ATI RN
MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following are manifestations of Cushing syndrome?
- A. Truncal obesity with thin extremities.
- B. Enlargement of face, hands, and feet.
- C. Cachexia.
- D. Thick scalp hair.
Correct answer: A
Rationale: Truncal obesity with thin extremities is a classic manifestation of Cushing syndrome due to the redistribution of fat. Enlargement of face, hands, and feet is seen in conditions like acromegaly, not Cushing syndrome. Cachexia is a state of severe weight loss and muscle wasting, typically seen in conditions like cancer or advanced infections. Thick scalp hair is not typically associated with Cushing syndrome.
2. During a well-child checkup, a mother tells Nurse Rio about a recent situation in which her child needed to be disciplined by her husband. The child was slapped in the face for not getting her husband breakfast on Saturday, despite being told on Thursday never to prepare food for him. Nurse Rio analyzes the family system and concludes it is dysfunctional. All of the following factors contribute to this dysfunction except:
- A. Conflictual relationships between parents.
- B. Inconsistent communication patterns.
- C. Rigid, authoritarian roles.
- D. Use of violence to establish control.
Correct answer: C
Rationale: In a dysfunctional family system, conflictual relationships, inconsistent communication patterns, and the use of violence to establish control are factors contributing to dysfunction. However, rigid, authoritarian roles, though also dysfunctional, are not directly linked to the use of violence for control.
3. A patient began antiretroviral therapy several weeks ago for the treatment of HIV, and he has now presented to the clinic for a scheduled follow-up appointment. He states to the nurse, “I've been pretty good about taking all my pills on time, though it was a bit hit and miss over the holiday weekend.” How should the nurse best respond to this patient's statement?
- A. “Remember that if you miss a dose, you need to take a double dose at the next scheduled time.”
- B. “It's acceptable to miss an occasional dose as long as your symptoms don't worsen, but it's important to strive for consistent adherence.”
- C. “Remember that your antiretroviral drugs will only be effective if you take them consistently and as prescribed.”
- D. “If you're not consistent with taking your medications, you're likely to develop more side effects.”
Correct answer: C
Rationale: The correct response is to remind the patient that antiretroviral drugs are most effective when taken consistently and as prescribed. Choice A is incorrect because taking a double dose after missing a dose is not recommended, as it can lead to medication toxicity. Choice B is incorrect as it may give the impression that missing doses is acceptable, which can reduce the effectiveness of the treatment. Choice D is incorrect because while consistency is important, the focus should be on treatment effectiveness rather than side effects.
4. A 21-year-old male is being started on zidovudine (AZT) for the treatment of HIV/AIDS. Which of the following statements made by the patient indicates that he has understood the patient teaching?
- A. “AZT inactivates the virus and prevents recurrence of the disease.”
- B. “AZT therapy may result in the development of AZT-resistant strains.”
- C. “AZT slows the progression of the disease but does not cure it.”
- D. “AZT prevents the occurrence of opportunistic infections.”
Correct answer: C
Rationale: The correct answer is C. When the patient states, “AZT slows the progression of the disease but does not cure it,” it shows an understanding that zidovudine (AZT) does not provide a cure for HIV/AIDS but helps in slowing down the progression of the disease. Choice A is incorrect because AZT does not inactivate the virus or prevent recurrence. Choice B is incorrect as AZT resistance can develop with therapy. Choice D is incorrect because while AZT can help prevent opportunistic infections by boosting the immune system, its primary action is not the prevention of opportunistic infections.
5. When treating a patient for a fungal infection with IV amphotericin B, what should the nurse consistently monitor the patient's levels of to prevent drug discomfort?
- A. sodium
- B. hemoglobin
- C. calcium
- D. leukocytes
Correct answer: C
Rationale: When a patient is being treated with IV amphotericin B for a fungal infection, it is crucial to monitor the patient's calcium levels consistently. IV amphotericin B can cause hypokalemia, hypomagnesemia, and most notably, hypocalcemia. Monitoring calcium levels helps prevent drug-related discomfort and adverse effects. Sodium (Choice A), hemoglobin (Choice B), and leukocytes (Choice D) are not the primary parameters to monitor specifically for drug discomfort related to amphotericin B. Therefore, they are incorrect choices.
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