a family member expresses concern to a nurse about behavioral changes in an elderly aunt which would cause the nurse to suspect a cognitive impairment

ATI RN

Pathophysiology Practice Questions

1. A family member expresses concern to a nurse about behavioral changes in an elderly aunt. Which would cause the nurse to suspect a cognitive impairment disorder?

A. Decreased interest in activities that she once enjoyed
B. Fear of being alone at night
C. Increased complaints of physical ailments
D. Problems with preparing a meal or balancing her checkbook

Correct answer: D

Rationale: The correct answer is D. Problems with tasks like meal preparation and balancing a checkbook can indicate cognitive impairment, as these activities involve cognitive functions such as memory, attention, and executive function. Choices A, B, and C are less indicative of cognitive impairment. Decreased interest in activities and increased complaints of physical ailments may be related to other factors like depression, while fear of being alone at night could be due to anxiety or other psychological issues.

2. When teaching a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

A. Oral contraceptives are 100% effective when taken correctly.
B. Oral contraceptives are effective immediately after starting.
C. Oral contraceptives are less effective if taken with certain antibiotics.
D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the effectiveness of the contraceptive. It is important for patients to be aware of this interaction to consider additional contraceptive methods during antibiotic therapy. Choices A and B are incorrect as no contraceptive method is 100% effective, and oral contraceptives typically require a period of time to reach full effectiveness. Choice D is incorrect as taking oral contraceptives with food does not significantly impact their effectiveness.

3. Which of the following characterizes ductal carcinoma in situ?

A. It is less common than lobular carcinoma in situ.
B. Malignant cells have not invaded the stroma.
C. It is considered a cancer precursor.
D. Malignant cells have not invaded the stroma; it is considered a cancer precursor and has a higher risk for invasive cancer compared to lobular carcinoma in situ.

Correct answer: D

Rationale: The correct answer is that ductal carcinoma in situ is characterized by malignant cells that have not invaded the stroma, making it a cancer precursor with a higher risk for invasive cancer compared to lobular carcinoma in situ. Choice A is incorrect because ductal carcinoma in situ is more common than lobular carcinoma in situ. Choice B is incorrect as it only partially describes ductal carcinoma in situ without mentioning its potential for progression to invasive cancer. Choice C is incorrect because it does not capture the complete characteristics of ductal carcinoma in situ, which include the risk for invasive cancer.

4. A 67-year-old man is receiving androgen therapy for osteoporosis. What laboratory test should the nurse monitor during this therapy?

A. Liver function tests
B. Blood glucose levels
C. Prostate-specific antigen (PSA)
D. Cholesterol levels

Correct answer: A

Rationale: During androgen therapy, monitoring liver function tests is crucial to detect any signs of liver dysfunction. Androgens can potentially impact liver function, making it essential to monitor enzymes such as ALT and AST. While blood glucose levels and cholesterol levels are important parameters to monitor in certain situations, they are not the primary focus during androgen therapy for osteoporosis. Prostate-specific antigen (PSA) monitoring is more relevant in the context of prostate health and cancer screening, not specifically during androgen therapy for osteoporosis.

5. Which of the following might result from severe diarrhea?

A. Respiratory acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Metabolic acidosis

Correct answer: D

Rationale: The correct answer is D: Metabolic acidosis. Severe diarrhea can lead to metabolic acidosis because the loss of bicarbonate ions in the stool results in an overall decrease in the body's bicarbonate levels. Respiratory acidosis (choice A) is caused by retention of carbon dioxide, usually due to inadequate alveolar ventilation. Metabolic alkalosis (choice B) is characterized by elevated pH and bicarbonate levels, usually caused by conditions like vomiting. Respiratory alkalosis (choice C) is a condition of low blood carbon dioxide levels and high pH, often due to hyperventilation.