ATI RN
ATI Pathophysiology Final Exam
1. A group of prison inmates developed tuberculosis following exposure to an infected inmate. On examination, tissues were soft and granular (like clumped cheese). Which of the following is the most likely cause?
- A. Coagulative necrosis
- B. Liquefactive necrosis
- C. Caseous necrosis
- D. Autonecrosis
Correct answer: C
Rationale: The correct answer is C. Caseous necrosis is characteristic of tuberculosis, where the tissue has a soft, cheese-like appearance. Coagulative necrosis involves protein denaturation, liquefactive necrosis is seen in brain infarcts and abscesses, and autonecrosis is not a recognized term in pathology, making them incorrect choices in this scenario.
2. What should the nurse discuss with a patient with a history of cardiovascular disease regarding the risks of hormone replacement therapy (HRT)?
- A. HRT may increase the risk of cardiovascular events, including heart attack and stroke.
- B. HRT may decrease the risk of osteoporosis.
- C. HRT may improve mood and energy levels.
- D. HRT may decrease the risk of breast cancer.
Correct answer: A
Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, especially in patients with a history of cardiovascular disease. Choice B is incorrect because HRT is not typically used to decrease the risk of osteoporosis. Choice C is incorrect as mood and energy level improvements are not the primary risks associated with HRT. Choice D is incorrect because HRT may actually increase the risk of breast cancer in some individuals.
3. A nurse on a postsurgical unit is providing care for a 76-year-old female client who is two days post-hemiarthroplasty (hip replacement) and who states that her pain has been out of control for the last several hours, though she is not exhibiting signs of pain. Which guideline should the nurse use for short-term and long-term treatment of the client's pain?
- A. Pain is what the client says it is, even if she is not exhibiting outward signs.
- B. Pain should be treated only when it is associated with observable symptoms.
- C. Long-term opioid use is generally safe for elderly clients in a hospital setting.
- D. The client's pain should be reassessed after every dose of pain medication.
Correct answer: A
Rationale: Pain is a subjective experience, and the client's report of pain should be taken seriously even if there are no outward signs. Choice B is incorrect because pain can be present without observable symptoms, and waiting for observable signs may delay appropriate pain management. Choice C is incorrect because the safety of long-term opioid use in elderly clients is a complex issue and should be carefully evaluated due to the risk of adverse effects. Choice D is incorrect because while pain reassessment is important, it should not be limited to just after medication administration but should occur regularly to ensure adequate pain control.
4. 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.
5. A teacher in a preschool is diagnosed with giardiasis. Which of the following medications will be administered to treat the diarrhea and abdominal distention?
- A. Sulfasalazine (Azulfidine)
- B. Metronidazole (Flagyl)
- C. Trimethoprim–sulfamethoxazole (Bactrim)
- D. Doxycycline (Vibramycin)
Correct answer: B
Rationale: The correct answer is B. Metronidazole (Flagyl) is the drug of choice for treating giardiasis, which is a common cause of diarrhea and abdominal distention. Sulfasalazine (Choice A) is used to treat inflammatory bowel disease. Trimethoprim–sulfamethoxazole (Choice C) is commonly used for urinary tract infections and Pneumocystis jirovecii pneumonia. Doxycycline (Choice D) is commonly used to treat various bacterial infections but is not the first-line treatment for giardiasis.
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