ATI RN
Final Exam Pathophysiology
1. When preparing to administer parenteral acyclovir (Zovirax) to an 80-year-old patient with chronic renal failure and herpes simplex, what would the nurse expect in regard to the dose?
- A. The dose is smaller due to the herpes simplex infection.
- B. The dose is smaller based on the patient's kidney function.
- C. The dose is higher in treating genital herpes.
- D. The dose is higher if the creatinine clearance is above 4.0 mg/dL.
Correct answer: B
Rationale: In patients with chronic renal failure, especially in older adults, dosages of medications excreted renally need to be adjusted based on kidney function. Acyclovir is primarily eliminated by the kidneys, so in a patient with chronic renal failure, the dose would need to be smaller to prevent drug accumulation and toxicity. Choice A is incorrect because the dose adjustment is more related to the patient's kidney function than the presence of herpes simplex. Choice C is incorrect because the type of herpes infection does not determine the dose adjustment for acyclovir. Choice D is incorrect as the creatinine clearance is a more accurate measure of kidney function compared to creatinine levels.
2. A female patient is concerned about the side effects of oral contraceptives. What should the nurse explain as a common side effect?
- A. Increased energy levels
- B. Decreased libido
- C. Weight gain
- D. Hair loss
Correct answer: C
Rationale: The correct answer is C: Weight gain. Weight gain is a common side effect of oral contraceptives due to hormonal changes. It is essential for healthcare providers to inform patients about this possibility to manage expectations. Choice A, increased energy levels, is not a common side effect of oral contraceptives. Choice B, decreased libido, can be a side effect for some individuals but is not as common as weight gain. Choice D, hair loss, is not typically associated with oral contraceptives. Therefore, it is important for the nurse to address the patient's concerns by discussing the more prevalent side effects like weight gain.
3. 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.
4. What is the action of amphotericin B?
- A. It binds to ergosterol and forms holes in the membrane.
- B. It binds to an enzyme required for the synthesis of ergosterol.
- C. It disrupts the fungal cell walls rather than the cell membrane.
- D. It inhibits glucan synthetase required for glucan synthesis.
Correct answer: A
Rationale: Amphotericin B is an antifungal medication that acts by binding to ergosterol, a component of fungal cell membranes, forming pores that disrupt the integrity of the membrane. This action leads to leakage of cellular contents and ultimately cell death. Choice B is incorrect as amphotericin B does not bind to an enzyme required for the synthesis of ergosterol. Choice C is incorrect as the drug primarily affects the cell membrane rather than the cell wall. Choice D is also incorrect as amphotericin B does not inhibit glucan synthetase.
5. After studying about viruses, which information indicates the student has a good understanding of viruses? Viruses:
- A. Contain no RNA or DNA
- B. Are capable of independent reproduction
- C. Replicate their genetic material inside host cells
- D. Are killed easily by antimicrobials
Correct answer: C
Rationale: The correct answer is C. Viruses replicate their genetic material inside host cells, which is a fundamental aspect of their life cycle. Choice A is incorrect because viruses contain either RNA or DNA. Choice B is incorrect as viruses cannot reproduce independently and rely on host cells for replication. Choice D is incorrect as viruses are not easily killed by antimicrobials due to their unique structure and mechanisms of infection.
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