a 58 year old woman comes to the clinic for evaluation of a sharp intermittent severe stabbing facial pain that she describes as like an electric shoc

ATI RN

Pathophysiology Final Exam

1. A 58-year-old woman comes to the clinic for evaluation of a sharp, intermittent, severe, stabbing facial pain that she describes as 'like an electric shock.' The pain occurs only on one side of her face; it seems to be triggered when she chews, brushes her teeth, or sometimes when she merely touches her face. There is no numbness associated with the pain. What is most likely causing her pain?

A. Temporal arteritis
B. Trigeminal neuralgia
C. Migraine headache
D. Cluster headache

Correct answer: B

Rationale: The correct answer is B: Trigeminal neuralgia. Trigeminal neuralgia is characterized by severe, stabbing pain in the distribution of the trigeminal nerve, often triggered by light touch, chewing, or brushing teeth. In this case, the patient's symptoms of sharp, intermittent facial pain triggered by activities like chewing and touching her face are classic for trigeminal neuralgia. Choices A, C, and D are incorrect. Temporal arteritis typically presents with unilateral headache, jaw claudication, and visual symptoms. Migraine headaches are usually throbbing in nature and often associated with nausea, vomiting, and sensitivity to light and sound. Cluster headaches are characterized by severe unilateral pain around the eye with autonomic symptoms like lacrimation and nasal congestion.

2. A patient with a history of venous thromboembolism is prescribed hormone replacement therapy (HRT). What should the nurse emphasize about the risks associated with this therapy?

A. HRT is associated with an increased risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
B. HRT may improve mood and energy levels, but it also increases the risk of osteoporosis.
C. HRT can decrease the risk of fractures, but it also increases the risk of developing diabetes.
D. HRT may increase the risk of breast cancer, so regular mammograms are essential.

Correct answer: A

Rationale: HRT is associated with an increased risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots and advised to seek immediate medical attention if they occur.

3. A patient with osteoporosis is prescribed raloxifene (Evista). What is the primary therapeutic action of this medication?

A. It decreases bone resorption and increases bone density.
B. It stimulates the formation of new bone.
C. It increases calcium absorption in the intestines.
D. It increases the excretion of calcium through the kidneys.

Correct answer: A

Rationale: The correct answer is A. Raloxifene works by decreasing bone resorption and increasing bone density. This helps in preventing further bone loss and reducing the risk of fractures in patients with osteoporosis. Choice B is incorrect because raloxifene does not stimulate the formation of new bone, but rather helps to maintain existing bone mass. Choice C is incorrect as raloxifene does not directly increase calcium absorption in the intestines. Choice D is also incorrect as raloxifene does not increase the excretion of calcium through the kidneys.

4. A patient is starting on finasteride (Proscar) for the treatment of benign prostatic hyperplasia (BPH). What should the nurse include in the patient teaching?

A. The medication will cure BPH after treatment is complete.
B. The effects of the medication may take several weeks or months to become noticeable.
C. The medication may cause increased hair growth.
D. The medication may decrease libido.

Correct answer: B

Rationale: The correct answer is B. The effects of finasteride in treating BPH may take several weeks or months to become noticeable. It is important for the nurse to educate the patient about this expected time frame to manage expectations. Choice A is incorrect because finasteride does not cure BPH but helps in managing symptoms. Choice C is incorrect as one of the side effects of finasteride is decreased hair growth. Choice D is incorrect as finasteride may cause a decrease in libido as a side effect.

5. A patient has been diagnosed with a fungal infection and is to be treated with itraconazole (Sporanox). Prior to administration, the nurse notes that the patient is taking carbamazepine (Tegretol) for a seizure disorder. Based on this medication regime, which of the following will be true regarding the medications?

A. The serum level of carbamazepine will be increased.
B. The patient's carbamazepine should be discontinued.
C. The patient's antiseizure medication should be changed.
D. The patient will require a higher dosage of itraconazole (Sporanox).

Correct answer: A

Rationale: When itraconazole is administered with carbamazepine, itraconazole may increase the serum levels of carbamazepine, potentially leading to toxicity. Therefore, choice A is correct. Discontinuing carbamazepine (choice B) or changing the antiseizure medication (choice C) is not necessary unless advised by a healthcare provider. Choice D, requiring a higher dosage of itraconazole, is not accurate in this scenario.