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NURS 6501 Advanced Pathophysiology FINAL EXAM: Multiple Choice Questions and Answers, Exam, Exams of Nursing

University College of London (UCL)Nursing

NURS 6501 Advanced Pathophysiology FINAL EXAM: Multiple Choice Questions and Answers, Exams of Nursing 2025/2026 Graded A+|Approved Documentation NURS 6501 Advanced Pathophysiology FINAL EXAM: Multiple Choice Questions and Answers, Exams of Nursing 2025/2026 Graded A+|Approved Documentation

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NURS 6501 Advanced Pathophysiology FINAL
EXAM: Multiple Choice Questions and Answers,
Exams of Nursing 2025/2026 Graded A+|Approved
Documentation
What is the role of the primary care provider in mental health? -
ANSWER-- Screen for mental health issues
- Improve outcomes and reduce health care costs
- Assess and give care to mild-moderate disorders or patients with
stable severe mental disorders
- From strong links with mental health specialty care for complex
cases
Sharing patient info (ex: meds used)
about PHQ2
- what does it screen for, what are the questions, scoring -
ANSWER-- Screens for MDD
- It is the first two questions of the PHQ9
- In the last two week, have you been feeling these (not at all,
several days, more than half the day, nearly everyday):
- Little interest or pleasure in doing things?
- Feeling down, depressed, or hopeless?
Scoring:
A single yes or score >3 (out of 0-6) = possible clinical depression
⇒ due the PHQ9
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Download NURS 6501 Advanced Pathophysiology FINAL EXAM: Multiple Choice Questions and Answers, Exam and more Exams Nursing in PDF only on Docsity!

NURS 6501 Advanced Pathophysiology FINAL

EXAM: Multiple Choice Questions and Answers,

Exams of Nursing 2025/2026 Graded A+|Approved

Documentation

What is the role of the primary care provider in mental health? - ANSWER -- Screen for mental health issues

  • Improve outcomes and reduce health care costs
  • Assess and give care to mild-moderate disorders or patients with stable severe mental disorders
  • From strong links with mental health specialty care for complex cases Sharing patient info (ex: meds used) about PHQ
  • what does it screen for, what are the questions, scoring - ANSWER -- Screens for MDD
  • It is the first two questions of the PHQ
  • In the last two week, have you been feeling these (not at all, several days, more than half the day, nearly everyday):
  • Little interest or pleasure in doing things?
  • Feeling down, depressed, or hopeless? Scoring: A single yes or score >3 (out of 0-6) = possible clinical depression ⇒ due the PHQ

If the pt screens (+) ⇒ continue to eval with the PHQ about PHQ

  • what its used for, questions, scoring - ANSWER -Used for screening, diagnosing, and treating
  • It asks about functioning impairments which is needed for the DSM-based diagnosis Includes asking about suicide or hurting self Scoring: 0-27 available 0-4: Minimal/none Monitor; may not require treatment 5-9: Mild Use clinical judgment; follow-up in one month 10-14: Moderate Use clinical judgment; may need meds if functionally impaired 15-19: Moderately Severe Warrants active treatment with psychotherapy, meds, or combo 20-27: Severe Warrants active treatment with psychotherapy, meds, or combo What is the appropriate initiation dose for fluoxetine for adults and geriatric adults? - ANSWER -20mg PO once daily in the AM
  • May ↑ daily dose after several weeks if inadequate response
  • Full therapeutic effect may be delayed 4 weeks or longer
  • SS cause significant impairment in any realm of functioning
  • Depressed mood
  • Loss of interest
  • Significant unintended ▲ in weight or appetite
  • Significant ▲ sleep
  • ▲ psychomotor activity (restlessness)
  • Fatigue, loss of energy
  • Worthlessness, guilt What is serotonin syndrome? - ANSWER -- Increased serotonergic activity in the CNS
  • Can be due to therapeutic med use, inadvertent drug interactions, or self-OD Serotonin in the Body: CNS: Modulates attention, behavior, and thermoregulation PNS: Regulates GI motility, vasoconstriction, uterine contraction, and bronchoconstriction, promotes PLT aggregation PE of serotonin syndrome 11 - ANSWER -- Hyperthermia, flushed skin, diaphoresis
  • Agitation
  • Slow, continuous, horizontal eye movements (ocular clonus)
  • Dilated pupils
  • Tremor, akathisia
  • Deep tendon hyperreflexia (common)
  • Inducible or spontaneous muscle clonus (common)
  • Muscle rigidity
  • Bilateral babinski
  • Dry mucus membranes
  • Increased bowel sounds What is discontinuation syndrome (from SSRIs)? "FINISH" - ANSWER -2-3 days after stopping SSRIs abruptly F: flu-like SS I: insomnia N: nausea I: imbalance S: sensory disturbances H: hyperarousal Bupropion
  • MOA
  • BENFITS AE CONTRA - ANSWER -MOA
  • act to inhibit reuptake of NE, dopamine, and serotonin BENFIT
  • Depression
  • Partner or friends with SA, living in a community with poverty, violence, and/or high ETOH/drug use Use of:
  • Caffeine, tobacco, ETOH, prescription meds, marijuana, illicit drugs
  • Mental health disorders
  • Highest in personality disorders What is withdrawal - ANSWER -process of removal of the drug of dependence from the body SS of substance abuse withdrawal 3 - ANSWER -Can last days to weeks
  • NVD
  • Flu-like SS: lacrimation, rhinorrhea, diaphoresis, shivering, piloerection
  • SNS/CNS Arousal: mydriasis, mild HTN and tachy, anxiety, irritability, insomnia, agitation, restless leg, general restlessness, tremor, low grade temp Which medications are central nervous system sedatives? - ANSWER -Include sedatives, tranquilizers, hypnotics
  • Good for treating anxiety, panic, acute stress reactions, sleep disorders Examples: Benzos:
  • Diazepam (valium), clonazepam (klonopin), alprazolam (xanax) Non-Benzo Sedative Hypnotics
  • Zolpidem (ambien) Barbiturates
  • Mephobarbital Initiation Strategies for Antidepressants: - ANSWER - Antidepressants are considered equivalent in efficacy for depression Decide on med by:
  • History of response
  • Family history of response
  • Symptoms
  • Medical history
  • Interactions
  • AE which antidepressant is good for smoking cessation, weight loss, and ADD? - ANSWER -Bupropion which antidepressant is good for fibromyalgia - ANSWER - Duloxetine which antidepressant is good for migraine prevention - ANSWER - Amitriptyline

