ATI RN
WGU Pathophysiology Final Exam
1. A patient with an 18 pack per year history presents to a family practice clinic complaining of painless hoarseness and inability to clear mucus. A biopsy of respiratory tract cells is taken and shows that these cells have been replaced by less mature squamous epithelium cells. The nurse knows this type of change is referred to as:
- A. Dysplasia
- B. Metaplasia
- C. Hyperplasia
- D. Coagulation
Correct answer: B
Rationale: Metaplasia is the replacement of one type of cell with another, which can occur in response to chronic irritation, such as from smoking. In this case, the respiratory tract cells being replaced by less mature squamous epithelium cells indicate metaplasia. Dysplasia refers to abnormal development or growth of cells, not replacement; hyperplasia is an increase in the number of cells, not a replacement; and coagulation is a process related to blood clotting, not cell replacement.
2. A patient receiving isoniazid (INH) and rifampin (Rifadin) has a decreased urinary output and decreased sensation in his great toes. Which laboratory values should be assessed?
- A. Hematocrit and hemoglobin
- B. ALT and AST
- C. Urine culture and sensitivity
- D. Erythrocyte count and differential
Correct answer: C
Rationale: In a patient receiving isoniazid (INH) and rifampin (Rifadin) with symptoms of decreased urinary output and decreased sensation in great toes, assessing urine culture and sensitivity is crucial. These symptoms could indicate peripheral neuropathy, a known side effect of isoniazid, and rifampin can cause renal toxicity. Checking for any urinary tract infection or drug-induced nephrotoxicity is important. Choices A, B, and D are incorrect as they do not directly address the symptoms presented by the patient or the potential side effects of the medications mentioned.
3. A nurse is providing discharge teaching to a patient who will be taking sildenafil (Viagra). Which of the following should the nurse include in the instructions?
- A. Take this medication 1 hour before sexual activity.
- B. Do not take more than one dose in a 24-hour period.
- C. Seek immediate medical attention if you experience vision or hearing loss.
- D. Take this medication on an empty stomach.
Correct answer: B
Rationale: The correct answer is B: 'Do not take more than one dose in a 24-hour period.' It is essential for the nurse to emphasize this instruction to prevent potential adverse effects from taking multiple doses of sildenafil. Choice A is incorrect because sildenafil should be taken approximately 30 minutes to 4 hours before sexual activity, not specifically 1 hour before. Choice C is important but not the priority; while vision or hearing loss are potential serious side effects of sildenafil, the immediate concern should be focused on dose frequency. Choice D is incorrect as sildenafil can be taken with or without food.
4. Prior to leaving on a backpacking trip to Southeast Asia, a college student has received a tetanus booster shot. This immunization confers protection by way of what immune process?
- A. Passive natural immunity
- B. Active natural immunity
- C. Passive artificial immunity
- D. Active artificial immunity
Correct answer: D
Rationale: The correct answer is D: Active artificial immunity. A tetanus booster shot confers protection through active artificial immunity. Active immunity involves the body producing its antibodies in response to an antigen, providing long-lasting protection. In this case, the tetanus booster shot triggers the student's immune system to produce specific antibodies against tetanus toxins. Choices A, B, and C are incorrect because passive immunity does not involve the individual's immune system producing antibodies; instead, it involves the direct transfer of antibodies from another source (natural or artificial) for immediate, but temporary, protection.
5. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?
- A. Has your child received all recommended vaccinations?
- B. Has your child been feeding poorly or showing signs of constipation?
- C. Has your child been exposed to any sick individuals?
- D. Has your child been displaying signs of respiratory distress?
Correct answer: B
Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.
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