ATI RN
ATI Pathophysiology Final Exam
1. A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following assessment findings would most likely occur?
- A. Bronze-colored skin
- B. Decreased iron
- C. Normochromic erythrocytes
- D. Aplastic bone marrow
Correct answer: A
Rationale: The correct answer is A: 'Bronze-colored skin.' Sideroblastic anemia is characterized by excess iron deposition, leading to bronze-colored skin. This occurs due to the abnormal accumulation of iron in tissues. Choices B, C, and D are incorrect because sideroblastic anemia does not typically present with decreased iron levels, normochromic erythrocytes, or aplastic bone marrow.
2. What should the nurse discuss with a patient with a history of cardiovascular disease regarding the risks of hormone replacement therapy (HRT)?
- A. HRT may increase the risk of cardiovascular events, including heart attack and stroke.
- B. HRT may decrease the risk of osteoporosis.
- C. HRT may improve mood and energy levels.
- D. HRT may decrease the risk of breast cancer.
Correct answer: A
Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, especially in patients with a history of cardiovascular disease. Choice B is incorrect because HRT is not typically used to decrease the risk of osteoporosis. Choice C is incorrect as mood and energy level improvements are not the primary risks associated with HRT. Choice D is incorrect because HRT may actually increase the risk of breast cancer in some individuals.
3. A nurse on a postsurgical unit is providing care for a 76-year-old female client who is two days post-hemiarthroplasty (hip replacement) and who states that her pain has been out of control for the last several hours, though she is not exhibiting signs of pain. Which guideline should the nurse use for short-term and long-term treatment of the client's pain?
- A. Pain is what the client says it is, even if she is not exhibiting outward signs.
- B. Pain should be treated only when it is associated with observable symptoms.
- C. Long-term opioid use is generally safe for elderly clients in a hospital setting.
- D. The client's pain should be reassessed after every dose of pain medication.
Correct answer: A
Rationale: Pain is a subjective experience, and the client's report of pain should be taken seriously even if there are no outward signs. Choice B is incorrect because pain can be present without observable symptoms, and waiting for observable signs may delay appropriate pain management. Choice C is incorrect because the safety of long-term opioid use in elderly clients is a complex issue and should be carefully evaluated due to the risk of adverse effects. Choice D is incorrect because while pain reassessment is important, it should not be limited to just after medication administration but should occur regularly to ensure adequate pain control.
4. Which of the following mediators of inflammation causes increased capillary permeability and pain?
- A. Serotonin
- B. Histamine
- C. Bradykinin
- D. Nitric oxide
Correct answer: C
Rationale: Bradykinin is the correct answer. It is a potent mediator of inflammation that causes increased capillary permeability and is responsible for the pain associated with inflammation. Serotonin and histamine are also mediators of inflammation, but they are not primarily known for increasing capillary permeability or inducing pain. Nitric oxide is involved in various physiological processes but is not a primary mediator of inflammation that causes increased capillary permeability and pain.
5. During surgery, the anesthesia personnel notice the client is having a steady rise in end-tidal carbon dioxide level. At this time, the nurse anesthetist begins to assess the client for malignant hyperthermia. The initial (priority) assessment for this disorder may include:
- A. measuring serum potassium levels.
- B. monitoring for muscle rigidity.
- C. evaluating renal function.
- D. checking arterial blood gases.
Correct answer: B
Rationale: The correct answer is B: monitoring for muscle rigidity. Muscle rigidity is a hallmark sign of malignant hyperthermia, a life-threatening condition triggered by certain anesthetics. Monitoring for this sign is critical in the early identification of the condition. Choices A, C, and D are not the initial priority assessments for malignant hyperthermia. Measuring serum potassium levels, evaluating renal function, and checking arterial blood gases are not specific initial assessments for malignant hyperthermia and would not aid in its early identification.
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