ATI RN
Pathophysiology Final Exam
1. A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which process will accompany the actions of the neurotransmitter in a chemical synapse?
- A. Two-way communication between neurons is permitted, in contrast to the one-way communication in electrical synapses.
- B. Communication between a neuron and the single neuron it is connected with will be facilitated.
- C. The neurotransmitter will cross gap junctions more readily.
- D. More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.
Correct answer: D
Rationale: When serotonin levels increase, more neurotransmitters will cross the synaptic cleft and bind with postsynaptic receptors, facilitating enhanced communication. Option A is incorrect because chemical synapses, unlike electrical synapses, are unidirectional. Option B is incorrect because neurotransmitters impact communication with multiple neurons, not just a single connected neuron. Option C is incorrect because neurotransmitters cross the synaptic cleft, not gap junctions.
2. What causes type I diabetes?
- A. Overproduction of insulin from the beta cells of the pancreas
- B. Destruction of the beta cells within the pancreas, resulting in an inability to produce insulin
- C. Loss of insulin receptors on the target cells, resulting in insulin resistance
- D. A pituitary tumor in the brain, resulting in increased antidiuretic hormone production
Correct answer: B
Rationale: Type I diabetes is caused by the destruction of the beta cells in the pancreas, leading to an inability to produce insulin. This results in a lack of insulin, leading to hyperglycemia. Choice A is incorrect as type I diabetes is characterized by a deficiency of insulin production, not overproduction. Choice C describes the pathophysiology of type 2 diabetes, where insulin receptors become less responsive to insulin. Choice D is unrelated to type I diabetes as it describes a pituitary tumor causing increased antidiuretic hormone production.
3. A patient is being educated about the use of raloxifene (Evista) for osteoporosis. What is the primary therapeutic action of this medication?
- A. It stimulates the formation of new bone.
- B. It decreases bone resorption and increases bone density.
- C. It increases the excretion of calcium through the kidneys.
- D. It increases calcium absorption in the intestines.
Correct answer: B
Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, a selective estrogen receptor modulator (SERM), works by decreasing bone resorption, which is the breakdown of bone, and increasing bone density. This action helps in preventing bone loss and maintaining bone strength. Choice A is incorrect because raloxifene does not stimulate the formation of new bone but rather prevents its breakdown. Choice C is incorrect as raloxifene does not increase the excretion of calcium but rather helps in maintaining calcium levels in the bones. Choice D is also incorrect as raloxifene does not directly increase calcium absorption in the intestines.
4. A 23-year-old pregnant female visits her primary care provider for her final prenatal checkup. The primary care provider determines that the fetus has developed an infection in utero. Which of the following would be increased in the fetus at birth?
- A. IgG
- B. IgA
- C. IgM
- D. IgD
Correct answer: C
Rationale: The correct answer is IgM. IgM is the first antibody produced in response to an infection and is elevated in a fetus with an in utero infection. IgG is the primary antibody responsible for providing immunity to the fetus and is transferred across the placenta during the third trimester. IgA is mainly found in mucosal areas and colostrum but not significantly elevated in fetal infections. IgD is involved in the development and maturation of B cells but not typically increased in fetal infections.
5. A 17-year-old woman has come to the clinic requesting emergency contraception after having unprotected sex 24 hours ago. What medication is the clinician most likely to prescribe?
- A. Levonorgestrel (Plan B)
- B. Mifepristone (RU-486)
- C. Ulipristal acetate (ella)
- D. Estradiol (Estrace)
Correct answer: A
Rationale: The correct answer is A: Levonorgestrel (Plan B). Levonorgestrel is the most commonly prescribed medication for emergency contraception within 72 hours of unprotected intercourse. It is effective when taken within 72 hours after intercourse, with better efficacy the sooner it is taken. Choice B, Mifepristone (RU-486), is not indicated for emergency contraception but is used for medical abortion. Choice C, Ulipristal acetate (ella), is another option for emergency contraception that is effective up to 120 hours after unprotected intercourse. Choice D, Estradiol (Estrace), is not used for emergency contraception.
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