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MSN 570 Advanced Pathophysiology Final 2024
1. In nephritic syndrome compared to nephrotic syndrome, there is:
- A. higher amounts of albuminuria.
- B. negligible hematuria or absence of hematuria.
- C. presence of red blood cell casts in the urine.
- D. hypoalbuminemia
Correct answer: C
Rationale: In nephritic syndrome, the presence of red blood cell casts in the urine is a characteristic finding, reflecting glomerular inflammation and damage. This differentiates it from nephrotic syndrome, where red blood cell casts are typically absent. Choice A is incorrect because nephritic syndrome usually presents with less albuminuria compared to nephrotic syndrome. Choice B is incorrect as hematuria is a common feature of nephritic syndrome. Choice D is incorrect as hypoalbuminemia is more commonly associated with nephrotic syndrome.
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 prescribed estradiol (Estrace) for hormone replacement therapy (HRT). What should the nurse monitor during this therapy?
- A. Blood glucose levels
- B. Liver function tests
- C. Kidney function tests
- D. Blood pressure
Correct answer: B
Rationale: During estradiol therapy, monitoring liver function tests is essential due to the potential for liver dysfunction. Estradiol can affect liver function, making it crucial to monitor enzyme levels. Choice A, blood glucose levels, is not directly impacted by estradiol therapy, making it an incorrect choice. Choice C, kidney function tests, is not typically affected by estradiol therapy, so it is not the priority for monitoring. Choice D, blood pressure, is also not the primary parameter to monitor during estradiol therapy unless there are pre-existing conditions that warrant such monitoring.
4. Which of the following women is at highest risk for the development of endometrial cancer?
- A. A 50-year-old postmenopausal woman with a history of high-risk human papillomavirus
- B. A 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods
- C. A 40-year-old woman who is overweight and has hypertension
- D. A 55-year-old woman who smokes
Correct answer: B
Rationale: The correct answer is a 45-year-old woman who is obese and has a menstrual pattern consisting of periods of amenorrhea and infrequent periods. Obesity and prolonged exposure to estrogen unopposed by progesterone due to infrequent ovulation are significant risk factors for endometrial cancer. Choices A, C, and D do not directly correlate with the increased risk of endometrial cancer. Postmenopausal status alone (Choice A), overweight with hypertension (Choice C), and smoking (Choice D) are not the primary risk factors for endometrial cancer.
5. Which of the following best describes Cushing’s syndrome?
- A. Hypersecretion of growth hormone
- B. Excessive production of cortisol by the adrenal glands
- C. Insufficient production of insulin
- D. Increased levels of ACTH
Correct answer: B
Rationale: Cushing’s syndrome is characterized by the excessive production of cortisol by the adrenal glands, not growth hormone (Choice A), insulin (Choice C), or ACTH (Choice D). The increased cortisol levels lead to a variety of symptoms associated with Cushing’s syndrome.
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