ATI RN
Pathophysiology Final Exam
1. A public health nurse is responsible for the administration of numerous immunizations. Which of the following guidelines regarding anaphylaxis should the nurse adhere to?
- A. The patient should be observed for anaphylaxis for 1 minute after administration.
- B. The patient should be observed for anaphylaxis for 5 minutes after administration.
- C. The patient should be observed for anaphylaxis for 30 minutes after administration.
- D. The patient should be observed for anaphylaxis for 90 minutes after administration.
Correct answer: C
Rationale: The correct answer is C: 'The patient should be observed for anaphylaxis for 30 minutes after administration.' This is because anaphylaxis can occur within minutes of administration of an immunization. By observing the patient for 30 minutes, the nurse can promptly identify and manage any signs of anaphylaxis. Choices A, B, and D are incorrect as they suggest shorter or longer observation periods, which may not be sufficient to detect and respond to anaphylaxis in a timely manner.
2. What important information should the nurse provide about the risks associated with tamoxifen (Nolvadex) for a patient with a history of breast cancer?
- 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 correct answer is A: Tamoxifen may increase the risk of venous thromboembolism. Patients on tamoxifen should be educated about the signs and symptoms of blood clots. Choices B, C, and D are incorrect. Tamoxifen does not decrease the risk of osteoporosis; it may cause hot flashes and other menopausal symptoms, and it may cause weight gain and fluid retention.
3. During a clinical assessment of a 68-year-old client who has suffered a head injury, a neurologist suspects that the client has sustained damage to her vagus nerve (CN X). Which assessment finding is most likely to lead the physician to this conclusion?
- A. The client has difficulty swallowing.
- B. The client has loss of gag reflex.
- C. The client has an inability to smell.
- D. The client has impaired eye movement.
Correct answer: B
Rationale: The correct answer is B. Damage to the vagus nerve can result in the loss of the gag reflex, which is a key indicator for the neurologist. Difficulty swallowing (Choice A) is more associated with issues related to the glossopharyngeal nerve (CN IX) and hypoglossal nerve (CN XII). An inability to smell (Choice C) is related to the olfactory nerve (CN I), and impaired eye movement (Choice D) is typically associated with damage to the oculomotor nerve (CN III), trochlear nerve (CN IV), or abducens nerve (CN VI), not the vagus nerve.
4. A patient arrives at her follow-up appointment 1 month post-hysterectomy and complains to the nurse that her scars do not seem to be healing properly. Upon inspection, the nurse notices that the scars are raised but still within the boundaries of the original incisions. The nurse tells the patient this kind of dysfunctional wound healing is called:
- A. Hypertrophic scarring
- B. Dehiscence
- C. Contracture
- D. A keloid
Correct answer: A
Rationale: Hypertrophic scarring occurs when a scar is raised but remains within the boundaries of the original wound, unlike keloids, which extend beyond the wound edges. Dehiscence refers to the separation of wound edges, while contracture involves the tightening or constriction of a scar, leading to limited mobility.
5. A 56-year-old woman has been experiencing memory loss and confusion for the past year. The client is diagnosed with Alzheimer's disease. Which finding is most characteristic of this disease?
- A. Neurofibrillary tangles in the brain
- B. Demyelination of neurons in the brain
- C. Accumulation of beta-amyloid plaques
- D. Formation of Lewy bodies
Correct answer: C
Rationale: The correct answer is C: Accumulation of beta-amyloid plaques. Alzheimer's disease is characterized by the accumulation of beta-amyloid plaques in the brain. These plaques are formed from the buildup of beta-amyloid protein fragments between nerve cells. Choice A, neurofibrillary tangles, are a hallmark of another neurodegenerative disease called Alzheimer's disease. Choice B, demyelination of neurons, is more characteristic of diseases like multiple sclerosis. Choice D, formation of Lewy bodies, is associated with Lewy body dementia, not Alzheimer's disease.
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