MSN 570 Advanced Pathophysiology Final EXAM Latest 2023 EXAM Questions AND Correct Answers
lOMoARcPSD| 19500986 MSN 570 ADVANCED PATHOPHYSIOLOGY FINAL EXAM LATEST 2023 EXAM QUESTIONS AND CORRECT ANSWERS|AGRADE 1. A 65-year-old man is admitted to the intensive care unit from the operating room after a triple coronary artery bypass graft. He is intubated and on a ventilator. Lactic acid levels were normal postoperatively, but now they are rising. The increased level could be an indication of: A) excessive sedation. B) bowel ischemia. C) excessive volume infusion in the operating room. D) mild hypothermia postoperatively. Ans: B 2. Which of the following statements describes a cellular membrane exchange process that is active? A) Sodium moving out of cells and potassium moving into cells B) The movement of water from an area of low solute concentration to an area of high solute concentration C) The movement of insulin using a protein to travel across the cell membrane D) Oxygen moving across the pulmonary capillaries to an area of high carbon dioxide Ans: A 3. The canola plants genome is altered to produce an herbicide resistant crop. The canola oil produced from this crop is an example of a: A) pesticide-free food. B) saturated fat food.
lOMoARcPSD| 19500986 C) genetically modified food. D) product that is pure. Ans: C 4. A 30-year-old man has a history of heart transplant and is receiving long-term steroids to prevent rejection. The patient is due for routine vaccines. Attenuated vaccines are contraindicated in this patient because the antigen is: A) live and can cause infection. B) mutated and infectious. C) inactive but still infectious. D) pathogenic. Ans: A 5. A 20-year-old male shoots his hand with a nail gun while replacing roofing shingles. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand? A) Eosinophils B) Neutrophils C) Leukotrienes D) Monocytes Ans: B 6. Plasma protein inflammatory mediator systems include: A) phagocytic, interferon, and complement systems. B) complement, fibrinolytic, and clotting systems. C) complement, clotting, and kinin systems. D) complement, clotting, and acute phase reactant systems. Ans: C 7. Which of the following types of vitamin or mineral deficiency can cause megaloblastic anemia and is associated with lower extremity paresthesias? A) Vitamin B12 B) Folate
lOMoARcPSD| 19500986 C) Iron D) Vitamin K Ans: A 8. Anemia of chronic inflammation is generally classified as: A) hypochromic and microcytic. B) hypochromic and macrocytic. C) normochromic and microcytic. D) normochromic and normocytic. Ans: D 9. A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person: A) is normal with no sickle disease. B) is a sickle cell carrier. C) has sickle cell anemia. D) has thalassemia. Ans: B 10. Primary hypercholesteremia is often a result of: A) high-density lipoprotein (HDL) defects. B) monogenic mutations and sedentary lifestyle and high cholesterol in diet. C) polygenic mutations and environmental factors. D) low-density lipoprotein (LDL) receptor mutation with defects in the breakdown. Ans: D 11. The early stages of atheroma development is characterized by: A) macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima. B) accumulation of lipids in the intima (i.e., fatty streak). C) accumulation of proteins such as collagen and elastin (i.e., fibrous cap). D) development of calcium and a necrotic lipid core. Ans: A 12. Pain in the lower extremities due to peripheral artery disease usually worsens: A) with rest because blood flow increases. B) with elevation of the extremity because blood is diverted away. C) when the leg is in a dependent position because blood pools. D) when the leg is touched or massaged because cytokines are released. Ans: B 13. In chronic obstructive pulmonary disease, the inflammatory response predominantly involves: A) eosinophils. B) neutrophils. C) monocytes. B cells 14. In which patient is alpha-1 antitrypsin deficiency the likely cause of chronic obstructive pulmonary
lOMoARcPSD| 19500986 disease? A) A 30-year-old who has smoked for 3 years B) A 65-year-old man who drove a taxi most of his life C) A 70-year-old woman who smoked for 40 years D) A 50-year-old with exposure to secondhand smoke Ans: A 15. Which of the following tests is recommended for lung cancer screening? A) Chest X-ray B) Pulmonary function test C) Computed tomography (CT) scan D) Magnetic resonance image Ans: C
lOMoARcPSD| 19500986 16. Most body fluids are located in the: A) intravascular space. B) intracellular space. C) extracellular space. D) transcellular space. Ans: B 17. In which of the following cases is dehydration more likely to occur? A) A 50-year-old woman who is a bodybuilder B) A 50-year-old man who is morbidly obese C) A 10-year-old child is thin D) A 30-year-old with multiple sclerosis Ans: B 18. 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 Ans: C 19. Which of the following is a clinical manifestation in a patient with renal impairment associated with polycystic kidney disease? A) Suprapubic pain B) Periorbital edema C) Low serum creatinine level D) Palpable kidneys Ans: D
