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UNIT 8 MN 551 PATHO QUESTIONS &
ANSWERS
1. A 40-year-old male patient with multiple health problems has been diag-
nosed with a testosterone deficiency. Which of the following assessment findings would his care provider attribute to an etiology other than this deficiency? Question options: The patient has a low muscle mass as a proportion of total body weight. The patient has a history of susceptibility to upper respiratory infections. The patient has long-standing anemia and low red cell counts. The patient has a voice that is unusually high in pitch.: The patient has a history of susceptibility to upper respiratory infections.
2. Which of the following sexually active women most likely faces the highest
risk of developing an ectopic pregnancy? Question options: A 22-year-old who has a history of anorexia nervosa and who has a body mass index (BMI) of 12.0 (normal is 18.5 to 24.9). A 27-year-old who stopped using medroxyprogesterone contraceptive injec- tion (Depo-Provera) several months ago
A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed A 14-year-old who experienced menarche 2 years prior: A 42-year-old who has decided to try to have one more child and has had her tubal ligation reversed
3. A 24-year-old woman has presented to an inner-city free clinic because of
the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman's most likely treatment and prognosis? Question options: Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism.
The woman's ovaries are not producing progesterone. The epithelium covering the woman's ovaries is broken during the time of ovulation. The woman's ovaries do not synthesize or secrete luteinizing hormone (LH). The woman's ovaries are not producing new ova.: The woman's ovaries are not producing progesterone.
6. A 60-year-old woman who is 11 years menopausal has presented to the
emergency department stating, "I haven't had my period in years, but lately I've been bleeding again, and quite heavily in the last few days." The care team needs to rule out endometrial cancer. How should they best explain the most accurate plan for confirming or ruling out the diagnosis? Question options: "We can do a Pap smear right now and we will get the results as soon as we can." "We are going to order blood work that will measure your hormone levels." "We're going to have to open your cervix with a speculum and take scrapings from the wall of your uterus." "We're going to book a CT scan for you as soon as possible so that we can see what is inside your uterus.": We're going to have to open your cervix with a speculum and take scrapings from the wall of your uterus."
7. A 66-year-old man has presented to a nurse practitioner to get a refill for
his antiplatelet medication. The patient has a history of ischemic heart disease and suffered a myocardial infarction 5 years ago and has unstable angina; he uses a transdermal nitroglycerin patch to control his angina. The patient has a 40-pack-year smoking history and uses nebulized bron- chodilators at home for the treatment of transient shortness of breath. He has long-standing hypertension that is treated with a potassium-sparing diuretic
His use of bronchodilators His antihypertensive medications: His use of bronchodilators
8. A 71-year-old man has visited his nurse practitioner for a check-up, during
which the nurse practitioner has initiated a discussion about the patient's sexual function. Which of the following phenomena would the nurse practi- tioner most likely consider a pathological rather than an age-related change? Question options: A decrease in the force of the man's ejaculation Cessation of FSH production A decrease in the size and firmness of the patient's testes The presence of relative or absolute hypogonadism: Cessation of FSH pro- duction
9. A 39-year-old male patient has been recently diagnosed with primary
hypogonadism. Which of the following lab results would be most indicative of this diagnosis? Question options: Low testosterone levels; normal levels of LH and FSH Low levels of GnRH Low free testosterone, LH, and FSH levels
Normal levels of free testosterone; low levels of total testosterone: Low testosterone levels; normal levels of LH and FSH
10. During a group prenatal class, the nurse teaching the course is explaining
the thinning of the cervix that accompanies the stages of labor leading up to delivery. A participant admits that she is not familiar with either the location or normal role of the cervix. Which of the following responses, by the nurse, would be most appropriate? Question options:
Each primary spermatocyte undergoes two nuclear divisions, yielding four cells with 23 chromosomes each. Spermatogonia adjacent to the tubular wall undergo meiotic division and provide a continuous source of new germinal cells. Sertoli cells differentiate into spermatids, each of which can contribute half of the chromosomes necessary for reproduction. Testosterone chemically lyses each primary spermatocyte into two sec-
ondary spermatocytes with 23 chromosomes each.: Each primary spermato- cyte undergoes two nuclear divisions, yielding four cells with 23 chromosomes each.
