pulls away. This response indicates a functioning reflex arc. Choices B, C, and D are incorrect as they do not involve testing the withdrawal reflex specifically. Checking for pupil response to light assesses the pupillary reflex, assessing the client's response to verbal commands evaluates their cognitive function, and observing the client's reaction to a cold stimulus tests for a different type of sensory response.
3. 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.
4. A group of nursing students and their professor are engaged in a service learning project and will be caring for patients in Haiti. What medication should be administered to prevent the development of malaria?
- A. Metronidazole (Flagyl)
- B. Oprelvekin (Neumega)
- C. Chloroquine phosphate (Aralen)
- D. Chloroprocaine hydrochloride (Nesacaine)
Correct answer: C
Rationale: The correct answer is Chloroquine phosphate (Aralen). Chloroquine is a medication used to prevent and treat malaria. It works by killing the malaria parasite in the red blood cells. Metronidazole (Flagyl) is an antibiotic used to treat various bacterial and parasitic infections, not malaria. Oprelvekin (Neumega) is a medication used to stimulate platelet production. Chloroprocaine hydrochloride (Nesacaine) is a local anesthetic used for epidural anesthesia. Therefore, Chloroquine phosphate is the appropriate medication for preventing malaria in this scenario.
5. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?
- A. Has your child received all recommended vaccinations?
- B. Has your child been feeding poorly or showing signs of constipation?
- C. Has your child been exposed to any sick individuals?
- D. Has your child been displaying signs of respiratory distress?
Correct answer: B
Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.
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