ATI RN
MSN 570 Advanced Pathophysiology Final 2024
1. In which patient is alpha-1 antitrypsin deficiency the likely cause of chronic obstructive pulmonary disease?
- A. A 30-year-old who has smoked for 3 years
- B. A 65-year-old man who drove a taxi most of his life
- C. A 70-year-old woman who smoked for 40 years
- D. A 50-year-old with exposure to secondhand smoke
Correct answer: A
Rationale: Alpha-1 antitrypsin deficiency is a genetic cause of chronic obstructive pulmonary disease (COPD). It is more common in younger patients with a history of smoking at a younger age, like the 30-year-old who has smoked for 3 years. Choices B, C, and D are less likely to be associated with alpha-1 antitrypsin deficiency as COPD in these cases is more likely due to smoking and environmental exposures.
2. A client presents to the emergency department with complaints of chest pain and shortness of breath. The client's ECG shows ST-segment elevation. What is the priority nursing intervention?
- A. Administer aspirin as prescribed.
- B. Prepare the client for emergent coronary angiography.
- C. Administer oxygen therapy.
- D. Initiate CPR.
Correct answer: B
Rationale: In a client presenting with chest pain, shortness of breath, and ST-segment elevation on ECG, the priority nursing intervention is to prepare the client for emergent coronary angiography. This procedure is crucial in diagnosing and treating acute myocardial infarction promptly. Administering aspirin (Choice A) is important but not the priority over emergent coronary angiography. Administering oxygen therapy (Choice C) is supportive but does not address the underlying cause of the ST-segment elevation. Initiating CPR (Choice D) is not the priority in this scenario as the client is stable and conscious.
3. In menopausal women, what is the primary goal of estrogen therapy?
- A. To relieve menopausal symptoms
- B. To prevent osteoporosis
- C. To increase calcium absorption
- D. To maintain bone strength
Correct answer: B
Rationale: The primary goal of estrogen therapy in menopausal women is to prevent osteoporosis by maintaining bone density. Estrogen helps in preserving bone mass and reducing the risk of fractures. While estrogen therapy may alleviate some menopausal symptoms, such as hot flashes, its primary focus is on bone health rather than symptom management. Increasing calcium absorption and maintaining bone strength are outcomes of preventing osteoporosis rather than the primary goal of estrogen therapy.
4. A patient is being educated on the administration of tinidazole (Tindamax). Which of the following indicates that the patient understands the administration of tinidazole?
- A. “I will report to the doctor if I have a slow heart rate.”
- B. “The medicine will leave a bitter or metallic taste in my mouth.”
- C. “I will report urinary urgency and incontinence.”
- D. “The medication is given in two doses every day.”
Correct answer: B
Rationale: The correct answer is B. Tinidazole (Tindamax) is known to cause a bitter or metallic taste in the mouth. This side effect is common and indicates that the patient understands the medication they are taking. Choices A, C, and D are incorrect because they do not specifically relate to the common side effects or administration details of tinidazole.
5. 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.
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