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MSN 570 Advanced Pathophysiology Final 2024
1. Which of the following is a characteristic of osteosarcoma?
- A. Slow-growing tumor that begins in the bone marrow
- B. Solitary tumor that most often affects the metaphyseal region of the femur or tibia
- C. An aggressive tumor most often found in the bone marrow of long bones
- D. A tumor that infiltrates the trabeculae in spongy bone and implants in surrounding tissue
Correct answer: C
Rationale: Osteosarcoma is an aggressive bone tumor that most commonly arises in the bone marrow of long bones, such as the femur or tibia. Choice A is incorrect as osteosarcoma is not a slow-growing tumor but rather a fast-growing one. Choice B is incorrect as osteosarcoma is not typically solitary but can involve multiple lesions. Choice D is incorrect as osteosarcoma primarily affects the medullary (marrow) cavity of bones, rather than infiltrating the trabeculae in spongy bone and surrounding tissue.
2. In Guillain-Barre syndrome, what pathophysiologic process underlies the deficits that accompany the degeneration of myelin in the peripheral nervous system (PNS)?
- A. The destruction of myelin results in a reduction in Schwann cell production in the client's PNS.
- B. The lack of myelin surrounding nerve cells compromises the axonal transport system.
- C. Without remyelination, the axon will eventually die.
- D. A deficit of myelin makes the client more susceptible to infection by potential pathogens.
Correct answer: C
Rationale: In Guillain-Barre syndrome, the destruction of myelin leads to axonal damage. If remyelination does not occur, the axon will eventually degenerate and die, impacting nerve function. Choice A is incorrect because the destruction of myelin does not affect Schwann cell production. Choice B is incorrect as the lack of myelin directly affects the conduction of nerve impulses, not the axonal transport system. Choice D is incorrect as a deficit of myelin does not predispose the client to infections by potential pathogens.
3. A patient is prescribed zanamivir (Relenza) to treat influenza B. The patient has a history of asthma. For which of the following symptoms should the nurse assess?
- A. Bradycardia
- B. Pneumonia
- C. Bronchospasm
- D. Pulmonary embolism
Correct answer: C
Rationale: The correct answer is C: Bronchospasm. Zanamivir (Relenza) is an inhaled medication used to treat influenza by reducing the severity and duration of symptoms. Patients with a history of asthma are at risk of bronchospasm as a potential side effect of zanamivir. Assessing for bronchospasm is crucial in this case to ensure the patient's safety and well-being. Choices A, B, and D are incorrect. Bradycardia, pneumonia, and pulmonary embolism are not commonly associated with zanamivir use in the treatment of influenza B, especially in a patient with a history of asthma.
4. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What important contraindication should the nurse emphasize during patient education?
- A. Use of nitrates
- B. History of hypertension
- C. History of peptic ulcer disease
- D. Use of antihypertensive medications
Correct answer: A
Rationale: The correct answer is A: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because they are not direct contraindications for sildenafil use. While a history of hypertension or peptic ulcer disease may require caution, they are not absolute contraindications like the concomitant use of nitrates.
5. A patient is being treated with raloxifene (Evista) for osteoporosis. What should the nurse teach the patient about this medication?
- A. It is used as a selective estrogen receptor modulator to prevent bone loss.
- B. It works by decreasing bone formation and increasing bone resorption.
- C. It should be taken with food to reduce gastrointestinal side effects.
- D. It may cause weight gain and fluid retention.
Correct answer: C
Rationale: The correct answer is C. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent bone loss. It should be taken with food to reduce gastrointestinal side effects, not on an empty stomach. Choices A and B are incorrect because raloxifene is indeed a SERM that prevents bone loss, but it does not directly work by increasing bone formation or decreasing bone resorption. Choice D is incorrect as weight gain and fluid retention are not common side effects of raloxifene.
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