ATI RN
WGU Pathophysiology Final Exam
1. A patient's current medical condition is suggestive of impaired erythropoiesis. Which of the following laboratory studies would be most clinically relevant in diagnosing this health problem?
- A. White blood cell count with differential
- B. RBC, hemoglobin, and hematocrit
- C. INR and aPTT
- D. d-dimer and C-reactive protein
Correct answer: B
Rationale: In this scenario, where impaired erythropoiesis is suspected, the most clinically relevant laboratory studies would focus on red blood cell parameters. Therefore, assessing RBC count, hemoglobin levels, and hematocrit values would provide direct insights into erythropoiesis. Choices A, C, and D are not directly related to erythropoiesis assessment. White blood cell count with a differential is more indicative of immune response and infection. INR and aPTT are coagulation studies, while d-dimer and C-reactive protein levels are more associated with inflammation and thrombotic events.
2. A patient receiving isoniazid (INH) and rifampin (Rifadin) has a decreased urinary output and decreased sensation in his great toes. Which laboratory values should be assessed?
- A. Hematocrit and hemoglobin
- B. ALT and AST
- C. Urine culture and sensitivity
- D. Erythrocyte count and differential
Correct answer: C
Rationale: In a patient receiving isoniazid (INH) and rifampin (Rifadin) with symptoms of decreased urinary output and decreased sensation in great toes, assessing urine culture and sensitivity is crucial. These symptoms could indicate peripheral neuropathy, a known side effect of isoniazid, and rifampin can cause renal toxicity. Checking for any urinary tract infection or drug-induced nephrotoxicity is important. Choices A, B, and D are incorrect as they do not directly address the symptoms presented by the patient or the potential side effects of the medications mentioned.
3. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What should the nurse include in the patient education about the use of this medication?
- A. Tamoxifen may increase the risk of venous thromboembolism, so the patient should be aware of the signs and symptoms of blood clots.
- B. Tamoxifen may cause hot flashes, so the patient should be prepared for this side effect.
- C. Tamoxifen may decrease the risk of osteoporosis, so the patient should ensure adequate calcium intake.
- D. Tamoxifen may cause weight gain, so the patient should monitor their diet and exercise regularly.
Correct answer: A
Rationale: The correct answer is A. Tamoxifen is known to increase the risk of venous thromboembolism, a serious side effect. Patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, or redness in the affected limb, and the importance of seeking immediate medical attention if they occur. Choice B is incorrect because hot flashes are a common side effect of tamoxifen but not a critical concern like venous thromboembolism. Choice C is incorrect as tamoxifen is not associated with a decreased risk of osteoporosis. Choice D is incorrect because while weight gain can occur with tamoxifen, it is not as crucial to educate the patient about as the risk of venous thromboembolism.
4. A nurse is providing discharge teaching to a patient who will be taking sildenafil (Viagra). Which of the following should the nurse include in the instructions?
- A. Take this medication 1 hour before sexual activity.
- B. Do not take more than one dose in a 24-hour period.
- C. Seek immediate medical attention if you experience vision or hearing loss.
- D. Take this medication on an empty stomach.
Correct answer: B
Rationale: The correct answer is B: 'Do not take more than one dose in a 24-hour period.' It is essential for the nurse to emphasize this instruction to prevent potential adverse effects from taking multiple doses of sildenafil. Choice A is incorrect because sildenafil should be taken approximately 30 minutes to 4 hours before sexual activity, not specifically 1 hour before. Choice C is important but not the priority; while vision or hearing loss are potential serious side effects of sildenafil, the immediate concern should be focused on dose frequency. Choice D is incorrect as sildenafil can be taken with or without food.
5. An older adult patient comes to the clinic complaining of not being able to do what he used to be able to. You know that normal changes associated with aging include:
- A. Improved blood flow
- B. Slowed metabolic rate
- C. Increased brain weight
- D. Improved nerve fiber conduction
Correct answer: B
Rationale: Normal changes associated with aging include a slowed metabolic rate and decreased brain weight. Option A, 'Improved blood flow,' is incorrect as aging is generally associated with reduced vascular health rather than improved blood flow. Option D, 'Improved nerve fiber conduction,' is incorrect as aging typically leads to a decline in nerve function rather than improvement.
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