ATI RN
ATI Pathophysiology
1. The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize?
- A. White blood cell levels with differential
- B. Red blood cell levels and morphology
- C. Urea and creatinine levels
- D. Liver function panel
Correct answer: B
Rationale: The correct answer is B: Red blood cell levels and morphology. Lead poisoning primarily affects red blood cells, causing anemia. Therefore, the priority test would be to assess red blood cell levels and morphology. Choice A (White blood cell levels with differential) is incorrect as lead poisoning does not primarily affect white blood cells. Choice C (Urea and creatinine levels) is unrelated to lead poisoning and not a priority in this scenario. Choice D (Liver function panel) is also not the priority as lead poisoning's primary impact is on the red blood cells, not the liver.
2. A 43-year-old man has tested positive for systemic candidiasis, and the care team has decided on IV fluconazole as a first-line treatment. When administering this medication, the nurse should
- A. administer the drug with lactated Ringer's.
- B. infuse the drug no faster than 200 mg/h.
- C. avoid administering the drug through a peripheral IV.
- D. administer prophylactic heparin prior to the fluconazole.
Correct answer: C
Rationale: When administering IV fluconazole, the nurse should avoid administering the drug through a peripheral IV. Fluconazole is known to cause phlebitis and tissue irritation if infused through a peripheral IV line. It is recommended to administer fluconazole through a central venous catheter to reduce the risk of complications. Choices A, B, and D are incorrect as there is no specific recommendation to administer the drug with lactated Ringer's, infuse it at a particular rate, or administer prophylactic heparin prior to fluconazole in this scenario.
3. After studying about fungi, which information indicates a correct understanding of fungi? Fungi causing deep or systemic infections:
- A. Are easily treated with penicillin
- B. Are extremely rare
- C. Never occur with other infections
- D. Are commonly opportunistic
Correct answer: D
Rationale: The correct answer is D: 'Are commonly opportunistic.' Fungi causing deep or systemic infections are commonly opportunistic, particularly in individuals with compromised immune systems. Choice A is incorrect because fungi infections are not easily treated with penicillin. Choice B is incorrect as deep or systemic fungal infections are not extremely rare. Choice C is incorrect as fungal infections can co-occur with other infections.
4. 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.
5. 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.
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