Surgeon's preference American Society of Anesthesiologists Anesthesia Classification System 1-4 - ANSWER -ASA Class 1: healthy, normal patient ASA Class 2: patient with mild systemic disease ASA Class 3: patient with severe systemic disease ASA Class 4: patient with severe systemic disease that is a threat to life major clinical predictors that increase surgical risk 7 - ANSWER -- MI within 30 days

  • unstable angina
  • decompensated HF
  • High-grade AV block
  • symptomatic ventricular arrhythmias
  • supraventricular arrhythmias with uncontrolled ventricular rates
  • severe valvular disease intermediate risk factors that increase surgical risk 4 - ANSWER -- mild angina
  • previous MI by history or pathologic Q waves, compensated or previous HF
  • DM (especially 1)
  • renal insufficiency minor risk factors that increase surgical risk 6 - ANSWER -- advanced age
  • abnormal EKG
  • rhythm other than sinus
  • low functional capacity
  • history of stroke
  • uncontrolled HTN How far in advance should herbal medications be held before a planned surgery? - ANSWER -All herbals should be stopped two weeks prior List the potential complication of spinal or regional anesthesia - ANSWER -HA, nerve damage, infection, limb loss presurgical guidelines for metformin - ANSWER -- take day before surgery, then resume it afterwards when patient is eating again
  • If procedure involves IV contrast or long surgical time ⇒ metformin is stopped when the preop fasting begins and restarted postop with normal diet resumption
  • If renal dysfunction found preop or postop ⇒ DC metformin until renal function normalizes SGLP2i presurgical guidelines - ANSWER -Stop immediately if undergoing emergency procedure Hold med 24h prior to elective surgery DM2 with insulin presurgical guidelines - ANSWER -Continue insulin therapy

O: Observed → has anyone observed you stop breathing or choking/gasping during your sleep P: Pressure → do you have or are being treated for HTN B: BMI > A: Age → >50yrs N: Neck size large → measured around Adam's apple Men: shirt collar → 17 inches/43cm or larger Women: shirt collar → 16inches/41cm or larger G: Gender → male scoring for STOP BANG - ANSWER -- Low risk: yes to 0-2 questions Intermediate risk: yes to 3-4 questions

  • High risk: yes to 5-8 questions OR yes to 2 or more STOP questions + male gender OR yes to 2 or more STOP questions + BMI > OR yes to 2 or more STOP questions + neck circumference What is your responsibility as a health care provider to do when a patient informs you that they have recently been sexually

assaulted? (IF WITHIN 72H) - ANSWER -- PCP should defer a PE and refer the pt to the ER if the sexual assault occured within the last 5 day, preferably within 72h

