ATI RN
ATI Pathophysiology Final Exam
1. What potential risk should the nurse identify as being associated with infliximab (Remicade) in the treatment of rheumatoid arthritis?
- A. Risk for infection
- B. Risk for decreased level of consciousness
- C. Risk for nephrotoxicity
- D. Risk for hepatotoxicity
Correct answer: A
Rationale: The correct answer is A: Risk for infection. Infliximab (Remicade) is a medication used to treat autoimmune conditions like rheumatoid arthritis. One of the main risks associated with infliximab is an increased susceptibility to infections due to its immunosuppressive effects. This drug works by targeting specific proteins in the body's immune system, which can weaken the body's ability to fight off infections. Choices B, C, and D are incorrect because infliximab is not typically associated with decreased level of consciousness, nephrotoxicity, or hepatotoxicity. It is important for healthcare providers to monitor patients on infliximab for signs of infection and educate them on the importance of infection prevention strategies.
2. Which nursing action is developmentally appropriate when caring for a hospitalized school-age child?
- A. Providing brochures regarding sexuality
- B. Giving clear instructions about details of treatment
- C. Offering medical equipment to play with prior to a procedure
- D. Using toys for distraction during a painful procedure
Correct answer: C
Rationale: Offering medical equipment to play with prior to a procedure is developmentally appropriate when caring for a hospitalized school-age child. Allowing the child to familiarize themselves with the equipment helps reduce fear and anxiety about the upcoming procedure. Choices A, B, and D are not as appropriate for a school-age child. Providing brochures regarding sexuality is not developmentally appropriate for this age group. Giving clear instructions about treatment details may overwhelm a child of this age. Using toys for distraction during a painful procedure is more suitable for younger children.
3. A client is receiving a new prescription for enoxaparin. Which of the following instructions should the nurse include?
- A. Rub the injection site after administration.
- B. Pinch the skin while administering the injection.
- C. Aspirate before administering the medication.
- D. Avoid taking aspirin while using this medication.
Correct answer: D
Rationale: The correct answer is D: 'Avoid taking aspirin while using this medication.' Enoxaparin is an anticoagulant medication, and taking aspirin concurrently can increase the risk of bleeding. Choices A, B, and C are incorrect. A nurse should not instruct the client to rub the injection site after administration as it may cause irritation. Pinching the skin while administering the injection is not recommended for enoxaparin injections. Aspirating before administering the medication is also unnecessary as enoxaparin is administered subcutaneously, not intramuscularly.
4. Which statement by the patient indicates a need for additional instruction in administering insulin?
- A. 'I need to rotate injection sites among my arms, legs, and abdomen each day.'
- B. 'I can buy the 0.5 mL syringes because the line markings will be easier to see.'
- C. 'I should draw up the regular insulin first after injecting air into the NPH bottle.'
- D. 'I do not need to aspirate the plunger to check for blood before injecting insulin.'
Correct answer: A
Rationale: This statement indicates a need for additional instruction because while site rotation is essential, it's important to rotate sites within the same anatomical region (such as staying within the abdomen for several injections before moving to a different region). Rotating too frequently between different regions can cause inconsistent insulin absorption, which can affect blood sugar control.
5. A client has been on levothyroxine therapy for several months. Which of the following findings indicates a therapeutic response to the medication?
- A. Decrease in level of thyroxine (T4)
- B. Increase in weight
- C. Increase in hours of sleep per night
- D. Decrease in level of thyroid stimulating hormone (TSH)
Correct answer: D
Rationale: A therapeutic response to levothyroxine is indicated by a decrease in the level of TSH. This decrease signifies that the body requires less stimulation to produce thyroid hormone, reflecting a normalization of thyroid function due to the medication's effectiveness. Choices A, B, and C are incorrect as an increase in T4 levels, weight gain, and increased sleep hours are not indicative of a therapeutic response to levothyroxine therapy.
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