ATI RN
Pathophysiology Practice Questions
1. A patient is diagnosed with type 2 diabetes mellitus. Which of the following is a common initial treatment strategy?
- A. Insulin therapy
- B. Lifestyle modification and metformin
- C. Sulfonylureas
- D. Thiazolidinediones
Correct answer: B
Rationale: The correct answer is B: Lifestyle modification and metformin. When managing type 2 diabetes mellitus, initial treatment often involves lifestyle changes such as adopting a healthy diet and increasing physical activity, along with the oral medication metformin. Insulin therapy (choice A) is usually reserved for cases where lifestyle changes and oral medications are not sufficient to control blood sugar levels. Sulfonylureas (choice C) and thiazolidinediones (choice D) are also oral medications used in diabetes management, but they are not typically recommended as first-line treatments due to various side effects and considerations in type 2 diabetes management.
2. The nurse should plan to implement which intervention in the care of a client experiencing neutropenia as a result of chemotherapy?
- A. Restrict all visitors.
- B. Restrict fluid intake.
- C. Teach the client and family about the need for hand hygiene.
- D. Insert an indwelling urinary catheter to prevent skin breakdown.
Correct answer: C
Rationale: In clients experiencing neutropenia, particularly due to chemotherapy, the immune system is significantly compromised, increasing the risk of infections. Hand hygiene is one of the most effective methods for preventing the spread of pathogens that can lead to infections. Teaching both the client and their family about the importance of frequent and proper handwashing helps create a safer environment and reduces the risk of infections, which can be critical in neutropenic patients.
3. A staff nurse is working with a patient who is on a critical pathway for education in preparation for home care. Which one of the following responsibilities would the nurse address first?
- A. Taking vital signs
- B. Answering the client's questions
- C. Evaluating client teaching
- D. Reviewing the information with the client and family
Correct answer: D
Rationale: The correct answer is D. Reviewing the information with the client and family should be addressed first. This step involves ensuring that the client and family fully understand the information provided, which is crucial before proceeding with any other responsibilities. Taking vital signs (choice A) is important but not the priority in this scenario. Answering the client's questions (choice B) and evaluating client teaching (choice C) can come after reviewing the information to ensure effective communication and understanding.
4. Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse would determine that this medication has had a therapeutic effect if which of the following is noted?
- A. Increased red blood cell count
- B. Decreased serum ammonia level
- C. Increased protein level
- D. Decreased white blood cell level
Correct answer: B
Rationale: Lactulose is prescribed for the client with hepatic encephalopathy to reduce bacterial breakdown of protein in the bowel. The medication creates an acidic environment in the bowel and causes the ammonia to leave the bloodstream and enter the colon. Ammonia then becomes trapped in the bowel. Lactulose also has a laxative effect that allows for the elimination of the ammonia.
5. The nurse is conducting discharge teaching with the parent of a 7-year-old child with minimal change nephrotic syndrome (MCNS). What statement by the parent indicates a correct understanding of the teaching?
- A. My child needs to stay home from school for at least 1 more month.
- B. I should not add additional salt to any of my child's meals.
- C. My child will not be able to participate in contact sports while receiving corticosteroid therapy.
- D. I should measure my child's urine after each void and report the 24-hour amount to the healthcare provider.
Correct answer: B
Rationale: Avoiding additional salt is crucial to help manage edema in children with MCNS. While monitoring urine output is important, the other statements either misinterpret the need for prolonged school absence or misunderstand the risk associated with contact sports during steroid therapy.
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