ATI RN
Pathophysiology Final Exam
1. What is the primary therapeutic action of tamsulosin (Flomax) in a male patient with benign prostatic hyperplasia (BPH)?
- A. Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.
- B. Reduction in prostate size and improvement in urinary symptoms.
- C. Increase in urine flow and relief of urinary obstruction.
- D. Improvement in erectile function.
Correct answer: A
Rationale: The correct answer is A: Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow. Tamsulosin, a medication commonly prescribed for BPH, works by selectively blocking alpha-1 adrenergic receptors in the prostate, causing relaxation of smooth muscles in the prostate and bladder neck. This relaxation reduces the constriction in these areas, improving urinary flow and reducing symptoms such as hesitancy, urgency, frequency, and weak stream. Choice B is incorrect because tamsulosin does not directly reduce the size of the prostate. Choice C is incorrect as tamsulosin primarily acts by relaxing muscles rather than directly increasing urine flow. Choice D is incorrect as tamsulosin is not indicated for improving erectile function.
2. Why does the nurse have a 2-year-old boy sit in a “tailor” position while palpating for the presence of the testes?
- A. It prevents the cremasteric reflex
- B. Undescended testes can be palpated
- C. The child has an inguinal hernia
- D. The child does not yet have a need for privacy
Correct answer: A
Rationale: The tailor position stretches the muscle responsible for the cremasteric reflex, preventing it from contracting and pulling the testes into the pelvic cavity. This position helps accurately palpate the testes. Choice B is incorrect because the position does not facilitate the palpation of undescended testes specifically. Choice C is incorrect as it does not relate to the rationale behind the tailor position. Choice D is incorrect as the reason for using the tailor position is not related to the child's need for privacy.
3. When providing teaching to a client with a prescription for Phenytoin, which of the following instructions should the nurse include?
- A. Take this medication at bedtime.
- B. Increase your intake of calcium-rich foods.
- C. Brush and floss your teeth regularly.
- D. Avoid eating foods high in potassium.
Correct answer: C
Rationale: The correct answer is C: 'Brush and floss your teeth regularly.' Phenytoin can cause gingival hyperplasia, a side effect that affects the gums. It is crucial for the client to maintain good oral hygiene to prevent oral health complications. Choices A, B, and D are incorrect. While the timing of medication administration and dietary considerations are important, they are not directly related to preventing the specific side effect of gingival hyperplasia caused by Phenytoin.
4. A healthcare provider is reviewing the client's history before administering opioid pain medication. Which of the following conditions is a contraindication to opioid therapy?
- A. Asthma
- B. Renal failure
- C. Diabetes mellitus
- D. Obesity
Correct answer: B
Rationale: Renal failure is a contraindication to opioid therapy due to the risk of drug accumulation and toxicity. Asthma, diabetes mellitus, and obesity are not contraindications to opioid therapy. Asthma is a respiratory condition that can be managed alongside opioids, diabetes mellitus and obesity do not directly contraindicate opioid therapy.
5. A client with multiple sclerosis and dysphagia requires care. Which intervention should the nurse include in the plan?
- A. Position the client supine with the head of the bed flat.
- B. Have the client tuck their chin while swallowing.
- C. Provide the client with thickened liquids.
- D. Place the food on the unaffected side of the mouth.
Correct answer: C
Rationale: For clients with dysphagia, especially those with multiple sclerosis, thin liquids can increase the risk of aspiration. Thickened liquids are recommended to reduce the risk of aspiration and help with swallowing difficulties. Positioning the client supine with the head of the bed flat can further increase the risk of aspiration. Having the client tuck their chin while swallowing is a strategy used for some types of dysphagia but not specifically for multiple sclerosis-related dysphagia. Placing food on the unaffected side of the mouth does not address the swallowing difficulties associated with dysphagia.
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