ATI RN
ATI Pathophysiology
1. What specific instructions should the nurse provide for a patient starting on alendronate (Fosamax) for osteoporosis to ensure proper administration?
- A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
- B. Take the medication with milk to enhance calcium absorption.
- C. Take the medication at bedtime to ensure absorption during sleep.
- D. Take the medication with food to prevent nausea.
Correct answer: A
Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because alendronate should not be taken with milk, as it can interfere with its absorption. Choice C is incorrect as there is no specific instruction to take alendronate at bedtime. Choice D is incorrect because alendronate should be taken on an empty stomach, not with food, to enhance absorption.
2. While a patient is receiving IV doxorubicin hydrochloride for the treatment of cancer, the nurse observes swelling and pain at the IV site. The nurse should prioritize what action?
- A. Stopping the administration of the drug immediately
- B. Notifying the patient's physician
- C. Continuing the infusion but decreasing the rate
- D. Applying a warm compress to the infusion site
Correct answer: A
Rationale: The correct action for the nurse to take when observing swelling and pain at the IV site during the administration of doxorubicin hydrochloride is to stop the administration of the drug immediately. Doxorubicin hydrochloride can cause severe tissue damage, so discontinuing the infusion is crucial to prevent further harm to the patient. Notifying the physician is important, but it should not take precedence over stopping the drug. Continuing the infusion, even at a decreased rate, can exacerbate tissue damage. Applying a warm compress is not appropriate in this situation and may worsen the tissue injury caused by the drug.
3. Which lab test is used to assess renal function?
- A. Check blood glucose levels
- B. Monitor serum creatinine
- C. Monitor BUN
- D. Check electrolyte levels
Correct answer: B
Rationale: The correct answer is B: Monitor serum creatinine. Serum creatinine is a key indicator of renal function as it reflects the glomerular filtration rate. An increase in serum creatinine levels indicates impaired kidney function. Checking blood glucose levels (choice A) is not specific to assessing renal function but is used to diagnose diabetes. Monitoring BUN (choice C) is important but not as specific as serum creatinine in assessing renal function. Checking electrolyte levels (choice D) is essential in assessing kidney function but is not as specific as monitoring serum creatinine.
4. If bleeding continues after delivery of the placenta using management, the FIRST thing you should do is call for help and:
- A. Massage the uterus
- B. Insert a urinary catheter
- C. Start an IV
- D. Check the placenta to ensure completeness
Correct answer: A
Rationale: In postpartum hemorrhage, massaging the uterus is the initial step to promote uterine contractions, which can help control bleeding by compressing the blood vessels. This action can help prevent further blood loss and stabilize the patient's condition. Calling for help is essential to ensure timely assistance, but taking immediate action by massaging the uterus is crucial in managing postpartum bleeding.
5. Abrupt withdrawal or discontinuation of prednisone can cause:
- A. adrenal crisis.
- B. hypercortisolism.
- C. ACTH stimulation.
- D. thyroid crisis.
Correct answer: A
Rationale: The correct answer is A: adrenal crisis. Abrupt discontinuation of prednisone can lead to adrenal insufficiency, resulting in adrenal crisis. Prednisone is a corticosteroid that suppresses the adrenal glands' ability to produce cortisol. Abrupt withdrawal can cause a sudden drop in cortisol levels, leading to adrenal crisis with symptoms like fatigue, weakness, abdominal pain, and potentially life-threatening low blood pressure. Choices B, C, and D are incorrect because hypercortisolism refers to excess cortisol levels, ACTH stimulation would not result from prednisone withdrawal, and thyroid crisis is not directly related to corticosteroid discontinuation.
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