ATI RN
Pathophysiology Practice Exam
1. In a patient with renal failure secondary to an overdose of a nephrotoxic drug, which assessment findings would the nurse recognize as being most suggestive of impaired erythropoiesis?
- A. Frequent infections and low neutrophil levels
- B. Fatigue and increased heart rate
- C. Agitation and changes in cognition
- D. Increased blood pressure and peripheral edema
Correct answer: A
Rationale: Impaired erythropoiesis refers to a decreased production of red blood cells. This can lead to anemia, resulting in symptoms like fatigue and increased heart rate (Choice B). However, the question specifically asks about assessment findings suggestive of impaired erythropoiesis. In this context, frequent infections and low neutrophil levels (Choice A) are more directly related to impaired erythropoiesis due to the impact of anemia on the immune system. Frequent infections are common in anemia due to a compromised immune response, and low neutrophil levels can be seen in conditions of impaired erythropoiesis. Agitation and changes in cognition (Choice C) are more indicative of neurological issues, while increased blood pressure and peripheral edema (Choice D) are commonly associated with renal failure but not specifically related to impaired erythropoiesis.
2. A patient is being treated with raloxifene (Evista) for osteoporosis. What should the nurse teach the patient about this medication?
- A. It is used as a selective estrogen receptor modulator to prevent bone loss.
- B. It works by decreasing bone formation and increasing bone resorption.
- C. It should be taken with food to reduce gastrointestinal side effects.
- D. It may cause weight gain and fluid retention.
Correct answer: C
Rationale: The correct answer is C. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent bone loss. It should be taken with food to reduce gastrointestinal side effects, not on an empty stomach. Choices A and B are incorrect because raloxifene is indeed a SERM that prevents bone loss, but it does not directly work by increasing bone formation or decreasing bone resorption. Choice D is incorrect as weight gain and fluid retention are not common side effects of raloxifene.
3. A patient with a history of venous thromboembolism is being considered for hormone replacement therapy (HRT). What should the nurse discuss with the patient regarding the risks of HRT?
- A. Discuss the potential for increased bone density.
- B. Discuss the potential for an increased risk of cardiovascular events.
- C. Discuss the potential for a reduced risk of breast cancer.
- D. Discuss the potential for improved mood and energy levels.
Correct answer: B
Rationale: The correct answer is B because hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including venous thromboembolism. Patients with a history of venous thromboembolism are at higher risk, so discussing this potential risk is crucial. Choice A, increased bone density, is not a major risk of HRT. Choice C, reduced risk of breast cancer, is not a common discussion point regarding HRT risks. Choice D, improved mood and energy levels, is more related to the benefits of HRT rather than its risks.
4. When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs?
- A. Autoimmune
- B. Anaphylaxis
- C. Alloimmune
- D. Allergic
Correct answer: C
Rationale: When the maternal immune system becomes sensitized against antigens expressed by the fetus, an alloimmune reaction occurs. In this situation, the mother's immune system recognizes the fetus as foreign due to differences in antigens, leading to an immune response against the fetus. Choice A, 'Autoimmune,' is incorrect because it refers to the immune system mistakenly attacking the body's own cells and tissues. Choice B, 'Anaphylaxis,' is not the correct answer as it is a severe allergic reaction that can be life-threatening. Choice D, 'Allergic,' is also incorrect as it refers to an immune response triggered by allergens, not antigens expressed by the fetus.
5. A patient is starting on alendronate (Fosamax) for osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?
- A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
- B. Take the medication at bedtime to ensure absorption during sleep.
- C. Take the medication with milk to enhance calcium absorption.
- D. Take the medication with food to prevent gastrointestinal upset.
Correct answer: A
Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because taking alendronate at bedtime can increase the risk of esophageal irritation due to lying down. Choice C is incorrect as taking alendronate with milk can reduce its absorption. Choice D is incorrect because alendronate should be taken on an empty stomach to enhance its effectiveness.
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