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. A patient taking hormonal contraceptives will soon turn 35 years of age. She is moderately obese and has smoked for 15 years. Which of the following is most important?
- A. Begin an exercise regimen.
- B. Begin smoking cessation.
- C. Begin daily aspirin therapy.
- D. Begin taking a loop diuretic to aid weight loss.
Correct answer: B
Rationale: The most important action for a patient taking hormonal contraceptives, who is nearing 35 years of age, moderately obese, and has a history of smoking for 15 years, is to begin smoking cessation. Women over 35, especially smokers, are at an increased risk of blood clots and cardiovascular issues when using hormonal contraceptives. Smoking cessation is crucial to reduce this risk. Beginning an exercise regimen may be beneficial for overall health but is not as critical as stopping smoking in this scenario. Daily aspirin therapy or taking a loop diuretic are not indicated in this situation and may not address the primary risk associated with hormonal contraceptives and smoking.
3. In a patient with a subconjunctival hemorrhage due to allergic rhinitis, which statement is accurate?
- A. The hemorrhage will resolve without treatment within 2 weeks.
- B. The patient should be referred for immediate ophthalmologic examination.
- C. Oral antihistamines should be started to prevent further complications.
- D. Topical corticosteroids may be considered to reduce inflammation.
Correct answer: A
Rationale: In a patient with a subconjunctival hemorrhage secondary to allergic rhinitis, the hemorrhage is typically self-limiting and will resolve on its own within 2 weeks without the need for specific treatment. Referring the patient for immediate ophthalmologic examination is not necessary unless there are other concerning symptoms. Starting oral antihistamines may help manage the underlying allergic rhinitis but is not specifically indicated for the hemorrhage. Topical corticosteroids are not routinely prescribed for subconjunctival hemorrhage as they may have limited benefit and could potentially cause complications.
4. A patient is prescribed zanamivir (Relenza) to treat influenza B. The patient has a history of asthma. For which of the following symptoms should the nurse assess?
- A. Bradycardia
- B. Pneumonia
- C. Bronchospasm
- D. Pulmonary embolism
Correct answer: C
Rationale: The correct answer is C: Bronchospasm. Zanamivir (Relenza) is an inhaled medication used to treat influenza by reducing the severity and duration of symptoms. Patients with a history of asthma are at risk of bronchospasm as a potential side effect of zanamivir. Assessing for bronchospasm is crucial in this case to ensure the patient's safety and well-being. Choices A, B, and D are incorrect. Bradycardia, pneumonia, and pulmonary embolism are not commonly associated with zanamivir use in the treatment of influenza B, especially in a patient with a history of asthma.
5. What should the nurse assess in a patient experiencing breakthrough bleeding while taking oral contraceptives?
- A. Adherence to the medication schedule
- B. The possibility of pregnancy
- C. The need for an increased dosage
- D. The effectiveness of the current oral contraceptive
Correct answer: A
Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of non-adherence, potentially reducing the effectiveness of the contraceptives. Assessing the adherence to the schedule helps in determining if the medication is being taken correctly. The possibility of pregnancy (choice B) is less likely if the patient has been taking the contraceptives as prescribed. Increasing the dosage (choice C) without assessing adherence first can lead to unnecessary medication adjustments. Evaluating the effectiveness of the current oral contraceptive (choice D) comes after assessing adherence to the schedule.
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