ATI RN
ATI Pathophysiology
1. Which of the following nursing diagnoses would provide the most plausible indication for the use of epoetin alfa (Epogen) in a patient with renal failure?
- A. Risk for infection related to decreased erythropoiesis
- B. Activity intolerance related to decreased oxygen-carrying capacity
- C. Powerlessness related to sequelae of renal failure
- D. Ineffective breathing pattern related to inadequate erythropoietin synthesis
Correct answer: B
Rationale: The correct answer is B. In a patient with renal failure, the use of epoetin alfa (Epogen) is primarily aimed at addressing the decreased oxygen-carrying capacity due to impaired erythropoiesis. Epoetin alfa is a medication that stimulates red blood cell production, thereby improving the oxygen-carrying capacity of the blood. This would directly address the activity intolerance commonly seen in patients with renal failure. Choices A, C, and D are incorrect because they do not directly relate to the primary purpose of using epoetin alfa in this context. Risk for infection, powerlessness, and ineffective breathing pattern are important considerations in the care of a patient with renal failure, but they are not the primary indications for using epoetin alfa.
2. A nursing student having trouble moving her head from side to side is likely experiencing a problem with which type of neurons?
- A. General visceral efferent neurons
- B. Preganglionic neurons
- C. Parasympathetic postganglionic neurons
- D. Pharyngeal efferent neurons
Correct answer: D
Rationale: The correct answer is D: Pharyngeal efferent neurons. Pharyngeal efferent neurons are responsible for controlling head movements, including side-to-side motions. General visceral efferent neurons (Choice A) are involved in innervating smooth muscles and glands in the body's internal organs. Preganglionic neurons (Choice B) are part of the autonomic nervous system and connect the central nervous system to the ganglia. Parasympathetic postganglionic neurons (Choice C) are the second neurons in the parasympathetic nervous system pathway, responsible for innervating target organs. In this case, the issue with moving the head from side to side indicates a problem with the pharyngeal efferent neurons.
3. Following a knee injury, a football player is taking ibuprofen, a nonsteroidal anti-inflammatory drug, for the control of pain. Which drug action is most likely to result in diminished sensation of pain for the player?
- A. Inhibition of cyclooxygenase (COX) enzymes
- B. Activation of opioid receptors
- C. Blocking of NMDA receptors
- D. Stimulation of serotonin receptors
Correct answer: A
Rationale: The correct answer is A: Inhibition of cyclooxygenase (COX) enzymes. Ibuprofen works by inhibiting these enzymes, which are involved in the production of prostaglandins that mediate pain and inflammation. This inhibition leads to decreased prostaglandin production, resulting in a decrease in pain and inflammation. Choices B, C, and D are incorrect because ibuprofen does not act on opioid receptors, NMDA receptors, or serotonin receptors to control pain. It primarily exerts its analgesic and anti-inflammatory effects through COX enzyme inhibition.
4. What action is specific to hormonal contraceptives and should be taught to this woman?
- A. The cervical mucus is altered to prevent sperm penetration.
- B. The release of follicle-stimulating hormone is increased to block fertility.
- C. The maturation of the endometrial lining is activated by the contraceptive.
- D. The pituitary gland increases the synthesis and release of luteinizing hormone.
Correct answer: A
Rationale: The correct action specific to hormonal contraceptives that should be taught to the woman is that they alter cervical mucus to prevent sperm penetration. This mechanism helps in preventing pregnancy by reducing the chances of sperm reaching the egg. Choices B, C, and D are incorrect. Choice B is inaccurate as hormonal contraceptives work by inhibiting ovulation rather than increasing follicle-stimulating hormone release. Choice C is incorrect as hormonal contraceptives do not activate the maturation of the endometrial lining; instead, they modify it to prevent implantation. Choice D is also incorrect as hormonal contraceptives do not stimulate the pituitary gland to increase luteinizing hormone synthesis and release.
5. A patient is being treated for active tuberculosis with ethambutol (Myambutol). The patient states to the nurse that he cannot identify the red and green on the traffic lights when he is driving. Based on this finding, what medical intervention is most appropriate?
- A. Assess for photosensitivity.
- B. Discontinue ethambutol (Myambutol).
- C. Decrease the ethambutol (Myambutol) dose.
- D. Administer vitamin B.
Correct answer: A
Rationale: The correct answer is to assess for photosensitivity. Ethambutol can cause optic neuritis, leading to visual disturbances, including difficulty differentiating red and green colors. This is a sign of optic nerve damage and requires immediate evaluation. Discontinuing ethambutol may be necessary if optic neuritis is confirmed, but this decision should be made by a healthcare provider. Decreasing the dose of ethambutol may not address the visual changes. Administering vitamin B does not directly address the side effect caused by ethambutol.
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