ATI RN
Pathophysiology Final Exam
1. A 21-year-old male is brought to the ED following a night of partying in his fraternity. His friends found him 'asleep' and couldn't get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the man's friends, the nurse begins by explaining that alcohol is:
- A. A water-soluble compound that is easily absorbed by the gastric lining of the stomach.
- B. Very lipid-soluble and rapidly crosses the blood–brain barrier.
- C. Able to reverse the transport of some substances to remove them from the brain.
- D. Very likely to cause sedation and therefore the client just needs to sleep it off.
Correct answer: B
Rationale: The correct answer is B. Alcohol is very lipid-soluble and rapidly crosses the blood–brain barrier, leading to its effects on the central nervous system and causing symptoms like sedation and unconsciousness. Choice A is incorrect because alcohol is not water-soluble; it is lipid-soluble. Choice C is incorrect as alcohol does not reverse the transport of substances from the brain. Choice D is incorrect as sedation from alcohol is not a reason to just 'sleep it off' in cases of alcohol poisoning, which can be life-threatening and requires medical attention.
2. A patient is administered isoniazid (INH) for tuberculosis. Which of the following adverse effects will result in discontinuation of the medication?
- A. Weight gain
- B. Jaundice
- C. Fever
- D. Arthralgia
Correct answer: B
Rationale: The correct answer is B: Jaundice. Isoniazid (INH) is known to cause hepatotoxicity, which can manifest as jaundice. Jaundice is a serious adverse effect that warrants immediate discontinuation of the medication to prevent further liver damage. Weight gain, fever, and arthralgia are not typically associated with isoniazid use and would not necessitate discontinuation of the medication.
3. What nursing diagnosis is suggested by the patient's statement regarding taking extra griseofulvin when she thinks her infection is getting worse?
- A. Deficient knowledge related to correct use of griseofulvin
- B. Effective therapeutic regimen management related to symptom identification
- C. Disturbed thought processes related to appropriate use of griseofulvin
- D. Ineffective coping related to self-medication
Correct answer: C
Rationale: The correct answer is C: 'Disturbed thought processes related to appropriate use of griseofulvin.' The patient's statement shows a misunderstanding of the correct use of griseofulvin by taking extra medication when she believes her infection is worsening. This behavior indicates a disturbance in her thought process regarding the appropriate use of the medication. Choice A is incorrect because the issue is not lack of knowledge but rather a misunderstanding leading to inappropriate actions. Choice B is incorrect as the patient's actions do not demonstrate effective management of her therapeutic regimen. Choice D is incorrect as the patient is not engaged in self-medication but rather misinterpreting signals and self-adjusting the prescribed medication.
4. A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which process will accompany the actions of the neurotransmitter in a chemical synapse?
- A. Two-way communication between neurons is permitted, in contrast to the one-way communication in electrical synapses.
- B. Communication between a neuron and the single neuron it is connected with will be facilitated.
- C. The neurotransmitter will cross gap junctions more readily.
- D. More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.
Correct answer: D
Rationale: When serotonin levels increase, more neurotransmitters will cross the synaptic cleft and bind with postsynaptic receptors, facilitating enhanced communication. Option A is incorrect because chemical synapses, unlike electrical synapses, are unidirectional. Option B is incorrect because neurotransmitters impact communication with multiple neurons, not just a single connected neuron. Option C is incorrect because neurotransmitters cross the synaptic cleft, not gap junctions.
5. A patient with erectile dysfunction is prescribed sildenafil (Viagra). What condition would contraindicate the use of this medication?
- A. History of hypertension
- B. Use of nitrates
- C. Recent use of antihypertensive medications
- D. History of peptic ulcer disease
Correct answer: B
Rationale: The correct answer is B: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of hypertension, recent use of antihypertensive medications, or a history of peptic ulcer disease are not direct contraindications for using sildenafil.
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