ATI RN
ATI Pathophysiology
1. A patient with endometriosis is prescribed medroxyprogesterone acetate (Provera). What should the nurse include in the patient education?
- A. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels.
- B. Medroxyprogesterone can be taken with food to reduce gastrointestinal upset.
- C. Medroxyprogesterone should be discontinued if side effects occur.
- D. Medroxyprogesterone should be taken once a week to maintain effectiveness.
Correct answer: A
Rationale: When educating a patient with endometriosis who is prescribed medroxyprogesterone acetate (Provera), the nurse should emphasize the importance of taking the medication at the same time each day. This helps maintain consistent hormone levels and ensures the effectiveness of the treatment. Option A is correct. Option B is incorrect because medroxyprogesterone should be taken consistently, regardless of food intake. Option C is incorrect because discontinuing the medication without consulting a healthcare provider can be harmful. Option D is incorrect because medroxyprogesterone is typically taken daily, not weekly, for the treatment of endometriosis.
2. A male patient receiving androgen therapy is concerned about side effects. What is the most serious adverse effect the nurse should monitor for during this therapy?
- A. Increased risk of cardiovascular events
- B. Increased risk of bone fractures
- C. Increased risk of venous thromboembolism
- D. Increased risk of mood changes
Correct answer: A
Rationale: The correct answer is A: Increased risk of cardiovascular events. Androgen therapy can significantly increase the risk of cardiovascular events, such as heart attack and stroke, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial during this therapy. Choice B, increased risk of bone fractures, is not typically associated with androgen therapy. Choice C, increased risk of venous thromboembolism, is more commonly linked to estrogen therapy rather than androgen therapy. Choice D, increased risk of mood changes, can occur with androgen therapy but is not as serious or life-threatening as cardiovascular events.
3. A 43-year-old man has tested positive for systemic candidiasis, and the care team has decided on IV fluconazole as a first-line treatment. When administering this medication, the nurse should
- A. administer the drug with lactated Ringer's.
- B. infuse the drug no faster than 200 mg/h.
- C. avoid administering the drug through a peripheral IV.
- D. administer prophylactic heparin prior to the fluconazole.
Correct answer: C
Rationale: When administering IV fluconazole, the nurse should avoid administering the drug through a peripheral IV. Fluconazole is known to cause phlebitis and tissue irritation if infused through a peripheral IV line. It is recommended to administer fluconazole through a central venous catheter to reduce the risk of complications. Choices A, B, and D are incorrect as there is no specific recommendation to administer the drug with lactated Ringer's, infuse it at a particular rate, or administer prophylactic heparin prior to fluconazole in this scenario.
4. The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize?
- A. White blood cell levels with differential
- B. Red blood cell levels and morphology
- C. Urea and creatinine levels
- D. Liver function panel
Correct answer: B
Rationale: The correct answer is B: Red blood cell levels and morphology. Lead poisoning primarily affects red blood cells, causing anemia. Therefore, the priority test would be to assess red blood cell levels and morphology. Choice A (White blood cell levels with differential) is incorrect as lead poisoning does not primarily affect white blood cells. Choice C (Urea and creatinine levels) is unrelated to lead poisoning and not a priority in this scenario. Choice D (Liver function panel) is also not the priority as lead poisoning's primary impact is on the red blood cells, not the liver.
5. Which of the following nursing diagnoses would provide the most plausible indication for the use of epoetin alfa (Epogen) in a patient with renal failure?
- A. Risk for infection related to decreased erythropoiesis
- B. Activity intolerance related to decreased oxygen-carrying capacity
- C. Powerlessness related to sequelae of renal failure
- D. Ineffective breathing pattern related to inadequate erythropoietin synthesis
Correct answer: B
Rationale: The correct answer is B. In a patient with renal failure, the use of epoetin alfa (Epogen) is primarily aimed at addressing the decreased oxygen-carrying capacity due to impaired erythropoiesis. Epoetin alfa is a medication that stimulates red blood cell production, thereby improving the oxygen-carrying capacity of the blood. This would directly address the activity intolerance commonly seen in patients with renal failure. Choices A, C, and D are incorrect because they do not directly relate to the primary purpose of using epoetin alfa in this context. Risk for infection, powerlessness, and ineffective breathing pattern are important considerations in the care of a patient with renal failure, but they are not the primary indications for using epoetin alfa.
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