lOMoARcPSD| 19500986 20. The decreased glomerular filtration rate in a patient with acute glomerulonephritis is due to which pathophysiologic process? A) Decreased renal-induced constriction of the renal arteries B) Immune complex deposition, increased capillary permeability, and cellular proliferation C) Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure D) Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis Ans: B 21. With nephritic syndrome in comparison 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. Ans: C 22. Which of the following characterizes ductal carcinoma in situ? A) It is less common than lobular carcinoma in situ. B) Malignant cells have not invaded the stroma. C) It is considered a cancer precursor. D) It has a higher risk for invasive cancer in comparison to lobular carcinoma in situ. E) Malignant cells have not invaded the stroma, it is considered a cancer precursor, and it has a higher risk for invasive cancer in comparison to lobular carcinoma in situ. Ans: E 23. Women who have breast cancer due to a BRCA1 gene mutation are usually: A) positive for human epidermal receptor 1 and 2. B) negative for receptor to estrogen. C) positive for receptors to estrogen, progesterone, and human epidermal receptor 2. D) negative for receptors to estrogen, progesterone, and human epidermal receptor 2. Ans: D
lOMoARcPSD| 19500986 24. Which of the following women are at highest risks for the development of endometrial cancer? A) A 50-year-old postmenopausal woman with a history of high-risk human papilloma virus B) A 45-year-old woman who is obese and whose menstrual pattern consists of periods of amenorrhea and are infrequent. C) A 40-year-old woman who is overweight and has hypertension. D) A 55-year-old woman who is smokes. Ans: B 25. Which of the following is a common cause of mechanical small intestine obstruction? A) Infection B) Postoperative adhesions C) Tumors D) Foreign body Ans: B 26. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following are consistent with this diagnosis? A) Right lower quadrant cramping B) Severe bloody diarrhea C) Nausea and vomiting D) Mostly affects the rectum Ans: A 27. Which of the following statements characterize irritable bowel syndrome? A) Usually causes anemia B) Generally associated with intestinal E. coli C) Can be associated with anxiety and/or depression D) Often associated with bloody diarrhea Ans: C
lOMoARcPSD| 19500986 28. Which of the following disorders is more likely associated with blood in stool? A) Gastroesophageal reflux B) Crohn disease C) Irritable bowel syndrome D) Colon cancer Ans: D 29. Which of the following patients are at higher risk for developing oral cancer? A) A female who has taken oral contraceptives for the last 4 years B) An adult male with a history of alcoholism C) An adult female who eats spicy foods regularly D) A middle-aged male who smokes a pipe E) An older adult female who chews gum frequently F) Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe Ans: F 30. Manifestations of Cushing syndrome GinRclAudDeE: A) truncal obesity with thin extremities. B) enlargement of face, hands, and feet. C) cachexia. D) thick scalp hair. Ans: A 31. The signs of thyroid crisis resulting from Graves disease include: A) constipation with gastric distension. B) bradycardia and bradypnea. C) hyperthermia and tachycardia. D) constipation and lethargy. Ans: C 32. A 51-year-old woman has the following clinical findings: thin hair, exophthalmos, hyperreflexia, and pretibial edema. These findings are consistent with:
lOMoARcPSD| 19500986 A) subacute thyroiditis. B) autoimmune thyroiditis. C) Graves disease. D) Hashimoto’s disease. Ans: C 33. A 30-year-old has poorly controlled asthma and is taking prednisone 10 mg by mouth once a day. He has been on this regimen for 6 weeks. Abrupt withdrawal or discontinuation of this medication can cause: A) adrenal crisis. B) hypercortisolism. C) ACTH stimulation. D) thyroid crisis. Ans: A 34. A 27-year-old woman who has epilepsy had a generalized seizure. After the seizure, she feels tired and falls asleep. This is: A) an ominous sign. B) normal and termed the postictal period. C) a reflection of an underlying brain tumor. D) only worrisome if there are focal neurologic deficits after. Ans: B 35. Multiple sclerosis manifests as asymmetrical and in different parts of the body because: A) autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system. B) acetylcholine receptors are destroyed by immunoglobulin G. C) autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra. D) cortical motor cells degenerate. Ans: A 36. A 70-year-old woman has difficulty with driving, and she has been frequently getting lost. Her husband said she has also been acting strange and seems to want to sleep a lot. He said the other night she kept saying she was seeing animals such as lions in her room. He says her memory is not too bad, but he is very concerned about her health. Physical examination reveals an alert woman with stable vital signs. Bradykinesia and limb rigidity are noted. These findings are consistent with: A) Alzheimer disease. B) vascular dementia. C) dementia with Lewy body. D) frontotemporal demen
lOMoARcPSD| 19500986 tia. Ans: C 37. In which patients would the manifestation of a headache be a sign of a serious underlying disorder? A) A 55-year-old man with new onset of headaches that are worse at night and reported mood swings according to his family B) A 30-year-old woman with a unilateral throbbing headache with photophobia and nausea C) A 60-year-old man with his head feeling full and throbbing and muscle aching around his neck and shoulders D) A 40-year-old woman who experiences food cravings, gets irritable, and then develops a pulsatile-like headache on the right side of her head Ans: A 38. _ is a cause of the crystallization within the synovial fluid of the joint affected by gouty arthritis.
