ATI RN
ATI Pathophysiology Final Exam
1. 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.
2. A patient suffers from dysmenorrhea. Which oral medication will be prescribed that has the ability to provide physiological actions on the neuroendocrine control of ovarian function?
- A. Estrogen
- B. Progestins
- C. Naproxen
- D. Ibuprofen
Correct answer: B
Rationale: Progestins are prescribed for dysmenorrhea as they help reduce menstrual pain by inhibiting ovulation and decreasing the production of prostaglandins. Estrogen (Choice A) is not typically used alone in dysmenorrhea treatment as it can worsen symptoms. Naproxen (Choice C) and Ibuprofen (Choice D) are nonsteroidal anti-inflammatory drugs (NSAIDs) commonly used to relieve pain associated with dysmenorrhea, but they do not directly affect the neuroendocrine control of ovarian function like progestins do.
3. A patient has suffered from several infections in the last 6 months and unexplained impaired wound healing. What assessment should the nurse prioritize?
- A. Assess for pain.
- B. Assess for nutritional deficiencies.
- C. Assess genetic tendency for infection.
- D. Assess for edema and decreased hemoglobin.
Correct answer: B
Rationale: In this scenario, the patient's history of multiple infections and impaired wound healing indicates a potential issue with their immune system and overall health. Therefore, the nurse should prioritize assessing for nutritional deficiencies. Proper nutrition is essential for a healthy immune response and wound healing. Assessing for pain (choice A) may be important but addressing the root cause of the recurrent infections and impaired wound healing is crucial. Genetic tendency for infection (choice C) would be a less immediate concern compared to assessing for nutritional deficiencies. Edema and decreased hemoglobin (choice D) are not the most relevant assessments based on the patient's symptoms.
4. Which of the following mediators of inflammation causes increased capillary permeability and pain?
- A. Serotonin
- B. Histamine
- C. Bradykinin
- D. Nitric oxide
Correct answer: C
Rationale: Bradykinin is the correct answer. It is a potent mediator of inflammation that causes increased capillary permeability and is responsible for the pain associated with inflammation. Serotonin and histamine are also mediators of inflammation, but they are not primarily known for increasing capillary permeability or inducing pain. Nitric oxide is involved in various physiological processes but is not a primary mediator of inflammation that causes increased capillary permeability and pain.
5. 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.
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