ATI RN
Final Exam Pathophysiology
1. A 5-year-old male was diagnosed with normocytic-normochromic anemia. Which of the following anemias does the nurse suspect the patient has?
- A. Sideroblastic anemia
- B. Hemolytic anemia
- C. Pernicious anemia
- D. Iron deficiency anemia
Correct answer: B
Rationale: The correct answer is B, Hemolytic anemia. Normocytic-normochromic anemia is a type of anemia characterized by normal-sized and normal-colored red blood cells. Hemolytic anemia is a condition where red blood cells are destroyed prematurely, leading to normocytic-normochromic anemia. Sideroblastic anemia (Choice A) is characterized by ringed sideroblasts in the bone marrow. Pernicious anemia (Choice C) is due to vitamin B12 deficiency. Iron deficiency anemia (Choice D) is characterized by microcytic-hypochromic red blood cells.
2. What should the nurse teach the boy about anabolic steroid abuse?
- A. The ability of anabolic steroids to build muscle is greatly exaggerated in the media.
- B. Anabolic steroids are universally dangerous but are especially harmful to adolescents.
- C. The muscle mass resulting from steroid use will atrophy unless doses are continually increased.
- D. Anabolic steroids will reduce the boy's ability to perform weight-bearing exercise later in life.
Correct answer: B
Rationale: The correct answer is B because anabolic steroids are indeed universally dangerous, but they pose greater risks to adolescents due to their impact on growth and development. Choice A is incorrect because anabolic steroids do have the potential to build muscle mass, though not to the extent often portrayed in the media. Choice C is incorrect as muscle mass gained from steroid use may persist for a period even after discontinuation. Choice D is incorrect as anabolic steroids can enhance muscle performance initially, though long-term use can have adverse effects on health and not specifically on the ability to perform weight-bearing exercises.
3. What is the etiology and most likely treatment for myasthenia gravis in a 22-year-old female college student?
- A. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids.
- B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins.
- C. Cerebellar lesions; surgical and immunosuppressive treatment.
- D. Excess acetylcholinesterase production; treatment with thymectomy.
Correct answer: B
Rationale: Myasthenia gravis is characterized by a decline in functioning acetylcholine receptors rather than autoimmune destruction of skeletal muscle cells (Choice A), cerebellar lesions (Choice C), or excess acetylcholinesterase production (Choice D). The most likely treatment for myasthenia gravis involves corticosteroids to reduce inflammation and intravenous immunoglobulins to block the antibodies attacking acetylcholine receptors. Intensive physical therapy and anabolic steroids are not primary treatments for myasthenia gravis.
4. Which statement best conveys an aspect of the role of cerebrospinal fluid (CSF)?
- A. CSF provides immune protection to the brain and spinal cord by serving as a physical barrier.
- B. CSF cushions the brain and spinal cord, protecting them from injury.
- C. CSF plays a limited role in the exchange of nutrients and waste products between the blood and brain.
- D. CSF functions primarily as a medium for the transmission of nerve impulses.
Correct answer: B
Rationale: The correct answer is B. Cerebrospinal fluid primarily cushions the brain and spinal cord, protecting them from injury. Choice A is incorrect because while CSF contributes to the brain's immune environment, its main role is not providing immune protection as a physical barrier. Choice C is incorrect because CSF has a significant role in the exchange of nutrients and waste products, rather than a limited one. Choice D is incorrect as CSF is not primarily a medium for nerve impulse transmission, but rather serves as a protective and supportive fluid.
5. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What key contraindication should the nurse review with the patient?
- A. Use of nitrates
- B. History of hypertension
- C. Use of antihypertensive medications
- D. Use of antihypertensive medications
Correct answer: A
Rationale: The correct answer is A: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, so their combined use can lead to a dangerous drop in blood pressure. Choices B, C, and D are incorrect because while a history of hypertension or use of antihypertensive medications may influence treatment decisions, they are not the key contraindication specifically related to sildenafil use.
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