ATI RN
Pathophysiology Final Exam
1. A child's thymus gland is fully formed and proportionately larger than an adult's. Which of the following processes that contribute to immunity takes place in the thymus gland?
- A. Differentiation of B cells
- B. Production of natural killer (NK) cells
- C. Proliferation of T cells
- D. Filtration of antigens from the blood
Correct answer: C
Rationale: The correct answer is C: Proliferation of T cells. The thymus gland is responsible for the maturation and proliferation of T cells, which play a crucial role in adaptive immunity. Option A, differentiation of B cells, is incorrect because B cell maturation primarily occurs in the bone marrow. Option B, production of natural killer (NK) cells, is incorrect as NK cells are mainly produced in the bone marrow and lymph nodes. Option D, filtration of antigens from the blood, is incorrect as antigen filtration is not a primary function of the thymus gland.
2. A woman has been prescribed Climara, a transdermal estradiol patch. Which of the following should she be instructed by the nurse regarding the administration?
- A. Avoid prolonged sun exposure at the patch site due to increased plasma concentrations.
- B. The application of heat at the patch site will decrease effectiveness and result in pregnancy.
- C. The medication, when exposed to sunlight, can increase the risk of breast cancer.
- D. Exposure of the medication to occasional cold will increase effectiveness with application.
Correct answer: A
Rationale: The correct answer is A. The Climara patch delivers estradiol transdermally, and patients should be instructed to avoid prolonged sun exposure at the patch site due to increased plasma concentrations. Sun exposure can accelerate the absorption of the medication, leading to higher systemic levels than intended. Choices B, C, and D are incorrect because heat at the patch site does not result in pregnancy but may alter absorption rates, there is no direct link between sunlight exposure and breast cancer risk related to this medication, and exposure to cold does not increase effectiveness of the transdermal patch.
3. After a thoracentesis on a client with a pleural effusion, which nursing intervention is most important post-procedure?
- A. Monitor for signs of infection.
- B. Assess for signs of bleeding or hematoma.
- C. Monitor vital signs and respiratory status.
- D. Instruct the client to rest and limit physical activity.
Correct answer: B
Rationale: The correct answer is to assess for signs of bleeding or hematoma. After a thoracentesis, it is crucial to monitor for any bleeding or hematoma formation at the puncture site, as this can lead to complications. Monitoring for signs of infection (Choice A) is essential but is usually a delayed concern compared to the immediate risk of bleeding post-procedure. While monitoring vital signs and respiratory status (Choice C) is important, assessing for bleeding takes precedence to address any immediate complications. Instructing the client to rest and limit physical activity (Choice D) is relevant for general post-procedure care but is not the most critical intervention in this scenario.
4. When caring for a patient with systemic lupus erythematosus (SLE), the disease the nurse is dealing with is an example of:
- A. Autoimmunity
- B. Alloimmunity
- C. Homoimmunity
- D. Alleimmunity
Correct answer: A
Rationale: When a nurse cares for a patient with systemic lupus erythematosus (SLE), the nurse is dealing with an autoimmune disease. In autoimmune diseases like SLE, the immune system mistakenly attacks the body's own tissues. Choice A, 'Autoimmunity,' is the correct answer because SLE is an example of the immune system attacking self-antigens, leading to tissue damage and inflammation. Choices B, C, and D are incorrect. Alloimmunity refers to the immune response against foreign antigens from members of the same species, homoimmunity is not a recognized term in immunology, and alleimmunity is not a valid term in this context.
5. An oncology nurse is providing care for an adult patient who is currently immunocompromised. The nurse is aware of the physiology involved in hematopoiesis and immune function, including the salient role of cytokines. What is the primary role of cytokines in maintaining homeostasis?
- A. Cytokines perform phagocytosis in response to bacterial and protozoal infections.
- B. Cytokines perform a regulatory role in the development of diverse blood cells.
- C. Cytokines play a significant role in the formation of all blood cells.
- D. Cytokines are produced in response to the presence of antibodies.
Correct answer: B
Rationale: The primary role of cytokines in maintaining homeostasis is to perform a regulatory function in the development of diverse blood cells. Cytokines act as signaling molecules that regulate the immune response and hematopoiesis. Choice A is incorrect because cytokines do not perform phagocytosis; they regulate immune responses. Choice C is incorrect because while cytokines are involved in the formation of some blood cells, they are not considered the basic 'building blocks' of all blood cells. Choice D is incorrect because cytokines are not formed in response to antibodies, but rather play a role in the immune response to various stimuli.
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