ATI RN
Pathophysiology Final Exam
1. A 40-year-old man has been living with HIV for several years but experienced a significant decrease in his CD4+ levels a few months ago. The patient has just been diagnosed with Mycobacterium avium complex disease. The nurse should anticipate administering which of the following medications?
- A. Clarithromycin
- B. Pyrazinamide
- C. Rifapentine (Priftin)
- D. Azithromycin
Correct answer: A
Rationale: The correct answer is A: Clarithromycin. In the case of Mycobacterium avium complex disease, a common treatment regimen includes a macrolide antibiotic like clarithromycin or azithromycin in combination with other antimicrobials. Clarithromycin is a key component of the treatment due to its effectiveness against Mycobacterium avium complex. Choice B (Pyrazinamide) is not typically part of the standard treatment for this condition. Choice C (Rifapentine) is mainly used in tuberculosis treatment and is not a primary agent for Mycobacterium avium complex disease. Choice D (Azithromycin) is another suitable macrolide antibiotic for treating Mycobacterium avium complex disease but is not the medication typically used first-line.
2. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?
- A. The vein for thrombophlebitis during IV administration.
- B. The subcutaneous site for redness following injection.
- C. The oral mucosa for ulceration after oral administration.
- D. The skin for irritation following removal of transdermal patch.
Correct answer: B
Rationale: Adalimumab is administered subcutaneously for Rheumatoid Arthritis. Injection-site reactions such as redness and swelling are common. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for potential adverse effects.
3. The client is receiving digoxin and has a potassium level of 2.8 mEq/L. What is the nurse’s priority action?
- A. Hold the digoxin and notify the healthcare provider.
- B. Increase the dose of digoxin.
- C. Continue the current dose of digoxin.
- D. Administer potassium supplements.
Correct answer: A
Rationale: The correct answer is to hold the digoxin and notify the healthcare provider. A potassium level of 2.8 mEq/L indicates hypokalemia, which can increase the risk of digoxin toxicity. Holding the medication and informing the healthcare provider is crucial to prevent adverse effects. Choice B is incorrect because increasing the dose of digoxin would further raise the risk of toxicity. Choice C is incorrect as continuing the current dose could exacerbate the toxicity risk. Choice D is incorrect because administering potassium supplements alone is not sufficient to address the potential digoxin toxicity; the first step should be to hold the digoxin and seek further guidance.
4. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?
- A. A client with a history of deep-vein thrombosis
- B. A client with a history of migraine headaches
- C. A client with a history of hypertension
- D. A client with a history of anemia
Correct answer: A
Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.
5. A nurse is reviewing the medical record of a client who has a new prescription for enalapril. Which of the following findings should the nurse report to the provider?
- A. Serum potassium 4.0 mEq/L
- B. Sodium 138 mEq/L
- C. Serum creatinine 3.8 mg/dL
- D. Hemoglobin 13 g/dL
Correct answer: C
Rationale: The correct answer is C. An elevated serum creatinine level can indicate impaired kidney function, which is crucial to report before administering enalapril. Enalapril, an ACE inhibitor, can affect kidney function, especially in patients with pre-existing renal impairment. Choices A, B, and D are within normal ranges and do not directly impact the initiation of enalapril therapy.
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