ATI RN
Final Exam Pathophysiology
1. A 10-year-old male is stung by a bee while playing in the yard. He experiences a severe allergic reaction and has to go to the ER. The nurse providing care realizes this reaction is the result of:
- A. Toxoids
- B. IgA
- C. IgE
- D. IgM
Correct answer: C
Rationale: The correct answer is C: IgE. A severe allergic reaction, such as the one experienced by the 10-year-old male after being stung by a bee, is mediated by IgE. IgE is involved in common allergic responses, triggering the release of histamine and other chemicals that lead to allergy symptoms. Choice A, Toxoids, are inactivated toxins used in vaccines. Choice B, IgA, is mainly found in mucosal areas and secretions, playing a role in mucosal immunity. Choice D, IgM, is the first antibody produced in response to an infection.
2. 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.
3. A male patient with benign prostatic hyperplasia (BPH) is being treated with tamsulosin (Flomax). What should the nurse include in the teaching plan for this patient?
- A. Avoid lying down after taking the medication.
- B. Take the medication with meals.
- C. Report any side effects such as dizziness or fainting.
- D. Take the medication at bedtime.
Correct answer: C
Rationale: The correct answer is C: 'Report any side effects such as dizziness or fainting.' Patients taking tamsulosin should be advised to report any side effects, such as dizziness or fainting, which can occur due to orthostatic hypotension. Choices A, B, and D are incorrect because avoiding lying down after taking the medication, taking it with meals, or at bedtime are not specific teaching points related to the potential side effects of tamsulosin.
4. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What should the nurse emphasize during patient education?
- A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be aware of the signs and symptoms of blood clots.
- B. Tamoxifen may cause weight gain, so patients should monitor their diet.
- C. Tamoxifen may cause hot flashes and other menopausal symptoms.
- D. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.
Correct answer: A
Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect. Therefore, patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, and redness in the legs, and advised to seek immediate medical attention if they occur. Choice B is incorrect because weight gain is not a significant side effect of tamoxifen. Choice C is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen but are not as critical to address as venous thromboembolism. Choice D is incorrect because tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss in premenopausal women.
5. A 34-year-old woman has presented to the clinic for the first time, and the nurse learns that she has been taking Depo Provera for the past 13 years. This aspect of the woman's medical history should prompt what assessment?
- A. Cardiac stress testing
- B. Renal ultrasound
- C. Bone density testing
- D. Evaluation of triglyceride levels
Correct answer: C
Rationale: The correct answer is bone density testing (Choice C). Long-term use of Depo Provera, a hormonal contraceptive, is associated with decreased bone mineral density. Assessing bone density is crucial to monitor for potential osteoporosis. Cardiac stress testing (Choice A) is not indicated based on the medication history provided. Renal ultrasound (Choice B) and evaluation of triglyceride levels (Choice D) are not directly related to the use of Depo Provera.
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