ATI RN
WGU Pathophysiology Final Exam
1. A patient with a complex medical history is considering the use of oral contraceptives. The nurse should be aware that many antibiotics and antiseizure medications cause what effect when combined with oral contraceptives?
- A. Increased risk of pregnancy
- B. Increased blood pressure
- C. Increased risk of thromboembolism
- D. Increased gastric acid
Correct answer: A
Rationale: The correct answer is A: Increased risk of pregnancy. Certain antibiotics and anticonvulsants can decrease the effectiveness of oral contraceptives by inducing liver enzymes that metabolize the hormones more quickly. This interaction can lead to a decreased contraceptive effect, thereby increasing the risk of pregnancy. Choices B, C, and D are incorrect as they do not directly relate to the effect of antibiotics and antiseizure medications on oral contraceptives.
2. What long-term risks should the nurse discuss with a patient starting on hormone replacement therapy (HRT)?
- A. HRT is associated with increased risks of cardiovascular events and breast cancer, so these risks should be discussed with the patient.
- B. HRT can improve mood and energy levels, but it also increases the risk of osteoporosis.
- C. HRT can increase the risk of venous thromboembolism, so patients should undergo regular screening.
- D. HRT decreases the risk of fractures, but it also increases the risk of developing diabetes.
Correct answer: A
Rationale: The correct answer is A. When starting on hormone replacement therapy (HRT), the nurse should discuss the increased risks of cardiovascular events and breast cancer with the patient. These risks are important to consider to make an informed decision. Choice B is incorrect as HRT does not increase the risk of osteoporosis; in fact, it may help prevent it. Choice C is incorrect as while HRT can increase the risk of venous thromboembolism, regular screening is not the primary focus for discussion. Choice D is incorrect as HRT does not decrease the risk of fractures and is not primarily associated with an increased risk of developing diabetes.
3. 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 A biopsy of respiratory tract cells is taken and shows that these cells have been replaced by less mature squamous epithelium cells.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.
4. The neurotransmitter GABA mainly functions to trigger inhibitory postsynaptic potentials (IPSPs). Therefore, when explaining this to a group of nursing students, the nurse will state:
- A. It takes at least three chemical substances (amino acids, neuropeptides, and monoamines) to stimulate any activity between the cells.
- B. There is a symbiotic relationship; therefore, the end result will be depolarization of the postsynaptic membrane.
- C. The combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable.
- D. The neurotransmitters will interact with cholinergic receptors to bind to acetylcholine in order to produce hypopolarization within the cell.
Correct answer: C
Rationale: When GABA binds with a receptor site, it causes hyperpolarization of the local nerve membrane, making it less excitable. This hyperpolarization leads to inhibition of nerve cell activity. Choice A is incorrect because GABA is a neurotransmitter itself and does not require three chemical substances to stimulate activity between cells. Choice B is incorrect as GABA triggers inhibitory postsynaptic potentials (IPSPs), leading to hyperpolarization, not depolarization, of the postsynaptic membrane. Choice D is also incorrect as it describes a process involving cholinergic receptors and acetylcholine, which is unrelated to GABA's mechanism of action.
5. 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.
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