ATI RN
ATI Pathophysiology Final Exam
1. 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.
2. A hospital patient's complex medical history includes a recent diagnosis of kidney cancer. Which of the following medications is used to treat metastatic kidney cancer?
- A. Filgrastim (Neupogen)
- B. Aldesleukin (Proleukin)
- C. Interferon alfa-2b (Intron A)
- D. Darbepoetin alfa (Aranesp)
Correct answer: B
Rationale: The correct answer is B: Aldesleukin (Proleukin). Aldesleukin is a medication used in the treatment of metastatic kidney cancer. It is a recombinant interleukin-2 that works by stimulating the immune system to attack cancer cells. Choice A, Filgrastim, is a medication used to stimulate the production of white blood cells. Choice C, Interferon alfa-2b, is used in the treatment of certain cancers but not specifically metastatic kidney cancer. Choice D, Darbepoetin alfa, is used to treat anemia by stimulating red blood cell production and is not indicated for metastatic kidney cancer.
3. A client with a history of chronic alcoholism presents to the emergency department with a complaint of double vision. Which cranial nerve is most likely involved?
- A. Cranial nerve I (Olfactory)
- B. Cranial nerve III (Oculomotor)
- C. Cranial nerve VI (Abducens)
- D. Cranial nerve VII (Facial)
Correct answer: C
Rationale: The correct answer is Cranial nerve VI (Abducens). Chronic alcoholism can lead to damage to the abducens nerve, which controls the lateral movement of the eye. This damage can result in symptoms like double vision. Cranial nerve I (Olfactory) is responsible for the sense of smell and is not related to eye movement. Cranial nerve III (Oculomotor) controls most of the eye movements but is less likely to be affected in chronic alcoholism than the abducens nerve. Cranial nerve VII (Facial) is responsible for facial movements and is not associated with double vision.
4. A teacher in a preschool is diagnosed with giardiasis. Which of the following medications will be administered to treat the diarrhea and abdominal distention?
- A. Sulfasalazine (Azulfidine)
- B. Metronidazole (Flagyl)
- C. Trimethoprim–sulfamethoxazole (Bactrim)
- D. Doxycycline (Vibramycin)
Correct answer: B
Rationale: The correct answer is B. Metronidazole (Flagyl) is the drug of choice for treating giardiasis, which is a common cause of diarrhea and abdominal distention. Sulfasalazine (Choice A) is used to treat inflammatory bowel disease. Trimethoprim–sulfamethoxazole (Choice C) is commonly used for urinary tract infections and Pneumocystis jirovecii pneumonia. Doxycycline (Choice D) is commonly used to treat various bacterial infections but is not the first-line treatment for giardiasis.
5. A patient has suffered from several infections in the last 6 months and unexplained impaired wound healing. What assessment should the nurse prioritize?
- A. Assess for pain.
- B. Assess for nutritional deficiencies.
- C. Assess genetic tendency for infection.
- D. Assess for edema and decreased hemoglobin.
Correct answer: B
Rationale: In this scenario, the patient's history of multiple infections and impaired wound healing indicates a potential issue with their immune system and overall health. Therefore, the nurse should prioritize assessing for nutritional deficiencies. Proper nutrition is essential for a healthy immune response and wound healing. Assessing for pain (choice A) may be important but addressing the root cause of the recurrent infections and impaired wound healing is crucial. Genetic tendency for infection (choice C) would be a less immediate concern compared to assessing for nutritional deficiencies. Edema and decreased hemoglobin (choice D) are not the most relevant assessments based on the patient's symptoms.
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