  • Ensures proper measures are taken and comply with standardized protocols
  • Support the patient's current or future desire for legal pursuits
  • PCP doesn't need to request specific info about the assault → this will be done in the ED what's the role of the PCP if sexual assault happened > 5 days? - ANSWER -- Medical care can be managed in the outpatient setting
  • Get a detailed hx and perform a full PE and gyn exam
  • 40% of rape victims sustain a collateral injury; 5% sustain a severe injury
  • Injuries most common in >30yrs old
  • Gyn injuries: vaginal or anal tearing, rectal bleeding, bruising, soreness
  • Use face of a clock for documenting locations
  • Other SS: GI irritability, dysmenorrhea, pelvic pain, UTIs
  • Get a gonorrhea, chlamydia, HepB/C, HIV, and pregnancy tests Does your responsibility change for sexual assault if the patient is under the age of 18? - ANSWER -Children and adolescents would need collaboration with agencies that are specific to this age group to prevent lifelong complications of the abuse what are the variables worth 1 point each in the CAD clinical decision rule - ANSWER -Men > 55 yrs, women > 65 yrs

Feeling of impending doom procedure for anaphylaxis 8 - ANSWER -1. Call 911

  1. Epi 1:1000 (0.01mL/kg IM)
  • Adult > 45 lb: Epi 0.3mL (Epipen or Twinject)
  • Repeat Epi x5 minutes if necessary
  1. Have pt lie down with feet elevated above the heart
  2. Monitor BP x10-15min
  3. Follow Epi with antihistamine (PO or IV benadryl)
  • Adults >12 years: 25-50mg PO OR 10-50mg deep IM
  1. Observe pt for a minimum of 60min after the pt is stable
  • Some pts may need 4h of observation due to late-phase anaphylaxis ⇒ call EMS
  1. Additional treatments may include:
  • Oxygen
  • Albuterol by nebulizer
  • IVF
  • Prednisone
  1. Short course of PO steroids is recommended after treatment of moderate to severe reactions Consider prescription for injectable Epi What is the typical dose of epinephrine for the treatment of anaphylaxis? How often can it be repeated? - ANSWER -Epi 1:1000 (0.01mL/kg IM)
  • Adult > 45 lb: Epi 0.3mL (Epipen or Twinject)

Repeat Epi x5 minutes if necessary what is neuropsychological testing used for? when should PCPs use it? - ANSWER -- can identify deficits r/t stages of dementia

  • indicated for best PCP practice for medical conditions that have a high propensity for cognitive decline pharm for grief - ANSWER -- Antidepressants shouldn't be used for acute grief → reserve for subsequent major depression
  • A sedative to help sleep may be used for NO MORE than 2 weeks at a time ⇒ goal is to re-establish a healthy sleeping pattern What are the principal symptoms and characteristics of concussion? - ANSWER -- HA, fatigue, dizziness, NV (self-limited), unsteadiness when standing/walking, feeling mentally slowed or foggy
  • Anterograde amnesia (Difficulty remembering the events AFTER to the event- Coming off the field, going to the hospital)
  • Retrograde Amnesia (Difficulty remembering things that happened PRIOR to the event- Who they're playing, score of game, what they ate prior to game)
  • Sleep Disturbances
  • Emotional changes
  • Occur immediately after blunt head trauma
  • look for vesicles → Ramsay Hunt Syndrome TRTMT Eye Protection = most impt
  • exposure keratitis can cause blindness, cornea can get abrasions Steroids:
  • w/i 72h
  • prednisone 60mg/day with 5 day taper Antivirals:
  • Acyclovir 400mg/day x 7 days
  • MUST be given with steroids otherwise no effect Definition of vertigo - ANSWER -- Illusion of movement of either oneself or the environment → spinning, tilting, moving back another forth
  • can be r/t peripheral or central disorder Causes of vertigo
  • peripheral (6)
  • central (4) - ANSWER -Peripheral Causes:
  • BPPV
  • vestibular neuronitis
  • acute labyrinthitis
  • Meniere disease
  • ototoxicity
  • head trauma Central Disorders:
  • brainstem or cerebellar ischemia/ hemorrhage
  • tumors
  • MS
  • migrainous syndrome What is the Hallpike-Dix maneuver, and why would it be used? - ANSWER -Hallpike-Dix Maneuver can be diagnostic for BPPV
  1. Check for spontaneous nystagmus while they're seated on exam table
  2. Bring pt quickly back to supine position with head extended 30- 45 degrees over the end of the table and head tilted 30- degrees to one side
  3. Repeat this x2 with head L and R
  4. Observe pt for latency, duration, direction, and fatiguability of nystagmus Vertigo without nystagmus is not indicative of BPPV Tension HA PAIN, DURATION, PRECIPITATING FX - ANSWER -- Most common