ATI RN
Final Exam Pathophysiology
1. A 20-year-old college student has presented to her campus medical clinic for a scheduled Pap smear. The clinician who will interpret the smear will examine cell samples for evidence of:
- A. Changes in cell shape, size, and organization
- B. Presence of unexpected cell types
- C. Ischemic changes in cell sample
- D. Abnormally high numbers of cells
Correct answer: A
Rationale: The correct answer is changes in cell shape, size, and organization (Choice A). Pap smears are performed to detect potential precancerous or cancerous conditions by examining the cells for any abnormalities in their shape, size, or organization. This helps in identifying early signs of cervical cancer. Choices B, C, and D are incorrect because Pap smears primarily focus on detecting cellular changes associated with cancer, not unexpected cell types, ischemic changes, or abnormally high numbers of cells.
2. What is responsible for initiating clonal selection?
- A. B cells
- B. T cells
- C. Antigens
- D. Lymphocytes
Correct answer: C
Rationale: Antigens are the correct answer as they are the molecules that trigger the immune response by binding to specific B or T cells. This binding activates these cells, leading to their proliferation and differentiation to fight off the antigen. B cells and T cells are the responders to antigens, not the initiators of clonal selection. Lymphocytes is a broad term encompassing both B and T cells, so it is not the specific factor responsible for initiating clonal selection.
3. 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.
4. A 30-year-old male was diagnosed with HIV. Which of the following treatments would be most effective?
- A. Reverse transcriptase inhibitors
- B. Protease inhibitors
- C. Entrance inhibitors
- D. Highly active antiretroviral therapy
Correct answer: D
Rationale: The correct answer is D: Highly active antiretroviral therapy (HAART). HAART involves a combination of different classes of antiretroviral drugs, which can effectively suppress the HIV virus, reduce the viral load, and improve the immune function. While choices A, B, and C are also used in HIV treatment, the most effective approach is a combination therapy like HAART due to its ability to target the virus at different stages of its life cycle, reducing the risk of drug resistance and improving treatment outcomes.
5. When assessing a 7-year-old child's pain after an emergency appendectomy, what is the most appropriate tool for the nurse to use?
- A. Use a visual analog scale (VAS) to assess the pain.
- B. Ask the child to rate their pain on a scale of 0 to 10.
- C. Use the Wong-Baker FACES scale to assess the pain.
- D. Ask the parents to describe the child's pain behavior.
Correct answer: C
Rationale: The correct answer is to use the Wong-Baker FACES scale to assess the child's pain. This scale is specifically designed for children and uses facial expressions of varying intensities to help them communicate their pain levels effectively. Choices A and B may not be as suitable for a young child who may have difficulty understanding or using a numerical scale. Choice D involving parents may not provide an accurate reflection of the child's pain experience, as it is essential to assess the child's self-reporting.
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