ATI RN
Final Exam Pathophysiology
1. What specific instructions should the nurse provide for proper administration of alendronate (Fosamax) in a patient with osteoporosis?
- A. Take the medication with milk to enhance calcium absorption.
- B. Take the medication with a full glass of water and remain upright for at least 30 minutes.
- C. Take the medication at bedtime to ensure absorption during sleep.
- D. Take the medication with food to prevent gastrointestinal upset.
Correct answer: B
Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper drug absorption. Choice A is incorrect as alendronate should not be taken with milk due to potential interactions. Choice C is incorrect as there is no need to take the medication at bedtime specifically. Choice D is incorrect as taking alendronate with food can decrease its absorption.
2. What key contraindication should the nurse emphasize to a patient prescribed sildenafil (Viagra) for erectile dysfunction?
- A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension.
- B. Sildenafil should not be taken with food as it can reduce its effectiveness.
- C. Sildenafil is contraindicated in patients with a history of hypertension.
- D. Sildenafil should not be taken with grapefruit juice as it can lead to dangerous side effects.
Correct answer: A
Rationale: The correct answer is A. Sildenafil is contraindicated in patients taking 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 there is no specific contraindication for taking sildenafil with food, having a history of hypertension, or taking it with grapefruit juice. The main concern is the concurrent use of nitrates with sildenafil.
3. When educating a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?
- A. Oral contraceptives are 100% effective when taken correctly.
- B. Oral contraceptives are effective immediately after starting.
- C. Oral contraceptives are less effective if taken with antibiotics.
- D. Oral contraceptives are less effective if taken with food.
Correct answer: C
Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the contraceptive's efficacy, potentially leading to decreased effectiveness. Therefore, patients should be advised to use additional contraception methods if they are also taking antibiotics. Choice A is incorrect because while oral contraceptives are highly effective, they are not 100% foolproof. Choice B is incorrect as oral contraceptives may take some time to reach their full effectiveness after starting. Choice D is incorrect since taking oral contraceptives with food does not necessarily impact their effectiveness.
4. A patient is prescribed finasteride (Proscar) for benign prostatic hyperplasia (BPH). What should the nurse include in the patient teaching regarding the expected outcomes of this therapy?
- A. The medication will cure BPH after treatment is complete.
- B. The effects of the medication may take several weeks or months to become noticeable.
- C. The medication may cause increased hair growth.
- D. The medication may decrease libido.
Correct answer: B
Rationale: The correct answer is B. The effects of finasteride in treating BPH may take several weeks or months to become noticeable, so patients should be informed about this expected time frame. Choice A is incorrect because finasteride does not cure BPH but helps manage symptoms. Choice C is incorrect as increased hair growth is a side effect of finasteride, not an expected outcome for BPH treatment. Choice D is also incorrect as decreased libido is a potential side effect of finasteride, not an expected outcome for BPH treatment.
5. A patient is being educated about the use of raloxifene (Evista) for osteoporosis. What is the primary therapeutic action of this medication?
- A. It stimulates the formation of new bone.
- B. It decreases bone resorption and increases bone density.
- C. It increases the excretion of calcium through the kidneys.
- D. It increases calcium absorption in the intestines.
Correct answer: B
Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption, which is the breakdown of bone, and increasing bone density. This action helps in preventing bone loss and maintaining bone strength. Choice A is incorrect because raloxifene does not stimulate the formation of new bone but rather prevents its breakdown. Choice C is incorrect as raloxifene does not increase the excretion of calcium but rather helps in maintaining calcium levels in the bones. Choice D is also incorrect as raloxifene does not directly increase calcium absorption in the intestines.
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