a patient is receiving intravenous amphotericin which of the following assessments warrants the discontinuation of the antifungal agent

ATI RN

ATI Pathophysiology Test Bank

1. A patient is receiving intravenous amphotericin. Which of the following assessments warrants the discontinuation of the antifungal agent?

A. Sodium level of 138 mEq/L
B. Hematocrit of 39%
C. Blood urea nitrogen of 60 mg/dL
D. AST level of 10 Unit/L

Correct answer: C

Rationale: Intravenous amphotericin can cause nephrotoxicity, leading to increased blood urea nitrogen levels. Elevated blood urea nitrogen (BUN) indicates impaired renal function, which is a known adverse effect of amphotericin. Therefore, a BUN level of 60 mg/dL warrants the discontinuation of the antifungal agent. The other options, such as a sodium level of 138 mEq/L, hematocrit of 39%, and AST level of 10 Unit/L, are within normal ranges and not indicative of the need to discontinue amphotericin therapy.

2. The early stages of atheroma development are characterized by:

A. macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima
B. accumulation of lipids in the intima (i.e., fatty streak)
C. accumulation of proteins such as collagen and elastin (i.e., fibrous cap)
D. development of calcium and a necrotic lipid core

Correct answer: A

Rationale: The correct answer is A. In the early stages of atheroma development, macrophages accumulate oxidized low-density lipoprotein (LDL) and transform into foam cells, leading to the formation of fatty streaks in the intima of blood vessels. This process is a hallmark of the initial stages of atherosclerosis. Choice B is incorrect as it describes the accumulation of lipids in the intima, which is a later event following foam cell formation. Choice C is also incorrect as it refers to the accumulation of proteins forming the fibrous cap, which occurs at a later stage to stabilize the atheroma. Choice D is incorrect as it describes the development of calcium and a necrotic lipid core, typically seen in advanced atherosclerosis rather than the early stages.

3. What is a cause of the crystallization within the synovial fluid of the joint affected by gouty arthritis?

A. Destruction of proteoglycans
B. Underexcretion of uric acid
C. Overexcretion of uric acid
D. Increased absorption of uric acid

Correct answer: B

Rationale: The correct answer is B: Underexcretion of uric acid. Gouty arthritis is primarily caused by the underexcretion of uric acid, leading to its accumulation in joints and subsequent crystallization. Choices A, C, and D are incorrect as they do not directly relate to the pathophysiology of gout. Destruction of proteoglycans, overexcretion of uric acid, and increased absorption of uric acid are not primary causes of gouty arthritis.

4. A patient is being treated with raloxifene (Evista) for osteoporosis. What should the nurse teach the patient about this medication?

A. It is used as a selective estrogen receptor modulator to prevent bone loss.
B. It works by decreasing bone formation and increasing bone resorption.
C. It should be taken with food to reduce gastrointestinal side effects.
D. It may cause weight gain and fluid retention.

Correct answer: C

Rationale: The correct answer is C. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent bone loss. It should be taken with food to reduce gastrointestinal side effects, not on an empty stomach. Choices A and B are incorrect because raloxifene is indeed a SERM that prevents bone loss, but it does not directly work by increasing bone formation or decreasing bone resorption. Choice D is incorrect as weight gain and fluid retention are not common side effects of raloxifene.

5. Cellular swelling is:

A. Irreversible
B. Evident early in all types of cellular injury
C. Manifested by decreased intracellular sodium
D. None of the above is correct

Correct answer: B

Rationale: Cellular swelling is indeed evident early in all types of cellular injury. This occurs due to the influx of water into the cell, leading to swelling. Choice A is incorrect because cellular swelling is reversible if the injury is not severe. Choice C is incorrect because cellular swelling is not manifested by decreased intracellular sodium; in fact, it is associated with increased intracellular sodium due to water influx. Choice D is incorrect as option B is the correct statement.