ATI RN
ATI Pathophysiology
1. A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia). How should the nurse respond when the patient asks what causes pernicious anemia? A decrease in ______ is the most likely cause.
- A. Ferritin
- B. Gastric enzymes
- C. Intrinsic factor
- D. Erythropoietin
Correct answer: C
Rationale: Pernicious anemia is primarily caused by a decrease in intrinsic factor. Intrinsic factor is a protein produced by the stomach that is necessary for the absorption of vitamin B12 in the intestines. Without intrinsic factor, vitamin B12 cannot be absorbed properly, leading to anemia. Ferritin is a protein that stores iron in the body and is not directly related to pernicious anemia. Gastric enzymes play a role in digestion but are not the primary cause of pernicious anemia. Erythropoietin is a hormone produced by the kidneys to stimulate red blood cell production and is not linked to pernicious anemia.
2. When a healthcare professional is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the healthcare professional calls these erythrocytes:
- A. Hyperchromic
- B. Hypochromic
- C. Macrocytic
- D. Microcytic
Correct answer: B
Rationale: Erythrocytes with an abnormally low concentration of hemoglobin are called hypochromic. Hyperchromic refers to erythrocytes with an abnormally high concentration of hemoglobin. Macrocytic indicates larger than normal red blood cells, while microcytic refers to smaller than normal red blood cells. Therefore, in this scenario, the correct term is hypochromic.
3. In which patients would the manifestation of a headache be a sign of a serious underlying disorder?
- A. A 55-year-old man with new onset of headaches that are worse at night and reported mood swings according to his family
- B. A 30-year-old woman with a unilateral throbbing headache with photophobia and nausea
- C. A 60-year-old man with his head feeling full and throbbing and muscle aching around his neck and shoulders
- D. A 40-year-old woman who experiences food cravings, gets irritable, and then develops a pulsatile-like headache on the right side of her head
Correct answer: A
Rationale: In this scenario, the correct answer is the 55-year-old man with new onset headaches that worsen at night and reported mood swings according to his family. These symptoms, especially when combined with nighttime worsening and mood changes, could indicate a serious underlying disorder such as a brain tumor or increased intracranial pressure. Choice B is incorrect as the unilateral throbbing headache with photophobia and nausea is suggestive of migraine headaches, which are usually not associated with serious underlying disorders. Choice C describes symptoms that are more indicative of tension-type headaches rather than a serious underlying disorder. Choice D presents symptoms that are more likely related to hormonal changes and migraines rather than a serious underlying disorder.
4. A patient is starting on alendronate (Fosamax) for the treatment of osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?
- A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
- B. Take the medication with milk to enhance calcium absorption.
- C. Take the medication at bedtime to ensure absorption during sleep.
- D. Take the medication with food to prevent nausea.
Correct answer: A
Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with alendronate absorption. Taking it at bedtime (choice C) is not necessary and may increase the risk of esophageal irritation. Taking the medication with food (choice D) can reduce its absorption and effectiveness.
5. A primiparous woman tells the nurse that she and her partner are highly reluctant to have their infant vaccinated, stating, “We've read that vaccines can potentially cause a lot of harm, so we're not sure we want to take that risk.” How should the nurse respond to this family's concerns?
- A. “Vaccinations are not without some risks, but these are far exceeded by the potential benefits they offer in preventing serious diseases.”
- B. “The potential risks of vaccinations have been investigated and determined to be minimal compared to the benefits of protecting your child from potentially life-threatening diseases.”
- C. “It is important to follow state laws regarding vaccines, but I understand your concerns. Let's discuss the specific risks and benefits of vaccines for your child.”
- D. “Vaccines indeed cause several serious adverse effects, but these are usually treated effectively, and the benefits of vaccination in preventing diseases far outweigh the risks.”
Correct answer: B
Rationale: When addressing concerns about vaccination, it is crucial to provide accurate information to help parents make informed decisions. Choice B is the most appropriate response as it acknowledges the concerns of the family while emphasizing that the potential risks of vaccinations are minimal compared to the significant benefits of protecting the child from serious diseases. This response shows empathy towards the parents' concerns while also highlighting the importance of vaccination in preventing life-threatening illnesses. Choice A is incorrect because it does not emphasize the significant benefits of vaccination in preventing diseases, which may not effectively address the family's concerns. Choice C is incorrect as it focuses more on state laws rather than addressing the family's specific concerns about vaccine safety. Choice D is incorrect as it may increase the family's anxiety by highlighting adverse effects without adequately emphasizing the benefits of vaccination in disease prevention.
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