ATI RN
ATI Pathophysiology
1. A patient is being administered chemotherapeutic agents for the treatment of cancer. Which of the following blood cells will be stimulated by the colony-stimulating factors in response to the effects of the chemotherapy?
- A. White blood cells
- B. Red blood cells
- C. Phagocytes
- D. Myocardial cells
Correct answer: A
Rationale: The correct answer is White blood cells. Colony-stimulating factors stimulate the production of white blood cells in response to the effects of chemotherapy, as it can lead to myelosuppression. Red blood cells are not directly stimulated by colony-stimulating factors. Phagocytes are a type of white blood cell involved in immune responses, but they are not specifically stimulated by colony-stimulating factors. Myocardial cells are cardiac muscle cells and are not directly involved in the response to chemotherapy-induced myelosuppression.
2. 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.
3. 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.
4. A male patient is receiving androgen therapy for hypogonadism. What adverse effect should the nurse monitor for during this therapy?
- A. Increased risk of bone fractures
- B. Increased risk of cardiovascular events
- C. Increased risk of liver dysfunction
- D. Increased risk of prostate cancer
Correct answer: B
Rationale: The correct answer is B: Increased risk of cardiovascular events. Androgen therapy can lead to an increased risk of cardiovascular events like heart attacks and strokes, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is essential during this therapy. Choices A, C, and D are incorrect because androgen therapy is not typically associated with an increased risk of bone fractures, liver dysfunction, or prostate cancer.
5. A toddler is displaying signs/symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The client's family asks how he got this. The nurse will respond:
- A. This could result from playing in soil and then ingesting bacteria that is now attacking his motor neurons.
- B. No one really knows how this disease is formed. We just know that in time, he may grow out of it.
- C. This is a degenerative disorder that tends to be inherited as an autosomal recessive trait.
- D. This is a segmental demyelination disorder that affects all nerve roots and eventually all muscle groups as well.
Correct answer: C
Rationale: The correct answer is C. Spinal muscular atrophy (SMA) is an inherited disorder, often autosomal recessive, that affects lower motor neurons. Choice A is incorrect because SMA is not caused by ingesting bacteria from playing in soil. Choice B is incorrect as SMA is not something that a person grows out of. Choice D is incorrect because SMA is not a demyelination disorder that affects nerve roots and muscle groups.
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