ATI RN
MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following characterizes ductal carcinoma in situ?
- A. It is less common than lobular carcinoma in situ.
- B. Malignant cells have not invaded the stroma.
- C. It is considered a cancer precursor.
- D. Malignant cells have not invaded the stroma; it is considered a cancer precursor and has a higher risk for invasive cancer compared to lobular carcinoma in situ.
Correct answer: D
Rationale: The correct answer is that ductal carcinoma in situ is characterized by malignant cells that have not invaded the stroma, making it a cancer precursor with a higher risk for invasive cancer compared to lobular carcinoma in situ. Choice A is incorrect because ductal carcinoma in situ is more common than lobular carcinoma in situ. Choice B is incorrect as it only partially describes ductal carcinoma in situ without mentioning its potential for progression to invasive cancer. Choice C is incorrect because it does not capture the complete characteristics of ductal carcinoma in situ, which include the risk for invasive cancer.
2. A male patient with erectile dysfunction has asked for a prescription for sildenafil (Viagra). Before giving this medication, the nurse should assess for which of the following conditions?
- A. History of peptic ulcer disease
- B. Use of nitrates
- C. Recent history of a stroke
- D. History of hypertension
Correct answer: B
Rationale: The correct answer is B: Use of nitrates. Sildenafil should not be used by patients taking nitrates due to the risk of severe hypotension. Nitrates can potentiate the hypotensive effects of sildenafil, leading to a significant drop in blood pressure. Assessing for the use of nitrates is crucial to avoid this potentially dangerous interaction. Choices A, C, and D are incorrect because they are not specifically contraindications for the use of sildenafil. While a history of hypertension should be considered, it is not as critical as the use of nitrates when prescribing sildenafil.
3. A nurse recalls an example of an immune-complex-mediated disease is:
- A. Bronchial asthma
- B. Contact dermatitis
- C. Serum sickness
- D. Rheumatoid arthritis
Correct answer: C
Rationale: The correct answer is C: Serum sickness. Serum sickness is characterized by the formation of immune complexes in response to certain medications or proteins. These immune complexes can deposit in tissues, leading to inflammation and tissue damage. Bronchial asthma (Choice A) is a chronic inflammatory condition of the airways not primarily mediated by immune complexes. Contact dermatitis (Choice B) is a type IV hypersensitivity reaction mediated by T cells, not immune complexes. Rheumatoid arthritis (Choice D) is an autoimmune disease where antibodies target self-antigens, but it is not primarily mediated by immune complexes.
4. A 20-year-old college student has presented to the campus medical clinic seeking to begin oral contraceptive therapy. The nurse has recognized the need for adequate health education related to the patient's request. The nurse should emphasize the fact that successful prevention of pregnancy depends primarily on the patient's
- A. current health status.
- B. vigilant adherence to the drug regimen.
- C. knowledge of sexual health.
- D. risk factors for adverse effects.
Correct answer: B
Rationale: The correct answer is B: 'vigilant adherence to the drug regimen.' When initiating oral contraceptive therapy, the success of preventing pregnancy relies heavily on the patient's commitment to following the prescribed regimen consistently. Compliance with taking the oral contraceptives as directed is crucial for their effectiveness. Choice A, 'current health status,' is not the primary factor for successful prevention of pregnancy with oral contraceptives. Choice C, 'knowledge of sexual health,' while important, is not the primary determinant of contraceptive efficacy. Choice D, 'risk factors for adverse effects,' though relevant for monitoring and managing side effects, is not the primary focus for ensuring contraceptive success.
5. A nursing student is learning about the effects of bactericidal agents. How does rifampin (Rifadin) achieve a therapeutic action against both intracellular and extracellular tuberculosis organisms?
- A. It is metabolized in the liver.
- B. It binds to acetylcholine.
- C. It inhibits synthesis of RNA.
- D. It causes phagocytosis.
Correct answer: C
Rationale: Rifampin (Rifadin) achieves a therapeutic action against both intracellular and extracellular tuberculosis organisms by inhibiting the synthesis of RNA. This action interferes with bacterial RNA synthesis, leading to the suppression of protein synthesis in the bacteria, ultimately causing their death. Option A is incorrect because rifampin is primarily metabolized in the liver, but this is not how it exerts its bactericidal effects. Option B is incorrect as rifampin does not bind to acetylcholine. Option D is also incorrect as rifampin does not cause phagocytosis.
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