ATI RN
Pathophysiology Final Exam
1. A patient with erectile dysfunction is prescribed sildenafil (Viagra). What condition would contraindicate the use of this medication?
- A. History of hypertension
- B. Use of nitrates
- C. Recent use of antihypertensive medications
- D. History of peptic ulcer disease
Correct answer: B
Rationale: The correct answer is B: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of hypertension, recent use of antihypertensive medications, or a history of peptic ulcer disease are not direct contraindications for using sildenafil.
2. In a patient with renal failure secondary to an overdose of a nephrotoxic drug, which assessment findings would the nurse recognize as being most suggestive of impaired erythropoiesis?
- A. Frequent infections and low neutrophil levels
- B. Fatigue and increased heart rate
- C. Agitation and changes in cognition
- D. Increased blood pressure and peripheral edema
Correct answer: A
Rationale: Impaired erythropoiesis refers to a decreased production of red blood cells. This can lead to anemia, resulting in symptoms like fatigue and increased heart rate (Choice B). However, the question specifically asks about assessment findings suggestive of impaired erythropoiesis. In this context, frequent infections and low neutrophil levels (Choice A) are more directly related to impaired erythropoiesis due to the impact of anemia on the immune system. Frequent infections are common in anemia due to a compromised immune response, and low neutrophil levels can be seen in conditions of impaired erythropoiesis. Agitation and changes in cognition (Choice C) are more indicative of neurological issues, while increased blood pressure and peripheral edema (Choice D) are commonly associated with renal failure but not specifically related to impaired erythropoiesis.
3. A patient has been prescribed clomiphene citrate (Clomid) for infertility. What should the nurse include in the teaching plan about the use of this medication?
- A. Clomiphene is taken daily for 5 days at the beginning of the menstrual cycle.
- B. Clomiphene is taken once daily throughout the menstrual cycle.
- C. Clomiphene is taken twice daily for 5 days at the end of the menstrual cycle.
- D. Clomiphene is taken three times daily for 10 days at the beginning of the menstrual cycle.
Correct answer: A
Rationale: Corrected Rationale: Clomiphene is typically taken daily for 5 days at the beginning of the menstrual cycle to stimulate ovulation. Choice A is the correct answer because it aligns with the standard dosing regimen for clomiphene citrate. Choices B, C, and D provide incorrect information about the dosing schedule for clomiphene, which can lead to ineffective treatment and potential side effects. Choice B suggests continuous daily intake, which is not the standard practice for clomiphene. Choice C and D mention different dosing frequencies and timings, which are not in line with the typical protocol for using clomiphene for infertility.
4. What is the primary cause of primary hypercholesteremia?
- A. High-density lipoprotein (HDL) defects
- B. Monogenic mutations, sedentary lifestyle, and high cholesterol diet
- C. Polygenic mutations and environmental factors
- D. Low-density lipoprotein (LDL) receptor mutation with defects in breakdown
Correct answer: D
Rationale: The correct answer is 'Low-density lipoprotein (LDL) receptor mutation with defects in breakdown.' Primary hypercholesteremia is mainly caused by mutations in the LDL receptor, leading to impaired clearance of LDL cholesterol from the blood. This results in high levels of LDL cholesterol in the bloodstream. Choices A, B, and C are incorrect because they do not directly relate to the primary cause of primary hypercholesteremia.
5. A 1-year-old child will receive her scheduled MMR vaccination shortly. The nurse should teach the child's parents that she may develop what possible adverse effect related to the administration of this vaccine?
- A. Cough and fever
- B. Pallor and listlessness
- C. Serum sickness
- D. Nausea and vomiting
Correct answer: A
Rationale: The correct answer is A: Cough and fever. After receiving the MMR vaccine, some children may experience mild adverse effects such as a low-grade fever and a mild cough. These symptoms are normal reactions to the vaccine and indicate that the child's immune system is responding appropriately. Choices B, C, and D are incorrect because pallor and listlessness, serum sickness, nausea, and vomiting are not common adverse effects associated with the MMR vaccine in children.
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