ATI RN
Final Exam Pathophysiology
1. A patient is being educated about the use of raloxifene (Evista) for osteoporosis. What is the primary therapeutic action of this medication?
- A. It stimulates the formation of new bone.
- B. It decreases bone resorption and increases bone density.
- C. It increases the excretion of calcium through the kidneys.
- D. It increases calcium absorption in the intestines.
Correct answer: B
Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption, which is the breakdown of bone, and increasing bone density. This action helps in preventing bone loss and maintaining bone strength. Choice A is incorrect because raloxifene does not stimulate the formation of new bone but rather prevents its breakdown. Choice C is incorrect as raloxifene does not increase the excretion of calcium but rather helps in maintaining calcium levels in the bones. Choice D is also incorrect as raloxifene does not directly increase calcium absorption in the intestines.
2. When preparing to administer parenteral acyclovir (Zovirax) to an 80-year-old patient with chronic renal failure and herpes simplex, what would the nurse expect in regard to the dose?
- A. The dose is smaller due to the herpes simplex infection.
- B. The dose is smaller based on the patient's kidney function.
- C. The dose is higher in treating genital herpes.
- D. The dose is higher if the creatinine clearance is above 4.0 mg/dL.
Correct answer: B
Rationale: In patients with chronic renal failure, especially in older adults, dosages of medications excreted renally need to be adjusted based on kidney function. Acyclovir is primarily eliminated by the kidneys, so in a patient with chronic renal failure, the dose would need to be smaller to prevent drug accumulation and toxicity. Choice A is incorrect because the dose adjustment is more related to the patient's kidney function than the presence of herpes simplex. Choice C is incorrect because the type of herpes infection does not determine the dose adjustment for acyclovir. Choice D is incorrect as the creatinine clearance is a more accurate measure of kidney function compared to creatinine levels.
3. What is a critical point the nurse should include in patient education for a patient prescribed tamoxifen (Nolvadex)?
- A. Tamoxifen may increase the risk of venous thromboembolism.
- B. Tamoxifen may decrease the risk of osteoporosis.
- C. Tamoxifen may cause hot flashes and other menopausal symptoms.
- D. Tamoxifen may cause weight gain and fluid retention.
Correct answer: A
Rationale: The critical point the nurse should include in patient education for a patient prescribed tamoxifen is that it may increase the risk of venous thromboembolism. This is crucial information because tamoxifen is known to promote blood clot formation, and patients need to be aware of the signs and symptoms of blood clots to seek prompt medical attention. Choices B, C, and D are incorrect as tamoxifen is not associated with decreasing the risk of osteoporosis, causing hot flashes and other menopausal symptoms, or directly causing weight gain and fluid retention.
4. A patient has been prescribed sildenafil (Viagra) for erectile dysfunction. What important information should the healthcare provider provide?
- A. This medication can cause sudden hearing loss.
- B. This medication should not be taken more than once a day.
- C. You should avoid taking this medication with high-fat meals.
- D. Avoid taking nitrates while on this medication.
Correct answer: D
Rationale: The correct answer is D. Sildenafil (Viagra) should not be taken with nitrates due to the risk of severe hypotension. Nitrates can potentiate the hypotensive effects of sildenafil, leading to a dangerous drop in blood pressure. Choice A is incorrect because sudden hearing loss is a rare but serious side effect associated with sildenafil, not a common side effect. Choice B is not the most important information related to sildenafil use. While it is generally recommended not to exceed one dose per day, the interaction with nitrates is more critical. Choice C is also important to consider as high-fat meals can delay the onset of action of sildenafil, but it is not as crucial as avoiding nitrates.
5. A patient has developed a decubitus ulcer on the coccyx. What defense mechanism is most affected by this homeostatic change?
- A. The mucous membrane is affected.
- B. The respiratory tract is affected.
- C. The skin is affected.
- D. The gastrointestinal tract is affected.
Correct answer: C
Rationale: In this scenario, a decubitus ulcer on the coccyx indicates a breakdown of the skin's integrity due to prolonged pressure. The skin is the primary defense mechanism of the body against external pathogens. When the skin is compromised, it can lead to infections and other complications. The mucous membrane (Choice A) plays a role in protecting internal surfaces, not the skin. The respiratory tract (Choice B) is involved in breathing and not directly related to the skin's defense. The gastrointestinal tract (Choice D) is responsible for digestion and absorption of nutrients, not the primary defense mechanism against external threats like the skin.
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