ATI RN
ATI Pathophysiology
1. A patient is starting on oral contraceptives. What should the nurse emphasize about the importance of taking the medication at the same time each day?
- A. Taking the medication at the same time each day helps maintain stable hormone levels and ensures effectiveness.
- B. Taking the medication at the same time each day reduces the risk of breakthrough bleeding.
- C. Taking the medication at the same time each day ensures consistent absorption and effectiveness.
- D. Taking the medication at the same time each day is important, but missing a dose occasionally is not a concern.
Correct answer: A
Rationale: The correct answer is A. Taking oral contraceptives at the same time each day helps maintain stable hormone levels and ensures their effectiveness in preventing pregnancy. Choice B is incorrect because the primary emphasis of consistent timing is on hormone levels and effectiveness, not on reducing breakthrough bleeding. Choice C is incorrect because while consistent absorption is a factor, the main focus is on maintaining stable hormone levels. Choice D is incorrect as missing doses can significantly impact contraceptive efficacy.
2. During an assessment of the respiratory pattern of an older adult client receiving end-of-life care, which of the following assessment findings should the nurse identify as Cheyne-Stokes respirations?
- A. Breathing ranging from very deep to very shallow with periods of apnea
- B. Shallow to normal breaths alternating with periods of apnea
- C. Rapid respirations that are unusually deep and regular
- D. An inability to breathe without dyspnea unless sitting upright
Correct answer: Breathing ranging from very deep to very shallow with periods of apnea
Rationale: Cheyne-Stokes respirations are characterized by a pattern of breathing that ranges from very deep to very shallow with periods of apnea (temporary cessation of breathing). This pattern is often seen in clients near the end of life or with certain medical conditions affecting the respiratory control center in the brain. The alternating deep and shallow breaths can be distressing for both the client and caregivers. It is crucial for the nurse to recognize this pattern to provide appropriate care and support to the client and their family during this challenging time.
3. A 40-year-old man has been living with HIV for several years but experienced a significant decrease in his CD4+ levels a few months ago. The patient has just been diagnosed with Mycobacterium avium complex disease. The nurse should anticipate administering which of the following medications?
- A. Clarithromycin
- B. Pyrazinamide
- C. Rifapentine (Priftin)
- D. Azithromycin
Correct answer: A
Rationale: The correct answer is A: Clarithromycin. In the case of Mycobacterium avium complex disease, a common treatment regimen includes a macrolide antibiotic like clarithromycin or azithromycin in combination with other antimicrobials. Clarithromycin is a key component of the treatment due to its effectiveness against Mycobacterium avium complex. Choice B (Pyrazinamide) is not typically part of the standard treatment for this condition. Choice C (Rifapentine) is mainly used in tuberculosis treatment and is not a primary agent for Mycobacterium avium complex disease. Choice D (Azithromycin) is another suitable macrolide antibiotic for treating Mycobacterium avium complex disease but is not the medication typically used first-line.
4. A client with angina is being taught how to use nitroglycerin transdermal ointment. Which instruction should the nurse include?
- A. Remove the prior dose before applying a new dose.
- B. Rub the ointment directly into the skin until it is no longer visible.
- C. Cover the applied ointment with a clean gauze pad.
- D. Apply the ointment to the same skin area each time.
Correct answer: A
Rationale: The correct instruction is to remove the prior dose before applying a new one to prevent toxicity. Nitroglycerin ointment can cause adverse effects if accumulated doses are not removed. Rubbing the ointment until it's not visible or covering it with gauze may alter absorption. Applying it to the same area each time can lead to skin irritation or desensitization.
5. When assessing a patient experiencing breakthrough bleeding while taking oral contraceptives, what should the nurse consider?
- A. The possibility of pregnancy
- B. The patient's adherence to the medication schedule
- C. The need for an increased dosage
- D. The effectiveness of the current oral contraceptive
Correct answer: B
Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, it is crucial for the nurse to consider the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of missed doses or inconsistent use, which can decrease the effectiveness of the oral contraceptive. Considering the possibility of pregnancy (Choice A) is important but secondary to assessing adherence. The need for an increased dosage (Choice C) is not typically the first consideration for breakthrough bleeding. Evaluating the effectiveness of the current oral contraceptive (Choice D) is relevant but should come after assessing adherence to the medication schedule.
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