ATI RN
MSN 570 Advanced Pathophysiology Final 2024
1. A 30-year-old man has a history of heart transplant and is receiving long-term steroids to prevent rejection. The patient is due for routine vaccines. Attenuated vaccines are contraindicated in this patient because the antigen is:
- A. live and can cause infection.
- B. mutated and infectious.
- C. inactive but still infectious
- D. pathogenic
Correct answer: live and can cause infection.
Rationale: The correct answer is A: live and can cause infection. Patients who are immunocompromised, like those receiving long-term steroids after an organ transplant, should not receive live vaccines because the live attenuated organisms in these vaccines can cause infections in individuals with weakened immune systems. Choice B is incorrect because attenuated vaccines are live but weakened, not mutated. Choice C is incorrect because while inactive, attenuated vaccines are not infectious. Choice D is incorrect because attenuated vaccines are not pathogenic; they are attenuated (weakened) forms of the pathogen.
2. When caring for a patient with a nasogastric (NG) tube, what is the most appropriate intervention to prevent aspiration?
- A. Flush the NG tube with water before each feeding.
- B. Check the placement of the NG tube before each feeding.
- C. Elevate the head of the bed to 30-45 degrees.
- D. Provide the patient with oral care every 4 hours.
Correct answer: C
Rationale: Elevating the head of the bed to 30-45 degrees is the most appropriate intervention to prevent aspiration in a patient with an NG tube. This position helps reduce the risk of regurgitation and aspiration by promoting the proper flow of contents through the gastrointestinal tract and minimizing the chances of stomach contents entering the airway. Flushing the NG tube with water before each feeding may not directly prevent aspiration. Checking the placement of the NG tube is important but does not specifically address the prevention of aspiration. Providing oral care every 4 hours is essential for maintaining oral hygiene but is not directly related to preventing aspiration in a patient with an NG tube.
3. When assessing a preschooler's chest, what should the nurse expect?
- A. Respiratory movements to be chiefly thoracic
- B. Anteroposterior diameter to be equal to the transverse diameter
- C. Retraction of the muscles between the ribs on respiratory movement
- D. Movement of the chest wall to be symmetric bilaterally and coordinated with breathing
Correct answer: D
Rationale: In a preschooler, chest movement should be symmetric and coordinated with breathing, indicating healthy respiratory function.
4. A client recently had an above the knee amputation and complains of pain distal to the amputation. What type of pain is the client experiencing?
- A. Nociceptive
- B. Neuropathic
- C. Visceral
- D. Cutaneous
Correct answer: Nociceptive
Rationale:
5. A nurse is providing teaching about folic acid to a client who is primigravida. Which of the following information should the nurse include in the teaching?
- A. You should take folic acid to prevent neural tube defects in your baby.
- B. You should consume at least 400 micrograms of folic acid daily.
- C. You can increase your dietary intake of folic acid by consuming cereals and citrus fruits.
- D. You should expect improved energy levels when taking folic acid supplements.
Correct answer: C
Rationale: The correct answer is C. Folic acid helps prevent neural tube defects, and dietary sources like cereals and citrus fruits are good options to increase folic acid intake. Choice A is incorrect because folic acid is primarily recommended to prevent neural tube defects, not to prevent infections. Choice B is incorrect because the recommended daily intake of folic acid for pregnant women is at least 400 micrograms, not 300. Choice D is incorrect because folic acid is not typically associated with improving energy levels.
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