ATI RN
ATI Pathophysiology
1. A 74-year-old woman states that many of her peers underwent hormone replacement therapy (HRT) in years past. The woman asks the nurse why her primary care provider has not yet proposed this treatment for her. What fact should underlie the nurse's response to the woman?
- A. The risks of stroke and breast cancer are unacceptably high in women taking HRT.
- B. HRT was found to cause mood disturbances in many women who used it long term.
- C. HRT was found to be a significant risk factor for bone fractures and osteoporosis.
- D. The risks of chronic obstructive pulmonary disease were found to be significantly higher in women using HRT.
Correct answer: A
Rationale: The correct answer is A because the main reason HRT is not recommended for all women is due to the increased risks of stroke and breast cancer associated with its use. Hormone replacement therapy (HRT) has been linked to an elevated risk of stroke and breast cancer, which outweigh its potential benefits for many individuals. Choices B, C, and D are incorrect as they do not address the primary concerns regarding HRT use. While HRT can indeed cause mood disturbances and may affect bone health, the significant risks of stroke and breast cancer are the primary reasons why healthcare providers may choose not to recommend HRT for some women.
2. During a home visit to a family of three: a mother, father, and their child, the mother tells the community nurse that the father (who is not present) had hit the child on several occasions when he was drinking. The mother further explains that she has talked her husband into going to Alcoholics Anonymous and asks the nurse not to interfere so her husband won’t get angry and refuse treatment. Which of the following is the best response of the nurse?
- A. The nurse agrees not to interfere if the husband attends an Alcoholics Anonymous meeting that evening.
- B. The nurse commends the mother’s efforts and agrees to let her handle things.
- C. The nurse commends the mother’s efforts and also contacts protective services.
- D. The nurse confronts the mother’s failure to protect the child.
Correct answer: C
Rationale: In this situation, the best response for the nurse is to commend the mother's efforts in seeking help for her husband by encouraging him to attend Alcoholics Anonymous. However, it is crucial for the nurse to also contact protective services to ensure the safety and well-being of the child. Option A is incorrect as it is not appropriate to condition non-interference on the husband attending a meeting that evening. Option B is incorrect because solely letting the mother handle things might put the child at risk. Option D is incorrect as it does not address the immediate need to ensure the child's safety through involving protective services.
3. In addition to matching ABO antigens, a blood transfusion must also be matched for:
- A. HLA type
- B. Rh antigen
- C. Immunoglobulins
- D. Platelet compatibility
Correct answer: B
Rationale: The correct answer is B: Rh antigen. In addition to ABO antigens, Rh antigen must also be matched for a blood transfusion. Rh antigen compatibility is crucial to prevent adverse reactions. Choice A, HLA type, is not directly related to blood transfusions but plays a role in organ transplantation. Choice C, Immunoglobulins, are not typically matched for blood transfusions. Choice D, Platelet compatibility, while important in specific cases, is not a standard requirement for all blood transfusions.
4. What should the nurse assess in a patient experiencing breakthrough bleeding while taking oral contraceptives?
- A. Adherence to the medication schedule
- B. The possibility of pregnancy
- C. The need for an increased dosage
- D. The effectiveness of the current oral contraceptive
Correct answer: A
Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of non-adherence, potentially reducing the effectiveness of the contraceptives. Assessing the adherence to the schedule helps in determining if the medication is being taken correctly. The possibility of pregnancy (choice B) is less likely if the patient has been taking the contraceptives as prescribed. Increasing the dosage (choice C) without assessing adherence first can lead to unnecessary medication adjustments. Evaluating the effectiveness of the current oral contraceptive (choice D) comes after assessing adherence to the schedule.
5. What is the best way to prevent transmission of infectious agents?
- A. Take antibiotics daily
- B. Call the practitioner for herbal supplements
- C. Wash hands
- D. Avoid public areas as much as possible
Correct answer: C
Rationale: The correct answer is C: Wash hands. Washing hands is the most effective way to prevent the transmission of infectious agents. Antibiotics are not effective in preventing infections, and their overuse can lead to antibiotic resistance. Calling a practitioner for herbal supplements is not a primary method for preventing the transmission of infectious agents. Avoiding public areas entirely is impractical and not as effective as proper hand hygiene.
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