ATI RN
ATI Pathophysiology Quizlet
1. A patient has been prescribed raloxifene (Evista) for the prevention of osteoporosis. What effect should the nurse include in the teaching plan regarding the action of this medication?
- A. Decreases calcium excretion by the kidneys.
- B. Increases intestinal absorption of calcium.
- C. Stimulates bone formation by increasing osteoblast activity.
- D. Selectively binds to estrogen receptors, decreasing bone resorption.
Correct answer: D
Rationale: The correct answer is D: Selectively binds to estrogen receptors, decreasing bone resorption. Raloxifene is a selective estrogen receptor modulator (SERM) that works by binding to estrogen receptors, thereby decreasing bone resorption. This action helps in the prevention and treatment of osteoporosis by preserving bone density. Choices A, B, and C are incorrect because raloxifene does not directly affect calcium excretion by the kidneys, intestinal absorption of calcium, or stimulate bone formation by increasing osteoblast activity.
2. A healthcare professional is documenting the recent vital signs for several clients on an acute medical ward of a hospital. Which hospital client with a noninfectious diagnosis would be most likely to have a fever?
- A. A 71-year-old female with limited mobility, chronic obstructive pulmonary disease (COPD), and vascular dementia
- B. A 33-year-old female with a postoperative deep vein thrombosis and pulmonary embolism
- C. A 51-year-old obese male with hepatic encephalopathy secondary to alcohol abuse
- D. A 71-year-old male with congestive heart failure and peripheral edema
Correct answer: B
Rationale: The correct answer is B. Pulmonary emboli can produce fever even without infection. This is known as a noninfectious cause of fever. Choices A, C, and D do not typically present with fever as a prominent symptom. Limited mobility, COPD, vascular dementia, hepatic encephalopathy, alcohol abuse, congestive heart failure, and peripheral edema are not directly associated with causing fever in the absence of infection, unlike pulmonary embolism.
3. A nurse is providing care for a 44-year-old male client who is admitted with a diagnosis of fever of unknown origin (FUO). Which characteristic of the client's history is most likely to have a bearing on his current diagnosis?
- A. The client is a smoker.
- B. The client has a history of IV drug use.
- C. The client was treated for an STD 2 years ago.
- D. The client has a family history of cardiac disease.
Correct answer: B
Rationale: A history of IV drug use is significant in cases of fever of unknown origin, as it increases the risk of infections like endocarditis, which can present with persistent fever. Smoking (Choice A) is not directly linked to FUO. While a history of STD treatment (Choice C) may be relevant, it is less likely to be associated with FUO compared to IV drug use. Family history of cardiac disease (Choice D) is not typically a primary factor in the diagnosis of FUO.
4. A female patient is taking combined hormonal contraceptives to prevent pregnancy. She visits the gynecology clinic and is noted to have a blood pressure of 176/102 mm Hg. The patient is started on enalapril mesylate 10 mg. In collaboration with the primary care provider, what other patient teaching should be provided based on her current medication regimen?
- A. Instruct on a low-salt diet.
- B. Instruct to discontinue the contraceptives.
- C. Instruct on the use of relaxation techniques to decrease stress.
- D. Instruct on the rationale for increasing the contraceptive dose.
Correct answer: A
Rationale: Women on hormonal contraceptives and antihypertensives like enalapril should be counseled to adopt a low-salt diet if severe hypertension occurs. This dietary modification can help in managing blood pressure levels. Instructing to discontinue the contraceptives is crucial in cases of severe hypertension as it poses an increased risk of cardiovascular events. Instructing on relaxation techniques may have some benefits in reducing stress levels but addressing the root cause, such as discontinuing contraceptives in this scenario, is more critical. There is no rationale for increasing the contraceptive dose when hypertension is present; in fact, it should be stopped to prevent complications.
5. A patient is starting on alendronate (Fosamax) for osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?
- A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
- B. Take the medication at bedtime to ensure absorption during sleep.
- C. Take the medication with milk to enhance calcium absorption.
- D. Take the medication with food to prevent gastrointestinal upset.
Correct answer: A
Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because taking alendronate at bedtime can increase the risk of esophageal irritation due to lying down. Choice C is incorrect as taking alendronate with milk can reduce its absorption. Choice D is incorrect because alendronate should be taken on an empty stomach to enhance its effectiveness.
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