ATI RN
Final Exam Pathophysiology
1. A nurse is conducting an assessment on a client who presents with symptoms that are characteristic of amyotrophic lateral sclerosis (ALS). What assessment finding would be expected in this client?
- A. Reduced reflexes in all four limbs
- B. Decreased cognitive function
- C. Involuntary muscle contractions
- D. Hyperreflexia
Correct answer: D
Rationale: The correct answer is D: Hyperreflexia. In amyotrophic lateral sclerosis (ALS), hyperreflexia is a common assessment finding due to the degeneration of upper motor neurons. This results in an overactive reflex response to stimuli. Reduced reflexes in all four limbs (choice A) are not typically seen in ALS; instead, hyperreflexia is more common. Decreased cognitive function (choice B) is not a primary characteristic of ALS. Involuntary muscle contractions (choice C) are more indicative of conditions such as dystonia or myoclonus, not ALS.
2. Which immunoglobulin presents the first challenge to the antigen?
- A. IgA
- B. IgG
- C. IgM
- D. IgE
Correct answer: C
Rationale: IgM is the first immunoglobulin to challenge the antigen during an immune response. IgM is the primary antibody produced during the initial or primary immune response. It is efficient in agglutination and complement activation, making it crucial in the early stages of defense. IgA is mainly found in mucosal areas and secretions. IgG is the most abundant antibody in circulation and is involved in secondary immune responses. IgE is primarily associated with allergic reactions and parasitic infections. Therefore, IgM is the correct choice as it acts first during the immune response, while the other immunoglobulins have different roles and functions.
3. A patient is being treated with raloxifene (Evista) for osteoporosis. What should the nurse teach the patient about this medication?
- A. It is used as a selective estrogen receptor modulator to prevent bone loss.
- B. It works by decreasing bone formation and increasing bone resorption.
- C. It should be taken with food to reduce gastrointestinal side effects.
- D. It may cause weight gain and fluid retention.
Correct answer: C
Rationale: The correct answer is C. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent bone loss. It should be taken with food to reduce gastrointestinal side effects, not on an empty stomach. Choices A and B are incorrect because raloxifene is indeed a SERM that prevents bone loss, but it does not directly work by increasing bone formation or decreasing bone resorption. Choice D is incorrect as weight gain and fluid retention are not common side effects of raloxifene.
4. Which information would indicate more teaching is needed regarding hypersensitivity reactions? Type _______ hypersensitivity reactions involve an antibody response.
- A. I
- B. II
- C. III
- D. IV
Correct answer: D
Rationale: The correct answer is D: Type IV hypersensitivity reactions involve cell-mediated immunity, not an antibody response. This question tests knowledge of hypersensitivity reactions and their classification. Type I hypersensitivity reactions involve IgE antibodies, Type II involves IgG or IgM antibodies, and Type III involves immune complex deposition. Type IV hypersensitivity reactions are delayed and involve T cells, not antibodies. Therefore, if a person believes that Type IV hypersensitivity reactions involve an antibody response, more teaching is required.
5. A 37-year-old woman has a 10 pack-year smoking history and has been using oral contraceptives for the past 2 years. The nurse should plan health education interventions knowing that this patient faces an increased risk of
- A. osteoporosis.
- B. dementia.
- C. myocardial infarction.
- D. deep vein thrombosis.
Correct answer: C
Rationale: The correct answer is C: myocardial infarction. Women aged 35 and older who smoke, especially with a history of 10 pack-years like in this case, face an increased risk of cardiovascular disorders, including myocardial infarction, when using oral contraceptives. Choice A, osteoporosis, is incorrect because smoking and oral contraceptives do not significantly increase the risk of osteoporosis. Choice B, dementia, is not directly associated with smoking, oral contraceptives, or their combination. Choice D, deep vein thrombosis, is a risk associated with oral contraceptives, especially in combination with smoking, but the highest increased risk in this case is for myocardial infarction.
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