ATI RN
ATI Pathophysiology Final Exam
1. During a flu shot clinic, one of the questions the student nurse asks relates to whether the client has a history of Guillain-Barré syndrome. The client asks, 'What is that?' How should the nursing student reply?
- A. A type of paralysis that affects movement on both sides of the body. It may even involve the respiratory muscles.
- B. Swelling of your arm where you got your flu shot and maybe your eyes and lips had some swelling as well.
- C. A degenerative disease where you have trouble walking without the help of a cane or walker.
- D. Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot.
Correct answer: A
Rationale: The correct answer is A because Guillain-Barré syndrome is an acute immune-mediated polyneuropathy that can lead to paralysis affecting movement on both sides of the body, and in severe cases, involving the respiratory muscles. Choice B is incorrect as it describes local swelling, not the systemic effects of Guillain-Barré syndrome. Choice C is incorrect as it describes a degenerative disease affecting mobility, not an acute immune-mediated condition like Guillain-Barré syndrome. Choice D is incorrect as it describes flu-like symptoms following a flu shot, which is not the same as Guillain-Barré syndrome.
2. A client in a prenatal clinic is being taught by a nurse in her second trimester with a new diagnosis of gestational diabetes. Which of the following client statements indicates a need for further teaching?
- A. I should limit my carbohydrates to 50% of caloric intake.
- B. I will reduce my exercise schedule to 3 days a week.
- C. I will take my glyburide daily with breakfast.
- D. I know I am at increased risk of developing type 2 diabetes.
Correct answer: I will reduce my exercise schedule to 3 days a week.
Rationale: Choice B, 'I will reduce my exercise schedule to 3 days a week,' indicates a need for further teaching. Regular exercise is beneficial in managing gestational diabetes and should not be reduced without proper guidance. Choices A, C, and D demonstrate understanding and appropriate actions in managing gestational diabetes.
3. When administering Phenytoin, what should you monitor?
- A. Behavior
- B. Therapeutic blood levels
- C. For signs of Stevens-Johnson syndrome
- D. All of the above
Correct answer: D
Rationale: When administering Phenytoin, monitoring the patient's behavior is important to assess for any changes that may indicate adverse effects. Monitoring therapeutic blood levels helps ensure the medication is within the effective range and not causing toxicity. Additionally, being vigilant for signs of Stevens-Johnson syndrome, a severe skin reaction associated with Phenytoin use, is crucial for early detection and intervention. Therefore, monitoring behavior, therapeutic blood levels, and for signs of Stevens-Johnson syndrome are all essential when administering Phenytoin.
4. The nurse counsels a client diagnosed with iron deficiency anemia. The nurse determines that teaching is effective if the client selects which of the following menus?
- A. Roast beef, brown rice, green beans, carrot and raisin salad, and milk
- B. Cheese pizza, tossed green salad, oatmeal-raisin cookie, and lemonade
- C. Two scrambled eggs, bacon, white toast with strawberry jam, and coffee
- D. Corn flakes with milk, whole wheat toast, and orange juice
Correct answer: A
Rationale: The correct answer is A. Roast beef is high in heme iron, which is best absorbed and helps treat iron deficiency anemia. Choices B, C, and D do not contain significant amounts of heme iron or other iron-rich foods that would be beneficial in managing iron deficiency anemia. Cheese pizza, scrambled eggs, bacon, white toast, corn flakes, and whole wheat toast do not provide the necessary heme iron needed to address the client's condition.
5. The client on nitroglycerin patches reports dizziness when standing up. What is the nurse’s best response?
- A. Advise the client to rise slowly to prevent dizziness.
- B. Instruct the client to discontinue the nitroglycerin patches.
- C. Encourage the client to rest and avoid physical activity.
- D. Suggest the client take an over-the-counter antiemetic.
Correct answer: A
Rationale: The correct answer is to advise the client to rise slowly to prevent dizziness. Dizziness when standing up can be a sign of orthostatic hypotension, a common side effect of nitroglycerin. Rising slowly can help minimize this symptom. Instructing the client to discontinue the nitroglycerin patches (Choice B) is not appropriate without consulting a healthcare provider as sudden discontinuation can lead to adverse effects. Encouraging the client to rest and avoid physical activity (Choice C) does not address the specific issue of orthostatic hypotension. Suggesting the client take an over-the-counter antiemetic (Choice D) is not indicated for dizziness related to orthostatic hypotension.
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