how should the nurse prepare a patient who is to receive a schilling test for pernicious anemia

ATI RN

ATI Pathophysiology Exam 1

1. How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?

A. Administer radioactive cobalamin and measure its excretion time
B. Measure antigen-antibody immune complexes
C. Measure serum ferritin and total iron-binding capacity
D. Administer folate and evaluate folate content in a blood serum sample

Correct answer: A

Rationale: The correct answer is A. To prepare a patient for a Schilling test for pernicious anemia, the nurse should administer radioactive cobalamin and measure its excretion time. This test is specifically designed to assess the absorption of vitamin B12. Choices B, C, and D are incorrect because they do not align with the preparation and procedure of a Schilling test. Measuring antigen-antibody immune complexes, serum ferritin, or total iron-binding capacity, as well as administering folate and evaluating folate content, are not part of the Schilling test protocol.

2. In which of the following cases is dehydration more likely to occur?

A. A 50-year-old woman who is a bodybuilder
B. A 50-year-old man who is morbidly obese
C. A 10-year-old child who is thin
D. A 30-year-old with multiple sclerosis

Correct answer: B

Rationale: The correct answer is B. Morbid obesity increases the risk of dehydration due to the larger body surface area and potential for greater insensible losses. Choices A, C, and D are less likely to experience dehydration compared to a morbidly obese individual.

3. Which of the following outcome criteria is appropriate for a client with dementia?

A. The client will return to an established schedule for activities of daily living.
B. The client will learn new coping mechanisms to handle anxiety.
C. The client will seek out resources in the community for support.
D. The client will follow an established schedule for activities of daily living.

Correct answer: D

Rationale: The correct answer is D. For clients with dementia, following an established schedule for activities of daily living is appropriate as it helps maintain routine and structure, which can be beneficial for their condition. Choice A has been rephrased to align better with the context of dementia care. Choice A is incorrect as expecting a return to a previous level of self-functioning may not be realistic for clients with dementia. Choice B is not the most appropriate outcome criteria as handling anxiety, while important, may not be the primary focus when working with clients with dementia. Choice C, seeking out resources in the community for support, is also important but may not be as directly related to the day-to-day care and management of activities for a client with dementia.

4. What is a potential implication of multiple dark bands on the nails?

A. They are considered a normal variant.
B. They can be associated with malignant melanoma.
C. They are indicative of a nail fungus.
D. They are associated with aging.

Correct answer: B

Rationale: Multiple dark bands on the nails can be a concerning sign of malignant melanoma, a type of skin cancer that can affect the nails. While some nail changes are considered normal variants, dark bands should not be dismissed lightly as they can indicate a serious condition like melanoma. Nail fungus typically presents differently, causing discoloration, thickening, or distortion of the nail without distinct dark bands. Additionally, aging can lead to various nail changes, but dark bands alone are not a common feature of normal aging.

5. A patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What outcome should the nurse expect to observe if the medication is effective?

A. Increased urinary frequency and urgency
B. Decreased prostate size
C. Increased prostate size
D. Decreased blood pressure

Correct answer: B

Rationale: The correct answer is B: Decreased prostate size. Finasteride is a medication used to reduce the size of the prostate gland in patients with BPH. By decreasing the size of the prostate, symptoms such as urinary frequency and urgency are improved. Choice A is incorrect as the medication aims to decrease, not increase, urinary symptoms. Choice C is incorrect because the goal of finasteride is to reduce, not increase, the prostate size. Choice D is also incorrect as finasteride is not indicated for lowering blood pressure.