ATI RN
Pathophysiology Final Exam
1. When educating a patient starting on oral contraceptives, what should the nurse include in the teaching plan regarding potential side effects?
- A. Weight gain, mood changes, and nausea
- B. Increased appetite, insomnia, and fatigue
- C. Breast tenderness, headaches, and dizziness
- D. Fatigue, hair loss, and joint pain
Correct answer: A
Rationale: The correct answer is A: Weight gain, mood changes, and nausea are common side effects of oral contraceptives. Weight gain may occur due to fluid retention or changes in metabolism. Mood changes can be caused by hormonal fluctuations. Nausea is a common side effect that usually improves after a few months of use. Choices B, C, and D are incorrect because they do not reflect common side effects associated with oral contraceptives. Increased appetite, insomnia, breast tenderness, headaches, dizziness, fatigue, hair loss, and joint pain are not typically reported side effects of oral contraceptives.
2. While assessing a critically ill client in the emergency department, the nurse notes on the cardiac monitor an R-on-T premature ventricular beat that develops into ventricular tachycardia (VT). Immediately, the client became unresponsive. The nurse knows that based on pathophysiologic principles, the most likely cause of the unresponsiveness is:
- A. metabolic acidosis that occurs spontaneously following any dysrhythmias.
- B. interruption of the blood/oxygen supply to the brain.
- C. massive cerebrovascular accident (CVA) resulting from increased perfusion.
- D. a blood clot coming from the heart and occluding the carotid arteries.
Correct answer: B
Rationale: The correct answer is B. Ventricular tachycardia (VT) can disrupt the normal heart function, leading to a decreased cardiac output. This decreased output can interrupt the blood supply to the brain, causing the client to become unresponsive. Metabolic acidosis (Choice A) is not the most likely cause of unresponsiveness in this scenario. A massive cerebrovascular accident (CVA) (Choice C) would not result from increased perfusion. A blood clot occluding the carotid arteries (Choice D) may lead to a stroke but is not the most likely cause of sudden unresponsiveness in this situation.
3. A patient is taking medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse teach the patient about this medication?
- A. Medroxyprogesterone should be taken with food to prevent nausea.
- B. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels.
- C. Medroxyprogesterone can be taken intermittently when symptoms worsen.
- D. Medroxyprogesterone should be stopped if side effects occur.
Correct answer: B
Rationale: The correct answer is B. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels and effectiveness. Choice A is incorrect because medroxyprogesterone does not necessarily need to be taken with food. Choice C is incorrect as it is typically prescribed continuously rather than intermittently. Choice D is incorrect because patients should not stop the medication if side effects occur without consulting their healthcare provider.
4. An adult patient has begun treatment with fluconazole. The nurse should recognize the need to likely discontinue the drug if the patient develops which of the following signs or symptoms?
- A. Jaundice
- B. Weight gain
- C. Iron deficiency anemia
- D. Hematuria
Correct answer: A
Rationale: The correct answer is A: Jaundice. Fluconazole, an antifungal medication, can rarely cause hepatotoxicity, which may manifest as jaundice. Monitoring for signs of liver dysfunction, such as jaundice, is crucial during fluconazole therapy. Weight gain, iron deficiency anemia, and hematuria are not commonly associated with fluconazole use and are not indications for discontinuing the drug.
5. A patient who is being administered isoniazid (INH) for tuberculosis has a yellow color in the sclera of her eye. What other finding would lead you to believe that hepatotoxicity has developed?
- A. Diarrhea
- B. Numbness
- C. Diminished vision
- D. Light-colored stools
Correct answer: A
Rationale: The correct answer is A: Diarrhea. Hepatotoxicity caused by isoniazid can present with various symptoms, including yellow discoloration of the sclera of the eyes, which indicates jaundice. Another common sign of hepatotoxicity is gastrointestinal symptoms such as nausea, vomiting, and diarrhea, which can occur due to liver dysfunction affecting bile production and digestion. Numbness (choice B) is more commonly associated with peripheral neuropathy caused by isoniazid, while diminished vision (choice C) and light-colored stools (choice D) are not typical manifestations of hepatotoxicity.
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