MN 551 MIDTERM EXAM 2 – QUESTION AND ANSWERS

MN 551 MIDTERM EXAM 2 – QUESTION AND ANSWERS MN551 week 10 final Which of the following sexually active women most likely faces the highest risk of developing an ectopic pregnancy? A 42 yo female patient with a long standing history of chronic nausea and vomiting but a near insatiable appetite has had her symptoms Which of the following individuals demonstrates a health problem with his or her axial skeleton? QUESTION 1. The unique clinical presentation of a three-month-old infant in the emergency department leads the care team to suspect botulism. Which of the following assessment questions posed to the parents is likely to be most useful in the differential diagnosis? (Points : 0.4) “Have you ever given your child any honey or honey-containing products?” Botulism in infants is frequently attributable to honey. Family history is not a relevant consideration given the bacterial etiology, and mold and chemical cleaning products are not known to predispose to botulism toxicity. “Is there any family history of neuromuscular diseases?” “Has your baby ever been directly exposed to any chemical cleaning products?” “Is there any mold in your home that you know of?” Question 2. 2. A nurse practitioner is providing care for a 68-year-old female whose anxiety disorder is significantly decreasing her quality of life. Which of the following pharmacologic therapies is most likely to benefit the woman? (Points : 0.4) A drug that influences gamma-aminobutyric acid (GABA) levels GABA is often implicated in anxiety disorders, and benzodiazepines address this neurotransmitter. An MAO inhibitor increases the concentration of serotonin and norepinephrine. MAO inhibitors are occasionally prescribed for depression not responding to SSRIs and would not be indicated for an anxiety disorder. Calcium channel blockers are good for lowering BP and minimizing arterial spasms but are usually not prescribed for anxiety. A selective serotonin reuptake inhibitor (SSRI) An antipsychotic medication that blocks dopamine receptors An epinephrine and norepinephrine supplement A 60 woman who is 11 years menopausal has presented to the emergency department stating “I haven’t had my period in years, but lately Ive been bleeding again A 20 year old male has been diagnosed with testicular cancer and is seeking information Question 3. 3. A 51-year-old has been admitted to a rehabilitation center after hospital treatment for an ischemic stroke. Which of the following aspects of the patient's history would not be considered to have contributed to his stroke? (Points : 0.4) He was diagnosed with type 2 diabetes eight years ago Elevated cholesterol Blood pressure that is normally 120/80 African American race, male gender, hypertension, and diabetes are all well-documented risk factors for stroke. Anemia, autoimmune disorders like rheumatoid arthritis, and the use of corticosteroids are not noted to predispose to stroke. The patient is an African American Male History of sickle cell anemia Question 4. 4. Following a motor vehicle accident three months prior, a 20year-old female who has been in a coma since her accident has now had her condition declared a persistent vegetative state. How can her care providers most accurately explain an aspect of her situation to her parents? (Points : 0.4) “Your daughter has lost all her cognitive functions as well as all her basic reflexes.” “Though she still goes through a cycle of sleeping and waking, her condition is unlikely to change.” A continuation of the sleep-wake cycle can exist in a persistent vegetative state. Reflexes often remain, as does spontaneous eye opening. Aspects of brain function beyond those governing consciousness are affected. “If you or the care team notice any spontaneous eye opening, then we will change our treatment plan.” “Your daughter's condition is an unfortunate combination of total loss of consciousness with continuation of all other normal brain functions.” Question 5. 5. A patient with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which of the following processes will accompany the actions of the neurotransmitter in her chemical synapses? (Points : 0.4) Two-way communication between neurons is permitted, in contrast to the one-way communication in electrical synapses. Communication between a neuron and the single neuron it is connected with will be facilitated. The neurotransmitter will cross gap junctions more readily. More serotonin molecules will cross the synaptic cleft and bond with postsynaptic receptors. In chemical synapses, neurotransmitters cross the synaptic cleft and bond with postsynaptic receptors to facilitate communication between neurons. This communication is one way, not two way, and each neuron has synaptic connections with thousands of other neurons. Gap junctions are associated with electrical synapses, not chemical synapses.