ATI RN
Final Exam Pathophysiology
1. A patient is being educated about the use of raloxifene (Evista) for osteoporosis. What is the primary therapeutic action of this medication?
- A. It stimulates the formation of new bone.
- B. It decreases bone resorption and increases bone density.
- C. It increases the excretion of calcium through the kidneys.
- D. It increases calcium absorption in the intestines.
Correct answer: B
Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption, which is the breakdown of bone, and increasing bone density. This action helps in preventing bone loss and maintaining bone strength. Choice A is incorrect because raloxifene does not stimulate the formation of new bone but rather prevents its breakdown. Choice C is incorrect as raloxifene does not increase the excretion of calcium but rather helps in maintaining calcium levels in the bones. Choice D is also incorrect as raloxifene does not directly increase calcium absorption in the intestines.
2. Which of the following is a characteristic of a well-written goal?
- A. Goals should be vague
- B. Goals should be unrealistic
- C. Goals need to be measurable, realistic, and achievable
- D. Goals should be easy to achieve
Correct answer: C
Rationale: The correct answer is C: Goals need to be measurable, realistic, and achievable. Well-written goals should be specific and quantifiable to provide clear direction and motivation. Choice A is incorrect as goals should not be vague but rather specific. Choice B is incorrect as goals should be realistic to be attainable. Choice D is incorrect as goals should challenge individuals and not be too easy to achieve to promote growth and development.
3. A woman has been prescribed Climara, a transdermal estradiol patch. Which of the following should she be instructed by the nurse regarding the administration?
- A. Avoid prolonged sun exposure at the patch site due to increased plasma concentrations.
- B. The application of heat at the patch site will decrease effectiveness and result in pregnancy.
- C. The medication, when exposed to sunlight, can increase the risk of breast cancer.
- D. Exposure of the medication to occasional cold will increase effectiveness with application.
Correct answer: A
Rationale: The correct answer is A. The Climara patch delivers estradiol transdermally, and patients should be instructed to avoid prolonged sun exposure at the patch site due to increased plasma concentrations. Sun exposure can accelerate the absorption of the medication, leading to higher systemic levels than intended. Choices B, C, and D are incorrect because heat at the patch site does not result in pregnancy but may alter absorption rates, there is no direct link between sunlight exposure and breast cancer risk related to this medication, and exposure to cold does not increase effectiveness of the transdermal patch.
4. When starting therapy with doxorubicin, which of the following findings should the nurse instruct the client to report?
- A. Hair loss
- B. Fatigue
- C. Sore throat
- D. Red urine
Correct answer: C
Rationale: The nurse should instruct the client to report a sore throat because it can indicate an infection due to the immunosuppressive effects of doxorubicin. Doxorubicin is known to suppress the immune system, making patients more susceptible to infections. Monitoring and reporting early signs of infection, such as a sore throat, are essential to prevent complications. Hair loss and fatigue are common side effects of doxorubicin but do not typically indicate immediate concerns for infection. Red urine is a known side effect of doxorubicin but is not a priority over potentially serious infections that can arise.
5. A nurse is caring for a client who has a history of angina. The client reports chest pain. Which of the following actions should the nurse take?
- A. Administer sublingual nitroglycerin every 5 minutes
- B. Administer aspirin 325 mg
- C. Encourage the client to use deep breathing exercises
- D. Apply oxygen at 2 L/min via nasal cannula
Correct answer: A
Rationale: The correct action for the nurse to take when a client with a history of angina reports chest pain is to administer sublingual nitroglycerin every 5 minutes. Nitroglycerin helps dilate blood vessels, improving blood flow to the heart and relieving chest pain associated with angina. Aspirin is often given during a suspected heart attack, not for immediate relief of angina. Deep breathing exercises may be beneficial for anxiety or respiratory conditions but are not the first-line intervention for angina. Oxygen therapy is not the initial treatment for angina unless the client is hypoxic.
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