lOMoARcPSD| 19500986 A) Destruction of proteoglycans B) Underexcretion of uric acid C) Overexcretion of uric acid D) Increased absorption of uric acid Ans: B 39. A man with gout has developed large, hard nodules around his toes and elbows. The phase of gout he is in is: A) asymptomatic. B) acute flare. C) the intercritical period. D) chronic gout. Ans: D
lOMoARcPSD| 19500986 40. Muscular dystrophy is a result of an abnormality of the muscle protein: A) glycoprotein. B) dystrophin. C) troponin. D) actinomyosin. Ans: B 41. Which of the following is a characteristic of osteosarcoma? A) Slow-growing tumor that begins in the bone marrow B) Solitary tumor that most often affects the metaphyseal region of the femur or tibia C) An aggressive tumor most often found in the bone marrow of long bones D) A tumor that infiltrates the trabeculae in spongy bone and implants in surrounding tissue Ans: C 42. Rhabdomyolysis can result in serious complications. In addition to muscle pain and weakness, a patient will complain of: A) paresthesias. B) bone pain. C) dark urine. D) diarrhea. Ans: C 43. In which disorder does a Staphylococcus aureus organism produce a toxin leading to exfoliation and large blister formation? A) Herpes simplex I virus B) Bullous impetigo C) Necrotizing fasciitis D) Cellulitis Ans: B
lOMoARcPSD| 19500986 44. Multiple dark bands on the nails: A) are considered a normal variant. B) can be associated with malignant melanoma. C) are indicative of a nail fungus. D) are associated with aging. Ans: B 45. Which of the following birthmarks usually fade or regress as the child gets older? A) Hemangiomas B) Congenital dermal melanocytosis (i.e., Mongolian spots) C) Macular stains D) Nevus flammeus (i.e., port wine stains) E) Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains Ans: E 46. Which of the following chronic inflammGaRtoAryDsEkSinLdAisoBrd.eCrsOisMcharacterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation? A) Psoriasis B) Melanoma C) Atopic dermatitis D) Urticaria Ans: A 47. A patient was sneezing frequently after a few days of allergic rhinitis, and she noticed her eye became red. She denies any trauma, eye pain, or visual disturbance. Physical examination reveals a subconjunctival hemorrhage. Which statement is accurate pertaining to this case? A) The hemorrhage will resolve without treatment within 2 weeks. B) The patient should be referred for immediate ophthalmologic examination. C) Corticosteroids eye drops will be prescribed to reduce the bleeding. D) Antibiotic eye drops will be prescribed to prevent infection. Ans: A
lOMoARcPSD| 19500986 48. Which of the following eye disorders manifest with red eye, pain, and visual acuity changes? A) Bacterial conjunctivitis B) Acute closed-angle glaucoma C) Chronic open-angle glaucoma D) Blepharitis Ans: B 49. 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. Ans: D 50. A woman is complaining that she feels like the room is spinning even though she is not moving. Which of the following is characteristic ofGbRenAigDnEpSosLitiAonBa.l vCerOtigMo? A) It usually occurs with a headache. B) Pupillary changes are common. C) It usually triggered when the patient bends forward. D) Nystagmus continues even when eyes fixate on an object. Ans: C