ATI RN
Final Exam Pathophysiology
1. A nurse is conducting an assessment on a client who presents with symptoms that are characteristic of amyotrophic lateral sclerosis (ALS). What assessment finding would be expected in this client?
- A. Reduced reflexes in all four limbs
- B. Decreased cognitive function
- C. Involuntary muscle contractions
- D. Hyperreflexia
Correct answer: D
Rationale: The correct answer is D: Hyperreflexia. In amyotrophic lateral sclerosis (ALS), hyperreflexia is a common assessment finding due to the degeneration of upper motor neurons. This results in an overactive reflex response to stimuli. Reduced reflexes in all four limbs (choice A) are not typically seen in ALS; instead, hyperreflexia is more common. Decreased cognitive function (choice B) is not a primary characteristic of ALS. Involuntary muscle contractions (choice C) are more indicative of conditions such as dystonia or myoclonus, not ALS.
2. Staff at the care facility note that a woman has started complaining of back pain in recent weeks and occasionally groans in pain. She has many comorbidities that require several prescription medications. The nurse knows that which factor is likely to complicate the clinician's assessment and treatment of the client's pain?
- A. Her advanced age may influence the expression and perception of pain.
- B. Her polypharmacy may complicate the pain management process.
- C. Her underlying conditions may mask or exacerbate the pain.
- D. Her cognitive function may decline, making pain assessment difficult.
Correct answer: B
Rationale: Polypharmacy, or the use of multiple medications, can complicate pain management due to drug interactions and side effects. While advanced age can influence pain perception, it is not the most likely factor to complicate assessment and treatment in this scenario. Underlying conditions may affect pain perception but do not directly complicate the management process. Cognitive decline can hinder pain assessment, but in this case, the focus is on factors directly impacting the treatment process, making option B the most appropriate choice.
3. A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has?
- A. Sideroblastic anemia
- B. Hemolytic anemia
- C. Pernicious anemia
- D. Iron deficiency anemia
Correct answer: B
Rationale: The correct answer is B, Hemolytic anemia. Normocytic-normochromic anemia is a type of anemia characterized by normal-sized and normal-colored red blood cells. Hemolytic anemia is a condition where red blood cells are destroyed prematurely, leading to normocytic-normochromic anemia. Sideroblastic anemia (Choice A) is characterized by ringed sideroblasts in the bone marrow. Pernicious anemia (Choice C) is due to vitamin B12 deficiency. Iron deficiency anemia (Choice D) is characterized by microcytic-hypochromic red blood cells.
4. What is the etiology and most likely treatment for myasthenia gravis in a 22-year-old female college student?
- A. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids.
- B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins.
- C. Cerebellar lesions; surgical and immunosuppressive treatment.
- D. Excess acetylcholinesterase production; treatment with thymectomy.
Correct answer: B
Rationale: Myasthenia gravis is characterized by a decline in functioning acetylcholine receptors rather than autoimmune destruction of skeletal muscle cells (Choice A), cerebellar lesions (Choice C), or excess acetylcholinesterase production (Choice D). The most likely treatment for myasthenia gravis involves corticosteroids to reduce inflammation and intravenous immunoglobulins to block the antibodies attacking acetylcholine receptors. Intensive physical therapy and anabolic steroids are not primary treatments for myasthenia gravis.
5. Why is a beta-blocker prescribed to a client with a history of myocardial infarction?
- A. To reduce myocardial oxygen demand.
- B. To increase cardiac output.
- C. To prevent arrhythmias.
- D. To prevent the development of angina.
Correct answer: A
Rationale: The primary reason for administering a beta-blocker to a client with a history of myocardial infarction is to reduce myocardial oxygen demand. By reducing myocardial oxygen demand, beta-blockers help decrease the workload on the heart, making it easier for the heart to function effectively. This is crucial for clients with a history of myocardial infarction to prevent further damage to the heart. Choice B is incorrect because beta-blockers do not aim to increase cardiac output; instead, they help improve cardiac function by reducing workload. Choice C is incorrect because while beta-blockers can help prevent certain arrhythmias, the primary reason for their use in this case is to reduce myocardial oxygen demand. Choice D is incorrect as preventing angina is not the primary purpose of administering beta-blockers to a client with a history of myocardial infarction.
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