ATI RN
ATI Pathophysiology Final Exam
1. What potential risk should the nurse identify as being associated with infliximab (Remicade) in the treatment of rheumatoid arthritis?
- A. Risk for infection
- B. Risk for decreased level of consciousness
- C. Risk for nephrotoxicity
- D. Risk for hepatotoxicity
Correct answer: A
Rationale: The correct answer is A: Risk for infection. Infliximab (Remicade) is a medication used to treat autoimmune conditions like rheumatoid arthritis. One of the main risks associated with infliximab is an increased susceptibility to infections due to its immunosuppressive effects. This drug works by targeting specific proteins in the body's immune system, which can weaken the body's ability to fight off infections. Choices B, C, and D are incorrect because infliximab is not typically associated with decreased level of consciousness, nephrotoxicity, or hepatotoxicity. It is important for healthcare providers to monitor patients on infliximab for signs of infection and educate them on the importance of infection prevention strategies.
2. During a flu shot clinic, one of the questions the student nurse asks relates to whether the client has a history of Guillain-Barré syndrome. The client asks, 'What is that?' How should the nursing student reply?
- A. A type of paralysis that affects movement on both sides of the body. It may even involve the respiratory muscles.
- B. Swelling of your arm where you got your flu shot and maybe your eyes and lips had some swelling as well.
- C. A degenerative disease where you have trouble walking without the help of a cane or walker.
- D. Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot.
Correct answer: A
Rationale: The correct answer is A because Guillain-Barré syndrome is an acute immune-mediated polyneuropathy that can lead to paralysis affecting movement on both sides of the body, and in severe cases, involving the respiratory muscles. Choice B is incorrect as it describes local swelling, not the systemic effects of Guillain-Barré syndrome. Choice C is incorrect as it describes a degenerative disease affecting mobility, not an acute immune-mediated condition like Guillain-Barré syndrome. Choice D is incorrect as it describes flu-like symptoms following a flu shot, which is not the same as Guillain-Barré syndrome.
3. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What important contraindication should the nurse emphasize during patient education?
- A. Use of nitrates
- B. History of hypertension
- C. History of peptic ulcer disease
- D. Use of antihypertensive medications
Correct answer: A
Rationale: The correct answer is A: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because they are not direct contraindications for sildenafil use. While a history of hypertension or peptic ulcer disease may require caution, they are not absolute contraindications like the concomitant use of nitrates.
4. A patient is to be administered an immunization. The serum contains aluminum phosphate. What route is most appropriate to administer this immunization?
- A. Intramuscularly
- B. Subcutaneously
- C. Intravenously
- D. Orally
Correct answer: A
Rationale: The most appropriate route to administer an immunization containing aluminum phosphate is intramuscularly. Aluminum phosphate is commonly used as an adjuvant in vaccines to enhance the immune response. Intramuscular administration allows for the vaccine to be delivered into the muscle tissue, where it can be effectively absorbed by the body's immune cells. Subcutaneous administration is not ideal for vaccines containing aluminum phosphate, as it may not elicit the desired immune response. Intravenous administration is typically reserved for specific medications or situations that require rapid absorption into the bloodstream. Oral administration is not suitable for vaccines containing aluminum phosphate as they would be degraded in the gastrointestinal tract.
5. A hospital patient's complex medical history includes a recent diagnosis of kidney cancer. Which of the following medications is used to treat metastatic kidney cancer?
- A. Filgrastim (Neupogen)
- B. Aldesleukin (Proleukin)
- C. Interferon alfa-2b (Intron A)
- D. Darbepoetin alfa (Aranesp)
Correct answer: B
Rationale: The correct answer is B: Aldesleukin (Proleukin). Aldesleukin is a medication used in the treatment of metastatic kidney cancer. It is a recombinant interleukin-2 that works by stimulating the immune system to attack cancer cells. Choice A, Filgrastim, is a medication used to stimulate the production of white blood cells. Choice C, Interferon alfa-2b, is used in the treatment of certain cancers but not specifically metastatic kidney cancer. Choice D, Darbepoetin alfa, is used to treat anemia by stimulating red blood cell production and is not indicated for metastatic kidney cancer.
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