ATI RN
ATI Pathophysiology Exam 2
1. What are the major mechanisms of spinal cord injuries?
- A. Hypoextension, expansion, hyperflexion
- B. Hyperflexion, expansion, hypometabolism
- C. Hypermetabolism, compression, hyperextension
- D. Hyperextension, hyperflexion, compression
Correct answer: D
Rationale: The correct answer is D. Spinal cord injuries commonly occur due to hyperextension, hyperflexion, and compression. Hyperextension and hyperflexion refer to the excessive bending or stretching of the spinal cord, while compression is the exertion of pressure on the spinal cord. These mechanisms can lead to damage such as contusions, lacerations, and compression of the spinal cord. Choices A, B, and C are incorrect as they do not accurately represent the major mechanisms of spinal cord injuries.
2. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What is a key contraindication that the nurse should review with the patient?
- A. History of hypertension
- B. Use of nitrates
- C. 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 act as vasodilators, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because having a history of hypertension, using antihypertensive medications, or having a history of peptic ulcer disease are not key contraindications for sildenafil use.
3. A nurse is caring for a client with a newly inserted pacemaker. What is the most important nursing action post-procedure?
- A. Monitor the insertion site for signs of infection.
- B. Educate the client about activity restrictions.
- C. Monitor the client's heart rate and rhythm.
- D. Assess the client's lung sounds for signs of fluid overload.
Correct answer: A
Rationale: Post-procedure, monitoring the insertion site for signs of infection is crucial because it helps in early detection of any potential complications such as infection. While educating the client about activity restrictions, monitoring the client's heart rate and rhythm, and assessing lung sounds for signs of fluid overload are important aspects of care, the immediate priority post-procedure is to prevent infection at the insertion site, which could lead to serious complications.
4. When teaching a patient about the use of finasteride (Proscar) for benign prostatic hyperplasia (BPH), what should the nurse emphasize about the expected outcomes of this therapy?
- A. Expect improvement in symptoms within a few days.
- B. Improvement in symptoms may take several weeks or months.
- C. Expect immediate improvement in urinary flow.
- D. The medication will cure BPH after treatment is complete.
Correct answer: B
Rationale: The correct answer is B. The effects of finasteride in treating BPH may take several weeks or months to become noticeable as it works by shrinking the prostate gland over time. Therefore, patients should be informed that improvement in symptoms may not be immediate. Choice A is incorrect because improvement in symptoms is not expected within a few days. Choice C is incorrect as immediate improvement in urinary flow is not typical with finasteride. Choice D is incorrect because finasteride manages BPH symptoms but does not cure the condition.
5. Which pathophysiologic process causes the decreased glomerular filtration rate in a patient with acute glomerulonephritis?
- A. Decreased renal-induced constriction of the renal arteries
- B. Immune complex deposition, increased capillary permeability, and cellular proliferation
- C. Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure
- D. Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis
Correct answer: B
Rationale: The correct answer is B: Immune complex deposition, increased capillary permeability, and cellular proliferation. In acute glomerulonephritis, immune complexes deposit in the glomerulus, leading to inflammation, increased capillary permeability, and cellular proliferation. These processes collectively reduce the glomerular filtration rate. Choices A, C, and D do not accurately describe the pathophysiologic process in acute glomerulonephritis. Decreased renal-induced constriction of the renal arteries, necrosis of nephrons due to increased kidney interstitial hydrostatic pressure, and scar tissue formation in the proximal convoluted tubule are not the primary mechanisms responsible for the decreased filtration rate in this condition.
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