ATI RN
Final Exam Pathophysiology
1. A client with Guillain-Barré syndrome is experiencing ascending paralysis. Which of the following interventions should the nurse prioritize?
- A. Monitor for signs of respiratory distress.
- B. Prepare the client for plasmapheresis.
- C. Administer analgesics for pain management.
- D. Initiate passive range-of-motion exercises.
Correct answer: A
Rationale: The correct answer is A: Monitor for signs of respiratory distress. In Guillain-Barré syndrome, ascending paralysis can lead to respiratory muscle involvement, putting the client at risk for respiratory distress and failure. Prioritizing respiratory monitoring is crucial to ensure timely intervention if respiratory compromise occurs. Plasmapheresis (Choice B) may be indicated in some cases to remove harmful antibodies, but the priority in this situation is respiratory support. Administering analgesics (Choice C) for pain management and initiating passive range-of-motion exercises (Choice D) are important aspects of care but are not the priority when the client's respiratory status is at risk.
2. A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What instructions should the nurse provide to ensure the effectiveness of the medication?
- A. Take the medication with a full glass of water and remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption.
- B. Take the medication with milk to enhance calcium absorption.
- C. Take the medication at bedtime to ensure absorption during sleep.
- D. Take the medication with food to prevent nausea.
Correct answer: A
Rationale: The correct answer is A. Alendronate should be taken with a full glass of water and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with the absorption of alendronate. Taking the medication at bedtime (choice C) is not necessary for optimal absorption. Taking the medication with food (choice D) is also not recommended as food can reduce the absorption of alendronate.
3. Why is a beta-blocker prescribed to a client with a history of myocardial infarction?
- A. To reduce myocardial oxygen demand.
- B. To increase cardiac output.
- C. To prevent arrhythmias.
- D. To prevent the development of angina.
Correct answer: A
Rationale: The primary reason for administering a beta-blocker to a client with a history of myocardial infarction is to reduce myocardial oxygen demand. By reducing myocardial oxygen demand, beta-blockers help decrease the workload on the heart, making it easier for the heart to function effectively. This is crucial for clients with a history of myocardial infarction to prevent further damage to the heart. Choice B is incorrect because beta-blockers do not aim to increase cardiac output; instead, they help improve cardiac function by reducing workload. Choice C is incorrect because while beta-blockers can help prevent certain arrhythmias, the primary reason for their use in this case is to reduce myocardial oxygen demand. Choice D is incorrect as preventing angina is not the primary purpose of administering beta-blockers to a client with a history of myocardial infarction.
4. An older adult patient has asked her primary care provider for a prescription that will help to resolve her “warped toenails.” The care provider has diagnosed the woman with onychomycosis. The nurse should anticipate that this patient will be treated with what drug?
- A. Micafungin (Mycamine)
- B. Terbinafine (Lamisil)
- C. Voriconazole (Vfend)
- D. Fluconazole (Diflucan)
Correct answer: B
Rationale: The correct answer is B: Terbinafine (Lamisil). Terbinafine is commonly used to treat onychomycosis, a fungal infection of the toenails or fingernails. It works by stopping the growth of the fungus. Micafungin (Mycamine) is an antifungal medication used for different types of fungal infections but is not typically used to treat onychomycosis. Voriconazole (Vfend) is another antifungal medication used for specific fungal infections, but it is not a first-line treatment for onychomycosis. Fluconazole (Diflucan) is also an antifungal medication, but it is more commonly used for yeast infections and may not be as effective for treating onychomycosis compared to terbinafine.
5. Staff at the care facility note that a woman has started complaining of back pain in recent weeks and occasionally groans in pain. She has many comorbidities that require several prescription medications. The nurse knows that which factor is likely to complicate the clinician's assessment and treatment of the client's pain?
- A. Her advanced age may influence the expression and perception of pain.
- B. Her polypharmacy may complicate the pain management process.
- C. Her underlying conditions may mask or exacerbate the pain.
- D. Her cognitive function may decline, making pain assessment difficult.
Correct answer: B
Rationale: Polypharmacy, or the use of multiple medications, can complicate pain management due to drug interactions and side effects. While advanced age can influence pain perception, it is not the most likely factor to complicate assessment and treatment in this scenario. Underlying conditions may affect pain perception but do not directly complicate the management process. Cognitive decline can hinder pain assessment, but in this case, the focus is on factors directly impacting the treatment process, making option B the most appropriate choice.
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