ATI RN
ATI Pathophysiology
1. A male patient with erectile dysfunction has asked for a prescription for sildenafil (Viagra). Before giving this medication, the nurse should assess for which of the following conditions?
- A. History of peptic ulcer disease
- B. Use of nitrates
- C. Recent history of a stroke
- D. History of hypertension
Correct answer: B
Rationale: The correct answer is B: Use of nitrates. Sildenafil should not be used by patients taking nitrates due to the risk of severe hypotension. Nitrates can potentiate the hypotensive effects of sildenafil, leading to a significant drop in blood pressure. Assessing for the use of nitrates is crucial to avoid this potentially dangerous interaction. Choices A, C, and D are incorrect because they are not specifically contraindications for the use of sildenafil. While a history of hypertension should be considered, it is not as critical as the use of nitrates when prescribing sildenafil.
2. A patient is prescribed dutasteride (Avodart) for benign prostatic hyperplasia (BPH). What outcome should the nurse expect to observe if the drug is having the desired effect?
- A. Decreased size of the prostate gland
- B. Increased urinary output
- C. Increased urine flow
- D. Decreased blood pressure
Correct answer: A
Rationale: The correct answer is A: Decreased size of the prostate gland. Dutasteride is a medication used for BPH to reduce the size of the prostate gland, thereby improving urinary flow and decreasing symptoms. Choice B, increased urinary output, is incorrect as dutasteride primarily targets the size of the prostate gland rather than directly affecting urinary output. Choice C, increased urine flow, is related to the expected outcome of dutasteride therapy but is not as direct as the reduction in the size of the prostate gland. Choice D, decreased blood pressure, is not an expected outcome of dutasteride therapy for BPH.
3. What important instruction should the nurse provide regarding the application of testosterone gel in a patient with hypogonadism?
- A. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
- B. Apply the gel to the face and neck for maximum absorption.
- C. Apply the gel to the genitals for improved results.
- D. Apply the gel to the scalp and back for better results.
Correct answer: A
Rationale: The correct instruction for applying testosterone gel in a patient with hypogonadism is to apply it to the chest or upper arms and allow it to dry completely before dressing. This method helps avoid transfer to others. Applying the gel to the face, neck, or genitals is not recommended as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp and back is not a standard or effective route of administration for testosterone gel. Therefore, choice A is the correct answer as it ensures proper application and safety.
4. A woman is being treated with clomiphene citrate for the treatment of infertility. She states to the nurse that she has seen an increase in vaginal discharge. The nurse knows that this effect is related to:
- A. Increased blood flow to the vaginal area.
- B. Increased cervical mucus production.
- C. Increased production of vaginal secretions.
- D. Increased lubrication in the vaginal canal.
Correct answer: C
Rationale: The correct answer is C: 'Increased production of vaginal secretions.' Clomiphene citrate affects cervical mucus production, leading to an increase in vaginal secretions. This effect is beneficial for fertility as it helps create a more hospitable environment for sperm transport. Choice A, 'Increased blood flow to the vaginal area,' is incorrect as the increase in vaginal discharge is primarily due to changes in cervical mucus. Choice B, 'Increased cervical mucus production,' is partially correct but does not fully explain the increase in vaginal secretions. Choice D, 'Increased lubrication in the vaginal canal,' is not directly related to the effect seen with clomiphene citrate treatment for infertility.
5. A client with a pneumothorax is receiving oxygen therapy. Which assessment finding would indicate that the treatment is effective?
- A. Increased respiratory rate
- B. Decreased oxygen saturation levels
- C. Improved breath sounds on the affected side
- D. Increased dyspnea and chest pain
Correct answer: C
Rationale: In a client with a pneumothorax receiving oxygen therapy, improved breath sounds on the affected side would indicate effective treatment. This finding suggests that the collapsed lung is re-expanding, allowing air to flow more freely in and out of the affected area. Choices A, B, and D are incorrect: Increased respiratory rate, decreased oxygen saturation levels, and increased dyspnea and chest pain are signs of ineffective treatment or worsening of the condition in a client with a pneumothorax.
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