ATI RN
Pathophysiology Practice Questions
1. Mrs. Jordan is an elderly client diagnosed with Alzheimer’s disease. She becomes agitated and combative when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation would be to:
- A. tell the client firmly that it is time to get dressed.
- B. obtain assistance to restrain the client for safety.
- C. remain calm and talk quietly to the client.
- D. call the doctor and request an order for sedation.
Correct answer: C
Rationale: When dealing with an elderly client with Alzheimer’s disease who is agitated and combative, the most appropriate nursing intervention is to remain calm and talk quietly to the client. This approach can help soothe the client and prevent escalating the situation. Choice A is incorrect as being firm may further agitate the client. Choice B is inappropriate as restraining should only be used as a last resort for safety reasons and after other de-escalation techniques have been attempted. Choice D is not the best initial intervention and should only be considered after other non-pharmacological interventions have failed.
2. The nurse is assessing for stoma prolapse in a client with a colostomy. The nurse would observe which of the following if stoma prolapse occurred?
- A. Sunken and hidden stoma
- B. Dark- and bluish-colored stoma
- C. Narrowed and flattened stoma
- D. Protruding stoma
Correct answer: D
Rationale: A protruding stoma is indicative of stoma prolapse, which occurs when the bowel protrudes excessively through the stoma.
3. You are doing bed bath to the client when suddenly, The nursing assistant rushed to the room and tell you that the client from the other room was in Pain. The best intervention in such case is:
- A. Raise the side rails, cover the client and put the call bell within reach and then attend to the client in pain to give the
- B. Tell the nursing assistant to give the pain medication to the client complaining of pain
- C. Tell the nursing assistant to go the client’s room and tell the client to wait
- D. Finish the bed bath quickly then rush to the client in Pain
Correct answer: D
Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.
4. A client has a new prescription for clonidine to treat hypertension. Which of the following instructions should the nurse include?
- A. Discontinue the medication if a rash develops.
- B. Expect increased salivation during the first few weeks of therapy.
- C. Avoid driving until the client's reaction to the medication is known.
- D. Stop the medication if you experience a dry mouth.
Correct answer: C
Rationale: The correct instruction for a client starting clonidine therapy for hypertension is to avoid driving until their reaction to the medication is known. Clonidine can cause drowsiness, so it is important for the client to refrain from activities that require alertness until they are aware of how the medication affects them. Choice A is incorrect because a rash is not a common side effect of clonidine. Choice B is incorrect as increased salivation is not an expected side effect of clonidine. Choice D is also incorrect as dry mouth is a common side effect of clonidine, but it is not a reason to stop the medication unless severe or bothersome. Therefore, the priority instruction for the nurse to include is to advise the client to avoid driving until their reaction to the medication is known to ensure safety.
5. A client prescribed clozapine is receiving discharge teaching from a nurse. Which statement by the client indicates an understanding of the teaching?
- A. I should report a sore throat to my provider.
- B. I should avoid drinking grapefruit juice while taking this medication.
- C. I should take this medication with food.
- D. I should avoid taking this medication with food.
Correct answer: A
Rationale: The correct answer is A. Clozapine can cause agranulocytosis, a serious condition that decreases the number of white blood cells. Reporting a sore throat is crucial as it could be a sign of infection. Choice B is incorrect because there is no specific interaction between clozapine and grapefruit juice. Choice C is incorrect because clozapine is usually taken without regard to meals. Choice D is incorrect as clozapine is generally taken without food to enhance absorption.
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