a client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense diffuse pain in her abdomen which ph
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ATI RN

ATI Pathophysiology Exam 2

1. A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?

Correct answer: C

Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.

2. A group of prison inmates developed tuberculosis following exposure to an infected inmate. On examination, tissues were soft and granular (like clumped cheese). Which of the following is the most likely cause?

Correct answer: C

Rationale: The correct answer is C. Caseous necrosis is characteristic of tuberculosis, where the tissue has a soft, cheese-like appearance. Coagulative necrosis involves protein denaturation, liquefactive necrosis is seen in brain infarcts and abscesses, and autonecrosis is not a recognized term in pathology, making them incorrect choices in this scenario.

3. What is the primary cause of primary hypercholesteremia?

Correct answer: D

Rationale: The correct answer is 'Low-density lipoprotein (LDL) receptor mutation with defects in breakdown.' Primary hypercholesteremia is mainly caused by mutations in the LDL receptor, leading to impaired clearance of LDL cholesterol from the blood. This results in high levels of LDL cholesterol in the bloodstream. Choices A, B, and C are incorrect because they do not directly relate to the primary cause of primary hypercholesteremia.

4. A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What should the nurse include in the patient education?

Correct answer: A

Rationale: Finasteride is expected to reduce the size of the prostate, which should improve urinary symptoms over time, although the effects may take several weeks or months to become noticeable.

5. 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?

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.

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