ATI RN
Pathophysiology Final Exam
1. A woman has been prescribed Climara, a transdermal estradiol patch. Which of the following should she be instructed by the nurse regarding the administration?
- A. Avoid prolonged sun exposure at the patch site due to increased plasma concentrations.
- B. The application of heat at the patch site will decrease effectiveness and result in pregnancy.
- C. The medication, when exposed to sunlight, can increase the risk of breast cancer.
- D. Exposure of the medication to occasional cold will increase effectiveness with application.
Correct answer: A
Rationale: The correct answer is A. The Climara patch delivers estradiol transdermally, and patients should be instructed to avoid prolonged sun exposure at the patch site due to increased plasma concentrations. Sun exposure can accelerate the absorption of the medication, leading to higher systemic levels than intended. Choices B, C, and D are incorrect because heat at the patch site does not result in pregnancy but may alter absorption rates, there is no direct link between sunlight exposure and breast cancer risk related to this medication, and exposure to cold does not increase effectiveness of the transdermal patch.
2. Which of the following statements about chest X-rays is false?
- A. There are contraindications for this test
- B. Before the procedure, the patient should remove all jewelry, metallic objects, and buttons above the waist
- C. A signed consent is not required
- D. Eating, drinking, and medications are allowed before this test
Correct answer: A
Rationale: The correct answer is A because there are contraindications for chest X-rays, such as pregnancy or concerns about radiation exposure. Patients may need to remove jewelry and metallic objects to prevent interference with the imaging. While a signed consent is typically not required for a routine chest X-ray, there are specific situations where consent may be necessary. It is essential for patients to follow fasting instructions before certain types of chest X-rays to obtain accurate results.
3. 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: macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima
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.
4. When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor?
- A. Decreased appetite
- B. Explosive diarrhea
- C. Decreased pulse rate
- D. Orthostatic hypotension
Correct answer: D
Rationale: Corrected Question: When administering Amitriptyline to a client experiencing cancer pain, for which of the following adverse effects should the nurse monitor? Amitriptyline is known to cause orthostatic hypotension, a sudden drop in blood pressure when moving from lying down or sitting to a standing position. Monitoring for orthostatic hypotension is crucial to prevent falls and related injuries. Educating the client about moving slowly and changing positions gradually can help mitigate this adverse effect. Choices A, B, and C are incorrect because decreased appetite, explosive diarrhea, and decreased pulse rate are not commonly associated with Amitriptyline use. Therefore, the correct answer is D.
5. What are influences that are unusual events with a major impact on individual lives because they disrupt the expected sequence of the life cycle?
- A. Nonnormative influences
- B. Normative history-graded influence
- C. Normative age-graded influence
- D. Sensitive period
Correct answer: A
Rationale: Nonnormative influences refer to unusual events that have a significant impact on individuals' lives by disrupting the typical life cycle. They are events that are not typical for a specific age or cohort. Normative history-graded influences (choice B) are common influences shared by a specific generation due to historical circumstances. Normative age-graded influences (choice C) are typical events that occur at a particular age for most people. A sensitive period (choice D) is a biologically determined time during which specific experiences have a lasting impact on development.
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