ATI RN
ATI Pathophysiology
1. What specific instructions should the nurse provide for a patient starting on alendronate (Fosamax) for osteoporosis to ensure proper administration?
- A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
- B. Take the medication with milk to enhance calcium absorption.
- C. Take the medication at bedtime to ensure absorption during sleep.
- D. Take the medication with food to prevent nausea.
Correct answer: A
Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because alendronate should not be taken with milk, as it can interfere with its absorption. Choice C is incorrect as there is no specific instruction to take alendronate at bedtime. Choice D is incorrect because alendronate should be taken on an empty stomach, not with food, to enhance absorption.
2. A male patient with erectile dysfunction has asked for a prescription for sildenafil (Viagra). Before giving this medication, the nurse should assess for which of the following conditions?
- A. History of peptic ulcer disease
- B. Use of nitrates
- C. Recent history of a stroke
- D. History of hypertension
Correct answer: B
Rationale: The correct answer is B: Use of nitrates. Sildenafil should not be used by patients taking nitrates due to the risk of severe hypotension. Nitrates can potentiate the hypotensive effects of sildenafil, leading to a significant drop in blood pressure. Assessing for the use of nitrates is crucial to avoid this potentially dangerous interaction. Choices A, C, and D are incorrect because they are not specifically contraindications for the use of sildenafil. While a history of hypertension should be considered, it is not as critical as the use of nitrates when prescribing sildenafil.
3. A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia). How should the nurse respond when the patient asks what causes pernicious anemia? A decrease in ______ is the most likely cause.
- A. Ferritin
- B. Gastric enzymes
- C. Intrinsic factor
- D. Erythropoietin
Correct answer: C
Rationale: Pernicious anemia is primarily caused by a decrease in intrinsic factor. Intrinsic factor is a protein produced by the stomach that is necessary for the absorption of vitamin B12 in the intestines. Without intrinsic factor, vitamin B12 cannot be absorbed properly, leading to anemia. Ferritin is a protein that stores iron in the body and is not directly related to pernicious anemia. Gastric enzymes play a role in digestion but are not the primary cause of pernicious anemia. Erythropoietin is a hormone produced by the kidneys to stimulate red blood cell production and is not linked to pernicious anemia.
4. A client with heart failure is experiencing pulmonary edema. Which intervention should be prioritized?
- A. Administer diuretics to reduce fluid overload.
- B. Position the client in high-Fowler's position.
- C. Administer oxygen therapy to improve oxygenation.
- D. Restrict fluid intake to prevent further fluid overload.
Correct answer: C
Rationale: In a client experiencing pulmonary edema due to heart failure, the priority intervention is to administer oxygen therapy to improve oxygenation. This helps in increasing the oxygen levels in the blood, thereby improving tissue perfusion and reducing the workload on the heart. Positioning the client in high-Fowler's position can also aid in improving oxygenation, but administering oxygen therapy directly addresses the immediate need for increased oxygen levels. Administering diuretics to reduce fluid overload and restricting fluid intake are important interventions in heart failure management, but in the acute situation of pulmonary edema, oxygen therapy takes precedence to ensure adequate oxygen supply to vital organs.
5. A male patient is receiving androgen therapy for the treatment of hypogonadism. What adverse effect should the nurse monitor for during this treatment?
- A. Liver dysfunction
- B. Kidney dysfunction
- C. Heart failure
- D. Pulmonary embolism
Correct answer: A
Rationale: The correct adverse effect to monitor for during androgen therapy for hypogonadism is liver dysfunction. Androgen therapy can lead to hepatotoxicity, so monitoring liver function tests is crucial during treatment. Kidney dysfunction (Choice B), heart failure (Choice C), and pulmonary embolism (Choice D) are not commonly associated with androgen therapy and are less likely adverse effects compared to liver dysfunction.
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