ATI RN
Final Exam Pathophysiology
1. 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.
2. A 20-year-old college student has presented to her campus medical clinic for a scheduled Pap smear. The clinician who will interpret the smear will examine cell samples for evidence of:
- A. Changes in cell shape, size, and organization
- B. Presence of unexpected cell types
- C. Ischemic changes in cell sample
- D. Abnormally high numbers of cells
Correct answer: A
Rationale: The correct answer is changes in cell shape, size, and organization (Choice A). Pap smears are performed to detect potential precancerous or cancerous conditions by examining the cells for any abnormalities in their shape, size, or organization. This helps in identifying early signs of cervical cancer. Choices B, C, and D are incorrect because Pap smears primarily focus on detecting cellular changes associated with cancer, not unexpected cell types, ischemic changes, or abnormally high numbers of cells.
3. 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.
4. Which immunoglobulin presents the first challenge to the antigen?
- A. IgA
- B. IgG
- C. IgM
- D. IgE
Correct answer: C
Rationale: IgM is the first immunoglobulin to challenge the antigen during an immune response. IgM is the primary antibody produced during the initial or primary immune response. It is efficient in agglutination and complement activation, making it crucial in the early stages of defense. IgA is mainly found in mucosal areas and secretions. IgG is the most abundant antibody in circulation and is involved in secondary immune responses. IgE is primarily associated with allergic reactions and parasitic infections. Therefore, IgM is the correct choice as it acts first during the immune response, while the other immunoglobulins have different roles and functions.
5. 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.
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