ATI RN
ATI Pathophysiology
1. 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.
2. In the ICU setting, a client transported from surgery following open heart bypass grafting will likely have his or her core temperature measured by:
- A. oral thermometer.
- B. rectal thermometer.
- C. esophageal thermometer.
- D. temporal artery thermometer.
Correct answer: C
Rationale: An esophageal thermometer is commonly used in ICU settings to accurately measure core body temperature, especially in post-surgical patients. The esophageal thermometer provides a more precise measurement of core temperature compared to other methods like oral, rectal, or temporal artery thermometers. In the ICU, accuracy in temperature measurement is crucial for detecting and responding to changes promptly, making the esophageal thermometer the preferred choice in this scenario.
3. 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.
4. A toddler is displaying signs/symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The client's family asks how he got this. The nurse will respond:
- A. This could result from playing in soil and then ingesting bacteria that is now attacking his motor neurons.
- B. No one really knows how this disease is formed. We just know that in time, he may grow out of it.
- C. This is a degenerative disorder that tends to be inherited as an autosomal recessive trait.
- D. This is a segmental demyelination disorder that affects all nerve roots and eventually all muscle groups as well.
Correct answer: C
Rationale: The correct answer is C. Spinal muscular atrophy (SMA) is an inherited disorder, often autosomal recessive, that affects lower motor neurons. Choice A is incorrect because SMA is not caused by ingesting bacteria from playing in soil. Choice B is incorrect as SMA is not something that a person grows out of. Choice D is incorrect because SMA is not a demyelination disorder that affects nerve roots and muscle groups.
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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