ATI RN
ATI Pathophysiology
1. 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.
2. A primiparous woman tells the nurse that she and her partner are highly reluctant to have their infant vaccinated, stating, “We've read that vaccines can potentially cause a lot of harm, so we're not sure we want to take that risk.” How should the nurse respond to this family's concerns?
- A. “Vaccinations are not without some risks, but these are far exceeded by the potential benefits they offer in preventing serious diseases.”
- B. “The potential risks of vaccinations have been investigated and determined to be minimal compared to the benefits of protecting your child from potentially life-threatening diseases.”
- C. “It is important to follow state laws regarding vaccines, but I understand your concerns. Let's discuss the specific risks and benefits of vaccines for your child.”
- D. “Vaccines indeed cause several serious adverse effects, but these are usually treated effectively, and the benefits of vaccination in preventing diseases far outweigh the risks.”
Correct answer: B
Rationale: When addressing concerns about vaccination, it is crucial to provide accurate information to help parents make informed decisions. Choice B is the most appropriate response as it acknowledges the concerns of the family while emphasizing that the potential risks of vaccinations are minimal compared to the significant benefits of protecting the child from serious diseases. This response shows empathy towards the parents' concerns while also highlighting the importance of vaccination in preventing life-threatening illnesses. Choice A is incorrect because it does not emphasize the significant benefits of vaccination in preventing diseases, which may not effectively address the family's concerns. Choice C is incorrect as it focuses more on state laws rather than addressing the family's specific concerns about vaccine safety. Choice D is incorrect as it may increase the family's anxiety by highlighting adverse effects without adequately emphasizing the benefits of vaccination in disease prevention.
3. A patient has been prescribed an estrogen-progestin oral contraceptive. The nurse should emphasize that the risk of thrombophlebitis is most likely in patients who:
- A. Are diabetic.
- B. Smoke cigarettes.
- C. Have a history of hypertension.
- D. Are older than 40.
Correct answer: B
Rationale: The correct answer is B: Smoke cigarettes. Smoking is a significant risk factor for thrombophlebitis, especially when combined with estrogen-progestin contraceptives. Choice A, being diabetic, does not directly increase the risk of thrombophlebitis in this context. Choice C, having a history of hypertension, is not a primary risk factor for thrombophlebitis. Choice D, being older than 40, is not the most likely factor associated with an increased risk of thrombophlebitis in patients taking estrogen-progestin oral contraceptives.
4. A male patient receiving androgen therapy is concerned about side effects. What is the most serious adverse effect the nurse should monitor for during this therapy?
- A. Increased risk of cardiovascular events
- B. Increased risk of bone fractures
- C. Increased risk of venous thromboembolism
- D. Increased risk of mood changes
Correct answer: A
Rationale: The correct answer is A: Increased risk of cardiovascular events. Androgen therapy can significantly increase the risk of cardiovascular events, such as heart attack and stroke, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial during this therapy. Choice B, increased risk of bone fractures, is not typically associated with androgen therapy. Choice C, increased risk of venous thromboembolism, is more commonly linked to estrogen therapy rather than androgen therapy. Choice D, increased risk of mood changes, can occur with androgen therapy but is not as serious or life-threatening as cardiovascular events.
5. A male patient receiving androgen therapy is concerned about the risk of prostate cancer. What should the nurse explain regarding this risk?
- A. Finasteride has been shown to lower the risk of developing prostate cancer.
- B. Finasteride does not affect the risk of prostate cancer.
- C. Finasteride may increase the risk of developing prostate cancer, so regular screenings are recommended.
- D. Finasteride has no effect on the risk of prostate cancer, so regular screenings are unnecessary.
Correct answer: A
Rationale: The correct answer is A. Finasteride has been shown to lower the risk of developing prostate cancer. However, regular screenings are still recommended to monitor for any potential issues. Choice B is incorrect because finasteride has been associated with a reduced risk of developing prostate cancer. Choice C is incorrect as finasteride is not known to increase the risk of prostate cancer; in fact, it has shown a protective effect. Choice D is incorrect because while finasteride may lower the risk of prostate cancer, regular screenings are still necessary to ensure early detection and treatment if needed.
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