a client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense diffuse pain in her abdomen which ph

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ATI Pathophysiology Exam 2

1. A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?

A. Somatic pain resulting from pressure on the parietal peritoneum
B. Referred pain from her small bowel
C. Visceral pain resulting from distension and ischemia
D. Neuropathic pain resulting from autonomic dysfunction

Correct answer: C

Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.

2. A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse teach the patient about the use of this medication?

A. Medroxyprogesterone should be taken with food to prevent nausea.
B. Medroxyprogesterone can be taken intermittently when symptoms worsen.
C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels.
D. Medroxyprogesterone should be discontinued if side effects occur.

Correct answer: C

Rationale: The correct answer is C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels and effectiveness. Taking it at different times can lead to hormonal fluctuations and reduced medication efficacy. Choice A is incorrect because medroxyprogesterone does not need to be taken with food to prevent nausea. Choice B is incorrect as medroxyprogesterone is typically taken continuously rather than intermittently. Choice D is incorrect because side effects should be reported to the healthcare provider for further evaluation and management, not automatically leading to discontinuation of the medication.

3. What adverse effect should the nurse monitor for during testosterone therapy in a male patient?

A. Increased risk of cardiovascular events
B. Increased risk of liver dysfunction
C. Increased risk of prostate cancer
D. Increased risk of bone fractures

Correct answer: A

Rationale: The correct answer is A: Increased risk of cardiovascular events. Testosterone therapy can lead to an increased risk of cardiovascular events, such as heart attacks and strokes. This is why nurses should monitor for signs and symptoms of cardiovascular issues during therapy. Choices B, C, and D are incorrect because testosterone therapy is not typically associated with an increased risk of liver dysfunction, prostate cancer, or bone fractures. It is crucial for nurses to prioritize cardiovascular monitoring in patients receiving testosterone therapy.

4. A 70-year-old woman has difficulty with driving, and she has been frequently getting lost. Her husband said she has also been acting strange and seems to want to sleep a lot. He said the other night she kept saying she was seeing animals such as lions in her room. He says her memory is not too bad, but he is very concerned about her health. Physical examination reveals an alert woman with stable vital signs. Bradykinesia and limb rigidity are noted. These findings are consistent with:

A. Alzheimer's disease.
B. Vascular dementia.
C. Dementia with Lewy bodies.
D. Frontotemporal dementia.

Correct answer: Dementia with Lewy bodies.

Rationale: The symptoms described in the scenario, such as visual hallucinations, fluctuations in cognition, and parkinsonism (bradykinesia and limb rigidity), are classic features of dementia with Lewy bodies (DLB). DLB is characterized by the presence of Lewy bodies in the brain, which are abnormal protein deposits. Alzheimer's disease (Choice A) typically presents with memory loss as a predominant symptom, which is not a major concern in this case. Vascular dementia (Choice B) is associated with a history of cerebrovascular disease and is not supported by the symptoms described. Frontotemporal dementia (Choice D) usually presents with changes in behavior and personality, rather than the symptoms described in the scenario.

5. What is the primary cause of primary hypercholesteremia?

A. High-density lipoprotein (HDL) defects
B. Monogenic mutations, sedentary lifestyle, and high cholesterol diet
C. Polygenic mutations and environmental factors
D. Low-density lipoprotein (LDL) receptor mutation with defects in breakdown

Correct answer: Low-density lipoprotein (LDL) receptor mutation with defects in breakdown

Rationale: The correct answer is 'Low-density lipoprotein (LDL) receptor mutation with defects in breakdown.' Primary hypercholesteremia is mainly caused by mutations in the LDL receptor, leading to impaired clearance of LDL cholesterol from the blood. This results in high levels of LDL cholesterol in the bloodstream. Choices A, B, and C are incorrect because they do not directly relate to the primary cause of primary hypercholesteremia.