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MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following statements characterizes irritable bowel syndrome?
- A. Typically does not cause anemia
- B. Not generally associated with intestinal E. coli
- C. Can be associated with anxiety and/or depression
- D. Not often associated with bloody diarrhea
Correct answer: C
Rationale: Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by abdominal pain, bloating, and changes in bowel habits. While IBS can lead to symptoms like diarrhea or constipation, it typically does not cause anemia (choice A), is not generally associated with intestinal E. coli (choice B), and is not often associated with bloody diarrhea (choice D). However, IBS can indeed be associated with anxiety and/or depression (choice C) due to the gut-brain axis, a bidirectional communication system between the gut and the brain. This association is well-documented in IBS patients, highlighting the importance of considering psychological factors in managing the condition.
2. Interpret the following arterial blood gas results: PH = 7.30; PaCO2 = 55 mmHg; HCO3 = 24 mEq/L
- A. Respiratory acidosis
- B. Metabolic acidosis
- C. Respiratory alkalosis
- D. Metabolic alkalosis
Correct answer: A
Rationale: The correct answer is A: Respiratory acidosis. In respiratory acidosis, there is an accumulation of CO2 in the blood, leading to a decrease in pH. The elevated PaCO2 of 55 mmHg in the given results indicates hypoventilation, causing respiratory acidosis. Choices B, C, and D are incorrect because the provided data does not show metabolic acidosis, respiratory alkalosis, or metabolic alkalosis.
3. A patient is being educated about the use of raloxifene (Evista) for osteoporosis. What is the primary therapeutic action 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: 'It decreases bone resorption and increases bone density.' Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption, which is the breakdown of bone, and increasing bone density. This action helps in preventing bone loss and maintaining bone strength. Choice A is incorrect because raloxifene does not stimulate the formation of new bone but rather prevents its breakdown. Choice C is incorrect as raloxifene does not increase the excretion of calcium but rather helps in maintaining calcium levels in the bones. Choice D is also incorrect as raloxifene does not directly increase calcium absorption in the intestines.
4. A client with a pneumothorax is receiving oxygen therapy. Which assessment finding would indicate that the treatment is effective?
- A. Increased respiratory rate
- B. Decreased oxygen saturation levels
- C. Improved breath sounds on the affected side
- D. Increased dyspnea and chest pain
Correct answer: C
Rationale: In a client with a pneumothorax receiving oxygen therapy, improved breath sounds on the affected side would indicate effective treatment. This finding suggests that the collapsed lung is re-expanding, allowing air to flow more freely in and out of the affected area. Choices A, B, and D are incorrect: Increased respiratory rate, decreased oxygen saturation levels, and increased dyspnea and chest pain are signs of ineffective treatment or worsening of the condition in a client with a pneumothorax.
5. Which of the following would the nurse see in a client with thrombocytopenia?
- A. A decreased platelet cell count
- B. Decreased white blood cell count
- C. Increased red blood cell count
- D. An increased platelet cell count
Correct answer: A
Rationale: Thrombocytopenia is characterized by a decreased platelet cell count, leading to an increased risk of bleeding. Therefore, the correct answer is A. Choice B, a decreased white blood cell count, is not typically associated with thrombocytopenia. Choice C, an increased red blood cell count, is not a characteristic finding in thrombocytopenia. Choice D, an increased platelet cell count, is the opposite of what is observed in thrombocytopenia.
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