13. A 29-year-old woman has been trying for many months to become preg-
nant, and fertilization has just occurred following her most recent ovulation. What process will now occur that will differentiate this ovulatory cycle from those prior? Question options: The basal layer of the endometrium will be sloughed in preparation for implantation. The corpus luteum will atrophy and be replaced by corpus albicans. The remaining primary follicles will provide hormonal support for the first 3 months of pregnancy. Human chorionic gonadotropin will be produced, preventing luteal regres- sion.: Human chorionic gonadotropin will be produced, preventing luteal regres- sion.
14. John presents to the clinic with complaints of scrotal heaviness. Your
assessment reveals swelling of the testicle and warm scrotal skin. What would your diagnosis be? Question options: Epididymitis
her nurse practitioner's best course of action? Question options: Begin low-dose HT but perform regular breast cancer screening and heart health checks Forgo HT but consider alternative therapies and reevaluate if her symptoms significantly affect her quality of life Forgo HT in light of her preexisting low bone density and consequent risk of osteoporosis Begin estrogen-progesterone HT (EPT) to prevent future menopausal symp- toms and coronary heart disease (CHD): Forgo HT but consider alternative therapies and reevaluate if her symptoms significantly affect her quality of life
16. Following a visit to her campus medical clinic motivated by persistent ab-
dominal pain and dyspareunia, a 20-year-old female college student has been referred for a diagnostic workup to rule out pelvic inflammatory disease. Her elevated white cell and C-reactive protein levels lead her care provider to suspect pelvic inflammatory disease (PID). What follow-up question is most likely to help with the differential diagnosis? Question options: "Have you ever had a therapeutic abortion in the past?" "How many sexual partners have you had?" "What does your daily hygiene routine usually consist of?"
"Are you using tampons during your period, or do you normally use pads?"- : "How many sexual partners have you had?"
17. After a long and frustrating course of constant vaginal pain, a 38-year-old
woman has been diagnosed with generalized vulvodynia by her nurse practi- tioner. What treatment plan is her nurse practitioner most likely to propose? Question options: Narcotic analgesia and nonsteroidal anti-inflammatory medications Lifestyle modifications aimed at accommodating and managing neuropathic
cancer that could accompany hormone therapy (HT). How should her care provider respond to her concerns? Question options: "There's in fact a slight protective effect against stroke associated with HT, but this is partially offset by increased rates of heart disease and breast cancer." "HT is actually associated with a decrease in heart disease risk, but there is an increase in stroke risk; the breast cancer connection is still unclear." "All things considered, the benefits of HT outweigh the slightly increased risks of heart disease, stroke, or breast cancer."
"There is a demonstrable increase in breast cancer risk with HT, but the risk of stroke or heart disease actually goes down slightly.": "HT is actually associated with a decrease in heart disease risk, but there is an increase in stroke risk; the breast cancer connection is still unclear."
20. A 40-year-old woman has been found to have a deficiency in estrogen.
Which of the following physiological phenomena is most likely to remain unaffected? Question options: The synthesis and release of adrenal glucocorticoids The maintenance of normal skin and blood vessel structure The regulation of uterine endothelial development Parathyroid hormone antagonism and the rate of bone resorption: The syn- thesis and release of adrenal glucocorticoids
21. A 57-year-old woman who has been diagnosed with atrophic vaginitis has
expressed her surprise to her care provider, citing a lifetime largely free of gynecological health problems. She has asked what may have contributed to her problem. How can the care provider best respond? Question options: "The exact cause of this problem isn't known, but it can usually be resolved with a diet high in probiotic bacteria." "This type of vaginitis is most commonly a symptom of a latent sexually
out first? Question options: Testosterone supplementation Surgical repair Circumcision Chromosomal studies: Circumcision
23. A 20-year-old male has been diagnosed with testicular cancer and is
seeking information about his diagnosis from a number of websites. Which of the following statements that he has read is most plausible? Question options: "Recent developments in the treatment of testicular cancer mean that few men now need to have a testicle removed." "For most men with testicular cancer, bloody urine is their first sign that something is wrong." "Men with cryptorchidism—the term for an undescended testicle—are known to have a higher risk of developing testicular cancer." "Testicular cancer is a leading cause of death among males who should be in the prime of their lives.": "Men with cryptorchidism—the term for an undescended testicle—are known to have a higher risk of developing testicular cancer."
24. Long, stretchy cervical mucus that exhibits ferning on a microscope slide
is characteristic of which of the following? Question options: Low human chorionic gonadotropin levels High progesterone levels Low estrogen levels High LH levels: High LH levels
